WASHINGTON – Sen. Tina Smith was in her late 30s, a successful career woman and the mother of two young boys, when depression hit.
“It just sort of feels like all the colors in the world start to fade out,” Smith said. “The things that gave you a lot of joy, there’s nothing there anymore.”
The Minnesota Democrat, now 61, is talking publicly for the first time about her own bouts with depression as she pushes for more federal spending on mental health programs. First as a teenager and again as an adult, Smith said, she battled to control a condition that challenged her view of herself as “a happy, cheerful person.”
The experience informs Smith’s focus on expanding treatment options for young people. She wants Congress to approve $1 billion in grants over five years for school districts to partner with local treatment organizations to deliver mental health services directly in school settings.
“I want people to know: At every point in my life that I needed help, it was right there,” Smith said. “And understanding that isn’t the case for everyone is just — well, I know what a difference it made for me.”
With no Republican coauthors yet in a GOP-controlled Senate, Smith’s measure faces an uncertain future. But she believes that greater public understanding — helped by stories like hers — could serve to build political momentum.
Some recent studies have found ominous trends about the mental health of young people. A 2016 study published in the journal Pediatrics found that the prevalence of depression in adolescents and young adults has increased in recent years. The study found that the percentage of adolescents aged 12-17 who experienced at least one major depressive episode a year rose from 8.7% in 2005 to 11.3% in 2014. The rates of increase are particularly high among girls and young women.
“To be honest, nobody is totally sure why. But you talk to anyone working with youth, they see it,” said Sue Abderholden, executive director of the Minnesota chapter of the National Alliance on Mental Illness.
A growing number of studies have linked the pervasiveness of social media and ready access to technology as a driving factor. Some in the mental health field also think that a lessening stigma around mental illness has led to more self-reporting. Whatever the reasons, mental health and education professionals alike see a need to fight the rise where it makes the most sense.
“Kids spend a huge part of their life in schools,” Abderholden said.
The alarming increase in school shootings in recent years has brought new attention to mental health treatment for young people. But Smith said she’s hesitant to make that link.
“I’m wary when legislators say the solution to school shootings is mental health care, because it suggests that people who are mentally ill are violent, and that’s just not true,” she said.
Minnesota has been a national leader in establishing programs that get mental health treatment directly into schools. The Minnesota School-Based Health Alliance is affiliated with 22 school clinics that provide mental health care throughout Minnesota, mostly in St. Paul and Minneapolis. Almost all the rest are in other metro-area school districts, with the sole exception of a school clinic in Rochester.
Smith’s proposal would provide money to spread the concept more widely.
Many school districts in Minnesota and nationwide have programs to help students get mental health treatment, often by partnering with clinics in their communities. But Abderholden said that often causes insurance complications for families, and even the simple logistics of getting to appointments outside school can be an issue, especially in small towns and rural areas.
“If we believe that a student needs additional support, then we’ll make a referral to an outside mental health agency,” said Emily Dierling, an elementary and intermediate school counselor in Stewartville. The closest place for her students to get those services is in Rochester. “If mom and dad both work or otherwise don’t have the ability to drive there twice a week, that can put a big strain on being able to receive the service,” she said.
Being able to access the treatment directly at school “would make a lot of sense for a lot of families,” Dierling said.
Shawna Hedlund, president of the Minnesota School-Based Health Alliance and director of health access for Minnesota Community Care, said that over the past two years her group has seen a 15% increase in requests from students to see mental health providers.
“When children are in good health, they are better learners,” Hedlund said. “Whether that is addressing a toothache or diagnosing asthma or identifying a trauma they are dealing with, when we address the whole child and their well-being, then we are making them ready to learn.”
Hedlund said she believes that helping more students resolve mental health issues could be a way to reduce Minnesota’s persistent gap in educational achievement between white students and students of color.
At the moment, Smith has support for her proposal only from fellow Democrats; the Senate is controlled by Republicans. But she noted that expanding mental health resources, not only for students but for many demographic and professional groups, has been a priority for politicians from both parties.
Smith said she decided to go public about her own experience because, as she has engaged with the issue as a lawmaker and talked about it with more people, she felt she was leaving something important out of the conversation.
“It started to feel weird that I wasn’t just saying, ‘Hey, I’m relating to this personally,’ ” she said.
Politicians have not always been able to talk so freely about their own mental health. In 1972, vice presidential candidate Thomas Eagleton dropped off George McGovern’s presidential ticket after it was revealed that Eagleton had been hospitalized several times for depression.
Smith was a teenager and a new college student the first time depression hit her. She had some therapy sessions with an on-campus counselor and learned coping mechanisms.
It swung back hard about two decades later. Smith said she returned to therapy, and a diagnostic test indicated depression. She first resisted the diagnosis, she said, but ultimately went on anti-depressants for about two years. She hasn’t gone back on depression medication since, she said.
“I ask myself: What do I need to do to stay healthy? And I do that all the time,” Smith said. “And it’s stuff like meditation, making sure I get good exercise, all the things we know. With mental health, it’s not like there’s a box where you’re healthy and another box where you’ve got a mental illness. You try to stay at the healthy end of the continuum, and watch as you move, and I’ve been able to do that.”