Mental health and suicide prevention in teens has rightly become more of a focus in the national conversation around mental health. The data shows why. The Center for Disease Control and Prevention (CDC) Youth Risk Behavioral Survey (YRBS) from 2019 found that 37% of high school students experienced persistent feelings of sadness or hopelessness, 19% seriously considered attempting suicide, 16% made a suicide attempt and 9% attempted suicide. The CDC’s Morbidity and Mortality Weekly Report from June 18, 2021 declared that during 2020, the proportion of mental health–related emergency department (ED) visits among adolescents aged 12–17 years increased 31% compared with that during 2019. In October 2021 the American Academy of Pediatrics (AAP), American Academy of Child and Adolescent Psychiatry (AACAP) and Children’s Hospital Association (CHA) declared a national emergency in children’s mental health. Then, in March 2022, a CDC news release reported that high school students experiencing persistent feelings of sadness or hopelessness had increased to 44%.
For LGBTQ youth, these numbers are even higher. According to the Trevor Project’s 2022 National Survey, 61% of LGBTQ youth reported symptoms of depression, while nearly 50% reported seriously considering attempting suicide in the past year and 18% made an actual suicide attempt – double the rate of U.S. teens altogether.
The World Health Organization (WHO) reveals that these concerns are not just a national problem. Adolescent mental health is a global issue.
One of the first steps in helping teens struggling with mental health issues is learning how to recognize the warning signs. It is important to understand that teens often do not outwardly express what they’re feeling inside and signs of mental health struggles can often be subtle.
Teens experiencing depression generally exhibit one or more of the following:
- Withdraw from friends or social events
- Sleep too much or too little
- Experience a significant decrease in energy
- Express uncontrolled anger or sadness, or develop significant irritability
- Loose interest in things they previously were interested in (hobbies, sports, etc.)
- Eat significantly more or less
- Have difficulty with concentration, focus and attention
Teens experiencing anxiety often exhibit one or more of the following:
- Feeling restless, wound-up or on-edge
- Easily fatigued
- Uncontrolled or difficult to control feelings of worry or fear
- Difficulty with falling or staying asleep
- Increased irritability
- Difficulty with concentration, focus and attention
- Frequent or persistent headache, stomach pain, body aches or other unexplained pain
What teens say can also sometimes cue us in to their mental state. Even if they don’t specifically mention depression, anxiety or suicide. The AAP has recognized the following statements, or anything similar, as red flags that warrant seeking out professional help for a teen.
- "I want to die."
- "I don’t care anymore."
- "Nothing matters."
- "I wonder how many people would come to my funeral?"
- "Sometimes I wish I could just go to sleep and never wake up."
- "Everyone would be better off without me."
- "You won't have to worry about me much longer."
These types of statements can be made out loud, or they can be expressed in writing or on social media. Regardless of the format, it is important to take such statements, or any mention of suicide, seriously.
WHAT ADULTS CAN DO
While hearing and thinking about these warning signs is scary, it is important to understand that parents, teachers, coaches, and other adults can make a big difference in the lives of teens struggling with mental health concerns.
Listen. If you are concerned your teen, or any teen you know, is struggling with their mental health an easy first step is simply to ask them. If your teen is sharing with you, always focus on listening to what your teen has to say, regardless of how you might feel. Listen, do not interrupt and remain calm. When it is time to respond, do so with empathy and provide validation. Never belittle your teen or tell them what they are experiencing is wrong or imaginary. Avoid judgment as well as giving personal opinions or lectures, as this can cause a teen to feel defensive. Remind them how much they matter. Above all, let your teen know that you love them and they are not alone.
Create a safe space. If you know or are concerned that someone in your home is struggling with mental health or has thoughts of suicide, having a safe and secure home can be lifesaving. Keep all firearms, sharp objects, alcohol and medications stored safely, under lock and key, or move all firearms elsewhere.
Get support. If you are a parent, you can always reach out to your teen’s pediatrician for screening and support. If you are a teacher, coach or other adult, reach out to the teen’s parent, guardian or caregiver. If that is not possible, consider reaching out to the school counselor. Mental health care professionals can also be a key component of treating and supporting teens struggling with depression, anxiety or other mental illness. Many insurances now allow self-referral for mental health concerns. Psychologists, licensed professional counselors, licensed marriage and family therapists, licensed clinic social workers and pastoral counselors are just some of the professionals available to help.
Advocate. Be an advocate for your teen at school by reaching out to the school counselor and tapping into any resources through your school district. In some school districts there are programs set for teens who are struggling with mental health disorders to help them manage academically while getting their health concerns stabilized.
Remember, teen mental health and suicide is a serious and growing concern. Taking notice of possibly concerning behaviors or statements can help raise the red flag about possible mental health issues. Take time to ask. Talking with teens about mental health is not a one-and-done conversation. Communication about depression, anxiety and overall mental health and wellbeing should be on-going, open and honest. It can be intimidating or feel awkward, but it is a conversation that could save, and has saved, the lives of many teens. Listen, create a safe space, reach out for support and be an advocate for your teen.
For More Information
National Suicide Prevention Lifeline
(800) 273-8255 or 988
California Mental Health Services Authority
Valley Children’s Mental Health
If you are concerned your child is an imminent threat to themselves or others, call 911.
CDC’s Youth Risk Behavioral Survey (YRBS), 2019. https://www.cdc.gov/healthyyouth/data/yrbs/yrbs_data_summary_and_trends.htm
Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health. https://www.thetrevorproject.org/survey-2022/
Suicide Is Preventable Website, by the California Mental Health Services Authority (CalMHSA). https://www.suicideispreventable.org/
CDC’s Morbidity and Mortality Weekly Report, June 18, 2021. https://www.cdc.gov/mmwr/volumes/70/wr/mm7024e1.htm
American Academy of Child and Adolescent Psychiatry, October 2021. https://www.aacap.org/App_Themes/AACAP/Docs/press/Declaration_National_Crisis_Oct-2021.pdf
Adolescent Mental Health, World Health Organization, 17 November 2021.
About the Author
Dr. Finnian Steele is a Valley Children’s pediatrician at Dakota Pediatrics in Fresno and is an advocate for mental health.