In crisis? Call or text 988 · Text HOME to 741741 · For LGBTQ+ youth, The Trevor Project
Independent · Reader-supported · No paid placement

Teen mental health, honestly.

Hartley is an independent publication for parents and teens navigating mental health. Clinical guidance written without marketing. Real talk, written for actual teens. And a way through to care that actually fits — when the time comes.

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Why trust Hartley No paid placement · Clinical review in progress · Independent editorial · Updated quarterly
Two audiences. One mission.

Where would you like to start?

For parents

I'm worried about my teen.

Clinical guidance written for real parents. Articles for the moment you're standing outside their bedroom door wondering what to do — and the months that follow.

Start here →
For teens, ages 11–19

Something is up with me.

Real information about anxiety, depression, therapy, treatment, and what's actually happening to you. Written for you, not at you. No moralizing.

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$0
Paid by treatment programs to Hartley — ever
Slowly
Published carefully. Reviewed before it runs.
Independently
Reader-supported. No affiliate revenue. No directory fees.
For families
Written for parents of teens and for teens themselves.
By state

State guides, written carefully.

How mental health care for teenagers actually works, state by state. Medicaid, regulators, crisis lines, and what's genuinely available — not a directory of every program that bought search ads.

All state guides →

Published

Arizona

AHCCCS coverage, ADHS regulators, crisis lines, and what teen mental health care actually looks like across the state.

Read the guide

Published

California

Medi-Cal, county behavioral health systems, school-based services, and the patchwork of access from L.A. to the Bay.

Read the guide

Published

Texas

STAR Health for foster youth, HHSC regulators, regional crisis access, and what coverage actually means in practice.

Read the guide

Published

Florida

SMMC managed care, AHCA oversight, the realities of the Baker Act, and what families navigate from Jacksonville to Miami.

Read the guide

More published guides

Browse the rest of the live state guides.

In production · State guides being written

Building carefully, one state at a time.

West

11 guides in production

Alaska·Colorado·Hawaii·Idaho·Montana·Nevada·New Mexico·Oregon·Utah·Washington·Wyoming

Midwest

12 guides in production

Illinois·Indiana·Iowa·Kansas·Michigan·Minnesota·Missouri·Nebraska·North Dakota·Ohio·South Dakota·Wisconsin

South

14 guides in production

Alabama·Arkansas·Delaware·Georgia·Kentucky·Louisiana·Maryland·Mississippi·North Carolina·Oklahoma·South Carolina·Tennessee·Virginia·West Virginia

Northeast

9 guides in production

Connecticut·Maine·Massachusetts·New Hampshire·New Jersey·New York·Pennsylvania·Rhode Island·Vermont

By condition

The full picture of teen mental health.

Hartley's clinical content covers the conditions that actually show up in adolescents — including the ones that get missed, misdiagnosed, or treated wrong.

All conditions →
Anxiety

Anxiety & OCD
Mood

Depression
Trauma

Trauma & PTSD

Self-harm

Self-harm
Suicidality

Suicidal ideation
Eating

Eating disorders
OCD

OCD
Neurodivergence

ADHD & autism

Mood

Bipolar disorder
Anxiety

School refusal
Substance

Vaping & cannabis

Co-occurring

Dual diagnosis
By level of care

From a 60-minute conversation to 24/7 residential.

Most teens never need the most intensive levels. Some teens need them and don't get them in time. Understanding the spectrum helps you ask better questions.

All levels →
Level 1 / Least intensive

Outpatient

Weekly therapy with a clinician. Teen lives at home.
Level 2

IOP

9–15 hours / week of structured therapy. Lives at home.
Level 3

PHP

6+ hours / day, 5 days / week. Lives at home.
Level 4

Residential

24-hour care. Length of stay varies widely.
Level 5 / Most intensive

Acute inpatient

Hospital-level care, typically 3–10 days.
Pillar guide

Levels of care, explained

The full reference on what each level looks like and how to know which fits your teen.
From the library

Clinical depth, without the wall.

Long reads written carefully, with clinical review in progress, and updated quarterly. A few pieces parents and teens come back to.

Browse the library →
Decision-stage · For parents

Will my teen hate me for sending them to residential?

The question almost every parent asks before they pick up the phone — and the honest answer.
Investigative

The troubled teen industry, explained

Wilderness, therapeutic boarding schools, behavior modification — fifty years of an under-regulated industry.
Pillar guide

How to choose a teen treatment program

A framework for evaluating programs without falling for marketing.
"You don't need to have the words yet. You don't need to know what's wrong. You just need to start somewhere — and we'll meet you there."
From the Hartley team
Common questions

Honest answers, no spin.

The questions parents and teens actually ask. We answer them in the simplest way we can.

How do I know if my teen needs residential treatment?

The honest answer: you usually can't know for certain on your own. The decision involves a clinical assessment that weighs safety, daily functioning, response to lower levels of care, and family system capacity. We cover this in detail in our levels of care guide and the decision-stage cluster.

What you can do at home: track concrete changes (sleep, school, withdrawal, self-harm, substance use, suicidal ideation) and bring that information to a clinician — ideally one not affiliated with a treatment program.

How much does treatment cost — and what does insurance actually cover?

Cost varies wildly. Outpatient therapy is often covered with a copay. IOP and PHP frequently are too. Residential treatment is where insurance gets harder — most policies cover it but require pre-authorization and may approve only short stays at first.

The federal Mental Health Parity and Addiction Equity Act gives you legal grounds to challenge denials. We cover this in our insurance guide.

My teen refuses to talk to me. What do I do?

It's not unusual. Adolescent withdrawal from parents is developmentally normal up to a point — and clinically significant past that point. The line between the two is what we cover in the decision-stage cluster.

What helps in the short term: lower the conversational stakes, find shared activities that don't require eye contact, and consider whether a therapist could function as a non-parent adult ally before pushing direct conversation.

Will my teen hate me if I send them to treatment?

Sometimes — at first. Often less than parents fear, and almost always less than the alternative of doing nothing while a teen is in genuine danger. The relationship after treatment is determined more by the family work that happens during and after than by the placement decision itself. We have a full article on this question in the decision-stage cluster.

What if I can't afford anything?

You have more options than the treatment industry's marketing suggests. Medicaid (called different names by state) covers adolescent behavioral health in expansion states. Community mental health centers offer sliding-scale care. Many therapists accept reduced-fee clients. School counselors are a free first point of contact. We cover this state by state in our state guides.

You don't have to figure this out alone.

If you or your teen needs support right now, these crisis lines are free, confidential, and available 24/7. They aren't sales lines. Nobody is paying us to send you to them.

988 Lifeline All crisis resources

Top States

Arizona California Texas Florida More state guides →

Conditions

Depression Anxiety & OCD Eating disorders Substance use Trauma Neurodivergence All conditions →

Levels of Care

Outpatient IOP PHP Residential Inpatient All levels →

Resources

For parents For teens Investigative reporting Glossary Crisis resources Editorial standards Full library →