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Boston has its first chief of behavioral health. Meet Dr. Kevin Simon.

“Starting with youth is a really good avenue to have the maximum potential for helping the most people.”

Dr. Kevin Simon. Boston Public Health Commission

Since the start of the COVID-19 pandemic, health professionals, families, and individuals working with young people have been sounding the alarm over how the ongoing public health emergency is impacting the mental health of the nation’s youth.

The U.S. surgeon general in 2021 warned of a mental health “crisis” among young people, cautioning that the pandemic had exacerbated and intensified mental health issues, such as anxiety and depression, that were already widespread. 

Now, addressing the ongoing mental health crisis, among young people in particular, in Boston will be the task of Dr. Kevin Simon, who is taking on the role of the Boston Public Health Commission’s first ever chief behavioral health officer.

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Simon, born and raised in Brooklyn, New York, by Haitian parents, has been serving as a child, adolescent, and adult psychiatrist, as well as an addiction medicine specialist caring for youth, young adults, and families through the Adolescent Substance Use & Addiction Program (ASAP) at Boston Children’s Hospital. He is an instructor at Harvard Medical School, a Commonwealth Fund Fellow in Health Policy at Harvard University, and medical director at the Wayside Youth & Family Support Network. 

“I think whether you are in city politics, whether you are a teacher, whether you are a parent, I think a lot of people recognize that youth are experiencing something that’s very different than what adults would have experienced when they were 8, 10, 14. … I figured that I could certainly continue with the clinical care that I do at Children’s, but if there is a way that I can help a larger subset of people, this would be an opportune time,” Simon told Boston.com. “Because again, the status quo of youth mental health, the status quo of adult/elderly mental health, something has to be different. So if I could be part of that change towards progress, I figured that this is the right opportunity and the right time.”

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Below, Simon shares more of what he plans to tackle in his new position, his priorities, and ways to help young people with their mental health.

The conversation has been edited for clarity and length. 

Boston.com: What do you see as the most pressing issues Boston is facing related to behavioral/mental health? And are there any immediate steps you want to see the city take to address those issues? 

Dr. Kevin Simon: I think the three predominant challenges that I hear over and over again from families, from providers, from administrators — one is an access issue. Whether you’re the parent of a 10-year-old in Roxbury or Dorchester or Roslindale, trying to find someone — I’m not even going to say child psychiatrist — just somebody who can engage your youth or you and your youth in behavioral health is extremely difficult. … Everywhere you go, up and down the mental health career or workforce, there’s not enough people. That was already happening pre-pandemic … [and] has just only been exacerbated by the pandemic. … So the access is definitely a challenge. And because the access is a challenge … the demand is now at a capacity where it’s like, ‘Oh, we’re really recognizing there are not enough providers.’ So there is going to be a challenge of how is it that we improve the clinical/educational pipeline to get more people — and then to get more people who are from diverse backgrounds. Because right now — I often tell families when I’m talking to them or groups that I’m teaching — it is impossible right now to have a one-to-one racial concordance. 

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If everybody said, ‘I want to have a provider who looks like me, from my culture, from my background,’ whether that’s Haitian, Caribbean, Irish, it’s just not possible. So we need more people that are from everywhere thinking about this is the career that I want to get into. … Simultaneously, we have to help people that are not racially, culturally concordant to understand the nuances of Irish immigrants, of Haitian immigrants, of any diaspora. Because more than likely, you’re going to engage with people who don’t look like you. So that’s going to happen in the educational pipeline, but also informing the nuances to current practitioners why they need to have a translator line or figuring out what the translator line is going to be. 

And the third challenge is, I’d say for youth specifically, we don’t have, currently, what I’ll call a mental health triage system. … The first step fairly often is, ‘I’m going to present to the emergency room.’ There could be something in between either a call from home or a call from school and the emergency room. That, I think, is a really ripe opportunity to think about: Is there something like a youth behavioral health — almost like an urgent care system? So that way there are providers — again, you have to find these providers, train these providers — in a clinic or in a center that can do urgent evaluations … so that the person doesn’t have to go to an inpatient unit. Because a lot of times the people who come to the emergency room actually don’t meet criteria for inpatient psychiatric care. 

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Right now we don’t have that middle system before home or school and ER. So that’s actually something that as a city we could try to figure out, what could we do there? … If we could address one of those, let alone three of them, that would be a significant boost to individuals that are experiencing mental health challenges right now. 

Why is it so urgent that we address these things that you’re talking about, that we address and improve the supports for the mental health for young people? What’s at stake here?

Youth are not independent entities. They exist within a system, which is called the family. So when youth are not feeling good about themselves, the system is going to feel that, the family is going to feel that. And so I get parents who are like, ‘I just want my son to be who he was months ago, years ago.’ Helping out youth, by its nature, is going to have to mean helping out the family. Because when we think about youth support, we are thinking about mom and dad support, we are thinking about guardian support, we are thinking about schools. 

So I think starting at youth, you as a system, as an agency, as a commission, have to then say wait a minute, youth are not by themselves. They don’t get to the clinic by themselves. How are we going to support the family? So I think … if we don’t try to help with youth, we are not helping the family. And if we are not helping the family, then we’re not helping adults. And if we’re not helping adults, we’re not helping individuals that are working. … When I am working with youth, I undoubtedly have to talk to parents and give them assistance in terms of what could it be that they’re doing for themselves to also be supportive of the youth, to have the unit functioning well.

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So I think starting with youth is a really good avenue to have the maximum potential for helping the most people. Because undoubtedly if you’re working with the individual youth, there has to be somebody else that is engaged — guardian, parent, sibling — that’s going to happen. So starting with youth, you can actually help the most people, you can think the most broadly in terms of youth are not these independent entities. 

What can caregivers, families, mentors, teachers do to help their young people who may be struggling? 

This is an ideal time in terms of time of the year — school is ending — youth have opportunities to engage in prosocial activities, so summer camps, leagues, families going on vacations. … I say often one of the best things you can do for your son/daughter is get them engaged in prosocial activities. Because for the last two-and-a-half to three years, there’s been a limitation on prosocial engagement. So if you are a teacher and it’s summer term and you hear that somebody is struggling, well, one, you should be validating their emotions and saying, ‘I understand and I hear you, I want to be supportive.’ So validation is very important and that’s something that a parent can do, a teacher can do, a coach can do. We can all validate people’s feeling. And that itself is meaningful. 

The next layer for a parent is you can actually today, say to yourself, wait a minute, have we been having weekly — it can be five minutes — targeted time with your child where they can tell you anything under the sun and you as a parent are just being receptive to that information. Youth want that. They want to engage their parent. But we’re very busy people, and it can be very easy to defer to a device, defer to a game. And just scheduling dedicated time where you and your son/daughter, guardians included, it’s dedicated time to just hearing them, listening to them. Because we want to help them develop that open transparent communication. That’s something that you don’t necessarily need to see a doctor for. That you can do. 

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The next thing that can happen is that in your community, what’s the network that currently exists? Meaning, do I as a mom know my daughter’s friend’s mother? Know my daughter’s friend’s dad? Do I know them? Oftentimes, again because of the pandemic, we were rather isolated. That can happen. And again, prosocial: Let’s go to the park together. So that way, when you create a community, when and if you’re experiencing something and your child is experiencing something, you can tap into that community. Because you don’t want to feel like you’re isolated. And I think that’s another thing that a lot of families have been feeling: ‘Am I the only person going through this thing?’ No, you’re not.

What, if any, involvement will you have in the city’s efforts to address the issues around Mass. and Cass? What would guide your approach to the crisis there?

The city has before my arrival done a phenomenal job in terms of trying to figure out a way to get persons into low barrier housing, low barrier treatment. And those services are going to continue. … My role is to be as supportive as possible in those efforts. Because yes, I have expertise in addiction services. But saying that, it’s just one component. It’s addiction services, again, housing, social work, case management. And there are programs that already have been going and are robust. How do we improve them? What are things that we could be thinking about? So where Dr. (Bisola) Ojikutu (executive director of the Boston Public Health Commission) needs me in terms of the Mass. and Cass response and the office of recovery services, I want to be as helpful as possible. 

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But the first priorities for me are thinking about what we’ve been really primarily talking about — is youth mental health and what does that mean in the city. And that undoubtedly will include things in relation to Mass. and Cass because it’s not only persons who are over 55 at Mass. and Cass.

Is there anything else you want to say or speak about that we haven’t covered that you would want people to know?

I’m trying very hard to learn quickly what exists, what doesn’t exist, so that way we can help the most Bostonians as possible. And we’re not just stopping at youth; we’re going to think about youth, we’re going to think about elder care, we’re going to think about adults. We’re thinking about the wide swath of individuals that exist. But I think the impact of beginning with youth, because youth are undoubtedly part of families, helps us have the largest initial impact. But the impact is going to take time and over years, [to] continue to move the needle towards progress.

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