A Flawless Conversation with John MacPhee, Executive Director and CEO of The Jed Foundation
Flawless Founder Janine Francolini sat down with John MacPhee, Executive Director and CEO of The Jed Foundation, to discuss mental health, the transition from high school to college, and how we can best prepare for what lies ahead!
Janine: Do you think the mental health crisis in college starts earlier because students are so stressed and burnt out by the time they get there?
John: Many young people today are experiencing mental health challenges before they get to college which is why we encourage high school students, parents and administrators, to focus on emotional preparation for college as part of their traditional college preparation activities.
Janine: What are the challenges that young people are facing?
John: So we know emerging mental illness is one of the challenges that young people face. 1 out of 5 people have a mental health condition, and that statistic includes young people as well. In fact, symptoms of mental illness often emerge before the age of 24, yet in many cases, it is not accurately recognized for years. So one of the keys is noticing when a person is struggling with their mental health and getting them help and care as soon as possible.
In addition, young people are facing many kinds of pressure: financial, academic, family, relationships, etc. Where are they going to go to school? Are their grades good enough? What are they going to do with their lives? They are navigating the social and digital media landscapes as they’re trying to make sense of this tumultuous world coming at them. There’s really a lot that adolescents are dealing with today.
Janine: The teen years are a time of asserting independence, but this can be an awkward process. If a teen is having challenges, how do you overcome their resistance and help them?
John: Helping someone who is struggling— particularly a young person who is struggling—starts with the idea that if you have a feeling something is wrong, you’re probably right. So, the first thing to do is to check in with them and ask, “Are you okay? You don’t seem yourself.” Be specific and say something like, “You seem to be withdrawing from your friends.” Whatever you’re observing, identify it and ask them about it, always emphasizing, “I’m here for you” and asking, “Are you okay? How are you, really?”
Janine: But then you get the answer, “I’m fine, I’m fine. You’re always criticizing me.”
John: Yes, the conversation is still progressing, because it reminds them that you’re there for them, that you notice them, that you love them and that you care, right? Keep checking in. If you’re really worried that they’re a threat to themselves or that something is deeply wrong, then you get outside help. You bring them to a physician or to a mental health clinician. The idea here is to lean into your concern, check-in, and get outside help if you feel you need to. Accordingly, if you’re a trusted adult in this young person’s life, rely on your instinct to detect that something is wrong. For peers, that can be a very difficult situation for them to navigate. They may not know how to help and they don’t want anybody to get in trouble.
And so, it is also important to remind teens and young adults that being a good friend means reaching out when you have concerns about a friend. Sometimes it means going to an adult or school counselor for help. And if you’re the parent of a teen or young adult, this can include letting them know that they can come to you for advice on how to best help a friend in a difficult situation. We’re trying to create a culture of caring with young people: helping them through these situations that are both common and difficult.
Janine: Second-semester senior year, kids are about to go off to college. What are your main pieces of advice to help kids and parents navigate this transition?
John: The first is to think deeply and comprehensively about what’s the goal for that young person. Is it to go to college? What college? What’s the right fit? Should they take a gap year or not? Really find that right fit. Then, help prepare them for the transition to independent adult living. Ask yourself: does this young emerging adult know how to live independently? Have they ever been outside of the home on their own? Do they know how to manage their own money? Can they do their own laundry? Etc. And if the answer to these questions is “maybe” or “no”, it’s time for them to start practicing. It’s time for the family to perhaps give them an opportunity to develop these skills on their own.
And then, a very specific conversation about privacy should take place between the student and their parents or guardians. For example, let them know: You’re eighteen years old, your privacy will be protected if you will be away at school. So your parents will no longer be automatically informed if you’re struggling academically, or you are experiencing physical or mental health challenges.
But if you are eighteen or over, you can sign a release form with the school, giving certain people legal access to protected information. Deciding to share this information is an important decision that requires a thoughtful, collaborative discussion. The Jed Foundation has a lot of resources on SetToGo.org that can explain this. It is important for families to understand the HIPAA laws and the specific policies of the school their student will be attending.
My second piece of advice is, if there is a history of mental health challenges–anxiety, depression, eating disorders, substance use issues–that occurred in high school, a thoughtful plan should be developed around how care is going to be provided in a college setting. What we see a lot is that, in the transition from middle school to high school, there may be struggles and issues particularly around anxiety. By the time that student is a senior in high school, they’re flourishing. They’ve figured out high school. And so the family of the student may not think so much about how this anxiety might flare up again in the transition to college. But it might. Again, there needs to be a plan in place beforehand, so the student knows how to access help in case things get difficult. This plan should include getting to know counselors and identifying other safety and support services on campus. Creating a coping strategy to deal with a potential mental health issue can help students and parents feel more secure about the transition to college. There are a lot of resources to help families with this at SetToGo.org.
Janine: So John, say you’ve had some challenges and accommodations, and now you’ve been accepted to a handful of colleges. What do you do? How do you decide where to go? How do you evaluate your options? How do you find support during this decision-making process?
John: Well, first, congratulations on your college acceptance.
At JED, we have something called the Right Fit worksheet, which is available on SetToGo.org. The idea is to think about what the right school looks like for you beyond academics. Is it large, small, urban, suburban? What extracurricular activities are available?
Once that you’ve made that choice and you’re admitted, we recommend that you learn as much as you can about the services that are available at the school.The counseling center, the disability office, for example, they’re there to help you. They’re there to help students with mental health conditions, or learning differences.
Talk to these offices, understand the support systems that are available. What I would really emphasize to students is: understand your resources. If you are experiencing a mental health condition, at least 1 in 5 of your peers are in exactly the same position; this is common, this is normal. These systems are there to help you. Educate yourself about them, so that you can avail yourself of all of the resources that are there, and know what they are before you get to campus.
What I would say to students who are heading off to college without a history of mental health challenges: the college years are an age of discovery and learning, yet there can also be challenges. So you might find yourself in a position where you’re struggling, and again, that’s okay. It’s perfectly normal. The key is to reach out for help. What we’re trying to do is let everyone know that this is a part of the human condition. And, there are resources on campus that are there to help you. The takeaway message is to learn about those resources before things get tough because that just makes it a little bit easier to take advantage of them when you are struggling.
Janine: What is your advice to parents and to teens about when they turn 18 and become responsible for their medical care?
John: Well, first to know the law. Understand what it means that the young adult has turned eighteen and is now entitled to their privacy. If there’s an academic issue, a health issue, a mental health issue that’s quite serious, it’s not like high school, where the school automatically calls the family to give them updates. That’s not going to happen unless the situation is one of an imminent threat.
Schools have policies and release forms, where a student can give permission to the school to share information with a loved one, a family member, a person of their choice. We advocate that families really understand these rules at each school. We partnered with NAMI to create a guide to explain all this, called Starting the Conversation. We encourage young adults and their families to gain access to medical release forms and understand them. We also encourage families of high school students to sit together with their high school seniors before they transition to college and to talk through this decision of whether to sign a release form. Have that conversation as a family, so everybody is on the same page.
Janine: So, basically, mid-senior-year, sit down and think about this?
John: Yes, I would say this is something to do after you’ve been accepted to college. Because there’s enough stress in the whole process of applying. So after the student has been accepted into college, it’s now time to pivot to, “Okay, let’s plan for the transition.”
Janine: John, what are your thoughts about gap years or postgraduate (“PG”) years? Taking time off after high school?
John: I would say the key to a gap year or a PG year is for the student to really think through where they are on their particular journey and to talk it through with their family. I think that gap years can be helpful in developing a young person’s independent living skills. It’s the right decision for many people, but it’s not the right decision for everybody. And so I have to give a sort of broad and vague answer. it needs to be thoughtfully considered and decided on an individual basis.
Janine: Do you think that eighteen-year-olds’ life skills aren’t as well-developed today as they were when we were kids?
John: I do. I think that independent living skills are not as well-developed as they used to be.
Janine: Why not?
John: One argument is that when you and I grew up, we didn’t have cell phones or digital maps to help us figure out how to get home, or what to do if we were lost. We couldn’t call somebody on our cell phones to help us; we had to figure it out. And so we developed some problem-solving skills that benefitted us at an earlier age. Today, some of these skills tend to be developed later. And yet, today, teens young adults (and even younger children) are getting more information thrown at them, and are asked to process things at a much faster rate than we ever were. So, in other ways, they’re growing up faster than we did. It’s just different. Having done this work for eight years, my opinion is that many eighteen-year-olds have less developed independent living skills today than they did a generation ago.
Janine: It seems that they’re not given jobs as much. I was babysitting when I was ten years old, and other kids were working with their newspaper routes. It seems like, with all of the pressure to get into college, you’re so busy that you don’t have time to get a job, and jobs teach you so much about responsibility. So, that’s my working theory.
John: Yes. I think young people are remarkable in so many ways. They’re more accepting, they’re more tolerant, they’re leading the way in that regard. They understand the world better than we ever did. They are committed to fighting stigma and prejudice. They’re willing to talk about mental health and they want to help their friends. I mean, there are so many ways that they are leading and are capable of leading. Many young people do work and do help their families in numerous ways that do result in the development of independent living skills during their teen years. But for many, adolescence has become more protracted. What it means to be eighteen today is often not what it meant a generation ago, in terms of life experience, and that’s just something we have to be aware of. And I think helping teens develop life skills and social-emotional skills is a really important thing that we, as a society, can do to help them get ready for adult life.
