andrew malekoff

The Evolving Landscape of Children’s Mental Health, by Andrew Malekoff, April 16, 2021

by | Apr 16, 2021 | Blog, Long Island Business News

The good women and men who started the Guidance Center had the foresight, intellect and diligence that led to the creation of a force that would provide quality mental health care for hundreds of thousands of children, teens and family members for nearly seven decades. 

I owe the founders a debt of gratitude for offering me such an enriching spot to hang my hat for almost all my adult life. Confucius was right when he said, “Choose a job you love, and you will never have to work a day in your life.” 

Although the 45 years have come and gone swiftly, I’ve developed a capacity akin to time-lapse photography that has enabled me to observe change through a series of evolving images.  

The waiting room of Guidance Center headquarters in Roslyn Heights provides a snapshot of who seeks help. And who seeks help at any given time is in part a function of how mental illness and mental health are viewed by the public. 

As I contemplate my 45 years, I discover that the waiting room has become a much more richly heterogeneous place with respect to race, ethnicity, religion and language. Increasingly, families who were once averse to seeking outside help for emotional issues occupy that space like never before. 

What led to the change? A combination of factors including sustained public education efforts aimed at reducing stigma and ambitious advocacy initiatives directed at reducing disparities and increasing access to care. Both education and advocacy combined to ensure that diseases of the brain be treated on par with diseases of the body. 

Along with the demographic changes in who seeks help, there came the need for diversifying the workforce and providing consistent professional education to enhance the cultural literacy of frontline mental health practitioners. This is especially germane today when the social and political winds inside our nation reveal more profound divisions than in all my time at the Guidance Center. 

Intersecting with my reel of waiting room images is a reel of traumatic events that I never would have predicted when I started in 1977, all of which impacted the children who sat in our waiting rooms. Just a few examples: the Challenger explosion (1986), LIRR massacre (1993), Columbine High School shooting (1999), 9/11 attacks (2001), Madoff financial disaster (2008), superstorm Sandy (2012), Sandy Hook Elementary School shooting (2012), Parkland High School shooting (2018) and today’s COVID-19 pandemic.

Throughout the reel is also a steady succession of racial injustices, deaths of unarmed people of color at the hands of law enforcement officers. The final frame I see is the January 6 domestic terrorist insurrection in Washington. 

In today’s waiting room sit people of all colors and backgrounds with personal stories of trauma and grief, and far too many young ones who feel as though they cannot live one day longer. They live in a world in which their mental health struggles are compounded by a toxic surround that we as adults either fuel, ignore or deny but cannot escape. 

These children have profound troubles and live in a profoundly troubled world. Yet there is hope in places like ours, where people of all backgrounds and skin colors share the dream that their children might live a peaceful and prosperous life in a better world.

My message to anyone who wishes to follow in my footsteps is to never lose sight of the situational surround. Context counts. We can all do better to understand our children from the inside-out and the outside-in. And, if you’re fortunate enough to find your authentic voice, don’t let anyone take it away from you. Healing involves quality care and a strong voice underpinned by a social consciousness, social conscience and an enduring quest for social justice.

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