a conversation with…

Autumn Boylan

Portrait headshot close-up photograph view of Autumn Boylan smiling
Autumn Boylan is a recognized public health and Medicaid expert and deputy director of the Office of Strategic Partnerships at the California Department of Health Care Services (DHCS). Putting equity and access at the center of her leadership, she leads the development of two of the nation’s largest initiatives supporting systemic improvements in behavioral health: the Children and Youth Behavioral Health Initiative, a $4.7 billion effort to reimagine behavioral health access and outcomes for children and youth; and the CalAIM Justice-Involved Initiative, which seeks to improve coverage and continuity of health services to justice-involved individuals. Together, these initiatives represent a historic investment in the well-being of the state’s most vulnerable populations. With 16-plus years of expertise in state health program delivery, Boylan is recognized for her ability to drive novel innovation and coordinate highly complex statewide partnerships at the intersections of Medicaid, public health, equity, education, justice and more.

a conversation with…

Autumn Boylan
Autumn Boylan is a recognized public health and Medicaid expert and deputy director of the Office of Strategic Partnerships at the California Department of Health Care Services (DHCS). Putting equity and access at the center of her leadership, she leads the development of two of the nation’s largest initiatives supporting systemic improvements in behavioral health: the Children and Youth Behavioral Health Initiative, a $4.7 billion effort to reimagine behavioral health access and outcomes for children and youth; and the CalAIM Justice-Involved Initiative, which seeks to improve coverage and continuity of health services to justice-involved individuals. Together, these initiatives represent a historic investment in the well-being of the state’s most vulnerable populations. With 16-plus years of expertise in state health program delivery, Boylan is recognized for her ability to drive novel innovation and coordinate highly complex statewide partnerships at the intersections of Medicaid, public health, equity, education, justice and more.
Portrait headshot close-up photograph view of Autumn Boylan smiling
Landscape close-up photograph view of two young female individuals seated down in chairs amongst a mental health discussion group inside an open-area office room of some sort
In January, DHCS released two apps to support student mental health — Soluna is intended for young people 13-25 and BrightLife Kids is designed for young children and their parents to use together.
What are the most common mental health issues you are seeing among K-12 students?
Elementary school students between kindergarten and third grade most commonly experience issues with sleep habits, tantrums and nonverbal communication. Students between fourth and seventh grade most commonly face such issues as relationship stress, organizational challenges, school/family transitions, sadness, anger and screen time. As such, BrightLife Kids prioritizes support for these focus areas for young students and their parents or caregivers.

Soluna, which is geared toward young adults, addresses stress and anxiety management, social pressure, social media, bullying, and more. The top five presenting issues among eighth graders and high schoolers are relationships (24 percent), anxiety (12 percent), low mood (10 percent), stress (8 percent), and family issues (8 percent). Social pressures, social media and bullying were prominent contributing factors to these issues. Soluna’s direct one-on-one coaching helps to address these mental health challenges early on, reducing the likelihood of escalation to more serious conditions.

Have these issues changed over the past few years? How did the pandemic and school closures affect student mental health?
The pandemic impacted student health and well-being by upending student routines and the sense of place and belonging generally found within the school and classroom environment. This resulted in remote learning challenges, friendship and relationship strains, and other presenting issues, leading to an increase in students with mental health concerns, including feelings of self-harm and suicidal thoughts.

The pandemic highlighted and accelerated the need to support student mental health, particularly by providing virtual services to help students build psychological strength on their own terms. Sixty-one percent of Soluna’s coaching sessions for eighth graders and high schoolers have occurred outside of 9 a.m.- 5 p.m., showing how important it is to provide support outside of work and school hours.

In addition, the U.S. is facing a nationwide shortage of mental health professionals, greatly increasing the wait times for appointments and access to care. Availability is even more limited among the uninsured, low-income families, people of color and people with disabilities. In California, two-thirds of young people with depression do not receive treatment.

The California Department of Health Care Services (DHCS) is addressing this growing crisis by delivering an accessible and personalized support system that focuses on prevention and early intervention. The goal is to provide an ecosystem that can help young people and families when and where they need help the most.

How were the apps designed? Was there input from school stakeholders? Was student voice considered?
DHCS spent two years interviewing parents, caregivers and more than 300 students and young adults to ensure the platform was designed to best support youth well-being. Interviewees were asked about the apps’ design, functionality and content. DHCS also convened a youth advisory board that provided recommendations throughout the implementation process, and held focus groups to test app concepts and view app demonstrations to gather input on vendor selection.

Young people made it clear that they would most appreciate a virtual behavioral health platform tailored to their needs. Specifically, they wanted the platform to:

  • Empower them to take control of their journey
  • Help them build a connection
  • Make them feel safe
  • Be easily accessible, even if you don’t have internet access, and available in multiple languages

App prototypes developed by Kooth and Brightline (the eventual contractors for Soluna and BrightLife Kids, respectively) were highly favored among youth and parents in initial testing, which reviewed more than 450 different behavioral health vendors.

What are the basic differences between the two apps?
BrightLife Kids provides support for very young children and their parents or caregivers on such issues as sleep habits, tantrums and non-verbal communication, while supporting tweens and their families on such issues as school/family transitions, sadness, anger and screen time. Soluna, which is geared toward young adults, addresses stress and anxiety management, social pressure, social media, bullying and more.

Both BrightLife Kids and Soluna provide live one-on-one meetings with trained and qualified behavioral health wellness coaches (in English and Spanish); a resource library with educational content and guidance; wellness exercises, such as assessments, journaling prompts, quizzes and goal-setting activities; and peer communities that are supervised by licensed behavioral health professionals.

Is there an effort to integrate these apps into schools?
DHCS is working collaboratively with Kooth and Brightline, as well as the California Department of Education, to drive adoption across the state through a variety of strategies (e.g., marketing and social media, as well as partnerships with schools, community-based and other child/youth-serving organizations).
How can the apps be accessed?
BrightLife Kids is available for download on iOS devices in the Apple App Store and will be available for Android devices later this year; it is also available online at CalHOPE.org. Soluna is available for both iOS and Android devices in the Apple App Store and Google Play Store. To find out more, visit CalHOPE.org.
In addition to deploying the apps, what else should/can school leaders do to support student mental health?
We highly encourage school leaders to visit the Children and Youth Behavioral Health Initiative (CYBHI) resources for schools webpage to see new resources to support students and staff. This site includes more than a dozen helpful resources, including an Adverse Childhood Experiences (ACEs) & Toxic Stress Toolkit, parent support videos and free professional development about social-emotional learning from UC Berkeley.

In addition, DHCS is working with county offices of education and local educational agencies in every California county to implement a new school-based services program, called the CYBHI Fee Schedule program, aimed at increasing access to school-based mental health counseling and supports. If your school/district isn’t yet participating in the CYBHI Fee Schedule program, school leaders can work with their district leadership to find out how to get involved. The program will provide additional funding and resources to schools to help address the mental health crisis for California’s youth.

Schools are on the front lines of the youth mental health crisis. We rely on their expertise and input to tailor our statewide mental health programs to the unique needs of the next generation of students. To make meaningful progress in combating the youth mental health crisis, we urge schools to continue their efforts to proactively provide critical care before students reach a breaking point. We must support all students, regardless of whether their issues escalate or if they perceive their issues as being severe enough for treatment.

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