TEENS IN CRISIS

Today’s teenagers are the first generation having to navigate an online world at the same time as learning to live with an unknown present and future.

Our teens are the first generation having to navigate an online world at the same time as learning to live with an unknown present and future. Here’s how to help them.

Our young people are facing unwelcome levels of mental ill-health – but, armed with knowledge and compassion, we can all help the teenagers we know and love to look after their minds and better cope with whatever life throws at them.

Adolescence isn’t an easy time for anyone, but the global pandemic has turned an already tumultuous time upside down. Rates of anxiety, depression, self-harm and suicide are escalating at unprecedented rates as teens grapple to forge their identities in a world of change and uncertainty.

In New Zealand, recent Victoria University of Wellington Youth19 research found the emotional and mental wellbeing of Kiwi teens has been worsening for the past seven years. Significant depression in high school students has almost doubled to 23 per cent, and suicide attempts are on the rise, particularly for rangatahi Māori (13 per cent of surveyed Māori high school students had attempted suicide in the previous 12 months).

According to Beyond Blue, one in seven young Australians aged 4-17 will experience a mental health condition in any given year. One in 10 aged between 12 and 17 will self-harm, and one in 40 will attempt suicide. In Australia, suicide is the leading cause of death for people aged 15 to 24 years old. Why are so many teens finding life difficult, and what can we do to support them? Victoria University of Wellington researcher Dr Theresa Fleming says there is no single cause for the rising distress in teens. Social media, loneliness, poverty, discrimination and harmful environments may all come into play, along with the social pressures that accompany the teenage years.

A PERFECT STORM

“It’s a huge time of transition for adolescents,” says Beyond Blue lead clinical adviser, Dr Grant Blashki. Along with hormonal upheaval and physical changes, their social worlds become more complex and academic pressure intensifies. “All these things collude and make things difficult for a lot of young people.”

Throw in a global pandemic and concerns about climate change, and it can become a perfect storm for mental ill-health.

“These large global issues, which are serious, are amplified by social media and the news cycle so there’s a risk young people take to heart what they’re seeing and lose perspective,” Dr Blashki says. “They can develop a sense of worry and despair about the future.”

“YOUNG PEOPLE CAN DEVELOP A SENSE OF WORRY AND DESPAIR ABOUT THE FUTURE.”

DR GRANT BLASHKI

In his role as a Melbourne GP, Blashki has seen a lot of “very anxious, stressed” young people come through his door since the pandemic began. Lockdown has been more distressing for some teens than others. Along with isolation, poor sleep, less physical activity and a lack of structure to their day, many teenagers have expressed worry about older family members getting COVID-19. “The general sense of uncertainty has made it a pretty bumpy time for a lot of teenagers,” Dr Blashki says.

And it isn’t over yet.

Nic Brown, CEO of the mental health charity, batyr, says the full impact on young people’s mental health isn’t yet clear. “Pandemic fatigue is a real issue as we head into 18 months of uncertainty,” he says. “This ongoing uncertainty and information overload has certainly led to higher rates of anxiety and depression, but it’s also exacerbated the symptoms of existing mental ill-health among young people, including complex types like disordered eating and OCD. This has been due to a loss of connection and loss of routine/normality.”

And while teens talk more openly about mental health than they used to, there is still a reluctance to get help. “Stigma is still the major challenge to overcome because it prevents young people from reaching out early before their mental ill-health reaches a crisis point,” Brown says.

HELPING HANDS

Although demand for psychological support is far outstripping supply, a growing array of tools and programmes – online and in-person – are playing an important role in bridging the gap. Beyond Blue’s Be You programme focuses on early intervention by teaching educators how to identify mental health problems in preschoolers, children and teenagers, and what kinds of support to give them.

Charity batyr works to break down the stigma of mental ill-health in schools by having young people who’ve faced mental health challenges share their lived experiences with high schoolers. “We’ve trained more than 900 young people to give a voice to their experience of mental ill-health, and have around 150 active lived experience speakers sharing their stories in our peer-to-peer programmes,” Brown says.

One of these speakers is Jenna*, a 21-year-old student studying art. “It’s very valuable work batyr is doing,” Jenna told MiNDFOOD.

“I didn’t know what mental health was when I was in school – I didn’t really learn about it, but it would have helped me for sure.”

Jenna’s mental health challenges started in primary school when she was bullied for how she looked.

“I was bullied for being different, and for the size I was; I was always on the small side because I was very active and anxiety would get in the way of food; I didn’t want to eat in front of other people.”

She had trouble making friends and spent much of her time alone.

“People would always comment on how I looked so I started to become very self-conscious about it and preoccupied with it, and I was diagnosed with an eating disorder at 13.” Although Jenna says anxiety was to blame for being underweight, once she was labelled as having an eating disorder, she felt she needed to live up to it.

“Being around people with eating disorders in hospital, I learned all these behaviours and I started doing a lot of things in secret,” she says. “I was good at tricking people, I was good at lying. That’s what my eating disorder turned me into – a horrible, moody, lying person, which goes against all my values now.”

For the next few years, Jenna was in and out of hospital for disordered eating, body dysmorphia, anxiety and suicide attempts. “It was lonely because I felt like people didn’t understand and there were always arguments with professionals and my parents,” she says. “There was a lot of fighting and yelling and self-blame and then self-harm and wanting to end my life – it was a cycle.”

Jenna’s parents moved her and her sisters to the UK for a fresh start, but it didn’t go as planned. “I was in a bad place here, I had just come out of more hospital admissions ... but I ended up in hospital over there for a longer amount of time.”

Although a lot of the treatments were around food, weight and body image, Jenna says she would have also benefited from in-depth therapy that encouraged her to build her identity. She says she felt like people just saw the eating disorder, when she wanted other parts of herself to be seen, too.

Three years later, Jenna moved back to Brisbane, where she now lives on her own.

ROAD TO RECOVERY

Jenna realised she could no longer pretend she had recovered when her eating challenges got in the way of a concerted effort to work, study and make friends back in Australia.

“Then I chose recovery again,” she says. “Instead of just focusing on food I was focusing on healing, finding my true identity, returning to my values, becoming my own person.”

Jenna says it’s important for young people to find what works for them when it comes to getting support for mental health challenges. “For me, helping myself online has been what’s worked.”

Through books, online resources, and therapists sharing advice on Instagram, Jenna has been able to educate herself about the reasons – conscious and subconscious – behind the challenges she faced, and how to deal with them.

Expressing her feelings through art and creativity has become an especially effective coping mechanism.

“I still have anxiety but the difference is that now I accept it and don’t believe it. I still do whatever I want to do, but before I let it take over everything,” she says.

She has a healthier relationship with food now, too. “I don’t think about what I’m going to eat or who I’m going to eat with or what time,” she says. “Before, it was very planned every single day – the nutritional value of food, what time, how much and what it was. Now I don’t care if it doesn’t look perfect, I don’t care anymore, which is great.”

As well as helping to normalise conversations around mental health through batyr’s school programmes, Jenna shares her inspirational road to recovery on Instagram (@ empowering mindsets_j ). Her goal today is to become an art therapist.

Today’s teenagers exist as much in their online worlds as they do offline, so tech innovations are proving helpful in the support of young people in need.

Although social media can be a valuable way for teenagers to find their tribe and stay connected with friends, it adds another layer of complexity to the complicated worlds teenagers are already navigating, and there’s a level of being continuously ‘on show’.

“It has always been hard to go through puberty and the stage of building your identity but with social media, everything is on the world stage and there is no safe space to figure that out,” says Dr Angela Lim, who trained and worked in paediatrics before co-founding Clearhead, New Zealand’s first AI-driven diagnostic and triage platform for youth mental health and wellbeing.

Tech-driven support for teens is proving effective as demand for mental health support grows. “There’s increasing growth in demand for mental health support in young people in a system that can’t keep up,” Dr Lim says.

In NZ, Dr Lim says 97 per cent of mental health funding goes to the top 3 per cent of people who need support: those actively in crisis. The situation is similar in Australia.

“IT TAKES AN AVERAGE OF 8 YEARS FOR SOMEONE TO SEEK HELP FROM THE TIME THEY START EXPERIENCING MENTAL HEALTH SYMPTOMS.”

EMPOWERING YOUNG PEOPLE

“Working in the hospitals, especially in the public system, I saw that we were not catering for the majority of people who needed help,” Dr Lim says. “I saw an increasing need for young people to be supported in their mental health and, rather than being the ambulance at the bottom of the cliff, I wanted to truly empower people to self-manage and be more proactive with their health. If I wanted to make an impact, it was clear that technology was the best way to do this.”

Accessing Clearhead’s app or site gives teens on-demand support, whether they’re being bullied at school, battling anxiety or depression, or feeling out of control. “Getting to the point of saying ‘I need help’ is so hard,” Dr Lim says. In fact, she says it takes an average of eight years for someone to seek help from the time they start experiencing symptoms.

Clearhead connects teens with a digital therapist and provides them with a judgement-free space to share what they’re going through. Using artificial intelligence, the system creates a personalised plan that helps teens work through their issues and build skills to deal with them. If more support is needed, NZ teens are matched with available therapists in their local area. Clearhead is now working on bringing local therapists on board for Australian teens.

Designed for over-16s, Clearhead also offers a pathway for family members and friends to learn how to support younger teens. Improving mental health literacy in the community widens the safety net for young people, Dr Lim explains, and early intervention can stop treatable problems worsening.

Teens often resort to cutting or self-medicating with drugs or alcohol to cope with emotional distress, so one of Dr Lim’s aims is to help teenagers learn how to handle life’s stresses without resorting to unhealthy coping mechanisms.

“This is the time we learn to navigate life and it becomes the blueprint for how we experience and deal with problems,” she explains. “Once an individual learns to deal with an issue in a healthy manner, life can continue to throw them unexpected circumstances that will be difficult, but now they have the tools to deal with them. It sets them up for success.”