The percentage of students who self-report depression in Waukesha County has been on the rise since the COVID-19 pandemic. Youth may have a higher rate of reporting depression due to the toxic social media culture, stigma, lack of access, financial limitations, and overwhelming high standards or expectations. Conversely, youth are less likely to report being depressed when they have access to care, have a stigma reduction, have education on healthy coping skills, families are engaged, have school connections, and have social acceptance. While the long-term goal is to have the percentage of students who self-report depression go down, we are aware that the number may go up initially. If the contributing factors are ineffective, students may be more knowledgeable and feel more comfortable admitting their depression and also be more willing to access care. 

Navigating Youth Risk Behavior Survey (YRBS) reporting for county-level data proves intricate. However, in 2021, Waukesha County not only met but exceeded the established threshold, ensuring a robust dataset. This criterion hinges on either more than 50% of public schools successfully surveying at least half of their students or surveying over 50% of all public high school students in the county. Our active encouragement and advocacy for schools to collect such data aim to enrich community decision-making processes.

Contributing Factors:

• Access to care (early, quality and affordable access)
• Reducing stigma
• Healthy coping skills and education
• Engaging families and parents
• Education on what mental health is
• School connectedness
• Limiting social media
• Social connectedness
• Culturally sensitive care
• Practicing using healthy coping skills
• Social acceptance

Restricting Factors: 

• Current toxic social media culture
• Lack of access
• Ratio of providers to clients
• Systematic cultural/political ideologies
• Societal pressures
• Culturally non-competent care
• Income/financial barriers (inflation)
• Basic needs (social determinents of health status)
• Chronic environmental stressors
• High ACE score
• Overwhelming high standards/expectations
• Family untreated mental health

Root Cause: Limited Financial Incentives in the Mental Health Sector

When considering partnerships, the action team kept things as broad as possible. Not all potential partners end up being a vetted resource and partner for the CHIP process, but it still is worthwhile to consider a wide-range of options. Below is a list of potential partners that may have a link to youth, mental health, or youth mental health. 

Potential Partners List:

1. Advocate Aurora Health 
2. Ascension Wisconsin 
3. Froedtert & the Medical College of Wisconsin 
4. ProHealth Care 
5. Waukesha Fee Clinic 
6. Rogers Memorial Hospital 
7. Health care providers 
8. La Casa de Esperanza 
9. Lake Area Free Clinic 
10. Simply Helping People 
11. Hope Instilled 
12. NAMI Waukesha 
13. Hispanic Community Center 
14. Oconomowoc Food Pantry 
15. Hartland Area Food Pantry 
16. Ixonia Food Pantry 
17. Food Pantry of Waukesha County 
18. Friends with Food 
19. Hebron House of Hospitality 
20. Salvation Army 
21. LSS Clubhouse 
22. The Women’s Center 
23. Community Action Coalition 
24. YMCA of Greater Waukesha County 
25. YMCA Children’s Academy 
26. West Suburban YMCA School Groups 
27. County Programs 
28. ADRC 
29. Public Health 
30. CAFSAC 
31. Public safety 
32. Municipalities 
33. City of Waukesha Chamber of Commerce 
34. Pewaukee Chamber of Commerce 
35. Greater Brookfield Chamber of Commerce 
36. Delafield Chamber of Commerce 
37. Waukesha County Business Alliance 
38. Oconomowoc Area Chamber of Commerce 
39. Local Colleges’ Behavioral Health Department 
40. Oak Hill Terrace Senior Living 
41. New Perspective Senior Living
42. Avalon Square 
43. Brookfield Senior Community 
44. Summit Woods
45. Waukesha County Senior Services
46. CLE Clarion Manor 
47. The P.a.D.D.S. at Moreland Grove 
48. Mission Creek 
49. Hickory Grove Senior Center 
50. Community Retirement Living 
51. Eras Senior Network 
52.  First Congregational Church 
53. Trinity Lutheran Church 
54. First Baptist Church 
55. Waukesha City Church 
56. Evangelical & Reformed United Church of Christ 
57. St. Marks Evangelical Lutheran Church 
58. St. Luke’s Lutheran Church 
59. First United Methodist Church 
60. St. Matthias Episcopal Church 
61. Crosswalk Church 
62. Trinity Presbyterian Church 
63. Grace Evangelical Lutheran Church 
64. St. Joseph’s Catholic Church 
65. Waukesha Church of Christ  
66. James Place 
67. Hebron House 
68. Family Promise of Western Waukesha County 
69. Hope Center 
70. Juno House 
71. Siena House Shelter 
72. Salvation Army 
73. The Women’s Center 
74. Law Enforcement & Criminal Justice 
75. Local Donors 

What works is a brainstorming process where the action team identifies strategies to impact mental health access and knowledge for adolescents between the ages of 12-18 in Waukesha County. Specifically, they considered the low money-making abilities of mental health services and how to lower the percentage of students who self-report depression.

While the action team cannot undertake every identified strategy, community partners may find this list helpful as a collaborative resource to address mental health for adolescents in Waukesha County.

Evidence-Based Strategies:

• Community Schools Model: Establish a Community Schools model personalized for Waukesha, addressing community needs, including mental health.
• Teach the Teacher - Mindfulness Workshop: Conduct workshops to teach teachers mindfulness tactics, fostering a supportive and stress-free classroom environment. This initiative also includes educating teachers on recognizing anxiety and depression in students. Example from Marathon County here. 
• Movement Campaign: Develop and advocate for a movement campaign, acknowledging the link between inactivity and increased rates of depression and anxiety.

Innovative & Creative Strategies:

• Therapy Animals in Schools: Introduce therapy animals, such as dogs, into schools to provide emotional support and reduce stress for students.
• Art and Music Therapy Programs: Incorporate art and music therapy programs into the curriculum to reduce symptoms of depression and promote emotional well-being.
• Nature-Based Interventions: Explore nature-based interventions or ecotherapy, allowing students to engage in activities in natural settings to enhance mental well-being.
• Advocacy for Funding and Physical Activity: Advocate at the state level for funding for mental health providers and create dedicated time in the school day for physical movement.

Low-Cost and No-Cost Strategies:

• Mental Health Career Exposure: Organize presentations or speaker series to expose youth to mental health care careers.
• Student-led Mental Health Clubs: Establish student-led clubs focused on promoting mental health awareness and destigmatizing mental health issues.
• Community Workshops: Organize community workshops on stress reduction, mindfulness, and mental health awareness, leveraging volunteers or collaborating with local mental health organizations.
• Education on Social Media Risks: Provide education on the risks of social media, addressing the overwhelming influences and dangers associated with online interactions.

Data Development and Research Agenda:

• Social Media and Mental Health: Investigate the relationship between social media use and student mental health, recognizing the need for more research in this area.
• Downtime and Mental Health: Explore the correlation between the lack of downtime, constant use of digital devices, and the rise in mental health issues. Investigate the impact of having no true "off" time and its relationship with mental illness, particularly concerning cell phone use and messaging boundaries.

Mental Health End Result 1: All adolescents between the ages of 12-18 in Waukesha County will have improved access to mental health services and increased knowledge of mental health resources

Selecting an effective strategy involves a meticulous evaluation based on four key criteria:

• Leverage, which assesses the potential impact on progress
• Feasibility, ensuring practicality and achievability
• Specificity, detailing budget and timeline considerations
• Values, ensuring alignment with the values of both the community and the organization

This comprehensive approach ensures that the chosen strategies have a meaningful impact, are feasible to implement, align with established values, and are supported by a clear budget and timeline.

Mental Health Team Selected Strategies:

Source: Youth Risk Behavior Survey (YRBS) Conducting a YRBS | Wisconsin Department of Public Instruction

Methodology: Survey is conducted every 2 years. This particular data is for school year 2020-2021. In the 2020-21 school year, there were 27 public schools in Waukesha county that served high

school students, including public charter, virtual, or other types of schools. 16 of these 27 schools

(59%) participated in the survey.

11 of the 27 public high schools in the county (41%) met or exceeded the minimum 50% school level

response rate, which was one criteria for generating county-level data. Across the county, the

average school-level response rate was 73%.

Participating schools included:

Menomonee Falls High, Oconomowoc High, Mukwonago High, Muskego High, Arrowhead High,

Pewaukee High, North High, South High, Waukesha Engineering Preparatory Academy, Waukesha

Academy of Health Professions, Waukesha East Alternative School, West High, High School

of Health Sciences, Kettle Moraine High, School for Arts and Performance, Kettle Moraine Global

School for Global Leadership and Innovation, NULL

A total of 10827 usable responses were collected from the 16 participating schools listed above.

This represented 53% of public high school students in the county.

The YRBS normally takes place during January to June of odd-numbered years (e.g., 2021, 2023, 2025). Administration for the 2023 YRBS has concluded however Waukesha County hasn't met the requirement to have the data aggregated for 2023.