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teen being chased by social media icons
No matter how you stack it, the numbers are alarming. In the U.S., approximately 1 in 5 youth (ages 13–18) experiences a severe mental disorder at some point. In Minnesota, suicide is the second-leading cause of death for 11- to 18-year-olds, and statewide surveys show increasing rates of youth depression, anxiety, and suicide.
We talked with four experts about what is driving this mental health crisis and how the medical community, schools, and communities are working to help youth get the attention and support they need.
“Teens are under incredible stress these days,” says Susan Nygaard, manager of Allina Health’s community health improvement. “Contributing factors include academics, peer pressure, sports, and jobs. Teens are taking on more and more, and the balancing act becomes too much.”
That “too much” includes their time spent online. Mental health experts point to the advent of social media as a strong factor driving an increase in anxiety and depression, especially among teens.
“Access to technology provides teens a wealth of information, while at the same time, it appears to cause much of their stress and anxiety,” Nygaard says.
Mental health became a priority for Allina in 2013, when its community health needs assessment found that high levels of stress among teens was robbing them of sleep, aggravating bad behavior, and hurting grades.
In response, Allina created its Change to Chill (CTC) program, an online resource to help teens manage stress and build resiliency. The CTC program is also reaching into schools, where it is helping more than 100,000 students learn deep-breathing strategies and mindfulness techniques.
Piloted in nine schools in 2018–2019 and set to expand to 16 more high schools in the coming school year, the CTC partnership provides schools with training for school staff, outreach to parents, and $1,000 toward creating a “Chill Zone,” a designated space where students can go to de-stress.
“We know when teens have resources and support to stress less, they are more resilient and able to live fuller and happier lives,” Nygaard says.
The Elephant in the Room
Being a teenager has never been easy, but in the past decade, the stresses teens navigate have grown exponentially, says Dr. David Hoy, executive director of David Hoy & Associates, a Twin Cities–based counseling and mental health practice.
“The elephant sitting in the middle of the living room is social media,” he says. Increased anxiety, panic attacks, and cyberbullying are common issues for teens today, and they have grown in proportion to the increase in cellphone use.
“By 2015, 73 percent of teens had access to a smartphone and 75 percent of Americans had social media profiles,” Hoy says. “I’ve interviewed about 50 kids, and the one thing that every kid says about social media is that it causes them to compare themselves to other kids.”
The problem, he says, is that “people are putting their idealized selves out there, and it’s just not real.” A survey of 500,000 American adolescents found that those—especially girls—who spent more time in onscreen activity were significantly more at risk of depression and suicidal ideation.
“When I was a kid, we got up every day and got with the neighbors; it was playing and interacting all day,” Hoy says. “That doesn’t happen anymore. If they’re playing, they’re playing a video game with someone a couple miles away.”
He points to studies that show a 20 percent decline in the number of kids who meet up with their friends every day. Meanwhile, teens’ loneliness rates have spiked to the same degree.
“When we’re bombarded on social media and don’t have much human contact, our empathy levels go down,” he says. “We need to look at this as a social problem.”
Is That “Normal” or Not?
Hoy says that parents sometimes have trouble separating “normal” teenage angst from signs of distress, but clinical depression has some telltale signs.
“The biggest one is when your child starts to isolate,” he says. “When he or she isn’t answering your calls, doesn’t respond to texts, when they sit in their room wired in with their door closed.”
Disrupted sleep patterns, changes in appetite, poor grades, and low energy are also important clues to how your teen might be feeling.
His advice to parents is simple and yet hard to do: “Hang in there, have empathy, and check yourself.” Yelling at kids for bad grades or calling them lazy won’t work, he says, but asking questions and talking can help. “Kids watch everything you do, and if you don’t give up, they know you’re there,” he says. “Big picture, the more authentic you are as a parent, the more your kid is going to listen.”
His company also offers online face-to-face counseling services for those unable to travel or otherwise connect with a mental health professional. He says the service doesn’t replace in-person counseling, but the telehealth connection can be a lifeline. “Imagine a college kid sitting in their dorm room, feeling isolated and suicidal. Now they have an option to get a counselor online,” he says.
More Than a Bandage
Dr. Joshua Stein says building awareness about mental illness is a big part of his job. Stein, the clinical director of a Brooklyn Park practice that offers intensive outpatient mental health care, says that 50 percent of all mental illness cases begin by age 14 and a full 75 percent begin by age 24.
Stein, who is also the president of the Minnesota Society of Child and Adolescent Psychiatry, says that in delivering mental health care, the state faces two problems. “We are struggling to have a good prevention model and identify things before they reach crisis,” he says. “There’s also a shortage of care providers. In rural Minnesota, this is an incredible issue.”
As a preventive measure, Stein and his colleagues are working for what he calls a more “wraparound” approach in which families, local government, and schools are involved.
“In the world of child psychiatry, the involvement of lots of people—more than just medication and therapy—is often needed,” he says.
To address gaps in mental health care for outstate communities, Stein’s colleagues have created a Psychiatric Assistance Line (PAL) to provide education and immediate support to other medical practitioners.
“Pediatricians, interns, family practitioners try to be a bandage, but they quickly get in over their heads,” he says. “The complexities are getting severe.” But with a call to PAL, out-state practitioners get detailed advice from a specialist for difficult cases. “There’s also a social worker on the line that helps docs be aware of services for their patients,” Stein says.
Know the Truth
At the Minnesota Adult & Teen Challenge (MnTC), information is a critical tool used to inspire and drive addiction prevention. MnTC’s program is called Know the Truth, and it reaches 60,000 middle and high school students across the state each year.
Tim Walsh, vice president of MnTC’s long-term recovery and mental health services, says it is the largest prevention program in the state. Part of the effort is to help young people understand who benefits from addictions such as gaming, porn, vaping, and drugs. “We need to back it up one step and look at manufacturing and marketing,” Walsh says. “Everyone who is part of creating those products is designing them with addiction in mind. They are creating the maximum potency in all those products that kids are using to stimulate themselves.”
Walsh points to vaping as an example, saying it delivers a high concentration of nicotine that is designed to addict users. The same goes for video games and opioids, which are designed for addictive effect, he says.
Parents also need to set a good example by limiting their own use of tobacco, alcohol, and social media, the experts say. They need to be empathetic and compassionate but not blind to their kids’ behaviors.
“You’ve got to be patient and ask some hard questions,” says Hoy. “Sometimes parents say what they think kids want to hear, and your kids can sniff that out. If you’re more honest and open about your struggles when you were that age, their ears are going to be more open.”
