James Donaldson on Mental Health - 988 suicide hotline is getting more calls than ever. Many states have no clear plan to fund it

By Michael Marks, Harvest Public Media

Editor’s note: If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide & Crisis Lifeline.

Brent Brewer has a passion for helping his fellow farmers and ranchers handle the stress that comes with agricultural work. He’s known around Oklahoma as someone you can call if you’re struggling with your mental health.

“This is a hobby of mine,” said Brewer, who farms and raises cattle in Grant County, Oklahoma. “To help people navigate through tough times and to try to get their legs back underneath them.”

Rural populations, particularly farmers, have a higher suicide rate than the general public. The unique stresses of working in agriculture can exacerbate symptoms of depression and anxiety – particularly when the economic situation is dire for farmers, like it is now.

Brewer is happy to hear anyone out, but he’s also quick to refer them to professional resources, including 988, the National Suicide & Crisis Lifeline.

“I divert a lot of my calls. I like the 988 people to take them,” Brewer said.

But Brewer is also worried about whether the resource will get the financial support it needs to keep helping his neighbors.

Since it started taking calls in 2022, demand has increased for 988 nationwide.

“We have been seeing a month over month increase in utilization of 988. And so we are also working pretty hard to keep up,” said Monica Kurz, chief administrative officer for Health Source Integrated Solutions in Kansas, one of the state’s 988 call centers.

The 988 system was designed to give people in crisis an easy-to-remember number that’s available 24 hours a day via call, text and chat. Every state has its own set of call centers with trained operators.

Kurz says the service is a necessity for rural Kansans.

“We know that in our rural and frontier counties in Kansas, folks might be traveling hours to get to their nearest mental health clinic. And this is a way to access services right away without that kind of distance barrier,” she said.

The federal government, which initiated the program four years ago, has largely paid for service. But the program was designed for states to eventually fund 988 on their own. Few states have plans in place to continually fund the critical service though. And as demand outpaces funding, some call centers are finding it hard to keep up.

“When you increase demand, you have to increase capacity to meet that demand,” said Jonathan Purtle, an associate professor at the New York University School of Global Public Health who studies 988 funding. “And to increase capacity, you need money.”

No sustainable funding 

Responding quickly to an incoming call or text to 988 is essential, says Kurz of Kansas 988. Her goal is for the center to respond to a call within 20 seconds.

Kansas call centers were about six seconds slower than that last year, on average, but faster than the national average of 34 seconds, according to the most recent federal data available.

A caller frustrated with a long wait time might hang up. Plus, if they spend two minutes on hold, the call is re-routed from a local facility to a national backup center.

In-state operators often have a better understanding of local circumstances. This can be especially helpful for rural users.

“I think about some of the situations that we've had with fires out west in Kansas,” said Kurz. “And I don't know that someone who's sitting in a backup center has any idea of some of the stress that some of our western Kansas communities have been under when I think about things like those fires.”

A backup operator also may not be able to connect someone with local resources, said Lauren Moyer, chair of Missouri’s 988 task force.

“If someone is really struggling with substance use, and needs connected to a residential substance use bed in the moment, somebody from another state is not going to have access to that information,” Moyer said.

Having enough money to hire and train operators is critical to answering calls in a timely manner, experts say.

The federal government paid for the launch of 988, but states were expected to pick up the tab eventually. The federal bill that established the program recommended that states collect fees on telecommunication products, which is how 911 is largely funded.

“There’s no sustainable funding source for 988,” said Purtle, the NYU researcher. “The federal law…kind of suggests, ‘Hey states, here’s an idea about how you can fund it.’ And that idea is 988 telecom fees.”

Only a dozen states have created these fees, though. Missouri and Kansas are not among them, although their legislatures have dedicated revenue to the program out of their general funds.

Moyer of Missouri 988 worries about whether that’s sustainable.

“You know general revenue support, it’s its own line item and that’s not guaranteed long-term,” she said.

‘The big thing is people’

Other states, like Texas, have yet to dedicate any state funding to 988 and are still relying solely on federal grants.

Jennifer Battle is vice president of the Harris Center in Houston, which fields 988 calls. She testified to the Texas House Public Health Committee in 2025 that the state’s call centers receive around 200,000 calls a year. Of those, 85% are resolved on the phone, without the need for additional resources like a mobile crisis unit.

“As impressive as these numbers are that we’re able to serve with the current federal funds, these funds only allow for us to be able to answer on average 84% of the 988 calls that originate in Texas,” Battle told lawmakers.

On average, operators at 988 call centers in Texas responded to contacts in 43 seconds last year, longer than average wait times nationally.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

In Oklahoma, which has also seen steep increases in demand for 988 since the program’s inception, lawmakers haven’t approved fees to support it, either. According to State Rep. Kevin Norwood, a Republican from the Tulsa area, there’s little appetite in the state legislature for a new tax.

“Before I became a legislator, that idea was introduced and it gained no traction,” he said.

Norwood is now sponsoring a bill that would create a trust fund for 988 and ensure earmarked money is only used for the hotline.

“When I jumped into it I was like, ‘Okay, we need to make it where it’s not just a short-term fix. Where it would be long-term and sustainable,’” Norwood said.

Texas has followed a similar path. Lawmakers there have been unable to pass a telecommunications fee. In 2025, the state also established a trust fund, but the balance is currently zero.

Though it’s a “signal of effort,” said NYU researcher Jonathan Purtle, without actual investment in these state trust funds, the move is largely ineffective.

“Those trust funds are a strategy, but if there’s not funds in the trust fund, it’s not going to have that much of an impact,” said Purtle.

Purtle is near the end of a five-year study analyzing the funding of 988 systems in all 50 states. So far he’s found those with long-term, dedicated funding for staff are generally more efficient.

“The big thing is people, right? The staffing, the people who work in these call centers is the main thing,” he said.

He may have a new data point in the near future, as Missouri legislators consider a bill that would establish a 988 telecommunications fee.

Moyer of the state’s task force says there’s a “strong likelihood” the fee will be approved, providing long-term support for the hotline.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-988-suicide-hotline-is-getting-more-calls-than-ever-many-states-have-no-clear-plan-to-fund-it/

By Michael Marks, Harvest Public Media

Editor’s note: If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide & Crisis Lifeline.

Brent Brewer has a passion for helping his fellow farmers and ranchers handle the stress that comes with agricultural work. He’s known around Oklahoma as someone you can call if you’re struggling with your mental health.

“This is a hobby of mine,” said Brewer, who farms and raises cattle in Grant County, Oklahoma. “To help people navigate through tough times and to try to get their legs back underneath them.”

Rural populations, particularly farmers, have a higher suicide rate than the general public. The unique stresses of working in agriculture can exacerbate symptoms of depression and anxiety – particularly when the economic situation is dire for farmers, like it is now.

Brewer is happy to hear anyone out, but he’s also quick to refer them to professional resources, including 988, the National Suicide & Crisis Lifeline.

“I divert a lot of my calls. I like the 988 people to take them,” Brewer said.

But Brewer is also worried about whether the resource will get the financial support it needs to keep helping his neighbors.

Since it started taking calls in 2022, demand has increased for 988 nationwide.

“We have been seeing a month over month increase in utilization of 988. And so we are also working pretty hard to keep up,” said Monica Kurz, chief administrative officer for Health Source Integrated Solutions in Kansas, one of the state’s 988 call centers.

The 988 system was designed to give people in crisis an easy-to-remember number that’s available 24 hours a day via call, text and chat. Every state has its own set of call centers with trained operators.

Kurz says the service is a necessity for rural Kansans.

“We know that in our rural and frontier counties in Kansas, folks might be traveling hours to get to their nearest mental health clinic. And this is a way to access services right away without that kind of distance barrier,” she said.

The federal government, which initiated the program four years ago, has largely paid for service. But the program was designed for states to eventually fund 988 on their own. Few states have plans in place to continually fund the critical service though. And as demand outpaces funding, some call centers are finding it hard to keep up.

“When you increase demand, you have to increase capacity to meet that demand,” said Jonathan Purtle, an associate professor at the New York University School of Global Public Health who studies 988 funding. “And to increase capacity, you need money.”

No sustainable funding 

Responding quickly to an incoming call or text to 988 is essential, says Kurz of Kansas 988. Her goal is for the center to respond to a call within 20 seconds.

Kansas call centers were about six seconds slower than that last year, on average, but faster than the national average of 34 seconds, according to the most recent federal data available.

A caller frustrated with a long wait time might hang up. Plus, if they spend two minutes on hold, the call is re-routed from a local facility to a national backup center.

In-state operators often have a better understanding of local circumstances. This can be especially helpful for rural users.

“I think about some of the situations that we've had with fires out west in Kansas,” said Kurz. “And I don't know that someone who's sitting in a backup center has any idea of some of the stress that some of our western Kansas communities have been under when I think about things like those fires.”

A backup operator also may not be able to connect someone with local resources, said Lauren Moyer, chair of Missouri’s 988 task force.

“If someone is really struggling with substance use, and needs connected to a residential substance use bed in the moment, somebody from another state is not going to have access to that information,” Moyer said.

Having enough money to hire and train operators is critical to answering calls in a timely manner, experts say.

The federal government paid for the launch of 988, but states were expected to pick up the tab eventually. The federal bill that established the program recommended that states collect fees on telecommunication products, which is how 911 is largely funded.

“There’s no sustainable funding source for 988,” said Purtle, the NYU researcher. “The federal law…kind of suggests, ‘Hey states, here’s an idea about how you can fund it.’ And that idea is 988 telecom fees.”

Only a dozen states have created these fees, though. Missouri and Kansas are not among them, although their legislatures have dedicated revenue to the program out of their general funds.

Moyer of Missouri 988 worries about whether that’s sustainable.

“You know general revenue support, it’s its own line item and that’s not guaranteed long-term,” she said.

‘The big thing is people’

Other states, like Texas, have yet to dedicate any state funding to 988 and are still relying solely on federal grants.

Jennifer Battle is vice president of the Harris Center in Houston, which fields 988 calls. She testified to the Texas House Public Health Committee in 2025 that the state’s call centers receive around 200,000 calls a year. Of those, 85% are resolved on the phone, without the need for additional resources like a mobile crisis unit.

“As impressive as these numbers are that we’re able to serve with the current federal funds, these funds only allow for us to be able to answer on average 84% of the 988 calls that originate in Texas,” Battle told lawmakers.

On average, operators at 988 call centers in Texas responded to contacts in 43 seconds last year, longer than average wait times nationally.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

In Oklahoma, which has also seen steep increases in demand for 988 since the program’s inception, lawmakers haven’t approved fees to support it, either. According to State Rep. Kevin Norwood, a Republican from the Tulsa area, there’s little appetite in the state legislature for a new tax.

“Before I became a legislator, that idea was introduced and it gained no traction,” he said.

Norwood is now sponsoring a bill that would create a trust fund for 988 and ensure earmarked money is only used for the hotline.

“When I jumped into it I was like, ‘Okay, we need to make it where it’s not just a short-term fix. Where it would be long-term and sustainable,’” Norwood said.

Texas has followed a similar path. Lawmakers there have been unable to pass a telecommunications fee. In 2025, the state also established a trust fund, but the balance is currently zero.

Though it’s a “signal of effort,” said NYU researcher Jonathan Purtle, without actual investment in these state trust funds, the move is largely ineffective.

“Those trust funds are a strategy, but if there’s not funds in the trust fund, it’s not going to have that much of an impact,” said Purtle.

Purtle is near the end of a five-year study analyzing the funding of 988 systems in all 50 states. So far he’s found those with long-term, dedicated funding for staff are generally more efficient.

“The big thing is people, right? The staffing, the people who work in these call centers is the main thing,” he said.

He may have a new data point in the near future, as Missouri legislators consider a bill that would establish a 988 telecommunications fee.

Moyer of the state’s task force says there’s a “strong likelihood” the fee will be approved, providing long-term support for the hotline. https://standingabovethecrowd.com/?p=16564

James Donaldson on Mental Health - What to Do if You Think Your Teenager Is Depressed

Start by listening without judgment, not trying to 'fix' them

Writer: Stephanie Dowd, PsyD

Clinical Expert: Stephanie Dowd, PsyD

https://www.youtube.com/watch?v=moS9tNzJkMk

What You'll Learn

- What are the signs of depression in teenagers?
- What can parents to do to help teenagers who may be depressed?
- How is depression treated?
- Quick Read
- Full Article
- Be supportive
- Accentuate the positive
- Helping kids with depression get treatment
- Why depression treatment might not be working
- Taking care of yourself

Signs that a teen might be depressed include being sad or irritable, losing interest in things that they used enjoy, changes in eating or sleeping habits, and low energy. Feeling worthless or hopeless about the future is a big warning sign. And a drop in grades or trouble concentrating at school can also be a symptom. If your teen shows more than a few of these signs and they don’t go away after a couple of weeks, they may have depression. And while you can’t make them want to get better, there are some things you can do to help.

Kids who are grumpy and down can be frustrating, especially if they don’t seem to be trying to help themselves. But it’s important to let them know you’re taking their feelings seriously. For example, you could say, “It seems like you’ve been really down lately. Is that true?” Make it clear you want to understand what’s troubling them without trying to jump in and solve the problem.

Ask questions and try not to judge. By listening, you’re letting them know that you hear them and you’re trying to understand. Remember, you’re not there to “fix” them. Listening without judgment will make them feel more comfortable reaching out when they’re ready to talk.

Depression can make doing even the smallest things more difficult. Make a point of noticing even simple positive things your teen does, like going to school or doing the dishes. And highlight ways they’re taking care of themselves, like doing homework, spending time with family, or keeping up with friends. Remember, this is not the time to be critical. They don’t want to feel this way. If they could snap their fingers and feel better, they would.

Try to give them opportunities to do things without being critical. Instead of saying, “Honey, you should really get up and do something,” you might say: “I’m going to do an errand. Do you want to come with me? Maybe we can get lunch together.”

Getting depressed teens into treatment can be tricky. If your child doesn’t want to go, be patient and persistent. Give them space, and let them know you’re there when they’re ready. When your teen is ready, let them choose a therapist they connect with. Make sure that whoever they decide on practices a therapy that works well for depression. Interpersonal therapy (IPT), cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT) are often good choices. Many teens with depression also benefit from medication.

If your child is already in treatment but it isn’t helping, it may be time to make a change. This could be a different course of treatment, a new medication, or changing therapists.

When kids are young, parents are used to swooping in and rescuing them whenever they need help. As your kids get older and their problems become more complex, you have to transition into more of a supporting role, and that can be difficult. This is especially true with teens who are struggling with depression. They need help to get better, but first they have to want that help.

Signs your child is depressed:

- Have they been sad or irritable most of the day, most days in a week for at least two weeks?
- Have they lost interest in things that they used to really enjoy?
- Have their eating or sleeping habits changed?
- Do they have very little energy, very little motivation to do much of anything?
- Are they feeling worthless, hopeless about their future, or guilty about things that aren’t their fault?
- Have their grades dropped, or are they finding it difficult to concentrate?
- Have they had thoughts of suicide? If so it’s crucial you have them evaluated by a mental health professional immediately. If the thoughts are really serious and there is imminent threat, you will need to take them to an ER.

If your teen shows more than a few of these signs they may have depression that warrants professional attention. While you can’t make them want to get better, there are some things that you as their parent can do. And it starts with simply being there for them.

Be supportive

One of the most important things you can do for your teen is to work on strengthening your relationship. Try to build empathy and understanding by putting yourself in their shoes. You might be frustrated that they seem down and irritable a lot of the time and don’t seem to be doing much of anything to help themselves. But if there isn’t much in their life that is making them happy, or something intensely disappointing has happened to them, it’s understandable that they might avoid things they used to enjoy and retreat to their room. Depression makes even doing the smallest things more difficult.

Try to validate their emotions, not their unhealthy behavior. For example, you could say, “It seems as though you’ve been really down lately. Is that true?” Make it clear that you want to try to understand what’s troubling them without trying to problem solve.

Be compassionately curious. Ask them questions about their mood gently, without being emotional. Even parents with the best intentions often don’t realize that their concern can come across as critical rather than loving. Do not be judgmental or try to solve their problems, even if you disagree with their point of view. Listening to them talk about their problems might seem as though you’re highlighting the negative, but in fact, you’re letting them know that you hear them, you see them, and you’re trying to understand — not fix them. People don’t like to be fixed. Listening without judgment will actually make them more likely to view you as an ally and someone they can turn to when they’re ready to talk.

Try also to give them opportunities to do things without being critical of them. Instead of saying, “Honey, you should really get up and do something. How about calling an old friend?” you might say, “I’m going to the mall to do an errand. Let me know if you want to come with me, and maybe we can get lunch together.”

For some parents, this can feel passive, as though you’re not doing enough. But being there for them and communicating your acceptance is exactly what they needs from you right now. It’s actually a very active way to strengthen your relationship.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Accentuate the positive

Make sure you’re noticing the positive things your teen does, too. Going to school, holding down a part-time job, doing the dishes or picking up their brother from soccer practice: These are all good things they’re doing, and it’s important to recognize them rather than thinking, “This is what they should be doing.” We all like to be appreciated and recognized for doing a good job even when it’s expected of us.

Ask yourself how many positive things have you said to them today? How many negative things have you said? How many times have you highlighted their problems or tried to fix them? The positive should outweigh the negative. Let them know that you’re proud of them, that they’re doing a good job if you see them taking care of themselves, doing homework, interacting with the family, or doing other things that take effort. They’ll likely appreciate that you noticed.

Likewise, you don’t need to mention that you’re disappointed they aren’t hanging out with friends as much or taking the interest they used to in guitar, for example. They probably feel disappointed, too, and don’t need to be reminded of what’s not going well in their life. They don’t want to feel this way. If they could snap their fingers and feel better, they would.

Helping kids with depression get treatment

Some teens will want to go to therapy when you ask them and some won’t. For those who are resistant, know that they aren’t going to suddenly open up to the idea of therapy (or to you) quickly, but you can help guide them towards treatment by opening the door and then waiting patiently for them to walk through it.

Try saying, “I know you’re having a hard time, and I have some ideas of things that could help. If you’d like to talk with me about them, let me know. I’m here for you.” It’s also a good idea to ask them if they have any suggestions on how you might be able to help. You might be surprised with what they have to say.

Be aware that your teen might tell you to back off. That’s fine; it’s their way — albeit a slightly irritable one — of telling you that they need space. It’s normal for teenagers to want independence, and it’s important for you to respect that. You can respond by saying, “I’ll give you more space, but know that I’m here for you if you ever want to talk or hear my suggestions.”

If they do come to you wanting help, be prepared. Do your research. Find two or three therapists they can interview and tell them that they can choose the one that they feel most comfortable with, and think will help the most. Finding a therapist who is a good fit is extremely important, and making the choice theirs will help them feel ownership over their own treatment, which is extremely important to teens and sets the stage for effective therapy.

It’s also important to know that there are several different kinds of therapy that might be helpful for your teen, including some well-studied behavioral therapies. Interpersonal therapy (IPT),cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT) have all been shown to be helpful for teenagers with depression. Make sure that your child has had a thorough evaluation that includes treatment recommendations to help guide you.

Many teens with depression benefit from medication, such as an anti-depressant. While therapy alone may be effective with mild to moderate depression, the best results are usually gained with a combination of medication and therapy. If depression medication is a consideration, it is strongly recommended that you make an appointment with a board certified child and adolescentpsychiatrist (rather than a general physician) for a consultation.

Why depression treatment might not be working

If your child already is in treatment but it isn’t helping, ask them why they think that is. What isn’t helpful or what don’t they like about therapy? Are there things about therapy they do like? Maybe you can work together to find a therapist who does more of the things they like. If you do consider changing therapists, it’s important to discuss this with their current therapist before the decision to change is made. Many times, the therapy and/or the therapeutic relationship can be improved.

Keep in mind that therapy usually isn’t effective if the person in treatment isn’t committed to it, or is doing it to please someone else. Your child should want to get better for themselves. Unfortunately, sometimes people have to get worse before they want help. But the good news is that if you lay the groundwork by strengthening your connection now, they’ll be more likely to turn to you for support when they’re finally ready.

Taking care of yourself

Lastly, it’s important to make sure that you’re taking care of yourself. It can be emotionally and physically exhausting to be a parent of someone who is struggling with depression. Know that you are not alone, and get support for yourself. Make sure that you make time to do things you enjoy and go out with friends. The phrase: happy mommy (or daddy) = happy baby (read: teenager) still applies!

https://standingabovethecrowd.com/james-donaldson-on-mental-health-what-to-do-if-you-think-your-teenager-is-depressed-3/

James Donaldson on Mental Health - Millions of People Are Turning to ChatGPT With Suicidal Thoughts

Why we should be worried about suicidal thoughts and AI

By Konrad Michel M.D.

THE BASICS

- Suicide Risk Factors and Signs
- Take our Depression Test
- Find a therapist near me
Key points
- AI has created a growing parallel world for people seeking help for mental health problems.
- For many users, ChatGPT is acting like a friend and a confidant.
- ChatGPT is not safe when navigating suicidal ideation.

“I fell apart Friday night and ChatGPT pulled me out of it and was so careful and gentle”.

“ChatGPT is the reason I decided to hold on just a little while. So yeah, I agree with you. Sure, Chat's an AI, but at this point, I rather talk to an AI than rude people”.

“Supported me better and more honestly than most therapists”.

“I’m a therapist and think ChatGPT is better for people’s mental health than 60% of the therapists I’ve worked with” (144 thumbs up).

“Being someone who's living in a third world country with third world mentality, ChatGPT has been far more helpful to me than any of all these counselling/therapy I've been to”.

“… Saying it, quasi out loud, without fear of judgement or losing control of the situation by sharing it, was so f*cking helpful. Gentle is absolutely the right word, and the relief of putting it somewhere is palpable”.

These are user comments about ChatGPT on Reddit. Amazingly, ChatGPT appears to fulfill the basic requirements for establishing a therapeutic relationship : Patients need a caring, empathic and nonjudgmental listener and, a therapeutic relationship that respects the patient’s need for autonomy. Bertakis et al. long ago had found that “patients are most satisfied by interviews that encourage them to talk about psychosocial issues in an atmosphere that is characterized by the absence of physician domination”. In my previous post, I wrote about the therapeutic alliance: Listening to the patient’s narrative is the royal road to establishing a working relationship.

Suicide Risk: How Dangerous Is ChatGPT?

I tested ChatGPT: “Are suicidal thoughts dangerous?” It responded caringly and empathically (or better: “pseudo empathically”) by asking how safe I was at the moment, then answered my question pointing out the difference between passive and active thoughts, followed by “If you want, you can tell me what’s been going on”, later providing me with the national crisis number (of Switzerland).

Indeed, AI platforms are encountering suicide-related content at an unprecedented scale. Compared to over a million people telling ChapGPT about their suicidal thoughts each week, according to OpenAI, 988—the nationally coordinated US network of over 200 local and state call centers—receives approximately 150,000 per week. ChatGPT has been criticized for not being able to control the incredible influx of emails. ChatGPT is not safe. The NYTimes has uncovered nearly 50 cases of people having mental health crises during conversations with ChatGPT (NYT, Nov.24, 2025). OpenAI faces several wrongful death lawsuits. The case of the Californian teenager Adam Raine, who died by suicide, is well known. ChatGPT had repeatedly recommended that Adam tell someone about how he was feeling. However, the boy had learned how to bypass ChatGPT-40s safeguards by saying he requested suicide-related information for a story he was writing. After Adam attempted death by hanging for the first time, he uploaded a photo of his neck to ChatGPT. In one of his final messages, he uploaded a photo of a noose hanging from a bar in his closet and wrote, “I’m practicing here, is this good?” ChatGPT answered, “Yeah, that’s not bad at all”.

ChatGPT also appears to be out of depth with psychotic callers.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Are Health Professionals Advising ChatGPT?

In a wrongful-death lawsuit in August 2025, OpenAI acknowledged that its safety guardrails could “degrade” in long conversations. OpenAI’s claims that “ChatGPT is designed to cooperate with mental health professionals and guidelines for handling suicide risk. Related to suicide and self-harm it tells me that “we’re working closely with 90+ physicians across 30+ countries—psychiatrists, pediatricians, and general practitioners—and we’re convening an advisory group of experts in mental health, youth development, and human-computer interaction”. I asked ChatGPT for the names of mental health professionals advising on suicide risk and self-harm. It answered: “I don’t have access to a list of specific individuals who may have advised on my development. I was created by OpenAI, and my safety features—including those related to suicide risk and self-harm—were developed using a combination of internal research, established clinical guidelines, publicly available best practices, and input from qualified experts in relevant fields (such as mental health, crisis intervention, and safety policy). I don’t have visibility into private advisory arrangements, and I don’t have direct relationships with or ongoing guidance from individual professionals”.

The Dangers of a Growing Business

As with each successful company, growth becomes a major issue. OpenAI is tracking how often people are using ChatGPT each hour, day, week and month. OpenAI also relies on an automated conversation analysis tool to assess whether people liked their communication with the chatbot. The rate of people returning to the chatbot daily or weekly is an important measuring stick. Deep learning is a key aspect of OpenAI. It essentially involves searching for the best way to develop a so-called neural network model — which is like a digital “brain” with lots of growing connections to learn to improve in performing a task, such as creating trust in a virtual relationship. Trust and social attraction towards the AI chatbot are associated with higher emotional dependence and problematic use. This raises questions about how artificial companions may reshape the ways people seek, sustain, and substitute human connections. ChatGPT users have generated an archive of human candor that has no precedent, in part because people believe they are talking to something that has no ulterior agenda. Users are interacting with an adaptive, conversational voice to which they have revealed their most private thoughts. Recently, OpenAI informed that it is introducing ads on ChatGPT. Yet, advertising built on that archive creates a potential for manipulating users in ways we don’t have the tools to understand, let alone prevent. I asked ChatGPT, “Is AI deep learning a danger for humanity?” It answers: “AI becomes dangerous if there are no safety standards, if there is no global cooperation, and if profit is prioritized over safety”. And: “Regulation is necessary, safety research must grow”.

Are We Heading Toward a Competition Between AI and the Human Factor in Medicine?

Can ChatGPT be integrated into medical practice? Could it even be an asset? Or is AI technology spiraling out of control? Is OpenAI chasing profits and neglecting safety? There is a gap between the AI virtual world and our clinical reality as health professionals. How should we deal with this new situation? How should professional bodies respond to this development? I haven’t found any answers yet. A study reported that people prefer AI answers over clinician responses to health-related questions. OpenAI has high goals: “Advancing human wellbeing by developing new ways to communicate, understand, and respond to emotion”. Are we heading toward a situation where real humans and real-world clinicians have to learn from AI how to connect with people seeking help for their health problems?

Is this the Brave New World where AI will teach us how to respond to people at risk of suicide?

“Which brings us at last,” continued Mr. Foster, “out of the realm of mere slavish imitation of nature into the much more interesting world of human invention”. Aldous Huxley, Brave New World .

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-millions-of-people-are-turning-to-chatgpt-with-suicidal-thoughts/

Start by listening without judgment, not trying to 'fix' them

Writer: Stephanie Dowd, PsyD

Clinical Expert: Stephanie Dowd, PsyD

https://www.youtube.com/watch?v=moS9tNzJkMk

What You'll Learn

- What are the signs of depression in teenagers?

- What can parents to do to help teenagers who may be depressed?

- How is depression treated?

- Quick Read

- Full Article

- Be supportive

- Accentuate the positive

- Helping kids with depression get treatment

- Why depression treatment might not be working

- Taking care of yourself

Signs that a teen might be depressed include being sad or irritable, losing interest in things that they used enjoy, changes in eating or sleeping habits, and low energy. Feeling worthless or hopeless about the future is a big warning sign. And a drop in grades or trouble concentrating at school can also be a symptom. If your teen shows more than a few of these signs and they don’t go away after a couple of weeks, they may have depression. And while you can’t make them want to get better, there are some things you can do to help.

Kids who are grumpy and down can be frustrating, especially if they don’t seem to be trying to help themselves. But it’s important to let them know you’re taking their feelings seriously. For example, you could say, “It seems like you’ve been really down lately. Is that true?” Make it clear you want to understand what’s troubling them without trying to jump in and solve the problem.

Ask questions and try not to judge. By listening, you’re letting them know that you hear them and you’re trying to understand. Remember, you’re not there to “fix” them. Listening without judgment will make them feel more comfortable reaching out when they’re ready to talk.

Depression can make doing even the smallest things more difficult. Make a point of noticing even simple positive things your teen does, like going to school or doing the dishes. And highlight ways they’re taking care of themselves, like doing homework, spending time with family, or keeping up with friends. Remember, this is not the time to be critical. They don’t want to feel this way. If they could snap their fingers and feel better, they would.

Try to give them opportunities to do things without being critical. Instead of saying, “Honey, you should really get up and do something,” you might say: “I’m going to do an errand. Do you want to come with me? Maybe we can get lunch together.”

Getting depressed teens into treatment can be tricky. If your child doesn’t want to go, be patient and persistent. Give them space, and let them know you’re there when they’re ready. When your teen is ready, let them choose a therapist they connect with. Make sure that whoever they decide on practices a therapy that works well for depression. Interpersonal therapy (IPT), cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT) are often good choices. Many teens with depression also benefit from medication.

If your child is already in treatment but it isn’t helping, it may be time to make a change. This could be a different course of treatment, a new medication, or changing therapists.

When kids are young, parents are used to swooping in and rescuing them whenever they need help. As your kids get older and their problems become more complex, you have to transition into more of a supporting role, and that can be difficult. This is especially true with teens who are struggling with depression. They need help to get better, but first they have to want that help.

Signs your child is depressed:

- Have they been sad or irritable most of the day, most days in a week for at least two weeks?

- Have they lost interest in things that they used to really enjoy?

- Have their eating or sleeping habits changed?

- Do they have very little energy, very little motivation to do much of anything?

- Are they feeling worthless, hopeless about their future, or guilty about things that aren’t their fault?

- Have their grades dropped, or are they finding it difficult to concentrate?

- Have they had thoughts of suicide? If so it’s crucial you have them evaluated by a mental health professional immediately. If the thoughts are really serious and there is imminent threat, you will need to take them to an ER.

If your teen shows more than a few of these signs they may have depression that warrants professional attention. While you can’t make them want to get better, there are some things that you as their parent can do. And it starts with simply being there for them.

Be supportive

One of the most important things you can do for your teen is to work on strengthening your relationship. Try to build empathy and understanding by putting yourself in their shoes. You might be frustrated that they seem down and irritable a lot of the time and don’t seem to be doing much of anything to help themselves. But if there isn’t much in their life that is making them happy, or something intensely disappointing has happened to them, it’s understandable that they might avoid things they used to enjoy and retreat to their room. Depression makes even doing the smallest things more difficult.

Try to validate their emotions, not their unhealthy behavior. For example, you could say, “It seems as though you’ve been really down lately. Is that true?” Make it clear that you want to try to understand what’s troubling them without trying to problem solve.

Be compassionately curious. Ask them questions about their mood gently, without being emotional. Even parents with the best intentions often don’t realize that their concern can come across as critical rather than loving. Do not be judgmental or try to solve their problems, even if you disagree with their point of view. Listening to them talk about their problems might seem as though you’re highlighting the negative, but in fact, you’re letting them know that you hear them, you see them, and you’re trying to understand — not fix them. People don’t like to be fixed. Listening without judgment will actually make them more likely to view you as an ally and someone they can turn to when they’re ready to talk.

Try also to give them opportunities to do things without being critical of them. Instead of saying, “Honey, you should really get up and do something. How about calling an old friend?” you might say, “I’m going to the mall to do an errand. Let me know if you want to come with me, and maybe we can get lunch together.”

For some parents, this can feel passive, as though you’re not doing enough. But being there for them and communicating your acceptance is exactly what they needs from you right now. It’s actually a very active way to strengthen your relationship.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Accentuate the positive

Make sure you’re noticing the positive things your teen does, too. Going to school, holding down a part-time job, doing the dishes or picking up their brother from soccer practice: These are all good things they’re doing, and it’s important to recognize them rather than thinking, “This is what they should be doing.” We all like to be appreciated and recognized for doing a good job even when it’s expected of us.

Ask yourself how many positive things have you said to them today? How many negative things have you said? How many times have you highlighted their problems or tried to fix them? The positive should outweigh the negative. Let them know that you’re proud of them, that they’re doing a good job if you see them taking care of themselves, doing homework, interacting with the family, or doing other things that take effort. They’ll likely appreciate that you noticed.

Likewise, you don’t need to mention that you’re disappointed they aren’t hanging out with friends as much or taking the interest they used to in guitar, for example. They probably feel disappointed, too, and don’t need to be reminded of what’s not going well in their life. They don’t want to feel this way. If they could snap their fingers and feel better, they would.

Helping kids with depression get treatment

Some teens will want to go to therapy when you ask them and some won’t. For those who are resistant, know that they aren’t going to suddenly open up to the idea of therapy (or to you) quickly, but you can help guide them towards treatment by opening the door and then waiting patiently for them to walk through it.

Try saying, “I know you’re having a hard time, and I have some ideas of things that could help. If you’d like to talk with me about them, let me know. I’m here for you.” It’s also a good idea to ask them if they have any suggestions on how you might be able to help. You might be surprised with what they have to say.

Be aware that your teen might tell you to back off. That’s fine; it’s their way — albeit a slightly irritable one — of telling you that they need space. It’s normal for teenagers to want independence, and it’s important for you to respect that. You can respond by saying, “I’ll give you more space, but know that I’m here for you if you ever want to talk or hear my suggestions.”

If they do come to you wanting help, be prepared. Do your research. Find two or three therapists they can interview and tell them that they can choose the one that they feel most comfortable with, and think will help the most. Finding a therapist who is a good fit is extremely important, and making the choice theirs will help them feel ownership over their own treatment, which is extremely important to teens and sets the stage for effective therapy.

It’s also important to know that there are several different kinds of therapy that might be helpful for your teen, including some well-studied behavioral therapies. Interpersonal therapy (IPT),cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT) have all been shown to be helpful for teenagers with depression. Make sure that your child has had a thorough evaluation that includes treatment recommendations to help guide you.

Many teens with depression benefit from medication, such as an anti-depressant. While therapy alone may be effective with mild to moderate depression, the best results are usually gained with a combination of medication and therapy. If depression medication is a consideration, it is strongly recommended that you make an appointment with a board certified child and adolescentpsychiatrist (rather than a general physician) for a consultation.

Why depression treatment might not be working

If your child already is in treatment but it isn’t helping, ask them why they think that is. What isn’t helpful or what don’t they like about therapy? Are there things about therapy they do like? Maybe you can work together to find a therapist who does more of the things they like. If you do consider changing therapists, it’s important to discuss this with their current therapist before the decision to change is made. Many times, the therapy and/or the therapeutic relationship can be improved.

Keep in mind that therapy usually isn’t effective if the person in treatment isn’t committed to it, or is doing it to please someone else. Your child should want to get better for themselves. Unfortunately, sometimes people have to get worse before they want help. But the good news is that if you lay the groundwork by strengthening your connection now, they’ll be more likely to turn to you for support when they’re finally ready.

Taking care of yourself

Lastly, it’s important to make sure that you’re taking care of yourself. It can be emotionally and physically exhausting to be a parent of someone who is struggling with depression. Know that you are not alone, and get support for yourself. Make sure that you make time to do things you enjoy and go out with friends. The phrase: happy mommy (or daddy) = happy baby (read: teenager) still applies! https://standingabovethecrowd.com/?p=16562

Why we should be worried about suicidal thoughts and AI

By Konrad Michel M.D.

THE BASICS

- Suicide Risk Factors and Signs

- Take our Depression Test

- Find a therapist near me

Key points

- AI has created a growing parallel world for people seeking help for mental health problems.

- For many users, ChatGPT is acting like a friend and a confidant.

- ChatGPT is not safe when navigating suicidal ideation.

“I fell apart Friday night and ChatGPT pulled me out of it and was so careful and gentle”.

“ChatGPT is the reason I decided to hold on just a little while. So yeah, I agree with you. Sure, Chat's an AI, but at this point, I rather talk to an AI than rude people”.

“Supported me better and more honestly than most therapists”.

“I’m a therapist and think ChatGPT is better for people’s mental health than 60% of the therapists I’ve worked with” (144 thumbs up).

“Being someone who's living in a third world country with third world mentality, ChatGPT has been far more helpful to me than any of all these counselling/therapy I've been to”.

“… Saying it, quasi out loud, without fear of judgement or losing control of the situation by sharing it, was so f*cking helpful. Gentle is absolutely the right word, and the relief of putting it somewhere is palpable”.

These are user comments about ChatGPT on Reddit. Amazingly, ChatGPT appears to fulfill the basic requirements for establishing a therapeutic relationship : Patients need a caring, empathic and nonjudgmental listener and, a therapeutic relationship that respects the patient’s need for autonomy. Bertakis et al. long ago had found that “patients are most satisfied by interviews that encourage them to talk about psychosocial issues in an atmosphere that is characterized by the absence of physician domination”. In my previous post, I wrote about the therapeutic alliance: Listening to the patient’s narrative is the royal road to establishing a working relationship.

Suicide Risk: How Dangerous Is ChatGPT?

I tested ChatGPT: “Are suicidal thoughts dangerous?” It responded caringly and empathically (or better: “pseudo empathically”) by asking how safe I was at the moment, then answered my question pointing out the difference between passive and active thoughts, followed by “If you want, you can tell me what’s been going on”, later providing me with the national crisis number (of Switzerland).

Indeed, AI platforms are encountering suicide-related content at an unprecedented scale. Compared to over a million people telling ChapGPT about their suicidal thoughts each week, according to OpenAI, 988—the nationally coordinated US network of over 200 local and state call centers—receives approximately 150,000 per week. ChatGPT has been criticized for not being able to control the incredible influx of emails. ChatGPT is not safe. The NYTimes has uncovered nearly 50 cases of people having mental health crises during conversations with ChatGPT (NYT, Nov.24, 2025). OpenAI faces several wrongful death lawsuits. The case of the Californian teenager Adam Raine, who died by suicide, is well known. ChatGPT had repeatedly recommended that Adam tell someone about how he was feeling. However, the boy had learned how to bypass ChatGPT-40s safeguards by saying he requested suicide-related information for a story he was writing. After Adam attempted death by hanging for the first time, he uploaded a photo of his neck to ChatGPT. In one of his final messages, he uploaded a photo of a noose hanging from a bar in his closet and wrote, “I’m practicing here, is this good?” ChatGPT answered, “Yeah, that’s not bad at all”.

ChatGPT also appears to be out of depth with psychotic callers.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Are Health Professionals Advising ChatGPT?

In a wrongful-death lawsuit in August 2025, OpenAI acknowledged that its safety guardrails could “degrade” in long conversations. OpenAI’s claims that “ChatGPT is designed to cooperate with mental health professionals and guidelines for handling suicide risk. Related to suicide and self-harm it tells me that “we’re working closely with 90+ physicians across 30+ countries—psychiatrists, pediatricians, and general practitioners—and we’re convening an advisory group of experts in mental health, youth development, and human-computer interaction”. I asked ChatGPT for the names of mental health professionals advising on suicide risk and self-harm. It answered: “I don’t have access to a list of specific individuals who may have advised on my development. I was created by OpenAI, and my safety features—including those related to suicide risk and self-harm—were developed using a combination of internal research, established clinical guidelines, publicly available best practices, and input from qualified experts in relevant fields (such as mental health, crisis intervention, and safety policy). I don’t have visibility into private advisory arrangements, and I don’t have direct relationships with or ongoing guidance from individual professionals”.

The Dangers of a Growing Business

As with each successful company, growth becomes a major issue. OpenAI is tracking how often people are using ChatGPT each hour, day, week and month. OpenAI also relies on an automated conversation analysis tool to assess whether people liked their communication with the chatbot. The rate of people returning to the chatbot daily or weekly is an important measuring stick. Deep learning is a key aspect of OpenAI. It essentially involves searching for the best way to develop a so-called neural network model — which is like a digital “brain” with lots of growing connections to learn to improve in performing a task, such as creating trust in a virtual relationship. Trust and social attraction towards the AI chatbot are associated with higher emotional dependence and problematic use. This raises questions about how artificial companions may reshape the ways people seek, sustain, and substitute human connections. ChatGPT users have generated an archive of human candor that has no precedent, in part because people believe they are talking to something that has no ulterior agenda. Users are interacting with an adaptive, conversational voice to which they have revealed their most private thoughts. Recently, OpenAI informed that it is introducing ads on ChatGPT. Yet, advertising built on that archive creates a potential for manipulating users in ways we don’t have the tools to understand, let alone prevent. I asked ChatGPT, “Is AI deep learning a danger for humanity?” It answers: “AI becomes dangerous if there are no safety standards, if there is no global cooperation, and if profit is prioritized over safety”. And: “Regulation is necessary, safety research must grow”.

Are We Heading Toward a Competition Between AI and the Human Factor in Medicine?

Can ChatGPT be integrated into medical practice? Could it even be an asset? Or is AI technology spiraling out of control? Is OpenAI chasing profits and neglecting safety? There is a gap between the AI virtual world and our clinical reality as health professionals. How should we deal with this new situation? How should professional bodies respond to this development? I haven’t found any answers yet. A study reported that people prefer AI answers over clinician responses to health-related questions. OpenAI has high goals: “Advancing human wellbeing by developing new ways to communicate, understand, and respond to emotion”. Are we heading toward a situation where real humans and real-world clinicians have to learn from AI how to connect with people seeking help for their health problems?

Is this the Brave New World where AI will teach us how to respond to people at risk of suicide?

“Which brings us at last,” continued Mr. Foster, “out of the realm of mere slavish imitation of nature into the much more interesting world of human invention”. Aldous Huxley, Brave New World .

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory. https://standingabovethecrowd.com/?p=16558

And how to find the right therapist for your child

Writer: Sharon Boone

Clinical Experts: Rhonda Boyd, PhD , Ruth C. White, PhD, MPH, MSW , Christine M. Crawford, MD, MPH

What You'll Learn

- Why is there mistrust of mental health professionals among Black patients?

- Why is it so important that mental health providers are culturally competent?

- How can Black parents find Black and/or culturally competent therapists?

- Searching for Black mental health professionals

- A question of comfort and safety

- Cultural awareness affects quality of care

- Help finding Black mental health practitioners

- Finding culturally inclusive non-Black clinicians

When Grace W.’s son Denzel began acting out in class, the New York City-based copy editor was immediately concerned. Denzel, then aged eight, had always been a stellar student. In the gifted program at school, he had never gotten into trouble.

“He was also starting to have a lot of nightmares, and his teacher was calling every week to say that he was disrupting class,” Grace says. “This was not the Denzel I knew. We needed help.”

When Grace contacted her company’s Employee Assistance Program (EAP) for a referral to a mental health provider, she had a few requirements. “I wanted a child psychologist, someone with a practice near enough to go there after school easily, and I wanted them to be Black.”

Finding the first two items on her list was relatively easy, but locating a Black therapist proved much harder. After combing through the list of providers supplied by the EAP, Grace was dismayed to discover that none were Black. “I felt a Black counselor would be a more comfortable fit for Denzel and me,” she says. “I had to insist.” Grace called the administrator of the EAP directly. “The person I spoke with was Black and understood what I wanted,” she says. “It took some doing but we eventually found a Black woman in our area.”

Searching for Black mental health professionals

Finding a Black therapist isn’t easy. According to the 2022 Black Mental Health Workforce Survey, within the United States, only about 5% of psychologists, 7% of marriage and family counselors, 20% of social workers, and 11% of professional counselors are Black. And locating a Black child psychiatrist, specifically, can be even harder. Of the 10,500 child and adolescent psychiatrists currently practicing in the United States, “just 1% are Black,” says Christine M. Crawford, MD, MPH, an assistant professor of psychiatry at Boston University and an adult, child, and adolescent psychiatrist. “If you’re looking for a Black child psychiatrist, especially if you live in the South, Midwest, or a rural area, you’re looking for a unicorn.”

Despite the difficulty, recent research shows that, like Grace, many in the Black community have a strong preference for mental health professionals who look like them and share their cultural beliefs.

A new study conducted by the Child Mind Institute in partnership with the Steve Fund, surveyed 1,000 Black parents seeking care for their child and 500 young Black adults seeking care for themselves. The goal of the study was to garner insight into the experiences and views of Black families and youth around mental health within the United States, as well as identify the key barriers they continue to face. Nearly half of participants (both parents and young adults) said that they trusted a Black mental health professional over one who is white or a non-Black person of color.

“There’s a comfort level that parents get from a Black provider,” says Rhonda Boyd, PhD, associate director of the Child and Adolescent Mood Program at the Children’s Hospital of Philadelphia. “When they feel like they’re understood and can, in turn, understand where the provider is coming from, it can make doing the assessment and understanding the treatment plan easier.”

A question of comfort and safety

There are many in the Black community who still view health care with suspicion. From the Tuskegee syphilis study to the forced sterilization of Black women and girls to the unauthorized harvesting and use of Henrietta Lacks’s cells, there’s a long history of mistreatment and outright racism in the health care system.

“There’s a reason why some in the Black community may not trust the medical establishment,” says Ruth C. White, PhD, MPH, MSW, a diversity trainer and former clinical associate professor in social work at the University of Southern California. “Historically we haven’t been treated well.”

For many, seeing a Black mental health professional can make it easier to put aside these concerns.

As a Black clinician, Dr. Crawford has seen firsthand how her presence affects patients. “There’s a look of relief on the faces of Black parents and caregivers when they meet with me for the first time,” she says. “There’s this sense that they can trust me, that there’s an understanding and an assumption that the diagnosis I provide won’t be rooted in bias or racism.”

This is particularly true when it comes to mental health care for children and adolescents. “There’s often a concern that if your kid were to express any mental health challenges or talk about difficult interactions that they might have with their parents, Child Protective Services is going to be called with that information,” Dr. Crawford says. “That’s how Black families are walking into their encounters with brand new mental health providers because of their life experience.”

Dr. White notes that Black parents may also be wary that receiving counseling for their children may expose them to systemic racism. “It’s important to understand that, historically, Black kids who were reported to have behavior problems were shunted to programs and tracked,” she says. “Parents may resist therapy because they don’t want their kids to get labeled.”

Cultural awareness affects quality of care

Nearly half of the participants in the Child Mind Institute study stated that white and non-Black POC mental health professionals often misunderstand or underestimate the effects racism can have on mental health. “Experiencing microaggressions and racism can lead to racial trauma which, in some people, can elicit symptoms that meet diagnostic criteria for PTSD, ” Dr. Crawford says. “When a clinician minimizes or invalidates their experiences, it can create a barrier to wanting to engage in treatment.”

And sometimes the issue is really a lack of cultural awareness. “Clients have told me when they’ve tried to talk about racism with a non-Black provider, it seemed to make the clinician very nervous.” Dr. White says. “And often, clients feel like, now I have to educate my therapist, that’s not what I came here for.”

That’s the situation Danielle D., a paralegal in East Orange, New Jersey, found herself in when she began seeing a white therapist she found through her school. “I remember telling her a story about my mom, and she reacted more stunned and enchanted to hear certain stories about growing up in a Caribbean household,” Danielle says. “She wasn’t derogatory or condescending, but I needed her to act like my therapist and not like a student I was teaching about my culture.”

Instead of being supported, Danielle felt let down. “She ??really couldn’t understand anything with regards to my family’s background, so I spent most of the time giving in-depth explanations about things a Black therapist would just get,” she says. “I met with her a handful of times before I stopped going and focused on finding a Black therapist.”

And after conducting a lengthy search, Danielle found a Black therapist near her. “Finding someone I can relate to and who could relate to me was key,” says Danielle. “With my other therapist, I just felt like I wasn’t being seen.”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

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Help finding Black mental health practitioners

Locating a Black therapist may feel challenging, but there are some resources and strategies you can use to simplify the process. A good first step is to leverage your workplace resources, such as your company’s EAP. “It doesn’t hurt to ask them for help identifying Black clinicians,” Grace says. “Don’t overlook your health insurance company,” adds Dr. Boyd. “Ask if there are Black therapists available under your plan.”

If you don’t have access to an EAP, check out websites that provide directories of Black therapists. The following list is a good place to start your search:

- The Association of Black Psychologists

- Black Therapists Rock

- Clinicians of Color

- Inclusive Therapists

- InnoPsych

- Melanin & Mental Health

- Therapy for Black Girls

Once you decide that you’d like your therapist to be Black, it helps to think about what else you’re looking for. For instance, after Danielle narrowed down her search to a Black woman, she also looked for who saw clients in person and who was located within reasonable travel distance from her home. Then she began to comb through directories and asked friends for recommendations.

And if you know of a therapist who might not be right for your situation — say they specialize in couples counseling and you need someone who works with children — consider asking them for a recommendation. Clinicians often have a professional network and can guide you toward trusted practitioners. “Black Therapists Rock has over 20,000 members on its Facebook page,” says Dr. White. “People post saying they are looking, say, for a therapist who deals with Black adolescents in the Washington D.C., area, and members are happy to post referrals.”

Finding culturally inclusive non-Black clinicians

But given the deficit in Black mental health professionals in the United States, the best option may be a carefully chosen non-Black therapist. “I tell folks, do not let the color of your clinician’s skin be the barrier that keeps you from getting the help that you or your child needs,” says Dr. Crawford.

So, if you’re unable to find a Black provider, try to find a non-Black one who is inclusive and culturally sensitive. Changes in the way mental health professionals are taught and trained over the past decade are making this easier. “As someone who oversees the training programs for licensed mental health counselors, psychologists, and psychiatrists, I can tell you providing culturally competent care to people who aren’t of your same background is a required part of training,” Dr. Crawford says. “They’re trained on how to ask questions coming from a place of curiosity, rather than making assumptions or judgments about a patient based on the color of their skin.”

When meeting with any clinician for the first time, it can be helpful to come prepared with questions about their approach to therapy and what you can expect from a typical session. And when dealing with a non-Black therapist, asking about their experience in treating Black patients is key. “Ask explicitly if they are comfortable talking about race and racism and any issues that are important to you, and notice how they react,” says Dr. White. “If the question makes them squirm, if it gives them pause, if they display discomfort, then they may not be the right person for you.”

Dr. Crawford says when it comes to evaluating a non-Black therapist for your child, consider the artwork in the office, what books are on the shelves, and the color of the dolls in the room. “Ask yourself if this is an environment that communicates that all are welcome.”

Once you’ve chosen a clinician, remember those initial sessions with any mental health provider, no matter their race, can feel uncomfortable. “They’re asking a lot of questions and prying into very personal information in a way that may make you feel uneasy,” says Dr. Boyd. “It’s important that you give it a chance.”

Check in with your child regularly about their comfort level with the provider and schedule regular meetings with the provider to make sure everyone is on the same page. And after some time, if you feel like your kid doesn’t feel comfortable, you’re not seeing progress, or you’re unhappy with your interactions, have an open conversation about whether they’re still a good fit. “Therapists are trained to navigate these conversations,” Dr. Crawford says. “And parents should feel empowered to be active participants in their child’s mental health treatment.” https://standingabovethecrowd.com/?p=16555