Honolulu Star Advertiser - Mental Health

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By Marie Vorsino

If you look at the numbers, two of the biggest causes of death among young people are suicide and car accidents. The risks from both are roughly equal. But the way we approach preventing these unnecessary and tragic deaths could not be more different.

Think about the teens in your life. How many times have they been told to buckle up? To look both ways? To

never drink and drive?

about self-harming behaviors and suicide? You could probably count the number of times on a single hand.

We need to change that. We need to have these important conversations with young people so they know it’s OK and safe to reach out for help. We need to make sure that when a young person asks for help, we know how to respond in a non-judgmental, supportive, and responsive manner. Here are five steps to help the teens in your life.

Marie Vorsino is executive vice president of Parents and Children Together, a statewide nonprofit that provides services to Hawaii’s most challenged residents; she has a doctorate in clinical psychology

By Lisa Jarvis

It’s no secret that kids in the U.S. are struggling with mental health issues in increasing numbers.

A recent study in the Journal of the American Medical Association (JAMA) emphasized the severity of the situation: Pediatric mental health hospitalizations are rising, and many more kids are being hospitalized for attempting suicide. The data couldn’t be clearer: We’re not identify-

chair of research for the department of pediatrics at Dartmouth-Hitchcock Medical Center in New Hampshire. She noticed a growing proportion of the patients at her hospital were coming in because of mental health conditions. She decided to mine the country’s largest public database of pediatric inpatient care to try to understand if it was a nationwide trend.

And clearly, it is. Between 2009 and 2019, pediatric mental health hospitaliza-

Suicide is a common cause of teen death we don’t talk about, but need to

The teen mental health crisis is no place to cut corners

Surgeon General Vivak Murthy recently stated that mental health challenges led to “devastating effects” among our kids.

Mental Health Awareness

Month is in May, and during this period, many people talk about mental health — but the issue needs to be recognized all year long. We can’t ignore the problem any longer. Between mass shootings, the pandemic and social media, our children are suffering. It’s estimated that approximately 8% of youth attempt suicide each year, and more than 15% of youth seriously consider suicide.

COVID-19 alone has in-

COMMON

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remove the prejudice and judgement that still exists around depression, anxiety and other common mental health challenges. Whether you are sharing your own experiences or asking teens about theirs, you are demonstrating that you care about them.

You’re also sending the clear message that it’s OK to talk about these topics.

Conversations about

is a link between social media and depression. In several studies, teenage and young adult users who spend the most time on Instagram, Facebook, and other platforms had a substantially (from 13 to 66%) higher rate of reported depression than those who spent the least time.” Unfortunately, most people spend several hours daily on these sites, which compounds the problem. While I don’t have all the solutions to improving mental health, I can tell you from personal experience that exercise profoundly impacts the mental health of adults and children alike. Physical

dia also has a powerful effect on our brain. Because our brains experience a rush of dopamine when using social media, we return for more and more, which leads to addictive behavior. And therein lies the problem. A study by the Journal of the American Medical Association (JAMA) found that teens who use social media for more than three hours a day are at “heightened risk for mental health problems.”

Sadly, while social media has become the norm for our children, physical education in schools has become almost nonexistent. In fact, some recent statistics

we have witnessed an increase in childhood obesity as well as perilous mental health risks in our children.

Building a solid fitness foundation at a young age will help lay the groundwork for them to become strong, healthy, and happier adults. Low-intensity exercise improves brain function and makes kids feel better, while high-intensity workouts three to four times a week can reduce clinical depression. The benefits of exercise are not up for debate. Exercise reduces feelings of depression, enhances mood, improves sleep and gives one an overall sense of emo-

hood obesity but also improves academic performance and mental health

Because of this, I’ve spent a substantial portion of my career working to put fitness centers in elementary and middle schools across the United States.

Getting our children to exercise is a tangible benefit that can be done now. Introducing physical activity and fitness to our kids is good medicine. Exercise will help kids maintain a healthy weight, improve their mental health, and ultimately enrich their quality of life.

The bottom line is that we must act now by prioritizing

feeling sad, angry, stressed or anxious, lead by example go for a walk together, kick around the soccer ball, or do some jumping jacks or push-ups. Step away from social media and step outside. Our mental and physical health depends on it.

Children are our most precious resource. When our kids are mentally healthy and strong, the future of our nation will be strong. Don’t quit!

Jake (“Body by Jake”) Steinfeld is a fitness expert who serves as chairman of the National Foundation for Governors’ Fitness Councils.

mental health should be as common as conversations about physical health.

Watch for warning signs

Most people who attempt suicide display some signs of distress.

Some are like flashing red lights: talking about death, saying they have no reason to live or suddenly giving away prized possessions. In these cases, seek help immediately.

Other warning signs may look like the typical upsand-downs of teenage life:

changes in sleep or school performance, neglecting appearances, being aggressive or withdrawn.

Some groups face significantly higher risks of suicide: kids who get bullied, LGBTQ kids, and those who have recently experienced a death in the family or the end of a romantic relationship.

Ask questions

Talk to the teen in your life. Teens are struggling with the many changes that they’re experiencing. Most of the time they just need

someone that will listen to them without judgment. Take the time to ask questions and show that you are listening: put your phone away, find a quiet place to sit, and be OK with silence. If you are worried about a teen in your life, reach out right away.

Don’t be afraid to ask direct questions. Have you ever thought about suicide? How frequently? Have you ever made a specific plan? If your teen answers yes to the last question, connect them to help right away.

CRISIS

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coming into the hospital after having attempted suicide or harmed themselves.

“This is reflecting a very real change in the patterns of disease that are being seen by acute care hospitals around the country,” Leyenaar says. She notes that diagnostic classifications were updated and hospitals changed their coding systems during the study period — for example, differences in hospital coding might have resulted in an increase in the number of kids receiving multiple diagnoses. But she says the changes can’t account for the huge increase in kids being admitted for mental health emergencies.

A few important things came out of the data Leyenaar and her colleagues analyzed. First, because they chose to look at the 10-year period starting in 2009, the study makes clear that this rise in more serious mental health conditions can’t be blamed on the pandemic — kids were already in crisis before that upheaval.

Second, the increase in mental health hospitaliza-

Listen without judgment

When talking with a teen in distress, you may hear difficult things and be uncertain of how to respond.

“Thank you for sharing this with me” is a way to reassure them and keep the lines of communication open.

Remind them that everyone deserves help and that people do get better.

Get help

If you remember only one thing, make it 988. That’s the number to call or text 24/7 for confidential

crisis help.

Mention it often to your teen so they learn it by heart.

Hawaii C.A.R.E.S. also offers crisis help. On Oahu, call 1-808-832-3100. On neighbor islands, call 1-800753-6879.

The Trevor Project offers crisis support for LGBTQ young people: call 1-866488-7386.

If you are unsure how to start a conversation with the teens in your life, text the link to this column along with a classic question: “Hey, how are you?”

tal health crises.

Last, many more kids are being admitted after having attempted suicide or harmed themselves. In 2009, about 31% of mental health hospitalizations included a report of self-injury; by 2019, that figure was just over 64%. That number doesn’t surprise Colleen Cicchetti, executive director for the Center for Childhood Resilience at Lurie Children’s Hospital of Chicago, who says it reflects not only the dire state of kids’ mental health, but also that limited capacity has raised the bar for being admitted to the hospital. In other words, conditions that would have warranted hospitalization in 2009 were, by 2019, being treated with outpatient care.

For mental-health workers, these new data confirm the scope of the problem. “This is going to be one we’re going to be quoting for a long time,” Cicchetti says. “This is a massive database across the whole country. It’s highlighting that we have a real need to do something about it.”

The question, of course, is what can be done.

The most obvious solution is to throw all of our resources into preventing

ter job training the people who interact with kids most: pediatricians, teachers and community leaders.

In the meantime, staff at acute-care facilities need more support. That includes training on how to best care for a child experiencing a serious mental health disorder. Most physicians in an acute care setting “are not trained mental health professionals, or have very minimal mental health training through medical school and residence,” Leyenaar notes.

And the U.S. simply needs more dedicated, high-quality mental health facilities for minors. The JAMA article pointed out that more kids are being admitted to acute care facilities at a time of shrinking resources.

Creating that capacity isn’t cheap. A recent article by WBEZ noted that outfitting a patient room in an adolescent psychiatric unit, an endeavor that involves special safety features, can run upward of $1 million. A single room.

Yet even if such rooms could be built for free, pediatric mental health would not be a profitable business. A child psychia-