In 1987, I reported to camp for my first full summer as a counselor. The campers were to arrive only a few days later, but I was confident that I would have no trouble as a staff member with a cabin of six 12-year-old campers. To my dismay, the camp leadership insisted that we attend training sessions during "pre-camp" so we could learn and be more prepared. As was the case at many camps back then, this deep dive into child development, behavior management, program planning, and crisis readiness consisted of a few key pieces: the consequences of coming back to camp drunk from a night off, how to go to the bathroom in the woods, and a brief piece on homesickness. The first two topics made sense to me. The last one seemed like a waste of time. Having been a camper since the age of five and now returning to lead my campers through the same course of self-discovery and success at camp that I had followed, why would we sit around and talk about kids struggling? This is camp. At camp, everyone thrives.

To be fair, there was more to that orientation experience 30 years ago. The camp was well-run, and I blocked a lot of the meaningful stuff out because I was an adolescent more excited to run basketball activities and be with my friends than to help children be in touch with their feelings. But the idea that camp was a place where everybody could do well was ingrained in me. Even after a few more summers on staff, including rising to a position of leadership, I continued to see campers and staff through a filter that painted camp as a utopian environment where real-world challenges were blocked, where all campers should succeed as long as they put 100 percent of their effort into the experience, and where the most significant issue counselors might face would be a camper's sense of missing home.

Despite our efforts at times to maintain camp as a self-contained, self-sufficient, and self-serving environment within a protective bubble, the reality is different. In fact, for as much time and intentionality as we put into creating these unique ecosystems that may be where our children thrive, develop grit, and become their best and truest selves, we have to come to grips with the truth that children come to our camps with more than their duffel bags, tennis rackets, and clothes with nametag labels. They come with their complete selves; their backgrounds and experiences; their trauma and challenges; their strengths and needs for development — and they come with their mental health. It's time we recognize that this matters at camp.

After 25 years working in the field, mostly as a camp director, I had an epiphany. But before that, I became aware that a tidal wave of challenges was crashing down on camps — including our own, URJ Camp Harlam — pushing us to develop new strategies. Campers were coming to camp having experienced real trauma. Families were sharing diagnoses of anxiety and depression. We were hearing about — and sometimes seeing — episodes of self-harm. Of course, in serving a mainstream population of children, camp was still rife with campers who needed to work through typical separation obstacles from their lives at home, and there were still social and behavioral concerns that camps had experienced for many years. But these issues regarding the mental health and wellness of our campers felt more pronounced, and we suddenly found ourselves at the intersection of opportunity and need.

More Young People Are Struggling

The National Institute of Mental Health (NIMH) reports that one in five 13- to 18-year-olds has, or will have, a mental illness at some point in their lives, noting significant prevalence and an increase in the diagnosis of depression and mood disorders, as well as anxiety. By age 14, at least 50 percent of these cases of diagnosed mental disorders will be present, and this will climb to 75 percent by the time a young adult is 24 (NIMH, 2018). Is it any surprise at camp — where so many of our campers and staff members fit into that age demographic — that we are seeing more young people struggling with how they feel, and that this is impacting their ability to have the positive experiences they are meant to have?

At Harlam, we began addressing wellness of campers in new ways by establishing an overarching initiative called "Open & Safe," aimed at reframing the type of community we were committed to establishing and spurring efforts to address a variety of areas such as inclusion, gender identity, sexual orientation, campers with special needs, and interfaith issues. This coincided with the building of a new department within camp featuring experienced professionals — first seasonal, then eventually a mix of summertime and year-round staff — to comprise a Camper Care team. These social workers, psychologists, and educators began to understand more effectively what was going on with our campers and applied their sophisticated skills to support the children, the staff members caring for them, as well as the parents at home who missed them. More attention and awareness led to more discovery; more success with helping children to be successful led to more families sharing more information about their children.

Mental Health First Aid

The aforementioned epiphany occurred after a few years of learning and improvement. Cori Miller, our Camper Care team's leader and a member of our year-round staff, told us about the National Council for Behavioral Health's Youth Mental Health First Aid (MHFA) program. Miller attended the eight-hour training, and that led us to consider how we might use the program's curriculum, which focused on teaching people to notice signs and symptoms, and apply a simple plan of action to potentially prevent an issue from growing more serious without attention. Similar to traditional Red Cross first aid, the course is meant to provide basic skills. A mental health first-aider will not diagnose or treat. But with an average delay of eight to ten years between the onset of mental illness symptoms and intervention (NIMH, 2018), and the mounting statistics describing the epidemic issues young people face, we posited that a counselor armed with MHFA training might be able to help. Over the course of the last four years — training more than 250 counselors and other camp staff — we can confidently say that we were right.

An eight-hour course, in and of itself, is not enough, but we had to start somewhere. Recognizing there was more to learn and experimenting with a new approach helped to move us forward. In addition to bringing trainers on-site to lead selected counselors through MHFA training, our Camper Care team provided scaffolding around the experience throughout the summer to both support the staff and best understand how this new initiative might be impacting their hands-on work with campers. Just as the MHFA program is evidence-based, so was our further investment. Surveys and qualitative feedback from counselors and families reinforced how this elevated awareness of mental health challenges and the basic skills to approach, listen to, reassure, and encourage campers to seek help could be valuable (National Council of Behavioral Health, 2018). In each of the last four years, we have continued to train more staff, including training all 160 counselors and leadership team members in 2017 in one day.

We are not preventing all of the issues, nor are we providing treatment to campers. The camp environment is not inherently therapeutic in nature, but combined with additional efforts we have been more adept at helping young adults recognize the signs of a concern that needs attention. Often this leads to typical intervention and strategies for typical issues, but on occasion it has allowed our staff members to make a real difference with more significant challenges. Newer staff members working with more experienced staff members mixed with the infusion of elevated training and support makes Harlam's setting a safer place for children who might be dealing with diagnosed or undiagnosed issues. Parents are grateful when a call comes from camp to share insight into something that may not have surfaced at home, or when we can maintain care of children to allow them the chance to succeed at camp.

Building Mental Health Bridges

In 2017, Miller and I were trained as Youth MHFA instructors. This has allowed us to better train our own staff members each summer, as well as to provide MHFA opportunities to others in our network and community. Our investment has drawn interest and support from outside sources, including grants from funders, gifts from donors, and connections to other organizations. Our partnerships with the American Camp Association's Mental Emotional Social Health (MESH) committee, Foundation for Jewish Camp, and our parent organization, the Union for Reform Judaism, signify the shift in attention toward mental health needs at camp and the promise to combat this crisis.

This past year challenged us to amplify and focus our efforts. Real-world tragedies — including the mass shooting at Stoneman Douglas High School in Parkland, Florida, and high-profile deaths by suicide — are affecting children who could come to camp and the parents who might send them. Depression, the most commonly detected mental health disorder, is now diagnosed in one in eight teens (US Department of Health and Human Services, 2018), and for the cohort of 15- to 24-year-olds, suicide is now the third-leading cause of death in the United States (NIMH, 2018). Families who may have once worried about whether their children would make a friend at camp may now be desperate to keep their children close to home, limiting their exposure to healthy and meaningful opportunities for development of resilience, independence, and life skills encompassed in camp programs. This is why camp leaders must become conversant in the language of mental health, which will be essential to help attract and sustain parents' interest.

Staff members need camp directors to pay attention to mental health too. They require mentorship and exposure to training and tools that will help them be successful with campers in their care, but they also have their own needs. The median age of onset of mental illnesses, such as substance abuse disorder, schizophrenia, and bipolar disorder, is between 20 and 25 (National Council for Behavioral Health, 2018), meaning an equal number of diagnoses are occurring before and after that age. Staff members who may be working through significant transitional stages in their lives may not yet realize why they feel the way they do, and then they arrive at camp to experience an intense and immersive job like no other. Are you equipped to help them?

Our campers and staff members who arrive at camp to have the time of their lives need our help to do so. My misconception as a young counselor that everyone could do well, and that camp was a fantasyland where all of life's ills would fall away the moment we walked through the gates, was naïve. While feelings of missing home are still challenging for some campers each season, there is so much more that we need to teach our staff members to prepare them for their work with other people's children. Campers' and staff members' mental health, and even your mental health as leaders, matters while at camp. It matters for the well-being of each of us, and it matters for the sanctity of the ideal developmental environments that we love and care for. It matters. 

References

• National Council for Behavioral Health. (2018). Youth mental health first aid. Mental Health First Aid USA. Retrieved from mentalhealthfirstaid.org/take-a-course/course-types/youth/
• National Institute of Mental Health. (2018). Mental illness. NIMH. Retrieved from nimh.nih.gov/health/statistics/mental-illness.shtml
• US Department of Health and Human Services. (2018). Adolescent mental health basics. Office of Adolescent Health. Retrieved from hhs.gov/ash/oah/adolescent-development/mental-health/adolescent-mental-health-basics/index.html

Aaron Selkow works for the Union for Reform Judaism as the executive director of URJ Camp Harlam and resides in Philadelphia with his family. His wife, Ann, has been the business manager for Pinemere Camp for 18 years, and his daughter, Lily, has spent all her summers at Pinemere (with two summers at both Pinemere and Harlam thrown in for good measure). Their unique experience as a hybrid camp family will be the subject of a future article.

Photos on pages 54–58 courtesy of Massachusetts General Hospital (MGH) Aspire, Lexington, Massachusetts; Morry's Camp, Project Morry, Elmsford, New York; Louisiana Lions Camp, Anacoco, Louisiana; Farm & Wilderness, Plymouth, Vermont; and Des Moines Y Camp, Boone, Iowa.