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Project YES: Can Watching a Porcupine Chomp On a Pumpkin Help My Anxious and Stressed-Out Patient? · Pediatrics Now: Cases Updates and Discussions for the Busy Pediatric Practitioner

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Yeah, I think Teddy Bear found some pumpkins for Halloween. What'd you find, Ted?
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I'm Holly Weyment, and this is Pediatrics Now, cases, updates,
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and discussions for the busy pediatric practitioner.
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Don't forget to click on the link in this podcast for free credit.
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It may include CME, MOC, or ethics credit, depending on our topic or podcast.
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I'm thrilled today because joining me here on the podcast today is Jacqueline
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Ware, project coordinator for a program that's coming back, and it's called YES.
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And it's a program in coordination UT Teen Health and Northwestern University, which is my alma mater.
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I went there for graduate school, and it's really exciting, and it couldn't
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be coming at a better time.
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Right, Jacqueline? Oh, absolutely. Thank you so much for having me.
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I'm super excited to talk about Project YES and, you know, such an important
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topic, teen mental health, that I feel like a lot of people can relate to.
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Yes. And pediatric practitioners, our listeners, they are just slammed with
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patients who are depressed and anxious.
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And as we all know, there's so many barriers to getting the mental health that
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kids and adolescents need, whether it be cost,
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availability of appointments, getting to the, you know, transportation to get
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to the appointment, stigma.
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Yeah. Tell us about Project YES and how this can help in this epidemic of anxiety and depression.
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Yeah, absolutely. Those are definitely barriers we see not only in San Antonio,
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but all over Texas and sadly all over the world.
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But with Project YES, we're super excited about it.
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Project YES stands for Youth Empowerment and Support. And it is a free,
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anonymous, online mental health resource that is built by and for young people.
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And I think that's one of the really important things to note about Project
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Yes is that it is tailored for teens.
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And of course, I encourage anyone to take Project Yes, but Project Yes is specifically
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designed for 13 to 17-year-olds who face really unique challenges to their mental health.
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And you know you mentioned several barriers like you
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know stigma so with Project Yes it's anonymous we
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don't ask for names another thing is you
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know just cost or transportation and so
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this is a free online resource that young people can access anytime whether
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it be their phone a computer an ipad anywhere you can have access to the internet
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you can access Project Yes and I think it's just a really great resource that
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really is focused on teens and helping alleviate those barriers that we often
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see with young people and getting access to their mental health.
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So when I tried out the program, anyone can try it. So it's great that parents
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can see what their kids are looking at.
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And I'm a mom of three teenagers.
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And it seems like, is being a teenager getting harder? It seems like it is.
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I'd have to agree. You know, part of UT Teen Health, we have a youth leadership
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council, and it's a group of high school students.
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We have over 100 students, and we meet them once a month, and they're great.
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They were actually involved in a little bit of the creating of or the updating
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of Project Yes to tailor to teens.
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And, you know, I asked for their feedback on certain things.
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And I mean, just there is unique experiences that whether it's social media
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or, you know, I do feel like people talk a lot about COVID, but it is something
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that happened in their lifetime.
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And I think, you know, especially that social media, that is something that
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is really tailored towards them and that is something unique about their mental health struggles.
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When I tried the program out this morning, so I didn't sleep well last night.
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I was kind of in a bad mood. And then I have to admit, when I watched the video
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part where you can choose which video you want to watch, it was this adorable
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porcupine eating a pumpkin.
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It sounds so simple, but you could hear the joy, the sounds,
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this adorable animal. Pick it up.
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Can you get it? Pick it up.
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Good boy, was making, and it's really, it really did make me feel better.
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And it seems so simple. Is it meant to kind of, in a way,
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combat the effects of social media because it's on the phone,
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it's something you're looking at, or it's with that in mind,
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at least, that a lot of teenagers are, as we know, they're on their phones so much in general?
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Yeah. I mean, I think part of it is you kind of have to meet students where
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they are, and they are online.
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And, you know, in some of the modules, for example, the body neutrality module
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that covers things like body image, and it talks a little bit about how social
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media can affect our body image.
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And so things like that all kind of come into play.
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But, you know, for teens who don't have access to transportation,
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yeah, you got to meet them where they are, and that's online.
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And you got to incorporate those things to help get them access.
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I know with one student I talked to, she had shared that she was scrolling through
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TikTok and she saw something that kind of upset her and made her feel bad.
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And she liked it because she was just able then straight from that to go right
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into Project Yes and do the Improve Your Mood module.
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And so that's kind of the nice thing too, is they're able to kind of quickly
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access it when they are online and if they do see something that can be upsetting
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or harmful to their mental health.
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And is the idea, though, that our moods constantly have to be improved,
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like pressure to feel happy all the time?
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I am so glad you brought that up. No, I think, you know, mental health is,
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you know, not a destination. It is a journey.
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And that's what I like about Project Yes, that it can be accessed at any time.
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And I think we kind of have to keep that in mind, that it's not a destination.
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You know, I don't think we can always have, you know, good, positive mental
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health and no negative thoughts, but it's what can we do to reframe those thoughts.
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It's what we can do to self-regulate. It's what we can do to manage our stress
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and anxiety or just how we can change the perspective.
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Another kind of example that is with that body image
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model it doesn't talk about necessarily body positivity
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which is just automatically putting a
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very positive rose-colored glasses but more talking about what is body neutrality
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and how can we look at ourselves in more of a neutral way and understanding
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like this is my body and this is what it does to take care of me and then same
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thing kind of with our mental health right like there are days we are going
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to be stressed, and that is okay.
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Stress is also that biological response that keeps us alive, that fight or flight.
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But how do I react? Or what can I do? Or what can I, you know, who can I reach out to?
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Right? And so I think that's the hard part with mental health.
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It is not a one-size-fits-all.
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It is not a, you know, you're fixed the next day.
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It is truly an ongoing process and journey. And that's why it's so important
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that especially young people learn skills to help with that journey.
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Jacqueline, for our pediatric practitioner listeners, who a lot of them see
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40 patients a day, who is this program right for?
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Where, of course, you don't want to recommend this for someone who's severely
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depressed, or would you?
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Can you tell us some of what you would look for, who this would be right for?
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Yeah, absolutely. So the project is tailored for teens.
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And there are different modules, which I think is really important because mental
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health is such a big topic.
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And there's so many different things that can affect our mental health.
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So, for example, the Improve Your Moon module is really great for those that just need a pickup.
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Like, I'm having a really rough day. I'm feeling down. Like I said,
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there's one on body image.
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There's one, though, that talks about handling self-harm urges, right?
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And that's definitely a more serious topic. It definitely requires,
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you know, more follow-up care and depending on the level of severity,
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right, different interventions.
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But if someone's kind of experiencing those things and they want something that
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can kind of start that conversation of, hey, I'm experiencing this,
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what are my tools that I can use to lessen my self-harm?
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Or there's one like staying safe during dark thoughts. So I will say there's,
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it is a great option for a lot of teens.
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I think the most important thing is that teens pick a module that resonates
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with them. So like the Improve Your Mood's great.
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I think the Reframing Negative Thoughts module is a really great module for anyone, adults as well.
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I think we're all guilty of sometimes taking a thought and looking at it kind
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of negatively and figuring out how can we, you know, spin it positively.
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And of course it acknowledges in the module not everything can
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be spit positively but you know
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all these different modules are designed to tailor to fit the need of what that
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young person is going through so i you know i do recommend it for everyone and
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i think the important thing is just finding that module that resonates with
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that teen and we also at ut teen health and you know northwestern we're always
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looking on adding modules as well and so that's something to.
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We're getting feedback from youth on, you know, hey, we think this would be
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a topic that we would want to know more about with mental health.
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And that's really important, too, in the needs of the community.
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Is there a specific teenage patient who this would be right for?
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And is it in place of, say, talking to a psychiatrist or in addition to or while
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you're waiting to get into a psychiatrist?
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Like, it can't hurt. It can only help. Or can you tell me more about who this is for, really?
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Yeah, absolutely. I would definitely say that it is for someone who is either
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one, like, waiting to get care, especially if it's something with a little more
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serious, like self-harm or higher levels of depression.
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I think it's something where if they're, like, in that current moment and they
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need a resource and they cannot access another resource, it is a great option.
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Or if they're waiting to get care and they're not able to get certain appointments
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until a certain time, this is a great resource, especially of just like handling
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and managing and lessening those thoughts or urges.
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I think this would be a great resource for. And then for some of the other ones,
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like improve your mood and reframe negative thoughts,
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I think those are good for young people who just want to kind of know more about
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mental health or want to gain different skills and strategies for managing stress and anxiety.
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So it is kind of a wide range, but I think that's kind of one of the good things
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about Project Yes is that it hits different mental health needs.
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But yeah, I would say people who, not as a replacement for care,
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but as something to help them if they're not able to get care right away.
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So how do kids access this?
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How do adolescents, what would you suggest the pediatric practitioners say to
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his or her patients? Yeah, absolutely.
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So Project Yes is online. It's very easy to access.
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It's www.tryprojectyes.org slash U-T-T-H and slash.
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And I think something that we have seen great success with is,
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you know, having something in their office where it's like, hey,
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you know, you mentioned this kind of mental health struggle.
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I want to share this resource with you. The big thing to emphasize is that it is anonymous.
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I feel like for young people, especially with mental health,
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that is one of their biggest concerns is, are my parents going to find out?
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You know, are people going to know it's me that I'm taking this module?
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And I always encourage them to just to emphasize, like, hey,
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like, I took the Improve Your Mood module.
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Like, if Peter Axes have time to take it, you know, because it is something
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that kind of helps level that playing field.
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It's like we all kind of go through different mental health struggles.
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I even took one of the modules, but it is available through like that QR code and link.
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And, you know, UT Teen Health, we're always available to come and offer different
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printed materials as well for anyone that needs them.
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And before we talk a little more about the program, what type of patients do
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you see at UT Teen Health?
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Because I spend a lot of time with pediatric community practitioners here in
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our community, and they want to know, how do I send a patient to UT Teen Health?
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And where is UT Teen Health?
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Yeah, absolutely. So UT Teen Health, we kind of have our hands in a lot of different fields.
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We focus on improving adolescent health and wellness in the community.
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We work with different schools and community partners and are trained in different
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evidence-based curriculum, and we go into those schools and teach that curriculum
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or train people to teach that curriculum, as well as we're involved in different community partners.
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I actually just came from a presentation on teen dating violence,
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so another important teen topic that connects to mental health.
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And so for— And Jacqueline, so you were talking to, was it high school students
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about dating violence? Yeah, it was high school students. And how did that go?
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It was really great. It was a small group, but I felt like they were really,
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really taking in the material we were talking about. It's definitely a heavy kind of topic.
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But, you know, we talked about unhealthy relationships, consent.
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We talked about, you know, what are relationship red flags?
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And we talked about, I don't know if you've ever heard the frog in hot water theory.
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But it's that. Where it happens slowly. Yes. And I feel like that's for that, you know, analogy.
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If you put a frog in boiling hot water, it'll jump right out.
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But if you put it in lukewarm water and gradually increase, the frog will stay in the water.
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That always sticks with students when we talk about teen dating violence.
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And it really opens up a lot of great conversations about some of the red flags.
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So that was something that kind of came up today. And, you know,
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but, you know, I love getting to work with youth and, you know, UT teen health.
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That's some of the things that we're passionate about of all different types
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of, you know, health topics, because they all kind of interconnect.
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Teen dating violence connects to mental health.
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We're part of the OBGYN department.
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At UT Health San Antonio. And so it connects to teen pregnancy,
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you know, all of those things come together.
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And so UT Teen Health is not directly involved in giving any clinic service,
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but we do have a collaboration clinic, the UT Teen Clinic, and I believe it's at the Robert B.
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Green Campus in downtown San Antonio, and they offer a lot of great teen health services.
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And we could put that information in the text for the podcast,
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as well as a link, of course to yes
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so yes went
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away for a while and now it's coming back yes so
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we had several years ago a previous grant that
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we used for project yes and we were able to actually it was really cool we were
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actually to get students to you know again be a part of the process in making
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it as well as participate in voice recordings where they were able to share
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their own personal advice and their own experience with their mental health
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and they were local San Antonio teens.
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And so we had that project for a few years, and then that project ended.
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And then we were very excited when we got grant funding from the Baptist Health
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Foundation to revamp Project Yes.
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And so it's really exciting. This Project Yes has been around,
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but this is a new version of it.
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So some of the things that are different are that the modules are shorter,
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and that's feedback that we got from teens. The previous modules were 30 minutes.
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And so a lot of teens were like, well, if I'm experiencing something.
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30 minutes is a really long time for me to sit down and go through a module.
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And so we were able to tailor it where now they're closer, you know,
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some are more like five minutes, like the improve your mood.
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And then the others are about 10 to 15 minutes.
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And teens said that really fit better with their need, especially if they're
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looking for mental health support.
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It also has a new look with a partnership through Coco, which provide the online
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web design. That was really important.
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That was big feedback we got from young people as well, and just easier to navigate and manage.
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And so we're excited about those updates. Again, just incorporating that youth feedback.
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And Jacqueline, can you walk us through the evidence base behind Project YES
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and why it was developed in partnership with Northwestern University?
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Yeah, absolutely. So in previous Project YES implementations,
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it showed decreased risk or decreased levels of hopelessness,
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decreased levels of depression, and increase in self-efficacy.
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So those were all really exciting results that we got to see.
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This was kind of done with the Northwestern Lab for Scalable Mental Health.
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And they have their backed research as well showing that Project YES works.
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They have tailored their Project YES modules for other areas.
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And so it has a really wide, far stretch that shows that it's evidence-based, that it's worked.
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It's backed by scientists. Again, we have three whole different teams and departments
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all coming together with a passion and focus on improving teen mental health.
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But we showed great, great results within those first few years of Project YES
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in San Antonio for levels of hopelessness, levels of depression,
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and levels of self-efficacy and readiness to change, readiness to improve their mental health.
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And so we're kind of excited with this new Project YES seeing what those numbers
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are and looking forward to hopefully seeing the same great results.
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I think the name is just great, too. There's so many for teenagers.
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No, no, no. You know, just yes is so much more welcoming.
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I think no is the most unpopular word in the English language,
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I think, or any language, not just English, any language.
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And for young people, it's one they hear a lot. I feel like a lot of young people are told no.
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And so I love that you brought that up. They're like, yeah, this is yes.
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Like, yes, this is for you. This is something you can access.
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Love that. It's so inviting.
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How do the short five to 10-minute sessions compare with traditional mental
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health interventions in terms of impact, would you say, Jacqueline?
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Yeah, I think one of the reasons that Project YES stands out in terms of that
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impact is that they're able to access it right away.
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Again, like, you know, other interventions absolutely are effective and important
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and absolutely have their place, especially when we're talking about,
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you know, serious mental health concerns like self-harm urges or,
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you know, levels of depression.
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But I think what's unique about Project Yes is that it takes away that shame
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of like, someone's going to judge me, but then it also gets that access right
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away where they don't have to wait.
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And Project Yes also works where it's able to connect them to local resources.
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You know, this was tailored for San Antonio. It does have some national resources.
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But it has a new feature where if a student writes in something that we've marked
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as like, hey, this is they're writing something and I feel like they're having
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a heightened level of a mental health crisis, we should intervene.
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And the module will actually intervene. It'll redirect them.
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Where it goes through some mental health questions and directs them to some
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crisis resources if it needs.
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And so I think just that level of like, it checks in with the student and it
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directs them to crisis if it needs.
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And then Project Yes standing out because they're able to get access to resources right away.
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So, and that leads to my next question, Jacqueline. So are there any indicators
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or red flags clinicians should watch for when deciding if a patient might benefit from trying Yes?
19:26
Yeah, I think that if someone's maybe experiencing those stigmas we talked about,
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they're talking a lot about like,
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well, I don't want my parents to find out, or I don't want my friends to judge
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me, or if they're worried about transportation, or if they're worried about costs.
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I think Project Yes is able to really help that person because it alleviates those barriers.
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I feel like especially for that lack of transportation, that cost,
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I think it's also great if they're maybe wanting to kind of open the door about mental health,
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but they're not sure how to navigate
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that, or they're not wanting to talk about it with another person.
20:06
Again, sometimes they're, you know, as pediatrics or people,
20:10
you know, we care, we want to help you.
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But for young people, sometimes saying out loud certain feelings can be really
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intimidating. And so they don't want to do that.
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But typing them online may help kind of alleviate that and kind of open the
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door for talking more about mental health.
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Practitioners, what does it look like? How will my teenager know how to use it?
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I know when I tried it today, it seemed pretty self-explanatory.
20:34
It was easy to use and fun. Yeah, I'm so glad to hear.
20:39
And I could see how this would really help with the stigma of it because it
20:45
just really almost just seemed like it was just it was a really relaxing, nice, fun exercise.
20:51
Yeah, and it's low pressure. I want to emphasize, too, that like if someone
20:55
starts a module and they want to stop, that is OK.
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They can stop at any time. And there's multiple modules, but that doesn't mean
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you have to do every single one, right? Do the module that connects to you.
21:06
So I want to emphasize, too, it's also low pressure.
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You know, I think going and talking to a counselor, that is a huge step for young people.
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And that may be too big of a step that they're not quite ready for.
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And so this can, you know, almost even be a step towards that where it's low pressure.
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They can stop at any time. And they can just kind of focus on the things that
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they want to talk more about.
21:27
So again, that's available online. We will provide the link.
21:32
It really just seems like this program is really meeting the moment.
21:37
You really just couldn't be coming at a better time.
21:40
Yeah, absolutely. I was just so
21:42
ecstatic when I heard we were able to get Project Yes up and going again.
21:46
I loved doing it. In previous years, we would actually go into schools and have
21:52
them go through different modules and talk about it. And you could just tell
21:56
students were interested in this.
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Again, with our Youth Leadership Council, I use them to get feedback.
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And a lot of students express interest in wanting to promote Project Yes at their own schools.
22:09
Or I even had some students who have their own little mental health and,
22:14
you know, good vibes club at their school. And they wanted me to come present
22:18
at their school and talk about it. I'm like, that's so cool.
22:20
You know, young people also want to be advocates in their community.
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And I've really loved getting to see the young people that we work with want
22:29
to promote Project Yes because that really just shows that it works and that
22:33
they enjoy it and care about it and want other students to have access to the same resource.
22:39
Is self-compassion part of it?
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It just it seems like teenagers can be really hard on themselves like we all
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can be. Yeah yeah absolutely Absolutely.
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And I think, you know, I'm always inspired when I see young people have such
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a passion for talking about mental health.
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And that really gives me that passion back. And, you know, one of the questions
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I always ask students that they're experiencing, maybe like negative thoughts,
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I always ask them, like, would you say that to a friend?
23:10
And they're always it's a great thing to say I said that to my daughter the
23:13
other day and it's something so simple and short but it really like it made her think like.
23:19
Of course, she wouldn't say that to her friend. Yeah. No, I think we,
23:23
I feel like especially young people can be hard on themselves.
23:26
And I think it's a good reminder for us as adults that we're not hard on ourselves,
23:31
but we also, you know, are modeling that and checking with our young people
23:34
of like, hey, like, I see this is really stressing you out.
23:37
Like, what advice would you give to a friend if they were in this scenario?
23:41
Right. You know, would you say that to a friend if they were going through this?
23:44
And of course, they're like, no. And so, you know, the most powerful thing I
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see in our community is that when young people are passionate about something,
23:53
they can have such a positive impact.
23:55
And we have a really great opportunity where young people, I feel like,
24:00
even though they're still Sigma, they are talking about it more.
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And it's so exciting to see them just make such a
24:06
positive impact in their community by sharing their voice and
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you know their passion for improving teen mental
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health they are there and so if you need them
24:15
at any time please access and you may do
24:18
a module and you're good and you're like
24:21
yeah then maybe a few weeks later something happens or
24:24
you see something and you're like wow this actually kind of you know
24:27
affected me i maybe kind of need to go do now the reframing negative thoughts
24:32
module you know again mental health is a journey there is not a single destination
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and so it is something where i would say like people can access as many times
24:41
as they need or if that's once then great i mean it's it is something where
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they're able to tailor to fit their needs.
24:48
Jacqueline, what inspired you to go into this field?
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Oh, I actually have like a slightly long story, but I'll keep it short.
24:57
I actually lived overseas for seven years and I got to travel to all kinds of
25:01
different places. And it kind of opened my eyes to so many different health disparities.
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And it really kind of led for my passion for public health. I got my master's
25:11
in public health and health education, health promotion.
25:14
And before this, I was doing a research, I was a research assistant,
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and we were doing healthy relationships and sex ed education with college students.
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And, you know, there was all these different misconceptions and things going
25:28
on. And I was like, wow, like, I feel like we're missing something.
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I feel like, you know, there's so many things connected to all these different
25:36
topics. I feel like we're missing it.
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And I remember being so happy when I got my job at UT Teen Health,
25:42
because We really encompass that overall teen adolescent health and wellness.
25:48
You know, we focus on so many different topics because they're all interconnected.
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You know, we talk about, you know, nutrition, but we also talk about healthy relationships.
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We talk about mental health. We talk about teen pregnancy prevention.
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You know, all of those things kind of connect. And I just feel really lucky
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to be a part of such a great team where we really try to connect all these different
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things to help decrease health disparities in our community.
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And I've always just had a passion for especially like, you know,
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reproductive health and teen pregnancy prevention, because I do think that's
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something that is really important in our community.
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And again, connects to so many different other health concerns with teens.
26:29
And where did you travel overseas? Where did you live?
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I lived in Singapore from when I was, yeah, yeah, I loved it.
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I was there from when I was 10 to 17, but it gave me the really unique opportunity
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to travel to places like Cambodia.
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I got to go to, you know, India, Vietnam, China, all over Asia, really.
26:48
But I particularly remember a moment where I got to go to Cambodia and I met
26:55
with someone from the Green Gecko Project who provides education to young Cambodian children.
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And I remember talking with her and she was talking about the teen pregnancy rates there.
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And the, you know, there wasn't a lot of information on things like menstruation.
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And it just, it created all, sparked a whole conversation in me.
27:13
And I was young, I was in eighth grade, and it really just kind of kicked off
27:17
this whole like health focus of like, how can we improve people's health at
27:22
multiple levels, focusing on different important key moments in their lives.
27:28
Wow. Well, when I was five years old, a Cambodian family, refugee family,
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moved in with me and my family, and it changed all of our lives for the better.
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It opened my eyes to the hardships that other people face.
27:45
And this family, they were all
27:46
going to be killed because the father was educated in the United States.
27:51
And it was during Pol Plot's rule, and they were, anyone who was educated or
27:58
an artist or doctor, they were all being killed.
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And I remember my father said, we can't help everyone, but we could help one family.
28:08
And it was pretty amazing. It's amazing when you see what people are going through,
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how it can open our eyes and.
28:15
And change lives for the better, right? Absolutely.
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And, you know, that's so amazing. Thank you so much for sharing.
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Yeah, no, Cambodia has definitely a special place in my heart.
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And, you know, it's crazy to think that when you take away that education,
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all the different things that it affects on all these different levels.
28:35
And again, you had, you know, girls that didn't know about menstruation because
28:39
there was no one there to talk about it with them.
28:41
And of course, there's misconceptions and shame. And there's just so many things that are affected.
28:46
And, you know, it definitely, I mean, changed the whole trajectory of my life getting to go there.
28:52
Well, I am hopeful for the future with our young people, and I'm continually
28:56
inspired by their dedication to help the people around them.
29:01
And I see that in our community. and do
29:05
you have i like to promote on pediatrics now having
29:08
a life outside of medicine are you reading anything
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watching anything that you would recommend listening to
29:14
or anything you want to mention there yeah there is a podcast called ologies
29:20
and they have different professions from different fields come and talk and
29:27
i i cannot remember what the specific ology is called but there was someone
29:32
who is an expert and studies bees.
29:34
And they were talking about the difference between American honeybees and Japanese
29:38
honeybees and how they work in their colonies. And I was very fascinated by that one.
29:44
But that's my recommendation. Or if anyone's looking to learn a fun fact,
29:48
just look up Japanese honeybees and learn more about them. I was very invested in them.
29:55
That's a great recommendation. I was listening to ologies while I was working
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out one day and it was on cheeseology.
30:02
And I was thinking like, maybe I'll listen for a couple minutes.
30:04
And I ended up, it was a two part series listening to the whole thing.
30:08
And it's so interesting.
30:09
And now I know so much more about cheese. I know.
30:13
That's what I recommend because everyone, each one, each episode's different.
30:18
And so it keeps you on your toes.
30:19
And I was talking about avalanches and I live in Texas.
30:24
So I don't have to worry about avalanches, but now I know more about them.
30:31
Well, this was so great, Jacqueline. Thank you so much for being here today on Pediatrics Now.
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Is there anything else you want to say about yes before we wrap up?
30:41
I just want to share that, again, this is unique because it is tailored for teens.
30:47
Of course, I encourage adults, parents to try it out as well.
30:50
I think it's a great way to kind of see what are the mental health struggles
30:55
that young people are facing.
30:56
But I just want to encourage people that if you are struggling with your mental
31:00
health to please look for resources.
31:02
Project Yes lists crisis and non-crisis resources.
31:06
Talk to a provider. There are resources out there and there are people here
31:09
that want to help and, you know, make you feel an overall better person,
31:14
especially if you're going through something really hard.
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And you're not alone. Yes, absolutely. Absolutely.
31:22
Jacqueline Ware with Project Yes. Thank you so much for being here today on
31:26
Pediatrics Now. Thank you so much for having me.
31:30
Click on the link in this podcast for free credit that may include CME,
31:34
MOC, or ethics credit, depending on our topic or podcast. I'm Holly.