Growing up on a farm in upstate New York, Jennifer Katzenstein started elementary school charting the course ahead:

“My parents tell me that I wanted to be a bus driver when I was asked in kindergarten or first grade,” says Katzenstein, Ph.D., ABPP-CN. “And then I think as I became a more argumentative adolescent, they thought it would be attorney for sure.”

Instead, Katzenstein drives a different kind of enterprise, the Center for Behavioral Health at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida. She is co-director of the Center for Behavioral Health as well as director of psychology, neuropsychology and social work at the hospital.

Katzenstein values the skills she learned on the farm.

“I think it blows everyone's mind that I can power wash a combine from top to bottom, that I’ve had to bale hay,” she says. “I'm not good at it, but I can weld and I've put an engine back together before.”

She credits the work ethic her father displayed and the conviction of her sister in her formative years.

“My dad worked really hard,” she says. “Basically, all of the daylight hours and so from a very young age, my sister and I were exposed to that pretty significant work ethic, but I also have to say, as I was thinking about it, my younger sister has been a role model too, because she's never feared saying anything to anyone.”

It was in college that Katzenstein found the road map toward her career, and it turned out to be a long haul from that bus fantasy on the farm.

“As I went into college, I became fascinated with the brain and the way that the brain coordinates our communication, the way that we perceive the world around us and our thinking and problem-solving skills,” she says.

Katzenstein earned her doctorate in clinical psychology at Indiana University-Purdue University Indianapolis followed by a post-doctoral internship and fellowship at Texas Children’s Hospital/Baylor University.

Not all families are familiar with neuropsychology. How do you describe it to them?

Neuropsychology is primarily focused on brain behavior relationships. How has the development of the brain and the brain structure and the brain's chemistry impacted the behaviors and the emotions that we see? While a psychologist is really focused on that emotions and behaviors piece and treating those concerns, the neuropsychologist takes into account how the brain may have changed as a result of birth history and/or medical history, such as having seizures or chemotherapy or radiation for a brain tumor or cancer.

From a behavioral health standpoint, kids were having a hard time even before the pandemic and it’s worse now. Can you speak to what many kids are going through?

We're still in crisis in a lot of ways. We know from the data that more and more kids are demonstrating mental health concerns, whereas I used to tell you that one in five kids would experience a mental health concern. The numbers are looking now like one in three or one in four. We have seen those continued increases in mental health concerns as well as kids experiencing suicidal thoughts or potentially trying to attempt or complete suicide.

We also continue to also have a shortage of workforce to help support our kids in need, and that’s not just in Florida but across the nation.

What should parents look for and do to support their kids?

The number one thing I can recommend that parents do is have daily communication with your kids about how things are going. That's 10-15 minutes, or more if possible. Everyone puts their devices down, the TV is turned off and we are tuned into one another. We don't have to have some type of earth-shattering conversation, but just to check in, because it's really getting to know the day-to-day activities and functioning of our kids. This allows our kids to know that we have an open communication time, where they can always chat or bring a problem. For parents, this is a time to make sure they're maintaining their composure if a problem is brought forward, so always staying calm, staying cool and collected. Even if you want to scream about the issue that's being presented to you, that level of emotionality may influence our kids sharing with us in the future. We need to respond coolly and calmly, which continues to reinforce for our kids that they have a safe place to bring their problems.

What made you want to work at Johns Hopkins All Children’s in 2015?

I was really excited to come to work here because there had never been a neuropsychology division at the hospital before and I had the opportunity to build it from the ground up, and build the training programs and bring in the providers to make this the top program in the state. That was really exciting to be able to do in a unique and innovative way. There are very few opportunities to do that in our country.

From there, you’ve expanded your responsibilities to oversee psychology, social work and you’ve been building the Center for Behavioral Health for a number of years. What is the current state and the vision for the future?

We're continuing to do our best meeting the outpatient needs. However, we're struggling because the demand is so high, but we also are offering some limited inpatient support for our kids with medical complexities that also have potential for mental health concerns. I am optimistic that our future is very bright.

We have a really strong opportunity to be the destination behavioral health program for the southeastern United States and to provide the full continuum of care and do that alongside multiple partners and other institutions that have similar mindsets to us. So again, I'm really optimistic that the future is bright for us and that we will be able to continue to grow and not just offer our outpatient services, which is what we primarily are doing, but be able to offer services more broadly to include inpatient care and intensive outpatient services as well.

Is there a piece of advice or a motto that guides you?

There's kind of two. I'll call them mantras that I hold dear. One of them is, “Everything's exactly the way it should be.”

So, when I'm feeling stressed, when I feel like everything's going haywire, I can re-center myself with that. Like everything right now is exactly the way it's supposed to be. Everything is the way it should be, and holding to that.

Another is, in college, I saw a poster that said, “Be the change you wish to see in the world,” so I have held that close to me as well.

Those two are things that I really do hold dear.

If you are thinking about suicide, or are concerned about a friend or loved one, call the National Suicide Prevention Lifeline at 1-800-273-8255. The Lifeline network is available for anyone at any time, 24/7.