In Kansas City, therapy waitlists leave kids with nowhere to turn: 'It’s a silent struggle'
Missouri students reported feeling more sadness and hopelessness compared to prior years. But the state is near the bottom of the country in terms of having the recommended ratio of students to school psychologists.
Sindhu Fedosyuk’s office is festooned with mementos from child clients throughout the years.
Her office is as lively as she is.
Free-hand paintings, colorful drawings, and a framed puzzle of Hogwarts houses — a running theme during sessions — adorn the walls. A shelf filled with gifts features a hot pink sparkly tumbler, family photos and what 12-year-old client Atticus called “an ugly car.”
“When I first came here, one of the first things that Sindhu said to me was just like, ‘There was no rules and like, you can go get whatever you want … go grab food or drink,’” Atticus said with a smile.
“This could be one space where I’m like, ‘Don’t ask me, just do it,’” Fedosyuk, a Kansas City psychotherapist, said. “I’ve noticed that voice coming out more, which I think happens when kids have more control.”
To which Atticus replied slyly: “Yeah, go do what you want. But talk to me while you’re doing it.”
Fedosyuk is a Kansas City psychotherapist certified in gender therapy and primarily works in child, adolescent and family therapy. Atticus is one of Fedosyuk’s trans kids who began seeing her in November of last year when he came out. He said it made him anxious and afraid to think of how his parents would react.
“I was terrified that they’re just gonna, like, treat me like totally different,” he said.
Other contributing stressors included things like school and the return of social events as the COVID-19 pandemic ebbed.
Kids in Aticcus’ age group — ranging between 5 years old and the early teens — have experienced higher rates of anxiety and depression in the past two years, according to the Centers for Disease Control and Prevention (CDC).
Mental health crises have also risen.
Between mid-March 2020 through October 2020, emergency room visits — often the first point of contact for children in distress — rose by 24% for children ages 5 through 11 and 31% among teens ages 12 through 17, according to the CDC. These data are compared with the same time frame in 2019.
Those figures track what local child therapists and parents are seeing.
Debra Walker with the Missouri Department of Mental Health said in an emailed statement to Flatland, “According to the 2022 Missouri Student Survey, which targets 6th through 12th grades, students are reporting an increase in sadness and hopelessness compared to prior years.”
Requests for help with certain topics ranged. Anxiety. Identity and gender dysphoria. Depression. Suicidal ideation.
In a joint letter, the American Psychological Association (APA) declared a State of Emergency in October 2021. The APA emphasized again in January of this year that the need to address mental health among children is greater now than it was pre-pandemic.
“When there’s a feeling of desperation or helplessness, what you want to know is help is on the way,” Fedosyuk said. “I always think of Mrs. Doubtfire, in her outfit, (leaping) across the table. I want people to envision me like that.”
But her waitlist has gotten longer and longer, and her office hours later and later.
“The heartbreaking thing for me is having to tell people, like, I can see you, but not for a bit,” she said.
Giving a voice to anxiety
For kids who need immediate support, therapists have begun to tap their connections to find other professionals with available appointments.
That was a lifeline for a local 13-year-old who struggled with anxiety silently for the better part of 2021.
Isolated from her friends and sports team, she had no one to turn to.
The teen didn’t tell her parents but soon began to self-harm. That, her mom said (who remained anonymous for privacy concerns), was her daughter’s call for help.
Self-harming was physical proof of a symptom that they didn’t know how to identify. The family’s attempts to find help revealed another roadblock: a months-long waitlist to see a therapist who specializes in children and adolescents. The teen is on a waitlist now and doing better, but her mom wishes her treatment hadn’t been delayed.
Other Kansas City parents echoed this concern, sounding off in parent support group pages online, with posts specifically asking for help locating therapists who focus on children.
Even more startling, the ages of children asking for help or showing signs of distress has gotten younger — as young as 5 years old.
Sondra Wallace, director of mental health services at the Jewish Family Services, can attest. Wallace said recently that caregivers, parents and guardians of young children are reaching out more now than when the pandemic first reared its head.
“These are elementary-age students and middle school students,” Wallace said. “A couple of the big requests, what the needs are, a lot of them are around social anxieties and that honestly kind of makes sense.”
Many young kids didn’t have preschool experience due to the pandemic. Their social skills have yet to be taught or developed. They don’t have the vocabulary to explain to their caregivers that their tummy ache could be a symptom of anxiety.
Now, these kids are walking into a room full of strangers — kids and adults alike — when for the past two years they’d been solely surrounded by family at home.
“All of those are experiences that can be unsettling,” she said.
This is why programs like YouBeYou are being employed in school settings and community centers. Wallace leads this effort at Fort Osage High School, which has seen success in building resilience and trust. Although they work with 15 other schools in the area, the hope is to expand as resources allow.
This is one example of alternative methods, reaching students where they are. Many times students cannot miss school to go to therapy and some cannot afford such services.
For instance, Fedosyuk extends her office hours late into the evening because some of her child clients have received unexcused absences and truancy for missing school.
“It’s frustrating,” she said, “because I don’t believe one is more important than the other, which is why I try not to get people in the position where they have to choose.”
She added: “I don’t want kids to pick between school and therapy.”
Atticus illustrated the real-world effects of having to choose. Between January and May, one of his friends’ grade point average went from a 4.0 in the first part of the year to a 2.6 in the final quarter.
This raises a question about what schools determine and excuse as a health emergency. Depending on the district, children are allotted a certain percentage of time allowed for mental health appointments.
Some states support a change in policies that would allow students to take mental health time to better support their academic success. But others have actively fought against such policies, according to Education Week.
There’s also a shortage of school psychologists and counselors as well as general child psychologists and counselors outside of school campuses, according to the APA.
Missouri and Kansas are near the bottom in terms of having the recommended ratio of students to school psychologists, according to Education Week.
So, programs like the one Wallace spearheads could help.
A 2020 survey by the New York Life Foundation and the American Federation of Teachers showed that only 15% of educators feel comfortable discussing pandemic grief and anxiety with young students. Mental health experts and advocates say implementing trauma-informed training within schools would support school staff and their students.
“Equipping kids with coping skills in the classroom can prevent strain on school psychologists while also improving students’ ability to learn,” according to an APA report.
Kids want to feel empowered and heard.
Atticus explained he has a few friends whose school counselors minimize their concerns to “just anxiety about school.” But it’s about more than that, he explained.
He and his peers see what’s going on outside of school walls and Zoom calls. They notice when legislation threatens kids like him. Life these past two years has been difficult to navigate and they want adults to listen.
“I feel like teachers should help us with that,” Atticus said.
Because even kids who are outgoing and extroverted will withdraw.
“The research tells us one of the biggest risk factors in suicidal ideation and risk factors is a feeling that you’re disappointing others,” Wallace said.
“We can talk about the number of youth (with) substance misuse, but for someone to say, ‘I didn’t want to disappoint.’ That isn’t really a number. It’s not a behavior. It’s a silent struggle.”
She explained that at times kids mimic adults. So, if adults are also suffering in silence they will do the same thing, she said.
In addition to learning how to communicate highs and lows, she said prevention and mitigating those risks earlier on are also key. In other words, start from ground zero.
Wallace recognizes that there are kids in crisis who deserve support now. But she also wants to focus on supporting children early before they reach the crisis stage.
“Before you even have a struggle or need to access support, there are things we can all do that build up and strengthen our mental health,” she said.
She emphasized preventative measures by reducing barriers to resources, including finances, food, transportation and housing.
Some community centers and school leaders are stepping up to the plate. One example is Sources of Strength training. Wallace says it can serve as a blueprint of what’s possible. Sources of Strength helps adults identify risks and learn how to communicate, while at the same time empowering youth to be peer leaders in suicide risk assessment and intervention.
Another is Behavior Checker, an online program researched through the University of Kansas and rolled out by Jewish Family Services that is completely free to users.
For instance, parents can get pointers if they’re having a combative conversation with their child who, rather than being defiant, is actually trying to express frustration as a way to signal they need help.
Wallace said getting back to basics and helping adults relearn how to act, react and speak makes a world of difference.
From the youth perspective, Atticus shared that he wants more opportunities for his friends to get the help and support they need. In other words, he hopes more people get access to therapy, understanding that there are limited seats.
“Therapy is very … I think really necessary, especially like now because pretty much, no matter who you are, there’s something to be scared of,” he said. “From a young age, we should be taught how to handle our mental health, and how to help it.”
- RULER – Free school resources and training through Yale Center for Emotional Intelligence
- Behavior Checker – Free to the public (soon) behavior checker with how-tos
- YouBeYou – A free mental health and wellness navigator for teens
- Quarky App – A free app with entertainment, resources and more for KC youth
- APA Mental Health Primers – Free resources for educators
- #GiveMe20 – A nonprofit led by two Kansas City mothers who lost their children to suicide provides workshops and group activities
- Anxiety Center’s Two Tents/Adolescent Intensive Outpatient Program – A specialized program to help provide youth between the ages of 12 to 18 with phobias, disorders, depression, anxiety and more. The center’s director also consults with schools and churches to equip them with the tools to help youth.