Kevin Simon: I am originally from Brooklyn, NY My parents are Haitian. My father, Deacon Mauclair Simon, was the first black deacon of the Roman Catholic Archdiocese of New York.
Very early on, I would see my father counseling people who were experiencing a wide range of challenges, whether it was immigration, whether it was spiritual in nature, mental health in nature. And he has a certain disposition that is just laid back. In addition to being a deacon, he was a public school teacher for 25 years in New York, then became a social worker.
While I was in medical school, the rotations and courses that intrigued me the most—because they require you to think more holistically about people—were psychology and sociology. Then clinically it was psychiatry, because you can make a significant impact on people and a significant impact on families.
And so I came to learn, the vast majority of psychiatric illnesses—schizophrenia, depression, bipolar, substance use disorders—actually begin in early or middle adolescence. If you want to be as preventive as possible, you should start seeing the children. And then when you see the kids, you find that there’s a strong co-morbidity of mental health, substance use, and juvenile justice involvement.
So I did a child psychiatry fellowship at Boston Children’s Hospital.
The work that my father was doing in terms of helping people at their lowest, I feel like that’s what I do as a child psychiatrist and addiction specialist.
The people who are most vulnerable in society – that’s where I wanted to be.
Q: Why are children having such a hard time today?
A: There is evidence that the increase in anxiety, the increase in depression, the increase in emergency room visits, were increasing before 2020.
Now the pandemic happened. There was a two-year period where the children were isolated, told not to come in person. If you increase isolation, it will increase anxiety, it will increase things like depression.
Then if we think about a young person who had neurodevelopmental conditions, who at one time had maybe 10 hours of organized structured behavioral engagement – you took that away. And not away for a day, but away for months.
If we think about other subgroups of youth—Latino youth, black youth, minority youth—who is being hit hardest by COVID? In June 2021 nationally there were more than 140,000 youth who had lost a caregiver to COVID. Now you combine that with – we actually don’t know when this is going to end.
All this only exacerbated the problems that preceded the pandemic.
Q: What are the biggest issues you will try to address?
A: One is access. Access to providers – therapists, counselors, psychiatrists, child psychiatrists.
I hear from the provider side, “Hey, it’s hard to keep providers.” I hear from parents and patients, “I can’t take my son to a clinic.” “I can’t get my daughter help – it’s a waiting list of over eight months.”
Access is a problem. At the same time, stigma is a problem. There are subgroups of populations that will not engage with a mental health clinic. I can speak from my ethnic culture of being a Haitian American. There is hesitation about: “Who is a mental health provider? Why would I want to talk to one of them?”
So part of my role is also being a communicator about how therapy is healthy and normal. And showing that yes, someone who looks like you, thinks like you, has done this kind of work.
Also, workforce development. We basically have two systems – the out-of-pocket shadow system [providers who don’t accept insurance] and MassHealth, the Medicaid system. Unfortunately, a fair number of behavioral health providers exist in the shadow system because the reward for services is not there.
Q: How can the city help with access to mental health care?
or: There is already a model where a clinician or a child psychiatrist serves as a consultant to primary care providers – the Massachusetts Child Psychiatry Access Program, or McPAP.
Potentially, the McPAP model could be piloted within community health centers and schools. This is one way to expand access.
The city could also advocate for different reimbursement rates and make the billing process a little simpler so providers can see more patients.
Additionally, in an effort to address mental health and behavioral concerns, the mayor and Dr. Ojikutu had thought about developing a center for behavioral health and wellness, where we could have people under one roof all together trying to better address the challenges that we. Look.
There is an Office of Recovery Services that focuses on substance use. There are services for the homeless; a large proportion of people who are homeless have mental illness. There is the Children and Family Bureau. How can you take a step back and say, “Oh, wait a minute, there’s actually a connection here and we can work together”?
There is a subset of young people who have experienced an increase in homelessness during the pandemic period. Those young people go to school, don’t they? You begin to see that we are actually all connected – housing, food insecurity, economic security, education, the living environment. We must think holistically.
Q: What do you think will be different in Boston as a result of being in this role?
A: I hope we can think about prevention, to create safe spaces for young people to gather, like Zumix in East Boston – where 8- to 18-year-olds learn how to host a podcast, play musical instruments and feel comfortable making mistakes. It doesn’t identify as a place for therapy, but I would call it a very therapeutic place. There aren’t enough of those places around. We can promote that kind of environment.
The challenges related to mental and behavioral health are clearly more than one person, a mayor, city hall office, or the Boston Public Health Commission can solve alone. It really is all hands on deck.
We are all related to someone who has a behavioral health challenge. There is no way to say that it is not important to you.
Sources:
If you or a family member is experiencing a mental health or substance use disorder crisis, the Massachusetts Emergency Services Program/Mobile Crisis Intervention is available 24 hours a day, seven days a week, 365 days a week. year. Call toll-free on 1 (877) 382-1609.
Massachusetts also now has a three-digit hotline for trained National Suicide Prevention Lifeline call takers. If you or a loved one is in emotional distress or having suicidal thoughts, call 988 anytime from anywhere.
The Boston Public Health Commission provides a list of residential and outpatient services hereincluding services offered in multiple languages.
More resources are available at Web page of the Massachusetts Department of Mental Health. https://www.mass.gov/guides/finding-mental-health-support-in-massachusetts
Felice J. Freyer can be reached at [email protected]. Follow him on Twitter @felicejfreyer.