Somewhere in Boston right now, a teenager is feeling stressed. They watch their parents struggle to make ends meet. They work after school and try to make sure their homework is done. Their mother works a night shift, their father juggles Uber with a fulltime job. They hardly see them.

They are lonely.

This scenario is not unique and has little to do with parental failure, inherited mental health, or mental illness. In fact, generations of structural racism and economic inequality have created deeply entrenched barriers to health. Black and brown families in Boston have been disproportionately affected by housing instability, wage gaps, over-policing, and limited access to culturally responsive mental health care. These systemic burdens compound everyday stress, increasing the risk of emotional distress for both youth and the adults around them.

The Boston Public Health Commission’s (BPHC) recent Health of Boston Mental Health Report confirms what many already sense: Youth mental health is in crisis. The data shows alarming increases in both the prevalence and severity of mental health challenges, particularly among LGBTQ+ youth and youth of color. More than 40% of Boston Public School students report feeling persistent sadness and hopelessness, and Black and Latinx youth report a higher prevalence of attempting suicide (6.7% and 8.8%, respectively) compared to white youth (3.5%). LGBTQ+ youth reported higher rates of purposely hurting themselves and considering, planning or attempting suicide.

BPHC’s Center for Behavioral Health and Wellness (“the Center”) has prioritized these youth in our efforts and has made significant progress — expanding access to diverse clinicians, increasing mental health training for teachers and youth workers serving teens in after school and summer settings, and launching a citywide campaign for teens themselves. These efforts are vital, but they will not succeed in isolation, as young people do not exist in a vacuum. Their mental health must be considered within the broader context of their family’s well-being.

As early as 1943, psychologist Abraham Maslow identified that individuals must first have their basic needs met, like food, housing and financial stability, before they can truly thrive. Today, these fundamentals are out of reach for many families. Boston’s rising cost of living forces parents into multiple jobs, leaving them little time for their children or their own mental health. This strain deepens inequities, hitting hardest those already stretched to their limits, especially families of color who face additional longstanding systemic barriers in housing, education and employment.

The numbers bear this out. In 2021, life expectancy comparisons between a neighborhood in Roxbury and in Back Bay show a 23-year difference. Mental health data follows these disparities. According to BPHC’s Live Long and Well Report, nearly one in four Black and Latinx adults in Boston report experiencing poor mental health on 14 or more days each month, significantly higher than white adults. These disparities are not a coincidence; they are the result of longstanding, avoidable inequities that shape who gets to be well and who doesn’t.

There is a cost to ignoring family well-being. Chronic stress, depression, trauma and anxiety don’t just impact individuals; they ripple through families, reinforcing cycles of hardship over generations. In response, as Surgeon General Murthy puts it, “Parents who feel pushed to the brink deserve more than platitudes. They need tangible support.”

Boston has many of the answers, but we’re often described as “resource rich but silo poor.” Services for housing, food and mental health are available, yet too often fragmented and disconnected. This fragmentation mirrors the common belief that mental health is an individual issue, living in our minds alone, isolated from the daily social and economic pressures families face.

At the Center, we reject that notion. Breaking down these silos isn’t just part of our work — it is our mission. Guided by BPHC’s Live Long and Well health equity agenda, we recognize that mental well-being cannot be siloed anymore. That’s why we’re building intentional connections across city agencies and placing the social determinants of mental health at the center of our work. We’re bringing this lens into every aspect of what we do, with the goals of shifting how Boston thinks about mental health and what families truly need to thrive.

Because every young person deserves to be part of families that don’t just survive, but thrive, and truly Live Long and Well.

Samara Grossman, MSW, LICSW is the director of the Center for Behavioral Health and Wellness at the Boston Public Health Commission. Prior to holding this position, she was a clinical social worker at Brigham and Women’s Hospital. Her interests lie at the intersection of trauma-informed care, and racial and social justice.