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Professionals See Uptick In Teen Mental Health Issues Aggravated By Pandemic


It's been a rough year for just about everybody - parents, business owners, medical personnel, folks in care homes. But right now, we want to talk about teenagers. This is a time of life when they should be spreading their wings, taking on more responsibility, getting more independence, maybe getting ready to leave home. But instead, for many, if not most, life has been on hold. They've had to stick close to home, miss sports, stop seeing friends. And now health care providers are telling us that this is taking a toll on their mental health.

While there isn't a lot of hard data, the Centers for Disease Control and Prevention reports that through most of 2020, the proportion of mental health-related pediatric emergency admission was 31% higher than it was in 2019. We wanted to hear more about what the last year has been like for teens, and we wanted to talk about ways to help them through it, so we've called a familiar voice, NPR education correspondent Anya Kamenetz. Welcome, Anya.

ANYA KAMENETZ, BYLINE: Thanks for having me.

MARTIN: Also joining us is Andrea Bonior, a clinical psychologist and an express advice columnist for The Washington Post. She was also the voice of the Post's mental health advice column, Baggage Check, for 15 years. Her most recent column, Our obsession with happiness is making our kids miserable, addresses the current crisis. Welcome to you, Andrea Bonior.

ANDREA BONIOR: Thanks for having me.

MARTIN: And Melisa Hannon is also with us. She's a counselor at Winters Mill High School in Westminster, Md. She's also the adult adviser for the Falcons of Strength program. That's a peer advocacy club aimed to help students deal with anxiety and mental health issues. Welcome to you as well, Melisa Hannon.

MELISA HANNON: Thank you. Thank you.

MARTIN: So we mentioned that the data around this is still emerging. I did want to ask you what you've seen, so I'm going to start with Anya, I know - because you've been doing some reporting on this topic.

KAMENETZ: Yes, I have. And I'll tell you, Michel, the signal that I'm getting is not only from parents, but also from professionals like the ones on this panel. I've actually had people cold call me over the past year on several different occasions and just say, Anya, I know you're a reporter. You have a platform. Please bring some attention to this issue because the kids are not OK. So that's just where I'm sitting as, you know, an individual in my personal life. I also am hearing many, many stories of people having children who are presenting for the very first time with some serious kinds of psychological issues.

MARTIN: And you've spoken directly with some families. I understand that you actually have some tape to share with us. And I think this is a student who we're going to protect this person's privacy, and we're going to call the student E (ph).

E: It's just - everything is hard because there's no end to it. It just - it's really sad to, like, see what was supposed to be, like, the best years of your life, like, go down the tubes.

MARTIN: Anya, tell us a little bit more if you can.

KAMENETZ: So E is 16. She lives in Alexandria, Va. I reached her with her mother. And she really struggled with her remote schooling, the lack of routine, loss of friendships, loss of milestones in her life. And this was something that she and her family were able to address with counseling, with medication. She pulled her grades up from failing and was able to pass the semester.

But this is something I hear very, very often. And I think when you are a teenager, I think we build up so much about that time of life. And so it's very hard for young people to see the bigger picture. And E was really talking about this - that, you know, I might be 18 before this goes back to normal. And she's really thinking in a kind of catastrophic way about the impact of the pandemic.

MARTIN: What about you, Andrea Bonior? What are you seeing?

BONIOR: Yeah. You know, I'm seeing a lot of the same things. And I'm also seeing a lot of the parents of these teenagers who are just watching their kids struggle and feeling helpless, especially if the kids seem particularly against the idea of talking about it or getting help. But I think one really important thing to remember is that a lot of these trends were happening before the pandemic, too. We really were starting to see an uptick in depression and anxiety among young adults and teens.

I think it's kind of disturbing in a way because I think with the added isolation, we're really seeing an uptick in self-harm and suicidal ideation. And so I think a lot of parents are really struggling, too, with feeling helpless because they know their kid's not OK. But their kid is having a hard time talking about it. And it's also very hard to get help at this point.

MARTIN: Melisa, what are you seeing?

HANNON: One thing that this has kind of brought out is that, you know, society thinks that school is important for kids academically, socially, mentally, you know, physical health. And hopefully, what this is going to do is, you know, allow us to have more funding in those areas because, you know, we did see that, you know, the trends were going upward before the pandemic with, you know, suicidal ideations and self-harm. But, you know, I don't think a lot of people really realized that we are the front lines for a lot of these students. You know, for - as far as school counselors are concerned, you know, a lot of the kids come to us first, and then what we try to do is refer out.

MARTIN: Wow. Andrea Bonior, can I go to you on this? Is there something that hits teens particularly hard, people in this age group particularly hard about the current circumstances? Because, you know, we've talked a lot about how parents are miserable. We've talked a lot about how young children are miserable. We've talked a lot about the business challenges. But I think teenagers have kind of gotten a little bit overlooked. So what is it about this? Is there something you could help us understand about why this is hitting teenagers particularly hard?

BONIOR: Yeah. I think it's hitting them in so many ways that we have overlooked because this is really a time of their lives where they're supposed to be developing independence and autonomy and privacy and the ability to sort of have a little bit of their own life and choose their friends and choose the decisions and test boundaries and be able to make mistakes and see how they need to handle it. And now we've got a lot of competing forces that are completely shutting down that development.

One is that a lot of them really don't have much of a life outside of their home right now, right? They're not able to get that separation. They're not able to miss their parents and appreciate their parents because their parents are in the next room. They're not able to really choose new friends or navigate the lunchroom. You know, I'm struck by - my own kids are sort of, like, yeah, I'm not totally sure who's in my classes at this point, right? And so they're not getting to have that autonomy, all the things that need to happen for a teen to develop their own sense of self and start living a life that feels like theirs, which is exactly what they're supposed to be doing - sort of differentiating from their parents and their family and learning what makes them them. That's really been so much harder.

MARTIN: Anya, have you talked to any kids about this? Do you have some reporting on this you could share?

KAMENETZ: Oh, sure. Absolutely. I mean, this pandemic is having an impact on families' livelihoods, and that impacts teens because they are taking on more responsibilities. They may have to watch children while adults are working, or they may have to be working themselves. And deprivation itself affects teens' mental health.

So there's a study that showed that when a family is experiencing food insecurity, for example, which we know has become very common during the pandemic, that the teenagers in the house are three times more likely to have mental health problems. They're absorbing that stress and the same worry that they see on their parents' face about, is the food going to last the week? Do I need to skip a meal so my little sibling can eat?

So I do want to play a clip from K (ph). She's another one of the teens. This was her situation. She was taking care of other children.

K: I have a lot going on mentally. It's been a lot there, but especially during COVID. Like, I'm already anxious. Like, I'm anxious to meet a new person. Like, it takes me a lot to even want to be, like, around people. So imagine me having to take care of all these people in one household with all the noise. And I'm very noise sensitive. Like, I'm very noise sensitive. If it's too loud, like, I just - I will go crazy.

MARTIN: Wow. That's important. Wow. So I do want to wheel it around, though, because I'm sure that a lot of people listening to this conversation will be like, well, that's - I didn't know those things. And I'm sure that some people will be, like, yeah, that's exactly right. That's exactly what I've been seeing. So what do you think would be helpful? I'm sure that some would like to know how can we better support folks in this age group if they are part of our lives.

I know that, Andrea, you've been writing about this, for one thing. I mean, you've talked about how - in one of your columns, you talked about how this kind of American cultural focus on positivity and brushing negative feelings off can stunt kids from dealing with negative emotions. Could you just talk a little bit more about how we - how parents and caregivers can be helpful to teens right now?

BONIOR: Sure. Sure. You know, I think we tend to start pretty young with our kids in terms of telling them that, you know, happiness is the only acceptable emotion at some point and that, you know, turn that frown upside down. And we sort of expect happiness, I think, a lot of times from our kids. Or we do it out of empathy. We want them to feel better. Oh, don't be sad. Oh, there's nothing to be afraid of. Oh, there, there. It's OK.

But what that ignores is that negative emotions, especially during difficult times like we've seen so much this past year - negative emotions are part of the human experience. And we shouldn't try to avoid them because when we avoid them, it basically teaches us that those emotions are frightening. They're something to not - you know, to not actually experience, to try to mask or to try to numb ourselves from.

It also denies us the practice, right? So when we constantly try to brush aside negative emotions, we don't get the tools. We don't get the actual experience of saying, here's what helps when I'm sad. The best path towards happiness might be the ability to accept some negative emotions and actually lean into them and say, I'm going to get through this. And so I think we can teach our teens this during this time. We can do it on a daily basis. We can listen. We can let them know that feelings are OK. We can let them know that if they're sad or angry, that that's different than acting destructively, right?

I think so many times we're afraid, OK, if I let my teen be angry, they're going to say something hurtful, or they're going to punch a wall. And so what our job is as parents is really to help our kids learn that it's the feelings that are OK. And then we have to pause and manage those feelings. And that's where we can help to teach them tools.

And that's where even talking about it and labeling the feelings can be so important. I mean, there's interesting data that says just by actually articulating what your feelings are, you feel more in control and less likely to act on them negatively. So I think that's part of the message that's so important to send to these kids and teens right now. You know, they are probably having a million negative emotions, and that's OK. And we can get through them together, and we can learn strategies to feel better.

MARTIN: Anya, anything you want to add here?

KAMENETZ: Absolutely. You know, I think for one thing, if there's one gift of this pandemic, it is a broadening of the conversation about mental health and mental wellness, not being afraid to have that engagement, even if you think it's going to be scary, with a child or with a teenager that you care about - to say, you know, you seem really down. Do you want to talk about it? You know, everybody can get the tools they need to have that conversation.

I also just want to add that I've had the privilege to talk to so many amazing teenagers over the course of this year who are weathering this pandemic with so much grace. And the things that are really helping them - you know, they're engaged in communities with caring adults, even when it's at a remove. They are engaging in activities that bring them meaning in art and creativity. You know, seeing in those teenagers their real resilience and the deep well that they're finding of ways to move on from this - you know, we're all living through history, but these kids are coming of age in history. And I think that can be very inspiring to witness.

MARTIN: Melisa, final thought from you.

HANNON: Yes. I would say for parents to listen. Listen to the kids. Talk to them. And always know that - plug for school counselors - if a parent needs, you know, extra support or extra help, and they just don't know where to turn to, contact your school counselor because, as I said, we can refer out. We can help. We can meet with students, even virtually. We're trying to move mountains here (laughter) to get help for everybody. So definitely reach out. And we're here to help.

MARTIN: That was Melisa Hannon, a high school counselor at Winters Mill High School in Westminster, Md. We also heard from Andrea Bonior, a clinical psychologist and advice columnist for The Washington Post, and our own Anya Kamenetz, NPR education correspondent. Thank you all so much for talking to us.

KAMENETZ: Thank you.

BONIOR: Thank you.

HANNON: Thank you.

MARTIN: If you or someone you know may be considering suicide, please do contact the National Suicide Prevention Lifeline. That number is 1-800-273-8255. Again, that number is 1-800-273-8255. Transcript provided by NPR, Copyright NPR.