Teen mental health crisis needs broad response

Andara Puchino

Children and adolescents in our country are in crisis. The Centers for Disease Control and Prevention (CDC) recently released a comprehensive survey that chronicled a startling decline in adolescent mental health from 2009 to 2019. According to that report, more than 1 out of every 3 high school students had experienced persistent feelings of sadness or hopelessness in 2019 — a 40% increase since 2009.

This is not an occasional bad day.

Left unchecked, this despondency has the potential to affect all aspects of a teen’s life, including their physical health, academics and social relationships. In short, a teen who feels this way is less likely to achieve their potential and thrive in society.

Further, the report states that in 2019, approximately 1 in 6 youth made a plan to commit suicide in the previous year — a 44% increase since 2009. Think of it this way: if you saw a group of high school students walking down the hallway, it is probable that at least one of them considered taking his or her own life in the past year. This is a heartbreaking reality. Notably, this report does not even capture the impact of the social isolation with missed rites of passage like prom or graduation, or the increased anxiety caused by the COVID-19 pandemic, which further exacerbated the crisis.

As a parent, physician of more than two decades, and the president and CEO of Sheppard Pratt, the largest private, nonprofit provider of mental health services in the country, I see the human stories behind this data each and every day. The teens who come into our hospitals and outpatient services have been grappling with depression and may be contemplating suicide. Their parents are scrambling to find answers and struggling to access care. There is so much need, and we all need to be part of the solution.

Change starts within us. We need to speak openly and honestly about mental health and its impact. Everyone knows someone who is affected. We need to change the narrative about access to care, normalize the conversation and tell kids it’s OK to not be OK. Removing the stigma of mental illness can help them seek out and get care. Our youth deserve that.

We also need to encourage healthy habits with our youth. The bedrock of mental wellness has not changed for millenniums: get enough sleep, exercise, get outside, enjoy social and family relationships, and engage in meaningful activities. However, for today’s youth, this might not be enough.

The constant buffet of information in the palms of their hands discourages teens from engaging in these healthy habits. Constant exposure can be detrimental to their health, such as intense scrutiny by peer groups, the nonstop intrusion of social media, the influence of platforms like TikTok, and the changing definition of what it means to do well or be popular. Adolescence is a critical stage of human development where we figure out who we are. Our youth need safe spaces to make mistakes and learn from them.

We also need to ensure access to critical programs and services long before our youth are in crisis. We need to address the barriers to care and re-imagine how children and families access mental health services across a comprehensive continuum of care. All adults interfacing with kids would benefit from learning Youth Mental Health First Aid.

Pediatricians can learn to manage more routine mental health issues through solutions like Project Echo, and they would benefit from more robust collaborative relationships with child psychiatrists and child mental health professionals. Insurance companies need to solve issues regarding phantom provider panels and network inadequacy. And employers need to demand better from their commercial health plans. Our youth shouldn’t need to end up on Medicaid to access more intensive services.

And while we are all inspired by “moonshots,” can we finally convince government, from local to national, to invest in a “moonshot for mental health?” Comprehensive models of care of youth mental health already exist. At this critical juncture, we need to collectively multiply our efforts to safeguard the mental health of our youth.

Harsh K. Trivedi, MD, MBA, is president and CEO of Sheppard Pratt, and co-author of “Practical Child and Adolescent Psychiatry for Pediatrics and Primary Care.” Dr. Trivedi can be reached at [email protected].


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