From Scratch

The new leader of SCU’s adolescent mental health concentration wants to design better mental healthcare delivery systems to help more kids, now.

From Scratch
Image courtesy Adobe Stock

Like so many others, Greg Hajcak had a bit of a professional crisis during the pandemic. Or at least a reassessment of priorities.

For the professor of psychology at Florida State University, the moment came when he updated his CV to reflect his latest published article—number 352, give or take.

Hajcak had spent two decades trying to understand the brain, studying the neuroscience of anxiety and depression in adolescents. Among other breakthroughs, his research helped identify vulnerability factors that can even predict who is going to become anxious or depressed.

Scholarly research is important, but in a country where so many young people couldn’t get the mental health treatment they needed, Hajcak couldn’t help but wonder if his efforts were missing the mark. The problems have shifted, shouldn’t his focus shift, too?

“Anxiety and depression rates are twice as high now as they were a few years ago. We haven’t focused enough on actually making a difference with people,” Hajcak says. “Was I going to spend another 20 years producing knowledge that might not reach people? That was hard to imagine.

“So I really started exploring some other career options.”

It wasn’t long before Hajcak found a path forward. In December, he was named the first Sheri Sobrato Endowed Chair in Child and Adolescent Mental Health at Santa Clara University. Funded through a gift by Sheri Sobrato Brisson M.A. ’94, the chair will establish an adolescent mental health emphasis at Santa Clara and will fund both research and community outreach project to support mental health among children and teens. Hajcak will finish out the academic year at Florida State before starting at Santa Clara in the fall.

For Hajcak, the new child and adolescent counseling program isn’t simply about increasing the number of therapists prepared for work with young people. In fact, closing the deficit through increasing the number of therapists alone might be impossible, he says.

Instead, he wants to dig into the lessons of the pandemic—mainly how technology can enable effective mental health treatment—to embrace new models of treatment that can maximize existing resources.

“It’s clear that the pandemic was more or less bad for most people,” Hajcak says, “but I think we can figure out how to use technology to help people reconnect also.”

Taking a step back

So much of the standard model of mental health treatment was designed without child or adolescent patients in mind, Hajcak says. Hour-long sessions are often too long for the attention span of young people. Getting non-driving patients to and from in-person sessions once a week is a burden some families can’t manage.

“I want to step back and think about how we would design mental health delivery for children and adolescents in 2023, if we were starting from scratch,” Hajcak says

So how would he design it? Much of that will be driven by continued research, but Hajcak has some ideas for how we might work differently with adolescents.. For starters, he envisions a stepped or tiered approach to care. For example, a young person going through a rough patch could review online resources at their own pace. Or if they preferred a guided approach, they could schedule a longer, one-time virtual group therapy session or a 1-on-1 session with a therapist or even start with a peer counselor.

Patients requiring more consistent care could have weekly virtual sessions or even shorter check-ins multiple times per week by video or a messaging app. Hajcak could imagine sending five minute videos for clients to review during the week so their virtual sessions could be more focused.

It might sound like a small adjustment, but in practice, it could mean all the difference. For example, studies consistently show engaging in social media is a big driver of depression among young people. What if, rather than tweeting out frustration day-to-day to trolls, a young person can text a mental health professional or access the right digital resources when they’re needed? It could be life saving.

These research-driven methods wouldn’t just offer more tailored treatment for patients, but also allow for more patients to be treated. Just like COVID vaccines helped to free up hospital beds for more seriously ill patients, tech-driven interventions would lower the burden on the mental healthcare industry.

“In academia, we often talk about this gap between research and practice that can be 15 to 20 years,” Hajcak says. “My goal is to try to bridge that to make it as small as possible.”

While it’s still early, Hajcak, who founded the Anxiety Disorders Clinic at Stony Brook University in New York, says he could also envision Santa Clara establishing an adolescent or child and adolescent psychological clinic–either on campus or in the community. Not only would that offer free or sliding scale mental health treatment for local young people, but it would offer immersive training for students.

“The idea would be to serve as a model for how to teach students to do more effective interventions,” Hajcak says. “That way they can know exactly what to do when they get out into the world and be the most effective therapist possible.”

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