The Mental Health Ripple Effect

Kelly's Story

When Kelly first sought help, she thought she only needed access to economic resources to solve the challenges she was facing.

Kelly’s housing situation was unstable, and she struggled to maintain participation in a vocational training program — this was worsened by tumultuous relationships with her mother and her son. While the immediate need for shelter and financial assistance was clear, Kelly was hesitant to admit her mental health needed to be addressed as well.

She was unlikely to seek mental health support independently, so Kelly was referred to United Way of Greater Atlanta’s Healthy Communities Primary Care Access Fund. The program provides funding to charitable clinics in rural counties like Coweta, Fayette and Henry to help increase access to critical health services for uninsured and underinsured populations. Additionally, funding supports health care access for women and children in domestic violence shelters.

Though she was reluctant at first, Kelly was willing to participate in therapy after receiving age- and culturally-appropriate, home-centered services.

The therapeutic case manager was then able to establish a rapport with Kelly by encouraging her to discuss strategies to help support her mother. Kelly gained an increased understanding of the ways her mother’s mental health challenges impacted her own emotional health.

Ultimately, these conversations led her to address her own emotional challenges with anger management, lack of trust, fear of abandonment and limited ability to set healthy boundaries with her son. Through counseling and persistent practice, she developed skills to communicate her feelings, frustrations and thoughts in a constructive manner.

The mental health services she received caused a ripple effect of positive change in Kelly’s life. She mended relationships with her family and peers, which helped her become more successful at home, in school and in the workforce.

Today, Kelly is thriving because she benefited from mental health services, along with housing stability, parenting education and case management services.

She secured an apartment, obtained affordable childcare, graduated from the vocational program and completed an internship that led to permanent full-time employment. Kelly also successfully re-established a healthier connection with her mother and transitioned into permanent housing with her son in March 2018.

Thanks to United Way’s integrated approach, Kelly can now contribute to building an improved life for herself, her child and our community to improve Child Well-Being in Greater Atlanta.

There’s a stigma that surrounds mental health issues and its treatment. In many ways, because of this stigma, children in Atlanta are not receiving proper care.

This was what United Way of Greater Atlanta learned in 2015 after hosting a mental health learning forum at the Carter Center. The forum was open to the community, and it featured many people who worked in the school districts and state government. The event was also heavily attended by community activists and behavioral health professionals.

“There were a wide range of individuals there that participated in that forum, and one of the first things that came out of that was that there are stigmas surrounding behavioral health, and how can United Way play a role in how to address those issues,” said Ebony Johnson, senior manager of health and community engagement. “We moved into this place of being able to fund services that help provide access to care.”

In 2016, United Way developed its School-Based Mental Health Initiative. United Way currently funds mental health agencies through the Impact Fund. The School-Based Mental Health Initiative provides funding to support onsite counseling services in elementary, middle and some high schools across Clayton, DeKalb and Fulton counties.

In its most recent grant year, the initiative served more than 250 students and families, which provided individual, family and group therapy sessions. The initiative also supported an educational puppetry program, Kids on the Block, that uses life-sized, multicultural puppets to promote mental wellness for children and their caregivers.


This helps children articulate issues they might otherwise feel uncomfortable talking about.

The School-Based Mental Health Initiative offers students therapy in a school environment, which gets rid of that barrier preventing children and their parents from accessing care. This treatment has led to better attendance among students, Johnson said.

Johnson said United Way provides support for about 15 schools across the tri-county area with low or very low child well-being.

“We have strong partnerships with mental health providers that go into the schools and provide funding to provide those services,” Johnson said. “There is an organization that is contracted to go in to provide that for them, and it all depends on the needs of the school.”

There are significant access barriers for families seeking behavioral health treatment. It’s estimated that only 15 to 25 percent of children with psychiatric disorders receive specialty care, Johnson said.

Johnson said most states across the country report shortages of child psychiatrists. She said there’s between 1 and 17 psychiatrists per 100,000 children.

“There are often not as many licensed professionals in areas, for one, depending on if they practice in rural areas vs. the city,” Johnson said. She said there are relatively small access points for professionals to enter the discipline, so there isn’t that pipeline of mental health professionals to choose from.

In Georgia, child and adolescent psychiatrists, psychologists and psychiatric nurses have fewer post-graduate training opportunities, which makes the path to gaining a license more difficult.

There are many factors that can determine a child’s mental health. Age and poverty level affect the likelihood of children receiving treatment for anxiety, depression or behavior problems, according to an article written by Ghandour RM Sherman in The Journal of Pediatrics.

Among children living in areas of low and very low child well-being in Atlanta, 1 in 5 of those children have an undiagnosed mental, behavioral or developmental disorder.

Improving the well-being of children in Greater Atlanta’s 13 counties has been the primary agenda for United Way since its last strategic planning meeting. Born out of this meeting was the Child Well-Being Index.

United Way found that certain zip codes where people were born created a barrier that prevented children from reaching their life’s full potential.

A data committee looked at how United Way measures potential for a child. Fourteen measures in determining child well-being were selected. Compiled data showed half a million children in Greater Atlanta grow up without the resources, opportunities or social supports to reach their full potential. United Way saw they could help improve the well-being of its children by offering access to quality health care.

The report from Voices for Georgia’s Children cites a “severe shortage’’ of child and adolescent psychiatrists statewide. It also reported that 76 of the state’s 159 counties do not have a licensed psychologist in 2015, and that 52 counties did not have a licensed social worker.

For United Way, this is an access to care issue. United Way has to give these children and their parents access to care. By doing this and making them aware of the prevalence of mental health disorders, we hope to erase the stigma related to behavioral health disorders.

“Behavioral health is the cornerstone of a person’s [child’s] ability to succeed,” Johnson said. “If there are issues or factors preventing a person from learning, holding down a job or maintaining housing, behavioral health drives all that.

“For us, it’s all about access to care for the purpose of providing these opportunities to the communities to eliminate the gap for those that wouldn’t have the outright knowledge base or services.”