Mental illness hits teens in alarming numbers
There's a crisis going on, and it's happening in our homes, our schools and our playgrounds.
Mental illness is affecting an alarming and growing number of our children and teens.
In fact, one in seven Australians aged four-17 are experiencing a mental health condition, according to beyondblue. That's more than half a million children and adolescents. A Mission Australia youth survey last year suggested the figures may be even higher.
About a quarter (23.7 per cent) of 15-19- year-olds were either extremely concerned (11.1 per cent) or very concerned (12.6 per cent) about depression. Shockingly, suicide is the biggest killer of young Australians - more deaths of young people than crashes. In 2015, 391 young people aged 15-24 died by suicide - against 290 in 2005.
Child psychologist Elizabeth Margules said about one in 10 adolescents was believed to be living with post-traumatic stress disorder triggered by a traumatic event, according to figures from the National Drug and Alcohol Research Centre at UNSW Sydney.
"Around half of these young people are self-medicating with drugs and alcohol, putting them at risk of chronic substance abuse,” said Ms Margules, who treats teens in crisis at Cape Byron Medical Centre.
While they are dealing with developmental issues - the transition from childhood to teen and then to adult - they are being hit with a range of factors, from bullying, trolling and social media saturation to family breakdown and an increase in health conditions such as diabetes that can be linked to depression.
"Whether we are discussing depression, anxiety or behavioural issues, mental health problems and behavioural problems stem from problems in emotional development,” said Mee Hee Douglas, a clinical psychologist. "To simply treat these issues with medication does a disservice to our profession and to the people we are meant to treat.”
Ms Douglas isn't saying antidepressants aren't sometimes important. Rather she's advocating a complete approach to emotional and physical wellbeing.
"Transitioning from childhood to adulthood and finding one's place in the world is a very precarious thing, especially for today's teenagers, who are confronted with an external world that is threatening and uncertain,” she said.
At the same time, smart devices and apps and the internet risk becoming children's total existence and meeting space.
Ms Margules agrees: "There used to be a stage in between childhood and adolescence that was a valuable time for acquiring problem-solving, decision-making and communication skills. This is now rushed through by changes in culture driven by the digital world. Technology presents a major issue for mental health, with around 60-90 per cent of the communication adolescents do being digital.”
SLEEP AND SELFIES
A Resilient Youth study in 2017 showed 68 per cent of Year 7-12 students report using technology between 10pm and 6am. Leading child sleep physician Dr Chris Seton, from the Woolcock Medical Institute, has suggested that screen time for children could be as addictive as drugs.
While we can't control teen obsessions such as selfies, we can support children to develop resilience, recognise what matters and focus on the positive.
"The greatest predictor of wellbeing is not being good-looking or having a lot of money. It is having a rich repertoire of friends and the support of parents,” Ms Margules said.
Parents also need to engage with children and teens in a genuine way, giving adolescents full attention and positive feedback.
"Adolescents are operating mostly out of the amygdala, a structure of the brain which operates well off feedback, short sentences and humour. The capacity for forward thinking and weighing up consequences is a work in progress,” Ms Margules said.
"Therefore, the role other caring adults play is pivotal in supporting limits and boundaries.”
Parents, as well as friends and relatives, need to watch out for the red flags of mental illness: sudden loss of interest and pleasure in activities that once really gave them joy; controlled eating; difficulty sleeping; and long-standing feelings of unhappiness or moodiness accompanied by a sense of emptiness or numbness for two-three weeks should be a concern. Children and teens may be self-critical or preoccupied with dark and gloomy thoughts - including those of suicide.
"Mental illness in teenagers occurs when they have trouble working through the adolescent task of separation and how they want to be in the world,” Ms Douglas said.
"It may be too much for them and then they can become symptomatic in the form of school refusal, eating disorders, panic disorder, social anxiety, anti-social behaviour and other forms of severe refusal syndrome.”
If you are concerned, try to create opportunities to talk. It's important to understand that asking about suicidal thoughts or ideas will not increase the likelihood of any action being taken.
If your child is open to professional help, seek a psychologist experienced with children and teens.
If you suspect children or teens are at immediate risk of suicide or self-harm, they should be referred to the emergency department or relevant acute mental health service or a child/youth psychiatrist.
WHERE TO GET MORE HELP
One of the major causes of psychological distress in young people is an inability to cope with stress, according to the Mission Australia report. That means programs that teach teenagers coping skills and emotional awareness could play a key part in addressing the issue.
Dr Fiona Shand, director of research for LifeSpan, a community-led suicide prevention approach at the Black Dog Institute, said: "It's imperative we make schools an environment where parents, teachers and the school system work together to teach mental health resilience in students.”
Black Dog runs a Youth Aware of Mental Health program that teaches skills for coping with adverse life events and stress. It has been completed by 5000 Year 9 students in NSW schools. Scientific modelling predicts LifeSpan can help prevent 21 per cent of suicide deaths and 30 per cent of attempts.
CBT (cognitive behavioural therapy) can help people change negative or unhelpful thought patterns to more positive reactions and problem solving.
WHO CAN HELP?
Your GP or family psychologist
Kids Helpline: 1800 55 1800 or kidshelp.com.au
The Black Dog Institute: blackdoginstitute.org.au/getting-help
For teens, online sites and apps including MoodGym (Online CBT), Breathe2Relax, video game Journey to Wild Divine and the BRAVE Self Help Program - brave-online.com
The Federal Government lists online programs at mindhealthconnect.org.au.