Kathy Holmes knows the importance of inclusion from personal experience.
The mother of eight, six of whom were adopted, describes her initial encounter with the child care system as “overwhelming to navigate.”
“Even with how confused (a novice) is with the system, imagine how much more confused a family must be, especially if they are in crisis. You can end up feeling lost and hopeless,” Holmes says. “When you start to see families get hope again, it’s really empowering.”
Hillside, which provides community-based services for youth and families, was an invaluable resource for gaining back her hope. It inspired Holmes so much that she joined the staff and has worked there for 21 years. She is the director of family-driven care.
Even with two decades of experience, Holmes’ tenure still only represents 11 percent of Hillside’s lifetime. On Feb. 28, the organization celebrated its 185th anniversary, a feat employees credit to the organization’s flexibility over the years. Currently, Hillside has more than 1,800 employees working in its education and residential programs in locations across Western and Central New York as well as Prince George’s County in Maryland.
Hillside is currently seeing a surge in mental health challenges for both youth and families.
“Children have been affected by the pandemic in so many ways we still do not know the full extent of. They’ve been socially isolated, in and out of remote learning, that’s an extreme amount of trauma,” says Maria Cristalli, president and CEO of Hillside, who has worked with the organization for more than 30 years.
Even prior to COVID-19, the Centers for Disease Control’s Youth Risk Behavior Survey, a nation-wide study held on a two year cycle, revealed a worrying trend in mental health for teens. From 2009 to 2019, all suicidal variables tracked by the survey increased, with over a third of respondents reporting persistent feelings of sadness or hopelessness.
Most recently, the U.S. surgeon general issued an advisory notice on worsening youth mental health in December. The surgeon general’s message noted that, between 2007 and 2018, suicide rates among youth ages 10-24 in the U.S. increased by 57 percent, and early estimates show more than 6,600 suicide deaths among this age group in 2020.
This scenario is not only affecting mental health but quality of care as well. A recent study published in the New England Journal of Medicine examined pediatric emergency rooms and their connection to the surge in teenage mental health issues. The authors found that the cost of caring for one behavioral health patient in a pediatric ED is approximately $219 an hour, with most activities offering little to no value to the patient.
“We need to get mental health services to children and families before they require high level interventions like that,” Cristalli says. “I’m not sure I would even call it real treatment in some of those cases.”
Ironically, the pandemic also provided options for treatment through the development of Hillside’s telehealth system, an emerging strength for the organization.
“I was always resistant to virtual when interacting with families, but when we were forced to do things that way, it was eye opening,” Holmes says.
Families who struggled with transportation or child care sometimes would not attend programs in the past. With the transition to remote options, there was greater opportunity for people to participate.
“One partner said to me, ‘I have never participated in a group before because of my social anxiety.’ Now they’re the most engaged I’ve ever seen,” Holmes says. “It was like the floodgates opened and all these people streamed through.”
“Telehealth is now a viable option,” Cristalli, who believes Hillside is much better now at utilizing technology, says.
Additionally, the organization is meeting challenges such as the lack of transportation and child care, by transiting to a community-based services model, as opposed to a residential model, where children receive services and live at a Hillside facility, sometimes for months on end.
“The residential programs are good, we have lots of skilled, caring people working there. They become like family over time. However, we know now from studies that having children in a stable home, getting support from outside is much more successful. Residential programs are important, but it’s not a stand alone solution for any child,” Cristalli, who compares the residential and community based programs to a hospital stay versus a doctor home visit, says.
“Residential is an intervention for the safety of families. With the community based services, we’re really able to include them fully in the process, because we’re doing it in their environment,” Holmes says, “And it’s really important to include families in the process.”
Similar to the shift to teleservices, the transition to a community-based service system is an example of the flexibility Hillside has displayed over the years. Since its beginning in 1837, when the Rochester Female Charitable Society founded the Rochester Orphan Asylum as an orphanage serving 46 children, the organization has evolved and expanded its services to include the latest developments in child care.
“The mission-driven focus of this agency makes it an essential community partner, an employer of choice, and a social resource that is worthy of the highest levels of community support,” notes Richard Gangemi M.D., chair of the Hillside Board of Governors.