Alex Yarijanian: 00:00:00

There is a teenager right now sitting alone at lunch because none of her friends understand what it's like to take 11 pills before noon.

Nobody's building her a robot companion.

Nobody's riding her a Medicare pilot.

We've decided as a system that loneliness is a senior problem.

And it's sad when it happens to a 75 year old.

It's sad and invisible when it happens to your 15 year old.

According to the National Library of Medicine, one in three young people in this country live with a chronic condition.

20 Million Americans, American kids are at higher risk of isolation, bullying, mood disorders because their peers don't get it and the system isn't built to catch them.

Today I'm talking to someone who refused to accept that she's not a health plan executive.

She's not a policy wonk.

She's the one living it.

And she built the fix herself.

Esha Mittal is the founder of Shared Strengths Project, a peer mentorship program pairing youth with chronic conditions to mentors who've been there.

To mentors who've been there and not based on their diagnosis.

That's not the sharing, that's not the matching criteria.

The criteria is lived experience.

Now she is partnered with UCSF's Wellness center for Youth and Young Adults with Chronic Conditions.

at the Behavioral Health Tech: 2026

Last time I remember a highly anticipated speaker, it was Paris Hilton.

So, Esha, welcome to the Value Based Care Advisory podcast.

Esha Mittal: 00:01:39

Hi.

Thank you so much.

I'm so excited to be here.

Alex Yarijanian: 00:01:42

Esha, take me back to your diagnosis.

What was that first year actually like?

Take us back.

Not, not medically, but socially.

Esha Mittal: 00:01:53

So I was diagnosed in October of my freshman year of high school.

And I had not only just started at a brand new school, I had actually transferred schools about a month into the school year to accommodate for my new diagnosis and missing school.

So I moved to a place that actually would be able to accept those absences better.

So I started a new school and then I switched pretty immediately.

And when I arrived at my new high school, I was already nervous because I came in a little later.

But also I didn't have the same opportunities to make friends with people around me because during social times like lunch or early in the morning before school, I was often either at doctor's appointments or I was sleeping, sleeping in to be able to attend the school day.

So the first semester of my freshman year, I really had a lot of bouncing around friend groups to find the group that would work out for me and be able to understand that I wasn't always going to be at school or present online to talk to them and hang out outside of school because my just chronic condition didn't allow for that.

And often I would actually have experiences where I would be at school and I would be so frustrated with my friends because I would say stuff like, oh, I'm really tired and burnt out.

I would have had a really crazy night of doctor's appointments and just being in terrible pain and not having a solution.

And I would tell my friends this and try to explain it to them and they would say stuff back to me like, oh, I'm really sorry.

Like, I had volleyball practice last night.

Like, I'm so tired too.

Alex Yarijanian: 00:03:24

Like, not getting it.

Esha Mittal: 00:03:26

They did not get it.

Alex Yarijanian: 00:03:27

Not getting it.

And it's like, first of all, do you even get it?

Not, you know, like, do you as that?

Esha Mittal: 00:03:33

Yeah.

Alex Yarijanian: 00:03:34

For you to identify, let alone expect for others to get it.

How did you come to even know?

Like, what's happening to you is different,.

Esha Mittal: 00:03:43

I think for me, and it's different for everybody with a chronic condition, which is what I think makes it challenging, is I had kind of always known something was not right, to put it simply.

Like, I had always known that I was always a little shorter than the other kids or I couldn't eat the same things as other kids.

So I had always known that.

And it was really, for me, the shift was more being able to accept, like, okay, this is what I'm gonna do.

Have to do different now.

I ended up going onto a gluten free diet and having to start an infusion medication.

So going every four weeks to an infusion center with my dad for two plus hours.

So it was really those little life adjustments that, that were a big deal to me.

And it was particularly challenging because I didn't have someone stable in my life when you start out of high school.

These kids had only known me in my chronic condition era, so it was hard for me to distinguish my personality outside of my illness with people I'd never met.

Alex Yarijanian: 00:04:50

What did the adults in the room think you needed versus what you felt you might need?

Esha Mittal: 00:04:56

I started when I was first diagnosed.

I was referred to, actually a support group specifically for my chronic condition by my doctors.

And I was actually very excited about it because I thought this is a great way to meet people who have been living with what I'm gonna go through in the next six months and for the rest of my life.

And what I found was when I joined that first Meeting, I actually found it much worse.

I found it really hard to be around people who shared a diagnosis with me, and most of them had been living with it since they were four years old.

And this was like a brand new experience for me.

But not only that.

Once we started talking about our chronic condition, it felt like that was all we could talk about.

And it just became like a pity party where I felt, like, so weighed down by this thing.

Alex Yarijanian: 00:05:47

Was this the correct diagnosis support group or was it the one before?

Esha Mittal: 00:05:52

It was before.

It's.

At the time, I thought I had that as my diagnosis.

So, like, it didn't shift the mindset for me because they were experiencing what I was experiencing.

But, like, in some ways, that just made it worse because, like, it felt like we were kind of grouped together as this pity party and like, there was nothing else we could talk about.

Alex Yarijanian: 00:06:11

Do you think that was more, like, programmatic or just like, it was logical to the pairing to happen based on diagnosis?

So now this is the label you have, and to make sense of life, you're gonna characterize yourself along with what it is that these are or what is your thoughts about the way the program might have been better?

Esha Mittal: 00:06:30

I think it's.

I think it's a little complicated.

I think that for someone with something like cancer, I think it's different to have that kind of support group, actually, because in some ways it's a lot more temporary.

And of course, like, it's a very tough experience to go through, and I'm not minimizing that at all.

But it is a very different experience than what someone with a chronic illness is going through.

And so the support is very different.

Also, people.

I was referred to it by my doctor, and so they actually do it within departments.

So if you're being seen by a GI doctor, you're going to get grouped with a GI social worker who is then going to refer you to this GI support group.

Same thing for rheumatology, same thing for hematology.

Alex Yarijanian: 00:07:20

Esha, tell us about what you've been up to and how you're addressing your experience turning poison into medicine.

Esha Mittal: 00:07:28

Yeah.

So In November of: 2025

And, yeah, I chose to pair people up based on shared interest because to me, when I was first diagnosed, I think it would have been so valuable for me to understand myself again outside of my illness.

And I think that's something that a lot of people who have been newly diagnosed really struggle with because it is a pretty life altering experience to have to add this piece to your identity.

So I started by outreaching to youth and young adults with chronic conditions across California and then across the US And I interviewed them and their caregivers and really tried to understand what they experienced on a day to day and how their isolation affected their daily lives.

And so once I did that, I found that this was a huge problem across everybody.

And from literally the age of 30 years old all the way to 8 year olds were experiencing this sense of isolation and disconnect from their peers.

And I'd asked about these support groups and many people found the same thing that I did, that it was not beneficial to them because it just became like kind of a pity party.

So I designed this mentorship program with a social worker who looked over my curriculum that I created that approaches each meeting that they have with a trauma informed like tone and it walks them through icebreakers and activities that they can do and like would you rather and get to know you questions and then always ends with a looking ahead conversation about something they're excited about or looking forward to or what they're going to take with them from the conversation.

Alex Yarijanian: 00:09:19

We're so inspired.

Actually, the part that no one talks about is exactly youth loneliness.

And I had a conversation with Dr. Todd May, he's a VP at Health Net, and see what he said.

Well, first let's talk about your take on youth loneliness and whether that's been a conversation at the plan at all based on again, not any particular health plan, but generally because your colleagues and folks that you have interacted with, you know, they usually talk about what's on their minds, which is typically what's in the minds of the boardrooms.

And have you heard anything about youth loneliness?

Todd May MD: 00:09:56

You know, Alex, that term hasn't actually come up.

There's, you know, ever since the pandemic in particular, there's been a lot of discussion about youth mental health.

Right.

And it's a mental health crisis for the youth.

And certainly the pandemic exacerbated everything.

And there's still a focus on mental health more broadly.

I think folks are mainly speaking of anxiety and depression as the kind of major drivers.

The loneliness piece is just not getting a lot of airplay.

So.

So I find that interesting.

Alex Yarijanian: 00:10:33

Tell us about your UCSF Wellness Partnership.

I'm so excited to hear about that part.

Esha Mittal: 00:10:39

Yeah, I'm really excited about that.

m the hospital in February of: 2024

It had this approach to care that I'd never seen before.

And it did not feel like a doctor's appointment.

I went into the room and I was greeted by these two wonderful.

I was greeted by a nurse practitioner and a social worker.

And instead of asking me how I was feeling that day or what my symptoms were or going over blood work with me, they sat with me for an hour and talked to me about my goals and what I like to do in my free time.

And art projects I had been working on because they knew that I liked art, and they recommended me.

Art.

All these things that just aligned.

And I felt like they got to know me as a person, and I have kept in touch with them.

I'm very close with them still, because we were able to build this very strong relationship, not just as patient provider, but really as people.

And I got to know them, and they got to know me, and they offered me to join their youth advisory council, which is how I found this community of people who lived with all kinds of chronic conditions.

But we had the purpose of the wellness center to kind of unite us.

And we were all working towards the goal of, you know, putting on these community events and running panels, and we have become.

It was just such a wonderful community where I felt like I could really accept, like, okay, I have a chronic condition.

And also, like, there's all these wonderful people that I met because of it, and.

And all these wonderful people doing amazing things despite having their condition.

And so one of those people was this social worker, actually, who is now working as a social worker at a hospital in New York, and she lives with a chronic kidney condition.

And she really empathized with me and told me that when she was first diagnosed, she also had a lot of anger towards her friends for not understanding what she was going through.

And so after that, actually, that's when I decided that I wanted to create.

Create the Shared Strength project because I wanted to mimic that sense of community and belonging I felt in that space for these other people by giving them a purpose with mentoring and also just building a really strong relationship with someone outside of just their illness.

Alex Yarijanian: 00:13:20

Wow, it sounds so logical, but no one has thought of it.

So who knew?

Who knew?

You know, where can people find you and what do you need from us anywhere in the world?

Esha Mittal: 00:13:35

I am on LinkedIn.

I'm building a website right now.

I do have a site.

Really what I am looking for right now is just opportunities to scale this project.

I am right now just in California and I would really like to get this to the people that need it.

Alex Yarijanian: 00:13:54

Tell us about BHT you're going to be in Nashville.

Esha, tell us what's going on, when and how people can come and make sure they get a seat before it's standing room only.

Esha Mittal: 00:14:06

Yeah, I'm really excited.

I'll be on a panel about designing tools that youth and young adults will actually use, which is definitely something that is important to me not only as a teen but also as I've tried to figure out how to make a virtual tour school engaging.

So very excited for that conversation.

There's going to be so many great people on it.

Alex Yarijanian: 00:14:26

You can catch Esha at the Behavioral Health Tech Conference and that is going to be in Nashville.

I Love Nashville.

th of this year,: 2026

It will be at the Gaylord Oprah Land Resort and Convention center.

So the BHD: 2026

Well, you so much.

I really appreciate your time.