How moms and dads can provide mental health care

Nationally, there are 5 psychiatrists for every 10,000 children who need one. About 80% of children in the U.S. who need mental health care do not receive it.

In 2019, two Stanford Medicine mental health experts started brainstorming concrete ways to address this crisis in kids’ access to care, which they had seen expanding for years.

“Our waitlists were just growing and growing,” said child psychologist Elizabeth Reichert, PhD, clinical associate professor of psychiatry and behavioral sciences.

Children with mental health problems waited six months to a year for treatment; by the time of their first appointment, some kids’ problems had eased, while others’ had severely worsened.

“Talking to colleagues across the country, it was the same,” she said.

Reichert and child psychiatrist Mari Kurahashi, MD, clinical associate professor of psychiatry and behavioral sciences, developed a way to help kids get faster care for common pediatric mental health problems that is now serving as a model for other institutions across the country: the Stanford Parenting Center.

They co-direct the center, which provides evidence-based parenting techniques via free webinars, low-cost online classes and practical resources shared on social media.

The center’s materials give parents of struggling kids easy access to information a psychologist or psychiatrist would typically share in early appointments, such as what to try at home to help ease a child’s anxiety, depression, attention-deficit/hyperactivity disorder or addictive behaviors. Essentially, the center helps parents learn how to deliver research-backed mental health care themselves.

“Our mission really is to target the pediatric mental health crisis on multiple levels: prevention, decreasing risk factors, intervening before things are full-blown, and then also offering treatments for full-blown psychiatric disorders,” Kurahashi said.

Adapting to the unexpected

Kurahashi and Reichert became friends soon after they were both hired at Stanford Medicine in 2014, bonding over the challenges of working with patients and discussing how their mental health expertise influenced their own experiences of parenting young children. (They each have two kids.)

“When I’m dealing with my own kids, my knowledge of research-supported methods helps me pivot, such as by being aware of my protective instinct and still fostering my kids’ ability to tolerate anxiety, rather than unintentionally maybe contributing to it,” Kurahashi said.

Expert techniques — a parent helping their anxious child cope and build confidence in a new situation rather than allowing them to avoid the situation altogether, for instance — “can make a huge difference for families,” Kurahashi said.

Conversations about the interplay between their work and their parenting were part of what drove Kurahashi and Reichert to find new ways to put validated parenting information into the hands of other moms and dads.

The parenting center launched online on March 1, 2020. Just over a week later, the COVID-19 pandemic was declared by the World Health Organization.

Families were suddenly dealing with severe disruptions: curtailed extracurricular activities and social lives, unprecedented financial and professional stressors, and virtual school for kids. Under those constraints, the web-based format for accessing the center’s materials turned out to be an excellent fit. “It was an incredible opportunity for us to say, ‘Wow, there’s this new need, and we’re positioned to help support it,’” Reichert said.

The team developed webinars on such topics as positive parenting during COVID-19, navigating kids’ screen time in a pandemic, and talking to children about illness and death. Later, they created content about how to support kids in transitions such as returning from online learning to in-person school. The center continues to develop new material in response to changing needs.

Today, the Stanford Parenting Center provides free access to a library of online videos and webinars.

Several Stanford Medicine experts have contributed to the videos and help teach the center’s small-group online classes, which are held weekly for four to eight weeks. This gives people anywhere — parents from across the country and as far away as Europe, Asia, Africa and South America have enrolled — the opportunity to learn how to help their children with mental health challenges and foster well-being.

Topics include childhood stress and anxiety, navigating adolescent screen dependence, using positive reinforcement to help change kids’ behavior, and helping young children manage difficult emotions. Scholarships are available to help defray the cost of classes for families in need and ensure access, a primary mission of the center.

“We really try to create a culture of support, not only between the instructor and the parents but also between the parents themselves,” Reichert said, adding that some participants have formed their own online chat groups after classes ended.

“The thing I hear the most [from class participants] is, ‘Gosh, I just felt so alone in this, and it’s so helpful to hear that others are going through it,’” Kurahashi said. “Parents’ self-judgment goes down when they know they’re not the only one, and sharing their hardships helps them connect with each other.”

Parents can fill out questionnaires about their class experiences, and their answers will form the basis of future scientific publications on the effectiveness of the center’s programming.  

Though moms and dads are the experts on their own children, tested parenting techniques can help, Reichert said.

“What we know can help them guide their child’s trajectory in a healthy way,” she said. “I feel very grateful to be able to think on a larger scale about how to make that expert knowledge more accessible and expand the treatment paradigm beyond the one clinician-one child model.”