“I’m not sure I can go on.”
Leila, a teenager, confided the words to her diary and then to her former teacher, Christina Guilbeau. The two checked in often via phone or text.
“Over the summer, some of her challenges were overwhelming her, to a point where she was struggling to cope,” says Guilbeau, who remembers feeling frightened and frustrated. Leila (not her real name) was a girl with so much promise — but her world, like that of many teens, swirled with conflict and pressure. “I felt the need to convince her to call the National Suicide Prevention Lifeline.”
Leila made the call, her feelings stabilized, and she worked through her personal crisis throughout the next few months. Guilbeau helped as best she could, providing encouragement and listening as Leila processed her experience.
But she knew Leila needed professional help that wasn’t available to her. Leila’s high school had a good reputation, but it had no integrated mental health support. Private therapy was inaccessible due to the cost, as well as the scarcity of therapists in the area.
As Guilbeau pondered Leila's unfortunately typical experience, she resolved to create Hopebound, a platform to connect teens from low-income families with mental health support. As she set out on a quest for solutions, she discovered a need among graduate students in mental health clinician programs to obtain required supervised practicum hours. Hopebound aims to facilitate matches between teens needing mental health support and graduate students pursuing their licenses.
Guilbeau, who graduated from Amherst College in 2013 and spent two years working for Teach For America in Baton Rouge, Louisiana, knows firsthand what the statistics show: There is a mental health crisis among teenagers. The suicide rate among children ages 10 to 17 increased by 70% between 2006 and 2016, according to the Centers for Disease Control and Prevention.
One in five teens lives with a mental health condition, with half of all lifetime cases beginning by age 14, according to the National Institute of Mental Health. There is a higher incidence of mental health conditions among low-income teens and teens of color. Historical adversity, which includes slavery, sharecropping, and race-based exclusion from health, educational, social, and economic resources, translates into socioeconomic disparities today. Socioeconomic status is linked to mental health: People who are impoverished, homeless, or incarcerated, or have substance abuse problems are at higher risk for poor mental health, according to Mental Health America. Rates of untreated mental illness also are higher in low-income communities where one-on-one mental health care is not affordable. In some communities of color, there is a cultural stigma against seeking mental health support.
Many schools, meanwhile, lack the resources to provide support. Fourteen million students are in schools with police but no counselor, nurse, or social worker, according to a report by the American Civil Liberties Union that analyzed data released for the first time by the federal Department of Education on the number of social workers, nurses, and psychologists employed in schools.
The Novel Idea
Part of the problem is a lack of resources, Guilbeau knows. So she developed Hopebound to match teens from underserved communities with an untapped pool: graduate students in mental health clinician programs, such as marriage and family therapy, clinical or school psychology, social work, and counseling.
Those programs require students to earn as many as 4,500 field hours. While some universities help students find opportunities to earn those hours, others do not.
“At some programs, the onus is put on graduate students to seek out local organizations and supervisors to fulfill their hours,” Guilbeau says. “A few of my immediate family members and one of my best friends are going through programs to become mental health clinicians. Their experiences allowed me to start to understand and gain an appreciation for what the process is like.”
She is building a convenient tool to match the supervisors — usually working at community health organizations or private practices — with graduate students at universities. Much of the counseling will be done via video, which studies show is as effective as in-person counseling. Video counseling is also more accessible and lower-cost than in-person therapy.
Hopebound will enable graduate students to earn hours more efficiently, give community health organizations access to a relatively low-cost pool of labor to help low-income families and schools — and get teens the care they need.
“Teens in need of this service will be connected through partnerships in public schools and after-school programs,” she says. “Further down the line, Hopebound could work with religious organizations, the foster care system, or the state Department of Juvenile Justice.”
She may begin with charging low-income families a small amount, to increase the incentive to attend and treat the program seriously.
To build the pilot program, which will launch in January, Guilbeau is focused on Atlanta. She is first finding therapists with community mental health providers who will supervise the grad-school interns. Then she will turn to local schools and after-school programs to offer counseling to students in need. The interns are legally required to be supervised, and Guilbeau will carefully screen participating adolescents to make sure they’re a good fit for the weekly video counseling — meaning that they aren’t at risk of self-harm or in crisis. Without the support of these interns who have completed their graduate coursework, many teens have no one-on-one support or may turn to a teacher or friend who has no formal mental health training. The program will follow protocols for diagnosis and refer teens with severe mental illness to expert clinicians.
Guilbeau will judge the pilot’s success by how much teens’ mental well-being improves, as measured by the Quality of Life Inventory and Beck’s Depression, Anxiety, Hopelessness, and Suicidal Ideation scales. The percentage of pilot partners that sign on for the following year will be another early indicator of success.
Guilbeau learned to value justice and compassion growing up in Fair Haven, New Jersey.
“When I was in middle school, my older brother and I tutored at an after-school program in a nearby town that had significantly less resources than where I’d grown up. That was when I first started to understand the whole concept of the achievement gap and educational inequity.” The towns shared a border. Yet there was a one-digit difference in the zip code. The U.S. practice of using property taxes to fund public schools made a world of difference in the educational outcomes of the students.
“From then on, I continued to work in that community as a camp counselor and as a volunteer, throughout all of high school,” says Guilbeau, who also volunteered as a tutor during college in the nearby town of Holyoke, Massachusetts., throughout her four years as an undergraduate. She emerged from Teach For America convinced she wanted to make a social impact — but she wanted to scale the impact to reach more than just 30 students in a classroom. She attended a summertime program at the Tuck School of Business to figure out how to do that and was recruited to work for Kantar Consulting in Norwalk, Connecticut. She applied to Stanford GSB while working at Kantar.
“I was drawn to the GSB specifically because of its dedication to social innovation,” she says.
At Stanford, several faculty members inspired her, including Fern Mandelbaum, whose course, Entrepreneurship from Diverse Perspectives, helped her think of herself as an entrepreneur, and Laura Arrillaga-Andreessen, who helped Guilbeau think through the framework and theory of change for Hopebound. A class with Allison D. Kluger, Good Morning America producer, and Alex Rodriguez, the baseball star, called Strategic Pivoting for Your Next Chapter, helped her prepare to take on the challenge she had set herself: finding a scalable way to help young people find the mental health resources they need. In her last quarter, Guilbeau completed the course Social Ventures Practicum, co-taught by Bill Meehan and Kimberly Jonker. She worked on Hopebound with a cross-disciplinary team of five students, one of whom is currently earning her hours as a social worker.
As for Leila, Guilbeau’s former student, the young woman is doing better now, but “clearly it took a lot for her to get to that point,” Guilbeau says. She can’t help but wonder what difference it would have made for Leila if seeking and finding mental health care had been routine and easy.
“There needs to be some way to make one-on-one mental health support accessible to all kids,” she says. “I’m excited to start building the connections between teens and the people who can help.”
— Elizabeth MacBride