By Paula Starnes
When we talk about mental health, too often the conversation begins after a crisis has occurred. A child struggles in silence, a family reaches a breaking point, a community mourns a loss that might have been prevented. We ask what could have been done differently, but rarely do we focus enough on what can be done sooner.
The truth is that early intervention in mental and behavioral health has the potential to dramatically change lives. The National Alliance on Mental Illness reports that half of all lifetime cases of mental illness begin by age 14, and 75% by age 24. Yet, research shows that on average there is an 11-year delay between the onset of symptoms and the start of treatment.
These are years when children and adolescents are navigating critical periods of emotional, cognitive, and social development. Left unaddressed, emerging challenges can compound, often becoming far more difficult to resolve later in life.
It is why our health care industry needs to shift its focus. Instead of reacting to crises, we must proactively create environments where conversations about mental wellness begin early, feel natural, and are reinforced regularly. Mental health education should not be reserved for moments of intervention. It should be embedded into the daily lives of our children, much like how we teach nutrition, exercise and safety.
In communities across Pennsylvania, we have seen the powerful impact of starting these conversations early through the Aetna Better Health Kids’ Wellness on Wheels (AWoW) Movie Watch Parties. These events blend entertainment with education, providing children and families with a safe, supportive space to explore emotions, develop coping skills, and build emotional resilience.
Whether watching films like “Inside Out 2,” engaging in interactive discussions, or participating in hands-on activities, children are learning how to recognize their feelings and talk about them.
“Inside Out 2” was selected for these events because of its creative and compassionate portrayal of emotions, particularly the introduction of anxiety. The movie helps children (and adults) understand how new emotions emerge, interact and shape our behaviors. This makes it a powerful catalyst for conversation, especially for parents and caregivers seeking to better understand and support their children’s emotional world.
Each child who attends leaves with a behavioral health journal, a tool I created to help them continue the conversation at home. These journals are more than just blank pages; they include prompts to help children name their emotions, reflect on their feelings, and practice self-regulation. For caregivers, they open a window into their child’s inner world, creating an opportunity for connection and understanding.
As a mom, I know how to treat my child’s cold or fever. But understanding how to recognize signs of anxiety and then knowing how to effectively help them navigate their behavioral health care needs, was completely foreign to me. I didn’t have tools to manage their emotional fragility, and I was afraid that without adequate training or resources, I wouldn’t be able to give them the care they needed. I created these resources to make these at times complex, deeply emotional and very real situations easier to navigate as a community. When we learn how to normalize these discussions and prepare for them, we drive better overall health and wellness.
In just the last year, AWoW Movie Watch Parties have engaged nearly 1,500 children and family members across Pennsylvania, distributing more than 1,400 behavioral health journals and thousands of healthy snacks and resources. From Harrisburg to Erie to Philadelphia, the feedback from school counselors, parents and community leaders has been overwhelmingly positive.
Of course, programs like AWoW are just one piece of a much larger puzzle. The need is great and growing. According to the Centers for Disease Control and Prevention, in the years following the pandemic, more than one in three high school students experienced poor mental health, and nearly half felt persistently sad or hopeless. Our children are telling us, in numbers too large to ignore, that they need our help.
While early intervention is essential, we must also ensure immediate help is available when crisis strikes. The 988 Suicide & Crisis Lifeline is a free, confidential resource that connects individuals with trained counselors around the clock, because no one should have to navigate a mental health emergency alone.
Mental health is not a single conversation. It is many small conversations, started early, sustained over time, and supported by an entire community that recognizes the lifelong value of emotional wellness. If we are willing to invest in those moments today, we will build stronger, healthier generations for years to come.
The opportunity is before us. Now is the time to act.
Paula Starnes is a health care executive with Aetna Better Health, a CVS Health company. She leads community engagement initiatives across Pennsylvania, focusing on children’s behavioral health and wellness.
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