The kids are not alright

Bekah Cooper was in sixth grade when COVID hit.

“I was so isolated and felt really alone,” says Bekah, who is nonbinary. “So even though I didn’t know I was struggling with mental health yet, I think that’s kind of where it all started.”

Two years later, Bekah began to feel depressed. They were back at Oregon Middle School after spending seventh grade attending classes virtually, and felt adrift socially. On top of that, Bekah’s father had two heart attacks and Bekah broke their ankle.

“A lot of things went wrong that year,” says Bekah, who notes that was the first time they considered suicide.

Bekah’s depression and anxiety continued while a freshman at Oregon High School, and they began to self-harm. Bekah’s mom, Melinda, took Bekah to their primary care physician who prescribed medication for anxiety.

When Bekah reported little change in their symptoms a couple of months later, the doctor increased the dose of anxiety meds and referred Bekah to a psychiatrist. It was April 2023; the earliest appointment Bekah could get was in October — a six-month wait.

Bekah would attempt suicide for the first time that September.

Increased demand for services

In July, the Wisconsin Department of Public Instruction released the results of the 2023 Youth Risk Behavior Survey, which found that “Wisconsin youth are in a mental health and emotional well-being crisis,” with 59% of high school students experiencing at least one mental health challenge in the past year. More than half of students reported experiencing anxiety, a significant increase from 2017, when 40% had such symptoms. A little more than two-thirds reported depression almost daily for two weeks in a row or more and 21% said they engaged in self-harm. The numbers were higher for LGBTQ+ and female students.

The 2024 Dane County Youth Assessment released in September showed some improvement; students surveyed through their schools between January and April 2024 reported depression, anxiety, and suicidal ideation at the lowest rates since 2015. Yet, mental health challenges continue to disproportionately impact LGBTQ+ youth and those from low-income households. 

Gov. Tony Evers referenced the state’s urgent mental health crisis in his State of the State address Jan. 22, noting the impact in particular on young people. “The state of our kids’ mental health continues to be concerning for me, both as a governor and as a grandfather,” he said. “A kid in crisis may be distracted or disengaged and may not be able to focus on their studies, if they are able to get to school at all.” He vowed to include nearly $300 million in his upcoming budget to provide “comprehensive mental health services” in schools statewide.

Local organizations providing mental health support and resources to at-risk teens are reporting increased demand. This includes RISE Wisconsin, a Madison-based nonprofit that provides a range of community-based services for youth and families, including mental health care coordination, crisis intervention, and emergency childcare.

“Since the pandemic, levels of anxiety, social isolation, depression and loneliness have increased,” says Scott Strong, executive director of RISE. “In my experience, we’ve always had a huge mental health need and we’ve been under-resourced to meet the needs, but it’s even more so now and it’s taken a toll on our kids.”

That toll appears greater for teens who identify as LGBTQ+. In the Dane County 2024 youth survey, 70% of high school students who identified as gender expansive, 66% of students who identified as transgender, and 59% of LGBQ+ youth reported feeling anxious “always or often” compared to 27% of youth who identify as straight/heterosexual. Nearly 37% of students of color reported experiencing anxiety always or often, compared to all other students at 34%.

While 9% of high school youth who identify as straight reported having seriously thought about killing themselves in the last 12 months, 30% of LGBQ+ youth and 41% who identify as transgender considered suicide during the same period.

More than 30% of LGBQ+ high school students, 53% of transgender students, and 48% who identified themselves as gender expansive reported that they had been harassed about their sexual orientation or gender identity.

The day after the 2024 presidential election, The Trevor Project, an advocacy organization that provides crisis services and peer support for LGBTQ+ youth, reported a 700% increase in calls to their crisis hotline. Isthmus reported in late November about the stress and anxiety being felt in Madison’s LGBTQ+ community after the election of President Donald Trump.

Jill Pfeiffer, the executive director of Briarpatch Youth Services, a 54-year-old agency that serves Dane County homeless and at-risk youth, emphasizes the challenges of an increasingly tumultuous world.

“Young people today hold awareness of every school shooting, war and climate disaster and that, in and of itself, is a lot for most of us,” Pfeiffer says. “When you add in factors like bullying or housing insecurity or being part of a group that is being criticized in the media or feeling threatened that can absolutely lead to heightened anxiety.”

Inpatient care

While waiting to see a psychiatrist Bekah continued to struggle. Part of that was about their gender identity and sexuality — today Bekah considers themselves a “nonbinary lesbian” — and concern that their father would not be accepting.

Five months into the six-month wait for their appointment, Bekah tried to overdose on anxiety medication. After taking the pills, Bekah texted their mom who was just finishing up a work shift. “I texted them back and I said ‘I’m gonna call you when I get in the car and we are going to stay on the phone until I get home.’”

Melinda brought Bekah to the emergency room and then Bekah spent the night at UW Children’s Hospital. From there Bekah went to the UnityPoint Health Meriter Child & Adolescent Psychiatry Center.

The Meriter Center is one of the three psychiatric inpatient adolescent facilities in Dane County, along with the newly opened Shorewood Behavioral Health in east Madison, and Miramont Behavioral Health in Middleton. Meriter’s 30-bed inpatient facility provides specialized care for children and teens facing mental health challenges.

Dr. Katie Schmitt, medical director at the Center, says inpatient care offers a more acute level of care and a safe environment for patients. “They need that facility where they can come and know that they’re in a safe and supported place to receive the therapies they need,” Schmitt says.

During an inpatient stay at Meriter, patients receive individualized treatment plans that include one-on-one counseling, group therapy, occupational therapy, medication management, and daily meetings with a psychiatrist. Lindsey Giese, director of philanthropy for the Meriter Foundation, says the facility also offers more holistic programming to try to help patients continue healing and coping after they depart. “Those are things like art therapy, music therapy and movement-based therapy,” Giese says. “It’s really about supporting the patient as a whole.”

Bekah describes their stay in September 2023 as largely “a blur.”

“I don’t remember a whole lot from my very first time there just because I was so out of it and I was so scared,” Bekah says. “I felt sort of better for a week or two after and then it just felt the same old thing again.”

Six weeks after being discharged, Bekah returned to the psychiatry center after confiding they were suicidal again. It may have happened sooner, Bekah says, if not for their involvement in a high school production of A Christmas Carol.

“The only reason I made it a month and a half was because of the show,” Bekah says.

Community and belonging

Helping students feel a sense of belonging is key to combating worrisome teen mental health trends, say public health experts and mental health professionals.

In the 2024 Dane County youth survey, nearly 65% of high school youth who identify as LGBQ+ reported feeling like they belong in school, compared to three-quarters of straight students. Almost 80% of LGBQ+ students, and more than 85% of gender expansive students reported “feeling lonely at least sometimes” compared to just over half of straight students.

“Generally, students who report having strong adult support, as well as high levels of school and extracurricular participation and belonging, are less likely to engage in risky behaviors…and more likely to report positive mental health and higher grades,” write the authors of a summary report on the DPI 2023 youth survey. 

Briarpatch tries to promote that sense of community with the Teens Like Us program. For the last 25 years, the program has offered a space for queer and questioning teens to gather with peers.

“It’s creating this judgment-free space where young people can come and be themselves,” Pfeiffer says.“It’s safe, it’s welcoming, it’s affirming and that’s what is most important.”

Journey Mental Health Center, a nonprofit behavioral health agency serving Dane County, annually screens approximately 5,000 6th and 9th graders in eight different school districts in the county, including Madison, to see if students are in need of mental health services. After screenings, Journey creates school groups that provide services to students who have been through traumatic experiences as well as counseling groups focused more generally on social-emotional wellness. Olivia Jones, a school based clinical specialist and coordinator with Journey, says they attempt to carve out space for LGBTQ+ youth in those groups.

“We try our best to have affinity spaces for LGBTQIA+ students,” Jones says. “I do foresee us in the future exploring some kind of more intense curriculum to support LGBTQIA+ students.”

Julia Stanley, school and community outreach manager for Journey, believes that fostering a sense of community is key to improving youth mental health.

“If I had a magic wand to help youth with their mental health, every youth would feel like part of their community,” Stanley says. “Big or small, in school or out, this can dramatically impact one’s resiliency.”

Another inpatient stay

After their second inpatient stay, Bekah did two months of outpatient treatment with the Meriter Center. When that concluded in January 2024, Bekah’s therapist recommended that Bekah not live at home, due to continued struggles with their dad. Bekah moved in with a teacher who was friends with Melinda.

That winter they were in the ensemble for the Children’s Theater of Madison’s production of The Lightning Thief, Bekah’s first time in a main stage show for the theater.

“It helped me a lot with getting through my depression and my anxiety because I had such a great group around me and everybody was so supportive,” Bekah says.

That spring Bekah played ultimate frisbee and met their girlfriend: “I felt genuinely happy for the first time in what felt like a really, really long time.”

In June, Bekah, their adult brother, and Melinda moved from Oregon to an apartment in Madison. Bekah continued to find their way that summer, working at the Lake Waubesa Bible Camp, and acting in CTM’s production of Mean Girls.

“Everything was kind of changing, I was going through a lot of good changes,” Bekah, now a junior at Madison West High School, says. 

But just before Thanksgiving break, Bekah was back at the Meriter Center for an inpatient stay after expressing suicidal thoughts. Bekah says the stay was helpful. In December, they enjoyed a church camp retreat and celebrated New Year’s Eve with their friends.

Accessing treatment

Bekah has been able to obtain mental health services in Dane County with private insurance that covers the vast majority of their hospital bills, but many students report struggling to access support. The Dane County youth survey found that 65% of high school students who report feeling anxious often or always are not receiving mental health services.

Most youth that are receiving services are doing so outside of school. According to the survey, of the 19% of students who report receiving mental health services, 94% are getting them outside of school and 20% are getting them in both places. When providing in-school mental health services, Journey will often refer students who need additional help to outside resources.

“The good thing about having it in the schools is we’re a good connecting point to refer kids to outside therapy,” Jones says. “Our programs are not the end-all be-all and we know that. Sometimes kids need more support and we can link them to our other mental health partners when needed.”

For students with private insurance, the starting point is often their primary care provider, which can help refer youth to mental health resources. In 2023, the American Psychological Association reported the average wait to see a practitioner was three months or longer, with the Wisconsin Office of Children’s Mental Health noting on its website that it can often be longer for youth. The issues of wait times prompted the Wisconsin Office of Children’s Mental Health to create a handout for what parents should do while they wait for mental health services.

The Wisconsin Department of Health Services also helps connect parents and youth with services through the Wisconsin Wayfinder program. The program offers a toll-free number, 877-947-2929, and an online form to reach a children’s resource guide who can assist in finding services.

The National Alliance on Mental Illness Wisconsin has named expanded mental health resources in schools one of its top legislative priorities in 2025. “Early identification and intervention help kids with mental health challenges thrive, reducing the need for intensive long-term services,” says Mary Kay Battaglia, executive director of the group.

A breakthrough

Bekah stayed up all night on Jan. 2, finishing a book of poems to give to their girlfriend. Around 6 a.m., Bekah began cutting their wrists.

“I was really scared because it wasn’t like the very first time when I felt like I had nothing to live for,” says Bekah. “It almost felt more like a desperate cry for help.”

Bekah’s older brother found Bekah self-harming in the kitchen, and stayed with them until Melinda returned from her overnight shift at the hospital. “I told him I was sorry and he said ‘you’re alive, that’s what matters,’” Bekah says.

Melinda drove Bekah to the Meriter Hospital emergency room where they underwent a full day of assessments and met with a social worker; the care team advised that Bekah return to the Meriter Center for inpatient treatment. It would be her fourth stay. 

Schmitt, who has been the medical director of the Meriter Child and Adolescent Psychiatry Program since 2010, says repeat visits from patients are atypical.

“It’s not common, but it does happen,” Schmitt says. “I think it speaks more to the nature of recurrent mental illness. Sometimes you can do everything that you’re supposed to do and mental health issues reoccur.” 

During their stay, Bekah was tasked with writing about their experiences in the third person. The assignment helped Bekah see things from a “different perspective.”

“I saw myself how the people around me see me. Not as a burden, or a mess-up, or a mistake, but a human being who messes up just like everyone else and is deserving of love,” Bekah says.

This time, Bekah says, their stay felt different. “All the other times, I’ve had a gut feeling that I would be back, but this was the first time that I didn’t have that.”

On Feb. 15, Bekah will be the keynote speaker for the Meriter Center’s Love is Love fundraiser at the Overture Center for the Arts. The gala raises money for enhanced resources for LGBTQ+ youth who receive services at the Meriter Center, including the provision of behavioral health specialists who specialize in LGBTQ+ affirming care. It’s also a celebration that includes live music, drag performances and dancing.

Schmitt says there are times when half of the youth at the inpatient treatment center will identify as LGBTQ+.

“If you’re not supported as an LGBTQ+ youth, the risk of suicide is greater, the risk of mental struggle is greater,” Schmitt says. “So we feel as a team that it is so important to wrap around all kids and create a safe place where they feel supported.” 

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Not your typical fundraiser

Olivia Tompach struggled with depression and anxiety as a teenager. It got progressively worse until she attempted suicide and was hospitalized, at age 15, at the Meriter Child & Adolescent Psychiatry Center in Madison.

“To leave your daughter at their most vulnerable state with a bunch of strangers when she doesn’t want to be on the earth anymore is really a challenge,” says Tina Noel, Tompach’s mother. “It is one of the hardest things I’ve ever done…but Meriter really saved Olivia’s life and she left that hospital with a toolbox that she still uses to this day.”

Noel, grateful for the care her daughter received at the center, joined the UnityPoint Health Meriter Foundation, where she co-founded, with John Sims, the annual “Love is Love” gala fundraiser. Co-sponsored by UW Health, this year’s event will be held Feb. 15 at the Overture Center for the Arts.

Funds will go toward advanced training for healthcare professionals, hiring therapists who specialize in LGBTQ+-affirming care, and purchasing gender-affirming resources such as chest binders and pronoun pins.

Lindsey Giese, director of philanthropy at the Meriter Foundation, says the Meriter Center has seen an increased number of LGBTQ+ patients in recent years, and wants to make sure they can adequately support the community. “The fact of the matter is they need extra support and we want to be the hospital that’s able to offer that support,” Giese says.

The first gala in 2019 drew 170 attendees and raised approximately $50,000. After a four-year hiatus due to COVID, the 2023 fundraiser drew 700 people and raised $350,000.

This year’s event features drag performances, music by disco band VO5, a set by DJ Cover Gurll, and a speech from Bekah Cooper. “I’ve been to a lot of fundraisers over the years, and this is not your typical hotel ballroom fundraiser,” Noel says.

Tickets for the event are still available on the Meriter Foundation website.

— Max Denning