build that skillset. The effect of doing so reduces unhealthy coping such as self-harm, substance misuse, and suicide, and promotes more positive experiences in school and beyond.
Barriers to Mental Health Treatment for Teens
Neither teens nor the adults who are close to them recognize the symptoms of their treatable illness.
Fear of what treatment might involve.
Belief that nothing can help.
They don't see help-seeking as a sign of strength.
They are embarrassed.
Belief that adults won't understand.
Limited access to resources (money, insurance, transportation, healthcare).
Source: From the American Foundation for Suicide Prevention, More Than Sad for Parents.
Standardized testing is a measurement strategy that many school systems use. Wherever you stand on the issue, it siphons considerable instructional time and resources during the school day and the casualties of that effort have been innovation, creativity, practical skills, opportunities to build connection, and social emotional skills. In short, there is not enough time. More trigonometry will not help a student learn how to cope with the loss of a sibling. Integrating skills to help students learn and manage life goes a long way in minimizing substance misuse, self-harm, eating disorders, promiscuity, and other unhealthy coping strategies, as well as preventing suicide during the school years and throughout a student's lifespan. What we do know is that several studies have shown that suicide rates increase during the school year and drop off during the summer when most students are out of school and during academic breaks, suggesting that social and academic pressure may play a role in student suicidal behavior.
In a 2018 study, Gregory Plemmons and his colleagues found that the rate of hospitalization of school-aged children for suicidal ideation and attempts increased by almost 300% from 2008 to 2015.3 Each year the rate of psychiatric hospitalizations is significantly higher in the school months than in the summer. A decrease occurred not just during summer vacation, but also during school vacation weeks, too. So in schools where parents are more involved and academic success and college prep are paramount, for example, the pressure of grades and college acceptance can be a contributor to student suicide risk and attempts.
Social media is another factor that can either boost student well-being or crush it. It's the lollipop land of shiny faces and perfect families, and in our accomplishment-obsessed culture, this highlight reel of influencers, likes, and comments can alter a student's feelings of self-worth. Positive interactions, social support, and connectedness on social networking sites are consistently related to lower levels of depression and anxiety. Conversely, negative interaction and social comparisons on social networking sites are related to higher levels.4 Extended time spent on these sites results in negative mental health outcomes.5 With an adolescent population, feelings of inclusion can shift fast, triggering impulsive thoughts and actions. For example, a student who is experiencing a great day can see a status update by another student that includes pictures to a party she wasn't invited to and her mood can transform from happiness to despair in seconds. Teens are more susceptible to social influence, the need for peer approval, and the conformity effect, which drives some adolescents to agree with or engage with what their friends have already commented on or liked.
Teen Worries
What are you and your friends most worried about?
College is scary and a lot of work.
Friends feel like they need to do everything every second of the day: volunteering, activities, etc.
Pressure to get perfect grades.
Getting acclimated to high school, feeling overwhelmed, figuring out feelings, figuring out who they are, can be very stressful.
Getting into varsity or JV teams.
Really worried about junior year, AP classes, preparing for the next year.
A lot of homework, a lot of pressure.
Getting along with others.
Personal appearance, hygiene, being made fun of.
Gender identity.
Middle school is a big popularity contest, with nobody winning and everybody losing.
Gossip, drama, rumors.
You're in that stage where you're trying to figure it out, but it feels risky to be open about that.
Feeling threatened threats of violence on social media and in person.
Not feeling safe at home.
Source: Survey question for teens and sample of comments from Signs of Suicide Youth Focus Group for reviewing new video content.
The trouble lies in how the teenage brain matures. The “let's party now” parts, the hippocampus and amygdala, which are associated with impulsivity, thrill seeking, and emotions, mature way ahead of the “cockpit” or prefrontal cortex part of the brain. That cockpit is responsible for regulating all that emotion as well as planning, focusing attention, following instructions, and juggling multiple tasks. Throughout the adolescent years and up through age 25, this executive portion of the brain lags behind. It's during this period of brain development that kids often act out based on their moods and impulses, misuse substances, and engage in self-harm. Half of all mental health concerns start by 14 years of age but most cases are undetected and untreated.6 So at an age when their brains are not yet fully equipped, teens with immature coping skills are trying to manage a multitude of complex mental health, social, and life issues.
Teenagers who feel less connected, with underdeveloped coping skills and executive functions, may resort to drugs and alcohol to numb feelings and/or experience highs. People don't heal if they can't feel and this concept is especially unknown to teenagers. The late 1990s and early 2000s brought on a period of normalization for using substances to treat both physical and mental pain. Meanwhile pain clinics that used alternative methods of pain management shut down. And the US, which makes up 4.4% of the world's population, started consuming 80% of the world's prescription painkillers and became the number one consumer of prescription pain medication.7 The overprescribing meant there were more unused drugs available in medicine cabinets that often ended up in the hands of teenagers more susceptible to dependence and addiction than adults. When adolescents try something and it runs out, they find alternatives in over-the-counter substances that can be bought in drug stores. They get those ideas from online collaboration and sometimes these students will stalk peers at school for their medications after wisdom teeth removal or athletic surgery.
Just because adults and schools rarely address subjects of mental illness, grief, self-harm, and substance misuse doesn't mean young people aren't seeking answers. Given the gap in that education,
