Research on social trends shows emotional and mental health is at the core of Gen Z's identity.

The Pew Research Center considers anyone born after 1996 as part of "Generation Z."

Lindsay Carr is a Gen Z-er herself, and a Youth Peer Recovery support specialist intern with the National Alliance on Mental Illness (NAMI) Northern Nevada, which advocates for mental health support and education.

Carr said she finds many don't think seriously about their mental health until they're really struggling.

But she says she finds younger people are having more conversations about it, especially through social media, which helps remove some of the stigma.

"The pandemic made it so that it was really OK to talk about not being OK," said Carr, "because we were all collectively not doing OK, and we all realized how important it was for us to talk to each other about it. But even if you don't have a diagnosed mental health condition, everyone has mental health - and that means everyone, in every generation."

Carr said the demand for mental health services has increased, which spotlights some barriers to access for care, especially for younger people.

She says it can be difficult to find a therapist accepting new clients, and sessions can cost from $100 to over $250 an hour. NAMI Northern Nevada tries to serve as a bridge to get people connected to the appropriate care.

National Medical Director for Behavioral Health with United Healthcare, Dr. Donald Tavakoli, said as Gen Z-ers enter the workforce and become eligible for their own healthcare plans, it's important that they understand the mental health coverage benefits they have.

He said he's found many young people value virtual visits.

"So increasingly, health plans offer telehealth that can be in-network opportunities to support your mental health," said Tavakoli. "And it's important to find a health plan that offers those."

He said many Gen Z folks, even up to age 26, can maintain coverage on certain plans through their parents' health insurance - giving them some time to transition.

He encouraged people of any age to stay engaged and connected with their insurance providers to find the care they need.

Data from last year show a growing percentage of Kentucky children and teens report struggling with depression or anxiety, largely driven by social media use. A new online toolkit from Mental Health America aims to provide information, tips and resources for young people, caregivers and school personnel on how to protect kids' mental health in a digital world.

Marcie Timmerman, Mental Health America Kentucky's executive director, said having resources to spot early warning signs can help families get off to a good start this school year, when many households are adjusting to new patterns and habits.

"I think one of the biggest early warning signs, especially related to social media use, is that they suddenly stop wanting to use it, or they are on it all the time," she explained. "There's an extreme change in their behavior and maybe their attitude as well toward the media platform."

The U.S. Preventive Services Task Force now recommends screening for anxiety in children and adolescents ages 8 to 18 years, even if they are not showing recognized signs or symptoms of anxiety. Over the past decade, feelings of persistent sadness and hopelessness, along with suicidal thoughts and behaviors, increased by about 40% among young people, according to the CDC.

Hannah Hallen, a Kentucky college student and mental-health advocate, believes traditional approaches to mental health have not kept up with the needs of her generation.

"I feel like they are trying their best with potentially old resources or things that used to work," she said. "But with the changes in this generation that are so niche to this era, there are a lot of differences."

In addition to social media, more young people report feeling distressed about mass shootings, climate change, and the growing political divide.

Advocates for mental health in Maine say the stigma of suicide often prevents those most at risk from getting the help they need. The CDC reports despite a decline in suicide deaths for those younger than 25 last year, total suicide deaths increased to nearly 50,000.

Joyce Morrissette, clinical suicide-prevention specialist with NAMI Maine, said suicide is a preventable tragedy and that talking to someone in distress about suicide does not trigger them to act but, instead, starts a conversation.

"In order to have a public health approach to suicide, we need to be able to acknowledge it and talk openly about suicide," she said.

Morrissette added NAMI Maine offers professional training, which describes how to have those discussions. Prevention works, she said, if people are willing to learn.

All public school personnel in Maine are required to undergo suicide-prevention awareness training, and health-care professionals also learn the best way to approach their patients. Research shows nearly half the people who die by suicide interact with the health-care system in the month before their death. That provides a critical window in which to utilize the advice from professionals that can save lives, Morrissette said.

"It's important for people to receive training and increase their awareness so that they're able to respond in systems such as schools and health care as well as in communities," she explained.

Morrissette added it is also important to remember that help is always available at the 988 Suicide and Crisis Lifeline or online at 988lifeline.org.

In rural states such as North Dakota, accessing mental-health care can be extremely difficult. Federal officials say it's even worse when someone's benefits for such care are improperly denied.

They're ramping up enforcement under a law aimed to address the issue.

The Mental Health Parity and Addiction Equity Act, in place since 2008, requires most health plans - offering coverage for behavioral health or substance use disorders - to not make those benefits more restrictive than those for standard medical care.

Lisa Gomez, assistant secretary for the Employee Benefits Security Administration, said their investigations have found that providers are still falling short in providing equal access.

"For example," said Gomez, "there were plans that were excluding coverage for nutritional counseling, if you were seeking that coverage for an eating disorder."

However, the plan in question was not restricting coverage for those seeking that type of counseling for help with a physical health issue such as diabetes.

In fiscal year 2022, Gomez's agency investigated nearly 150 plans and found almost two dozen violations.

An EBSA report suggests correcting these situations is significant because in some cases, hundreds of plan participants were affected by a single provision not in compliance.

Report authors say forcing the provider to make good on the claim can be a life-changer for those struggling with a mental-health issue.

Gomez said for underserved populations, such as rural areas, getting rid of obstacles helps that individual make their situation more manageable.

She added that the last they need is to have to wait for something like a co-pay error to be sorted out.

"We've seen what mental-health conditions and substance-use disorders can do to a person, to a family," said Gomez. "And so, it's really important that we try to use the tools that we have available to us and work together to try to address these issues."

Gomez acknowledged that while there is progress, it isn't moving fast enough to remove these specific coverage hurdles.

Various federal agencies are trying to finalize proposed rules that would strengthen provisions under the law.

Outside of benefits roadblocks, Kaiser Family Foundation data show that in North Dakota, only 19% of mental-health care patients' needs are being met due to provider shortages.




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