Frieda Edgette wants our youth to co-create mental health policy

That question set off a chain reaction, and in a remarkably short period of time it has grown into something large enough to potentially change how San Mateo County thinks about and supports youth mental health. It has also arrived at a moment when the numbers say the numbingly quiet part out loud. Of lifetime mental health challenges, 75% begin by age 25. Of Gen Z, 94% report struggling with climate, affordability, discrimination and gun violence. Suicide remains a leading cause of death for local youth. These are not isolated concerns, and they are conditions shaping a generation’s daily experience.

Edgette’s response is the Futures Commission, a youth-led and globally connected effort that asks San Mateo County to turn beyond crisis management and build to change systems. The Commission calls for youth to play a role in informing the county’s next chapter, real youth commission seats, and a structural commitment to foresight. San Mateo County could also become the first local government in the United States to adopt the September 2024 United Nations Declaration on Future Generations, a unanimously adopted global agreement centered on the well-being of people and planet.

The declaration recognizes today’s decisions have an intergenerational multiplier effect and children and youth are agents of change whose perspectives must be included in policy. It requires governments to make decisions with long term well-being as the baseline rather than an afterthought. This is the kind of scaffolding that shifts an entire system from reacting to shaping. It is also one of the few modern policy frameworks that treats youth participation as a democratic requirement rather than a courtesy.

When Edgette co-founded the county’s Behavioral Health Commission Youth Action Board in 2021, it began as an attempt to move beyond the usual cycles of youth engagement. Four cohorts later, it has become a youth-led, adult scaffolded structure shaping tangible results like countywide mental health curriculum, crisis line campaigns, intergenerational dialogues and more. It has also produced something harder to quantify but deeply felt — hope, connection, agency.

Ours is a county that has been slowly preparing for a conversation like this. Shared Vision 2025 is sunsetting and prevention dollars are shrinking. As our workforce continues to age, the internet and artificial intelligence offer some solutions and a trail of very human challenges. All of these challenges interact with youth mental health in ways we can no longer treat as separate policy domains. While more administratively burdensome, the promise a decade from now is otherworldly.

When you zoom out, the Futures Commission is part of a larger web of global acknowledgment of an epidemic being swept under the rug. Wales reshaped its entire governance model around the well-being of future generations. Washington State is pursuing long-term, whole of society strategies to address poverty. Vermont is exploring wellbeing budgeting. Hawai’i is building an Indigenous led economic framework centered on community and stewardship. We are positioned to contribute something original to this movement by being the first county jurisdiction to set policy here.

The commission’s proposal invites residents to imagine a future where mental health is shaped upstream rather than downstream, where our community’s youth are not sidelined until adulthood, and where civic participation becomes both expected and welcome. I know for many I have spoken to over the years, the sidelining feels very real and infrastructure as a forcing function for generational collaboration will be welcome.

Today, the San Mateo County Board of Supervisors, supported by President David Canepa whose tenure has been marked by elevating mental health as a public concern, will vote on whether San Mateo County should support the United Nations Declaration on Future Generations. This is a chance to formalize something young people have been telling us for years. They want to shape the future they are inheriting, and they are done sitting on the sidelines watching their future world be created on their behalf. Our youth want a real seat at the table, and they want their ideas treated as a source of innovation and catalyst for collaboration rather than opportunity for performative gestures.

Edgette’s original question still stands. What if young people were empowered to co-create policy? Hopefully this time, we get to see.