Broadening Access to Mental Health Care for Ethnically Diverse Students

Jan 17, 2024

Diana Chao and Evan Rose discuss the complexities of accessing adequate mental health services for ethnically diverse students and share frameworks to support mental well being in academic institutions and beyond.

Hosted by Carla Harris


Carla Harris: According to a 2023 Best Colleges survey, more than half of the college students across the U.S. say that their mental health worsened during their time in college. In that same study, only 41% of students said their school is doing enough to help their mental health. Another 2023 study by the National Education Association reports that students of color are far less likely to get treatment for mental illness due to factors such as: lack of access to a diverse selection of counselors, cultural stigmas surrounding mental health and the cost of care. And while numbers have shown mental health awareness improving over recent years, there is still work to be done when it comes to providing equitable care.

Today, we'll hear from two founders whose own experiences led them to create organizations that provide and advocate for adequate mental health services.

Diana Chao: When you transition from let's say, high school to college you're often away from home for the first time, your parents are no longer there legally required to sign off on things, and you're in charge of all this health data and healthcare decisions – and maybe you don't know how to manage it?

Carla Harris: This is Diana Chao, a graduate student at Oxford University and Executive Director and Founder of Letters 2 Strangers, a global, youth-run mental health non-profit. We'll hear from her first.

And later, we'll hear from Evan Rose. Evan is the co-founder of The Steve Fund, a non-profit member in the Morgan Stanley Alliance for Children’s Mental Health. The Steve Fund is the U.S.’s leading organization focused on supporting the mental health and emotional wellbeing of young people of color.

Evan Rose: We spend a lot of our time in our workplace. We spend a lot of time in, you know, our college and our schooling. And if those environments are more supportive and they're more open, then the world is going to be a better place because you've got many, many people being impacted by these spaces they spend their time.

Carla Harris: Welcome to Access and Opportunity, I'm your host Carla Harris. And we're telling the stories of individuals working to drive change within their communities. We provide context about systemic inequities and share tangible examples of how ideas around access and opportunity are being made real every day.

Diana Chao: I was diagnosed with bipolar disorder when I was 13 and a blinding eye disease when I was 14. And navigating those things as an immigrant, as the daughter of people who didn't speak English, growing up beneath a poverty line, there was a lot of stigma that made it really difficult to access care. And so I ended up turning to writing as a means of escape, but also a means of finding my own identity and voice.

And it was when I was writing these letters to strangers, to people who I realized for the first time could actually care about me, that I started to discover the value in my own story.

Carla Harris: Diana and her family relocated to the U.S. from a rural province in China when she was just nine years old. The transition was tough on Diana, who says she knew she needed professional help to navigate her diagnosis, but encountered many barriers to accessing that care as a young person and as an immigrant.

Diana Chao: I will have to preface that with saying that the American healthcare system in and out of itself, especially when it comes to mental health care, can be very difficult to navigate, no matter your status or identity. But I think it's just the fact that my family didn't speak English, and also the fact that my parents were always working, trying to make a living as we were living below the poverty line. And as a kid, you can't go see the doctor by yourself. So it was really hard to seek the care I needed in a way where I felt affirmed and validated by both my care provider, as well as by my own family, and then do it in a way that was consistent and affordable enough to be consistent to see actual help. But it was when I was writing things in a letter format where there had to be someone on the other side to read it, that I started to feel more reflective about what it was that I was putting down.

Carla Harris: And not long after discovering the power in writing for herself, Diana discovered the power of writing for, and with, others.

Diana Chao: When I first started Letters to Strangers [laughs] I had to bribe my friends with free pizza to come to the lunch meetings and I kind of viewed it as another excuse to get them to hang out with me even if they didn't want to. But what amazed me was that even after the pizza ran out, they still came, and then more people who I didn't know showed up, and people from nearby schools heard about it and wanted to join in, and we grew to what we are today.

Carla Harris: At present, Letters 2 Strangers has moved from outside of Diana's high school cafeteria and stands as a global organization with programs implemented in over 70 countries.

Diana says Letters 2 Strangers achieves their mission to destigmatize mental illness and increase access to affordable, quality treatment — particularly for youth — through three main pathways.

Diana Chao: The first is of course our namesake: anonymous letter writing exchanges — which happen on school campuses, in local communities, and our online public platform. The second pathway is science-based peer education. So that includes our curriculum, which is the world's first youth-for-youth mental health guidebook, and the teacher's handbook that accompanies it. And the third pathway is grassroots, policy-based advocacy. So that looks like things like implementing changes on school campuses, working with the government and local administrators to figure out ways to provide more access to care for young people, etcetera.

Carla Harris: Data from the American School Counselors Association for the 2021-2022 school year showed a student to counselor ratio of 408 to 1. The ASCA's recommended ratio is 250 to 1. And while there’s already a lack of counselors for students of color, it’s even more difficult to find the right fit.

Diana Chao: I think when it comes to college students, what I would love to see is, first of all, a greater recognition of the need for cultural and just, in general, diversity of care provision. So, if the provider you're seeing doesn't necessarily understand the background and nuances you're coming from, it can make it difficult to have care that feels relevant to you. And similar to that, I think there's an important discussion that would need to be had just on the logistics of navigating care once you're an adult. Because when you transition from let's say, high school to college, you're often away from home for the first time, your parents are no longer there legally required to sign off on things, and you're in charge of all this health data and healthcare decisions, and maybe you don't know how to manage it.

Carla Harris: Letters 2 Strangers runs workshops that provide in-depth mental health education to tens of thousands of people who may need assistance when navigating that transitional phase for themselves.

Diana Chao: So not just the basics of mental health, like, what are some signs you might be struggling? — but also intersections of mental health with your racial, cultural, socioeconomic, disability, religious, LGBTQ+ identity background, all of these different things. That's a really big deal to us, and a really big deal to fellow young people, as well. And outside of the US, I'm really happy to say that our curriculum has been implemented in numerous high schools across Nepal with our partner organization and the Nepal government. So we are on track to teach over 10,000 high school students by the end of this year, and we are part of the national budget for the Liberian government starting next year with our hotline where we run the first toll-free pan-African mental health hotline.

Carla Harris: 2023 marks the ten year anniversary for Letters 2 Strangers. And Diana describes the journey as surreal. She says that leading this organization is a blessing and a huge responsibility, which has contributed to her decision to pursue an MBA. She believes this degree will better equip her to lead Letters 2 Strangers and serve her community.

But ultimately, Diana's work is to educate and advocate for mental wellness, and she'll continue to do so with the power of the pen.

Diana Chao: I really want us to be able to view mental health as the global, truly human conversation that it is, in the context, of course, of the challenges our own local community faces, and recognize that we are all human at the end of the day. So, like we say with our motto: “Writing is humanity distilled into ink.”

Carla Harris : Diana is set to graduate with her MBA in 2024. As she embarks upon this new chapter of her life, she is in good company. Through her work with Letters 2 Strangers, she’s equipped a wave of Gen-Z students with the tools and resources to better navigate their next steps, such as starting a first job.

Our next guest, Evan Rose, is also devoted to helping young people move confidently through life’s milestones. Evan is the co-founder of The Steve Fund, a non-profit member in the Morgan Stanley Alliance for Children’s Mental Health, and the U.S.’s leading organization supporting mental health for minority students by giving colleges a framework to support students' mental well being.

The Steve Fund’s reach has grown over the years, and as a result, so has their mission. Their work now includes pairing with companies to build better support systems for recent graduates transitioning into the workforce.

Carla Harris: Well, Evan Rose, thank you so much for being here with me today. It's a pleasure to have you on the show.

Evan Rose: Thank you for having me.

Carla Harris: All right, let's jump right in. Can you start by telling us about how The Steve Fund and your role as co-founder & president came to be?

Evan Rose: The Steve Fund was founded in 2014. It was, unfortunately, as a result of my brother's passing. My brother committed suicide after a long battle with mental health issues. And, ultimately what happened to us is that we gathered as a family and we were broken at that point in time.

I wound up writing a post. And so I just wrote about Steve, and about what he had been struggling with, and about how brave he was for fighting through it. And what happened as a result of that was that almost a hundred people reached out sharing similar stories that they had been through. And ultimately, I started to realize that, that there are other people dealing with this and that they're willing to talk about it.

So that's really how The Steve Fund began. We sat in our dining room, the whole family, and we put up these gigantic Post-It notes — essentially they were like those, you know, corporate size Post-It notes — and we started whiteboarding, and what we came down to was we want to find a way that other families won't have to feel this way. They won't have to feel that they're suffering alone. They won't have to feel like there's things that are happening to them that might not be happening to others.

Carla Harris: And it sounds like, Evan, that it was first conceived as trying to build a network where people could talk, and where people could get educated about what mental wellness was really all about, and what the different verticals are within it, and the kinds of challenges that young people were having.

Now, you all, from the very beginning, have focused on addressing the mental and emotional well being of students of color. So why was it so important for The Steve Fund to work with students of color? I mean, you're not exclusive to that, but that certainly was a target at the outset, and has remained an important constituent.

Evan Rose: Yeah, so there's really two things around that, right? So there's the young piece of it, right? — which is young people of color are our target. ‘Young’ meaning that these are folks who are in the area of their life where mental health issues tend to arise. They tend to arise in that college age range into the early 20s, and a lot of times they won't even show up prior to that.

And then, the ‘young people of color’ piece is really important because young people of color historically have used mental health services less. And I think part of it is because of that stigma and the issues that they're dealing with are also unique because very often there are stressors that are unique to that population.

So you have this kind of compounding factor where there's not many people of color who are service providers in the mental health space. So then you can't connect them with the right people who look like them, and who have shared, lived experiences with them. So this is a historically underserved group and a group that actually needs it a lot.

Carla Harris: So you, you have technically a bit of a train-the-trainers model in many cases, when you think about what you're doing at the college level.

Evan Rose: We do, we do. And I think a lot of it is really related to supporting these bounded environments where young people are forming their, you know, worldviews in their lives. And so if you can create supportive environments at the institutional level there, and at the workforce level, then you're more likely to create supportive environments for them that they feel comfortable attaining services in, speaking about any issues and not being, you know, judged for those issues in any of those environments. So it's a really important aspect of what we do.

Carla Harris: And frankly, when I think about it, Evan, you are also helping these emerging leaders, because these folks will lead one day to create environments that are inclusive and supportive, from a mental wellness perspective, because you're giving them these tools and you're serving them. So, you know, people tend to lead the way they were led. And by investing in them on this, in particular, you actually are creating, I would say, better leaders, you know, for the next 20 or 30 years.

Evan Rose: That's our hope. It's better leaders and folks that will set the policies that will create ever more supportive environments for folks.

Carla Harris: Now, there's a 2021 Healthy Minds study that found that the percentage of students experiencing mental health problems has increased nearly 50% since 2013. That's the last 10 years. So when you think about services and solutions, what have you seen work on college campuses when addressing some of these stressors, and addressing mental health more broadly?

Evan Rose: So I think there's a really great framework. So there's the Equity and Mental Health Framework, which is our kind of flagship program — really terrific and sort of research backed approach to this. And really it's 10 different things, right? One is the public acknowledgement of importance. That's a huge piece of it. You have to publicly say: “This is something that we're going to be focused on,” specifically, as it relates to mental health and well being of students of color.

The second is involving students. So students need to have a say, right? They need to be able to give guidance. They need to be able to give feedback as it relates to things that will support them.

Another piece is recruiting, training, and most importantly, retaining a diverse and a culturally competent faculty and professional staff. That's huge. Especially as, you know, young people of color in predominantly not colored, you know, institutions. There's a lot of challenges around that, and making sure that there are staff that looks like them is a big piece of it.

The other piece is engaging around national and international issues and events. So when there's a big moment, COVID happens, you need to be able to publicly acknowledge this is happening, but also say, “Here's how it might impact you. And here's what we're doing to support you.”

Another is dedicated roles being created to support the well being and success of students of color. Promoting, specifically, safe communications with campus administration. So, keeping that door open to allow communication to be two way. Creating specific, supportive programs, but also delivering them in a variety of forms — formats — is an important piece, because the person that will go to a public town hall might not be the person that's going to read a blog post, might not be the person that's going to read a micro series, or take a micro course. Those different formats open the door to multiple different types of folks who are actually going to now access this information.

Advertising them — that's a big piece of it, right? If you build it, they might not come, so you've got to advertise these programs and services, and you've got to do so through multiple channels.

Of course, identifying and utilizing culturally relevant programs — so you've got to measure them, is the biggest piece as a result of that. Once you've done this, you need to look at how people are engaging, and then to adjust your strategy as a result.

And then the final piece of that is sharing data within your own school, but also between schools. So don't keep that data in a silo — publish it internally, share it with folks like us or others that are sharing data between schools, and then that helps to increase the efficacy of these programs across the entire spectrum.

Carla Harris: Wow. These are really 10 points that I would argue are basic playbook points for any institution of higher learning to create an environment and a culture that will support mental wellness.

And then if you, for some reason, don't get the help you need or are not brave enough to talk about it while you're an undergrad, then, as you say, you take those things into the workplace, trying to create products and availability and access once people start work, because often it's the same set of issues. They may deal with the stigma, they may deal with the racism, they may deal with the ‘imposter syndrome’, which I hear a lot now, which — oh my gosh, Evan, almost every time I speak, I get the question about ‘imposter syndrome’, and I'm scratching my head saying: That was a big thing when I was walking out of Harvard Business School or Harvard undergrad in the ‘80s. How can it be, 30 years later, that people are struggling with that?

Evan Rose: Yeah, these are huge challenges and it really can have ripple effects on people. People going into the workforce, a lot of times, especially, high achieving people — they're into the hot pot, right? They're going from, you know, an environment that might've felt cozy into a high stress environment. That's another area where they're incredibly at risk, especially when they're expected to perform at the highest level and show no sign of weakness, at any point, in a working context.

Carla Harris: Yeah. And you're far more exposed — let's face it — in a work environment, than you are in a classroom. Because whether it's a classroom of six people, or a classroom of 60, or 600, in a big survey course, there's still the comfort of the confines, if you will, of the classroom. So there's still some room to move. But when you're in an office, or you're walking in the building, or you're sitting in a conference room, there's a whole different level of exposure. So, as I said, I hate the fact that people are struggling with the ‘imposter syndrome’, but I understand why it's still there, why it's real — because you don't feel the same level of support.

Evan Rose: Absolutely.

Carla Harris: Yeah. Let's talk about you a little bit. Because even beyond The Steve Fund, you are the founder & CEO of Rose Digital, which is a digital branding agency that you started in 2013 — happy 10th anniversary. So now, as a Black CEO of a tech startup and a co-founder of The Steve Fund, you are clearly a pioneer in these spaces. So can you share a little bit about that entrepreneurial journey, and how your work in the mental health space influenced your path?

Evan Rose: Definitely. Yeah. So the organization that I founded is a digital agency and it focuses on delivering web, mobile and augmented reality services to a variety of brands. And what we do is we build technology within the context of their organization that they will then use as products to ship to their users and their customers. And so it takes a variety of different forms, but, as it relates to mental health, I think these two organizations grew up at the same time and they followed a lot of the same, kind of, curve in terms of the development and the growth of the organization. And what I found is that entrepreneurial pathways can be inherently isolating, especially solo founder-type environments.

Carla Harris: Oh yes.

Evan Rose: And the work of The Steve Fund — super important to me. And I, you know, find myself reviewing materials and thinking about how I can create an environment, not only at my workplace, but at the other workplaces that other folks that I know have founded, to support their teams. And, you know, thinking about just myself alone as a solo founder, how can I support myself in this context? Because it can feel isolating when you're the only person at the helm, trying to figure out the right decisions to make and the responsibilities of managing a team. So it's a lot of shared learning across the two organizations, as well.

Carla Harris: Mm hmm. After working with entrepreneurs for almost a decade of my career, I now understand where that term came from: it’s lonely at the top — because so often you don't feel like there's anybody you can turn to. You can't turn to your team to share your stresses or your stressors, or you feel uncomfortable showing some level of vulnerability there, because you are the boss and the buck stops with you. So I completely get it now — what, especially early stage founders, go through, and I do think that there should be a level of support that sometimes their boards don't even see because their boards are impatient, you know, produce, produce. But I would argue that being a solo entrepreneur, and being an early stage entrepreneur, you need far more support than even someone that is at the helm of a midsize public company, if you will.

Now, there was a 2020 study by the APA that says 62% of workers now reported feeling comfortable speaking openly about mental health with their supervisors. That's a more than 10% increase from the 51% in 2019, just in a year, which again, I think is just fantastic. And what do you say is driving the increase?

Evan Rose: I think there's a couple of things. One is just a generational, kind of cultural shift towards openness. The cultural aspect of it is really important because I think it dovetails really nicely with the rise of social media. And we think a lot about the upside, but also the downsides of social media.

But one of the upsides is that, if you share something, and it gets picked up, a lot of people will see it. And so if you're sharing that you might be dealing with issues, a lot of people could, and likely will see that same portion of them. So at least some larger portion of them are actually going to say, “Hey, I might feel that way myself some days.” And that creates opportunity for them to then share, which then it kind of creates this virtuous cycle where the sharing begets more sharing, and then people ultimately are able to connect with each other, and to share what's going on with them. And it's not like suffering alone. It's: we've got something that's pervasive across society. Let's deal with it together and create a band of relations here.

Carla Harris: So Evan, you know, I often get asked the question, how can I communicate to my people that, you know, I do believe in mental wellness? How can I help to remove the stigma associated with that? And I'm thinking to myself, based on what you just said, that maybe it's about the language that you use as a leader.

Maybe you stand up in front of your people and say, “Listen, I've gotten to where I've gotten to. If you view me as a powerful leader, I've gotten here because I've been intentional about building space for myself to restore my creativity, to restore my energy level, to restore my problem solving. And if I'm doing that all the time with no break, then I won't be as efficient. I won't be as high impact. So here's what I do.”

And building in that space to help them think about that as restoration time, not that this is a liability, or, if I need this time, there's a problem. No, I need this time to keep operating at this level, and this is how I do it. So, modeling that and messaging that might be something important as a leader, if you want to build that culture within your team, without stigma.

Evan Rose: I would agree with that 100%. It really is about regenerating and creating the space for yourself to continue delivering. You can't go 150% all the time without running out of energy or exploding. It's impossible to do that. Nobody can sprint for hours.

Carla Harris: What would be your dream of how colleges and companies address the mental health of their students and early stage employees in the next 10 years?

Evan Rose: You know, given how much the world has changed in the last 10 years, I think, you know, we have to account for some level of white swan or black swan type events. But realistically, I think if we can continue down the pathway that we're on, as it relates to reducing the stigma and increasing services attainment, part of that is the technological aspects of it, right? So you've got telehealth starting to increase, especially folks being able to access therapists who are either, you know, in video format, in text format. All of these different formats. So increasing the way that folks are able to attain services, but obviously and incredibly importantly, having more institutions sign on to the Equity and Mental Health Framework would be incredibly powerful because we know that it works, right? We know that these cohorts go through this process. We know at the end of the process that they've seen results, and we want to then increase the throughput of these programs. Another aspect of what we hope to see as a result of that is people coming out feeling and saying that they feel, especially in surveys, more prepared for the workplace and feeling supported through that workplace as they enter, you know, some of the more stressing years of their lives in their first two, three years out of undergrad.

So our hope is to continue to scale the impact of the programs and use technology to scale it in ways that increases the value of these programs, but doesn't dilute the benefit, because there's a human aspect to this as well.

Carla Harris: So Evan, you know, I, I see the Steve Fund continues to evolve. You all have a new CEO.

Evan Rose: That's right. David McGhee has joined us. We're incredibly excited about his impact on the Steve Fund and our mission. And really it speaks to a focus on continuing to develop the internal capacity of The Steve Fund and to be able to galvanize the team, build out the capabilities that we need and then, ultimately, layering on technology to increase the impact of The Steve Fund.

Carla Harris: Well, exciting things to come for The Steve Fund. Evan, thank you so much for taking the time to speak with us today.

Evan Rose: I appreciate you. Thank you for having me.

Carla Harris: I want to thank Diana Chao and Evan Rose for joining me on this episode of Access and Opportunity.

If you or someone you know is struggling with their mental health, there are resources available. You can reach the National Suicide and Crisis hotline by phoning or texting 988.

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Thanks for coming along.

Rates of depression, anxiety and suicidal ideation among college students are at an all-time high. And while students of all backgrounds face similar levels of mental health challenges, ethnically diverse students are far less likely to seek treatment. That gap is due to factors including lack of access to a diverse selection of counselors; cultural stigmas surrounding mental health; and the cost of care. The need for more robust mental healthcare continues once students transition into the workforce.


On this episode, we hear from Diana Chao, a graduate student and the executive director and founder of Letters 2 Strangers, a global, youth-run mental health nonprofit that emerged from Diana’s own battle with mental illness. Then, host Carla Harris sits with Evan Rose, co-founder of The Steve Fund, the leading organization in the U.S. focused on supporting the mental health and emotional wellbeing of young people of color, and a non-profit member of the Morgan Stanley Alliance for Mental Health. They discuss the work that The Steve Fund is doing to offer a roadmap for higher education institutions and companies to create accessible mental healthcare solutions for their students and colleagues, respectively.


For more information about the Steve Fund, go to To learn more about Morgan Stanley’s Alliance For Children’s Mental Health, visit

Interested in the Morgan Stanley Inclusive Ventures Lab?

Read about the firm’s in-house accelerator for underrepresented founders.

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