CORONAVIRUS (COVID-19) RESOURCE CENTER Read More
Add To Favorites

Stressed, anxious and home for the holidays: Steps to help your teens mental health

Detroit Free Press - 12/19/2021

"When will we ever get a break? When will things actually get better?"

These questions come from Bailey Ganey, a 14-year-old freshman who survived the Oxford High School shooting last month.

They are feelings echoed by many teens across Michigan as students head into a two-week holiday vacation after a stressful string of pandemic and copy-cat threat school shutdowns. Experts urge parents and caregivers to use this time to talk to their kids, recognizing that COVID-19 and school safety worries have piled dangerous levels of anxiety onto the already pressure-filled lives of young people.

"We've been through so much, not just in Oxford, but worldwide. We've been going through this stuff for over a year now," said Ganey. "People need to realize that things with mental health, it should be taken seriously ... how to recognize the signs in people before it gets to that kind of point where they harm themselves or other people."

U.S. Surgeon Gen. Dr. Vivek Murthy issued a rare public health advisory earlier this month, citing national surveys that show 1 in 3 high school students reported persistent feelings of sadness and hopelessness in 2019 — an increase of 40% since 2009. Prevalence is higher among girls than boys. About half of high school girls reported feeling that way.

"The challenges today's generation of young people face are unprecedented and uniquely hard to navigate. And the effect these challenges have had on their mental health is devastating," Murthy said. "Too often, young people are bombarded with messages through the media and popular culture that erode their sense of self-worth — telling them they are not good looking enough, popular enough, smart enough, or rich enough.

"That comes as progress on legitimate, and distressing, issues like climate change, income inequality, racial injustice, the opioid epidemic, and gun violence feels too slow."

That distress has grown during the pandemic.

In early 2021, hospital visits for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared with the same time in early 2019, he said.

Parent Arlyssa Heard, of Detroit, is worried for her teenage son and others who may not ask for help when they need it. She's especially worried for young Black children in the city, hit hard by the pandemic.

"Most of our children either have a family member or somebody close to them that died from COVID," Heard said. "There are kids who have lost parents. They've lost grandparents. We haven't had time to mourn. Couldn't go to school. ... People are on edge about everything."

The Oxford High School shooting and copycat threats around the region "shattered a fragile peace" some teens were just starting to regain as pandemic restrictions eased and they largely returned to in-person school this fall, along with sports and other activities, said Lori Warner, a psychologist and director of Beaumont Center for Human Development and the Ted Lindsay Foundation HOPE Center.

"People in general were starting to get their feet back under them," she said, "and the students in particular were just so joyful to be able to be together again.

"Now there's another wave looming of a more transmissible variant and then to have another new tragedy on top of it. Kids are feeling like I am standing back up, but I'm getting knocked back down and there's a lot of fear and a lot of hesitation about things."

Heard, an education organizer with the Detroit nonprofit 482Forward, said knowing how and when to step in and get help for teens can be difficult, especially if they are resistant or pretend "everything is fine."

"Let's not assume that because our kids are getting up every day and playing their games every day that they are OK, that there's nothing wrong with them," Heard said. "Kids process things differently."

Distress in kids doesn't always manifest in an obvious way. Some teens and younger children might not be able to express themselves well enough to talk about it. It's important to watch their demeanor and look for changes in their behavior, Warner said.

"Are they going to school?" she said. "Are they keeping up with their homework? Are they doing things with their friends, whether it's online or in person? Are they sleeping? Are they eating?

"Even though they may be in their room a lot and it may be a little hard to get them out of there at times, there are signs that you would be able to see that they're functioning in the way they normally do versus if they're not."

Parents should look for changes in appearance and shifts in whether they interact with others the way they normally would. Red flags could be if your child is suddenly staying up all night, not eating, seems overly irritable or is getting into fights.

"Even if kids don't talk a lot, it's important for us as parents to not give up trying to talk and just remind them: I'm here," Warner said. Parents can tell them, "'I know you may not want to talk to me right now, but ... if anything comes up, I want you to know I'm here.'

"Then we have to back that up with actually being available when they need us. ... We need to prioritize time with them because they may come to you seeming kind of casual, like it's not a big deal, but it might be a big deal. It's sometimes these very low-key, casual conversations that give you a lot of information.

"If you can communicate to your child that they have a safe and secure base of support, their resilience is going to be much much greater than a child who doesn't feel they have anybody to talk to that won't judge them."

A good first step is to talk to your pediatrician and ask for recommendations, Warner said.

If you have medical insurance, she suggests calling the behavioral health phone number on the back of your insurance card to find mental health professionals near you who are in your provider network.

If your child has Medicaid coverage, community mental health resources are available by calling the number on the back of the Medicaid card as well, Warner said.

Schools often have referral list for mental health resources, too, and some provide free counseling, she said.

"Places of worship will have ideas about community partners," Warner said, "and there are a number of nonprofits in the area that offer different types of services. It all just depends on what's available right now in your area that meets your particular need.

"It may take a little persistence."

The wait time for professional counseling services can be highly variable, and depends on the family's personal circumstances, Warner said, such as where the family lives, whether they have access to technology that would allow for virtual visits with a therapist or counselor and whether they have transportation to get to an in-person appointment.

Finances play a part in access, too. Some doctors and therapists accept only cash and don't bill insurance plans.

"Right now, even families of means are struggling with wait lists," Warner said, because demand is so high.

"I've personally referred a number of people to psychiatry teams and clinics that offer both therapy and medical support ... and found that they're not taking any new patients," she said. "Couple that with the fact that in health care in general — including mental health care — we're finding a real staffing problem ... it can be extremely challenging to find help.

"All of us in the mental health field are taking on more than we thought we would, or maybe even than we should, because we just don't want to turn people away. But there's a cost to that, too. ... I don't know anyone who's getting in quickly."

Schools, community groups and religious organizations often have counselors or other resources that can bridge the gap and offer some help while you wait for an appointment with a therapist or other mental health professional.

Ask what might be available for your child.

Murthy said parents also should consider taking these steps at home:

Be a role model: Children learn habits and behavior from the people around them, so be sure you are taking care of your own mental and physical health. That should include getting regular exercise, taking work breaks, getting adequate sleep, eating healthy meals, following regular routines, staying connected with family and friends, and unplugging from technology or social media.

Talk to children about the importance of maintaining good mental health, about seeking help when it's needed, and show positive ways to cope with stress.

Build up your relationship: Spend time with your kids doing activities that are meaningful to them. Praise their successes. Show them love and accept them for who they are. Communicate openly with them about their feelings.

Help them make friends: Whether it's through playtime and structured activities at school or through after-school activities, sports or volunteering, connections with peers are important to children's development. Talk to your kids about peer pressure and about being confident and establishing healthy boundaries.

Create a stable home environment: As much as you can, provide kids with a supportive, predictable and stable home. Helping children stick to a consistent schedule with a regular dinnertime and bedtime can help.

Prevent access to weapons, drugs, alcohol: Ensure children cannot access prescription medication or alcohol in the home. If you have guns in the home, be sure they are stored safely — locked up and unloaded.

Monitor screen time: Pay attention to how much time kids are spending online, and watch for cyberbullying, peer pressure and other unhealthy behavior. Set limits and be certain you're aware of the devices your child is using along with social media accounts and interactions your child may have online.

Robin Greiner, a behavioral health therapist with MyMichigan Health, said if teens don't want to pursue counseling, parents could ask them if there is another adult in their life with whom they would feel comfortable talking.

Maybe the teen isn't ready now but parents shouldn't be afraid to bring up the possibility again later, Greiner said.

"They can just express their concern for their student and not try to give a lot of advice," she said. "You can be very specific like 'I am noticing you are not eating' or 'I am noticing you are not sleeping very well and this concerns me.'"

Warner said it's vital to keep the lines of communication open because forcing the child to go to a counselor won't help.

"It's probably about kind of playing the long game and being available," she said, and being persistent.

Check in with your kids regularly, she said, "even if they roll their eyes at you." Tell them, 'I want to know how you're doing. I'm here,' and remind them that if they tell you something unsettling, it's OK. You won't be angry. It's safe to talk to you."

Asking a teen to betray the confidence of a friend who confessed a desire to hurt themselves or asking a teen to alert authorities to another student's threat can put tremendous pressure on a young person.

Talking about how to handle these scenarios ahead of time can give kids more confidence, said Lauren Mangus, a licensed psychologist for The Beaumont Center of Human Development.

"When you're nervous is the worst time to make a decision," said Mangus, who is also president of the Michigan Association of School Psychologists. "You want to make a decision when things are calm and safe."

Mangus said parents could make the discussion a part of an overall safety talk, when they touch on a variety of topics, such as their family's fire evacuation plan.

The key is "telling them if someone is going to be hurt, you have to tell an adult," she said.

Make the conversation a dialogue, asking questions rather than issuing orders. And talk about the teen's fears, such as how their friend might react if they share their conversation with other adults, she said.

"Why and what are important questions," Mangus said. "It becomes a dialogue where you are collaboratively problem-solving. ... Teens don't prefer when we talk to them like they don't really have a voice."

Greiner said having these conversations in the car can often unlock a teenager who wouldn't normally open up. They may be more comfortable not making eye contact. Interrupting their video games to chat may have the opposite result.

"So you know creating a space with you having the intention of talking about this but waiting until they are ready, not trying to do it on the fly," Greiner said.

Warning signs could be explicit, such as a troubling comment on social media with a direct threat, or they can be more subtle, such as an online search, said Dr. Peter Langman, a psychologist based in Allentown, Pennsylvania, and author of "Warning Signs: Identifying School Shooters Before they Strike."

School officials shouldn't brush off comments or behavior that feel vague or borderline.

"You're left kind of guessing and that's where it's really important to communicate because different people may have different pieces of the puzzle," he said.

Districts across the state participate in OK2SAY, where anyone can submit anonymous school safety tips if they are worried about a classmate or other possible threat. Since 2014, OK2SAY has received more than 29,000 tips.

R.J. Webber, assistant superintendent at the Novi Community School District, said the vast majority of information related to threats comes from parents and students. In some cases, friends of a student will come forward when they hear something troubling about their friend.

Webber said social media has led to an explosion of tips about threats and behavior. "Many times that's how districts find out about things that aren't so great," he said.

Pictures of weapons are common concerns, he said. Any post that implies harm to anyone will be investigated.

Webber said in Novi a lot of tips go immediately to school resource officers, police officers stationed around the school district. The officers will look into any possible threat "immediately."

"We try to suss out what is the validity of it," he said.

Part of that investigation includes talking to parents and could even necessitate a visit to the student's house, Webber said. Novi teachers, administrators and social workers are also trained in protocol to get students psychiatric help quickly when they seem "off" or behave in a concerning way.

Multiple school security experts recommend schools put together threat assessment teams to assess a child from all angles and provide training for school staff members to look for warning signs.

A student who makes a troubling comment or drawing could prompt a review from a threat assessment team.

These teams usually include school psychologists, social workers, counselors and educators who try to look beyond just one incident, said Amy Klinger, a former principal and educator who cofounded the Educator's School Safety Network.

Klinger said threat assessment teams will usually consult social media accounts, friends and family members, too, to determine the extent of a threat.

"What's on social media? What do the friends say? What did the parents say? What did the other teachers say?" she said the review asks. "It's a fact-based investigation of all the different components, rather than just looking at one piece of information."

Threat assessment teams are not required in Michigan schools, so how districts respond to threats vary widely.

Get immediate help by calling the National Suicide Prevention Lifeline at 800-273-8255. You can also chat online with a counselor at https://suicidepreventionlifeline.org/chat/. Both are available 24 hours a day, seven days a week.

You can also call 411 for immediate help or text the word HELLO to 741741.

In a true crisis, "we tell families to go to the emergency room," Warner said, because they may need a bed in a psychiatric unit.

If your child has begun cutting or resorting to other forms of self-harm, Warner said there's an app called Calm Harm that can help interrupt the behavior. To learn more, go to: calmharm.co.uk/#row1.

More: In the aftermath of Oxford school shooting, our kids think they're going to die

More: More than 10,000 sign petition for Oakland schools to go virtual amid increase in threats

Bringing some calm to teens' lives doesn't have to be complicated, said 16-year-old Lina Iyer, a member of her Novi High School's Student Mental Health Committee.

An outdoor walk, trying mediation, journaling, drawing or just spending time with them away from their cellphone helps, she said. Iyer helped sponsor a "Self-care Week" at her school before the holiday break, which included doing relaxation exercises and writing letters to Oxford High School students.

"Opening up is definitely hard, especially when you are going through something stressful," Iyer said. "I would say for parents to talk to their teens, be open, make sure they know they are in this together and that they will be there for them no matter what happens."

Contact Christine MacDonald: cmacdonald@freepress.com or 313-418-2149. Follow her on Twitter @cmacfreep

Contact Kristen Shamus: kshamus@freepress.com. Follow her on Twitter @kristenshamus.

Contact Lily Altavena: laltavena@freepress.com or follow her on Twitter @LilyAlta.

©2021 www.freep.com. Visit freep.com. Distributed by Tribune Content Agency, LLC.