"Hi, my name is Dr. Lydia Sit. I'm a child and adolescent psychiatrist. And I work here at Covenant House PA, which is a youth-oriented homeless shelter in the Germantown section of Philadelphia. It wasn't actually on my horizon that I would go into psychiatry. I was able to get into an accelerated program, which kind of just placed me right on the direct path to going to med school. And while I was in the early years of med school, my uncle, who I actually did not even know had any kind of mental health conditions, ended up getting admitted to a psych hospital and had a very severe episode of depression, and he has a diagnosis of bipolar, which I learned at that point, um, and it was one of those things where I suddenly realized, like, I, Especially like within the culture that I grew in, grew up in.
We just never talked about mental health conditions. There was still a lot of shame and stigma. And just the idea that, um, it was something that someone would be ashamed about, so we shouldn't talk about it when it's not our business. But then suddenly when he was in a real mental health crisis is when sort of all of it came out and I became like a lot more curious about, um, to what extent us not talking about it and not maybe being able to reach out and support him prior to that hospitalization might have Um, changed the trajectory of things coming to Covenant House was like, completely different and, um, the youth who come here are not coming here for mental health services necessarily. They walk in the doors because they're in a desperate situation, they're experiencing housing insecurity, they need a place to stay.
They need you know, all the other kind of basic support services that they offer here at Covenant House. And my role here is to be a source of support for them and see if they'd be willing to engage in some mental health care. Um, and also like a lot of them have come in to Covenant House not having the best experiences with mental health. If they grew up in the foster care system, oftentimes they were forced to see or a therapist, they were forced sometimes to go to the hospital, um, and oftentimes they were prescribed a lot of medications and because they were minors they didn't really get a say in that, so there's overcoming that aspect to it, but I think it's such an opportunity too, because Um, I think if left on their own, so many of our youth would like never want to talk to a psychiatrist again, and I get that, but what a great opportunity for me to try and engage them in a different way and sort of model what a collaborative relationship with a mental health professional could be like, something that is like on their terms.
They sort of come up with the goals and they have a right to refuse. So, youth choice kind of comes into play here in a big way. And just overall engagement. Um, and, and therapy in whatever way that sort of they feel like is helpful to them. . It's Covenant House, um, and the funders that pay for these services here have made sure that whoever comes through the doors, and whoever, even former youth, can still come and get the services. Um, what I think is like the best quality care with good providers, not just myself, but like the medical team as well, and insurance doesn't matter.
If they end up requiring a medication, let's say, or if something else that's normally there would be maybe a lot of barriers for, we do everything that we can to be able to provide those for them. I think that it's fundamental to our engagement with the youth, especially as a healthcare professional. There have been so many ways that the healthcare system hasn't been deserving of trust. And I think unless we make it clear and empower the youth to have their own autonomy in these decisions, um, you really just won't move forward.
I think, um, mental health and psychiatry in particular is very prone to mental illness. lists of symptoms, and then sort of using DSM to kind of automatically put labels or categories for people. And I think, by and large, that's really done a disservice to a large number of youth. Um, very often they have had, like I said, contact with mental health in the past, and oftentimes they want to just launch into this list of A, B, C, D diagnoses.
And I will say that for the most part, I just put those aside because I, I believe that there are a lot more than just a bunch of symptoms and the real story is about their life and their life experience. And once you hear about who they are as people, and also who they What was the context of why that situation happened that led to maybe that hospitalization you Are very like easily going to be seduced into thinking like you can just sort of Diminish it into just those Those labels or categories For the most part I would say most of our youth who have been through our doors Um, the main overlying, um, shared experience is trauma. I think being able to sit down and do this collaborative model of putting together a story that actually makes sense, a narrative that makes sense, knowing them as a full, whole person, is probably the biggest intervention that I do here.
I'd like to think that, by youth coming here and at least for the time being not having to worry about where they're going to sleep each night, not having to worry what they're going to eat for the day because our, our facility is able to provide all those things, I hope that we could almost buffer those. Those everyday stressors and worries such that we can make room for joy. Because when you're in a survival mode, I think that there's very little space for that. And, I see joy every day. I see joy in the cafeteria when one of our young moms and their little baby is playing around and another youth will kind of like do a back and forth with the little toddler. I see joy when we have our music production group on Tuesdays come and our youth are able to express their story through raps and they lay tracks and they get their groove on about that. Um, I think it's in the everyday little things. Seeing the youth being able to be youth, you know, so much of society, especially for our black youth have made them...have adultified them and expected them because of their life situation to not be young people anymore and That's unfair. We need to be able to honor Where they are and also celebrate them instead of just worrying about them as a risk factors, you know
I think sometimes as someone who works here at the shelter, I can start feeling very down and negative of like, why is the system, like, in this world, there really should not be a need for a place like this. There should be no 18 year old that does not have a home that needs to come to a place like this, right? So I think it's very easy to get bogged down about like, what is this world coming to? And we're so broken. The system is so broken. Everything's fighting against us. It feels like a fight, fight, fight all the time. And obviously that's me just as someone who is not living it the way that our youth are living it, but to see them have hope and feel like the hope for the future and oftentimes through families of that they want to make their own or their chosen family among peers, I think gives me so much hope.
It actually feels like more renewing, like I'm the one bringing the negative energy and the youth are the ones feeling, bringing in the positivity. I would like people who listen to not think about the youth that I work with here at our safe haven shelter as like some kind of statistic Each youth that comes through this building is Amazing and they have their own life story and they have also just this is only one part of their trajectory, I feel like Engaging with these youth have been like the biggest honor of my life, and I, I can't wait to see what they end up doing in the future because they have such passion and advocacy for not just like helping their own situation out, but they really genuinely care about others and want to make sure to make this world a better place.
So I'd love people to kind of recognize that...
We just never talked about mental health conditions. There was still a lot of shame and stigma. And just the idea that, um, it was something that someone would be ashamed about, so we shouldn't talk about it when it's not our business. But then suddenly when he was in a real mental health crisis is when sort of all of it came out and I became like a lot more curious about, um, to what extent us not talking about it and not maybe being able to reach out and support him prior to that hospitalization might have Um, changed the trajectory of things coming to Covenant House was like, completely different and, um, the youth who come here are not coming here for mental health services necessarily. They walk in the doors because they're in a desperate situation, they're experiencing housing insecurity, they need a place to stay.
They need you know, all the other kind of basic support services that they offer here at Covenant House. And my role here is to be a source of support for them and see if they'd be willing to engage in some mental health care. Um, and also like a lot of them have come in to Covenant House not having the best experiences with mental health. If they grew up in the foster care system, oftentimes they were forced to see or a therapist, they were forced sometimes to go to the hospital, um, and oftentimes they were prescribed a lot of medications and because they were minors they didn't really get a say in that, so there's overcoming that aspect to it, but I think it's such an opportunity too, because Um, I think if left on their own, so many of our youth would like never want to talk to a psychiatrist again, and I get that, but what a great opportunity for me to try and engage them in a different way and sort of model what a collaborative relationship with a mental health professional could be like, something that is like on their terms.
They sort of come up with the goals and they have a right to refuse. So, youth choice kind of comes into play here in a big way. And just overall engagement. Um, and, and therapy in whatever way that sort of they feel like is helpful to them. . It's Covenant House, um, and the funders that pay for these services here have made sure that whoever comes through the doors, and whoever, even former youth, can still come and get the services. Um, what I think is like the best quality care with good providers, not just myself, but like the medical team as well, and insurance doesn't matter.
If they end up requiring a medication, let's say, or if something else that's normally there would be maybe a lot of barriers for, we do everything that we can to be able to provide those for them. I think that it's fundamental to our engagement with the youth, especially as a healthcare professional. There have been so many ways that the healthcare system hasn't been deserving of trust. And I think unless we make it clear and empower the youth to have their own autonomy in these decisions, um, you really just won't move forward.
I think, um, mental health and psychiatry in particular is very prone to mental illness. lists of symptoms, and then sort of using DSM to kind of automatically put labels or categories for people. And I think, by and large, that's really done a disservice to a large number of youth. Um, very often they have had, like I said, contact with mental health in the past, and oftentimes they want to just launch into this list of A, B, C, D diagnoses.
And I will say that for the most part, I just put those aside because I, I believe that there are a lot more than just a bunch of symptoms and the real story is about their life and their life experience. And once you hear about who they are as people, and also who they What was the context of why that situation happened that led to maybe that hospitalization you Are very like easily going to be seduced into thinking like you can just sort of Diminish it into just those Those labels or categories For the most part I would say most of our youth who have been through our doors Um, the main overlying, um, shared experience is trauma. I think being able to sit down and do this collaborative model of putting together a story that actually makes sense, a narrative that makes sense, knowing them as a full, whole person, is probably the biggest intervention that I do here.
I'd like to think that, by youth coming here and at least for the time being not having to worry about where they're going to sleep each night, not having to worry what they're going to eat for the day because our, our facility is able to provide all those things, I hope that we could almost buffer those. Those everyday stressors and worries such that we can make room for joy. Because when you're in a survival mode, I think that there's very little space for that. And, I see joy every day. I see joy in the cafeteria when one of our young moms and their little baby is playing around and another youth will kind of like do a back and forth with the little toddler. I see joy when we have our music production group on Tuesdays come and our youth are able to express their story through raps and they lay tracks and they get their groove on about that. Um, I think it's in the everyday little things. Seeing the youth being able to be youth, you know, so much of society, especially for our black youth have made them...have adultified them and expected them because of their life situation to not be young people anymore and That's unfair. We need to be able to honor Where they are and also celebrate them instead of just worrying about them as a risk factors, you know
I think sometimes as someone who works here at the shelter, I can start feeling very down and negative of like, why is the system, like, in this world, there really should not be a need for a place like this. There should be no 18 year old that does not have a home that needs to come to a place like this, right? So I think it's very easy to get bogged down about like, what is this world coming to? And we're so broken. The system is so broken. Everything's fighting against us. It feels like a fight, fight, fight all the time. And obviously that's me just as someone who is not living it the way that our youth are living it, but to see them have hope and feel like the hope for the future and oftentimes through families of that they want to make their own or their chosen family among peers, I think gives me so much hope.
It actually feels like more renewing, like I'm the one bringing the negative energy and the youth are the ones feeling, bringing in the positivity. I would like people who listen to not think about the youth that I work with here at our safe haven shelter as like some kind of statistic Each youth that comes through this building is Amazing and they have their own life story and they have also just this is only one part of their trajectory, I feel like Engaging with these youth have been like the biggest honor of my life, and I, I can't wait to see what they end up doing in the future because they have such passion and advocacy for not just like helping their own situation out, but they really genuinely care about others and want to make sure to make this world a better place.
So I'd love people to kind of recognize that...