Relational Health Is Health

A few weeks ago, I met a young girl named Little Kellie. Neglected by the foster care system, abused by her family, and failed by our mental healthcare system.

This is her story.

(???? WARNING ???? This story contains self-harm and other challenging topics)

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Little Kellie was born into a family that was unable to support her, so she ended up in the foster care system as one of the 400,000 youth in foster care custody.?

For months her foster care team desperately tried to find her a stable home. However, each new home placement created new challenges for Little Kellie such as bullying, adjusting to new schools, and navigating a new set of health providers. With no other people to trust and rely on, Little Kellie had to learn to fend for herself.?

To protect herself, she developed behaviors such as hiding food and being aggressive towards other kids when she felt threatened. These behaviors were deemed “disruptive” by her foster parents who would request that she be transferred to a different home.

After months of bouncing from home to home, Little Kellie was able to find a stable foster home. One where she fit in with the other kids and felt comfortable enough with her foster parents. Though it took a while, she began to feel a sense of normalcy and was able to let her guard down and begin trusting others again…

Until the day her foster father sexually abused her.

Little Kellie was forced to enter the foster care system once again. Overwhelmed by the repeated traumas that she faced, Little Kellie became hopeless and attempted to take her own life.

Fortunately, she was unsuccessful. And at this point, Little Kellie’s care team was immensely concerned about her wellbeing and safety. They decided that what was best for her was to send her away to an in-patient treatment facility.

So Little Kellie was separated once again from anyone that she had known and taken to a far away place where she could not leave. Here, she had to acclimate herself with a new host of people who she did not know or trust. She stayed at the facility for weeks but unfortunately did not improve.

After leaving the in-patient treatment center, Little Kellie’s suicide attempts continued. Each time, her care team would remove her from wherever she was and place her into another treatment center. Each time, she would lose connection with anyone she had previously known and navigate a new roster of people.?

After many unsuccessful in-patient stays, her care team didn’t know where else to turn.

So they asked Little Kellie… “What is it that you want right now?”

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Little Kellie quickly responded that she wanted to meet her biological parents. She wanted to belong to something, wanted to know where she came from. She longed to know who she was and where she fits in. She wanted someone to love her and to be around people who were not paid to be there to watch her.?

Desperate to try anything, her care team searched through their records for her biological parents and managed to find a few family members to reach out to.

After a few dead-end phone calls, her aunt picked up. “Oh my goodness, we’ve been looking for her for years!” she exclaimed. A name change by her previous adoptive parents had made it impossible for her biological family to find her despite their attempts over the last decade.

Reconnecting with her biological family allowed Little Kellie to engage with her family for the first time. Her care team encouraged Little Kellie to invest in the relationships with her family, and encouraged her family to invest in Little Kellie. Though trust was not built immediately, Little Kellie slowly grew to feel hope that she might be able to finally have people who she could trust and rely on.

Over time, her care team noticed Little Kellie beginning to engage with their treatment recommendations. Slowly, they saw improvements in her behavior and Kellie was able to stop self-harming. Eventually, they were able to move Little Kellie back in with her biological family and give Little Kellie a stable home where she could begin building a new life for herself.

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Unfortunately, in using the tools that they had at their disposal, Little Kellie’s care team had to repeatedly uprooted her from all of the relationships in her life and left her without a stable foundation of relationships. They opted for treatment after treatment because those are the tools that our healthcare system has to offer.?

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Though Little Kellie’s name was changed for the sake of privacy, her story is real.

The point of Little Kellie’s story? To illustrate how often we forget something fundamental… that relational health is health, or that the quality of our relationships has a huge impact on our wellbeing.

Studies show that the number one predictor of lifelong wellness is the quality of our relationships(1). This is especially true for youth—having trusted adults inside and outside of the family is a major positive protective factor for long term youth resilience and wellbeing (2).

“Quality of relationships with family members such as parents, siblings, and extended family members are significantly associated with mental health and well-being Furthermore, studies showed that romantic relationship status and psychosocial characteristics within relationship contexts affect the mental health of young” (3)

If we hope to make a meaningful impact in the lives of many struggling youth, we must invest in doing the work needed to help facilitate and cultivate stronger relationships, even when they might not meet a standard treatment protocol. This is often not afforded by traditional treatment options and requires thinking more broadly about how we support those in care.?

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I was so deeply inspired by Kellie Hans Green 's talk “Relational Health is Health” at the Behavioral Health Innovations conference last week that I felt compelled to collaborate with her to share Little Kellie’s story today (this post was co-authored and approved by Kellie Green and all original content can be attributed to her).

Stories like Little Kellie’s, though not always easy to hear, are the stories that we must be reminded of if we are to make radical improvements to our behavioral healthcare system.