Youth in crisis face high rates of depression, anxiety, trauma, and suicidal thoughts. They are also disconnected from family, friends and community, putting them at risk for mental health issues and future outcomes.
They may be exhibiting dangerous behaviors like running away, using drugs or alcohol, and engaging in sexual prostitution. Most children and youth live with families, so any crisis must involve the whole family.
Mental Health Issues
Young people may be less likely to ask for help or seek treatment, especially if they feel that they should “handle it themselves.” They might also fear being seen as a burden or not being taken seriously.
Research shows that one in seven 10-19-year-olds experiences a mental disorder, such as depression, anxiety and behavioural disorders. The increase in these conditions has been attributed to various factors, including climate change, family environment and educational pressures, socio-economic precarity and inequality, traumatic life events and abuse and the impact of social media.
Many of these factors are part of what are known as the’social determinants’ of mental health. These are the structural conditions that affect individuals at global, national and local levels and are largely shaped by policy choices. These include income, housing and employment, education, food security, social support and neighbourhood conditions, discrimination and childhood adversity. (87-89)
Substance Abuse
Adolescence is a time of dramatic physical, psychological and social change. Substance abuse during this time can lead to poor health outcomes and interfere with a young person’s ability to learn and make good choices.
Some of the drugs teens may use include alcohol, marijuana, prescription opioids, benzodiazepines (Valium, Ativan, Xanax), amphetamines and hallucinogens such as LSD, mescaline (“mushrooms”) and phencyclidine (PCP or angel dust). Youth who experience substance abuse may develop mental health disorders, be involved in the juvenile justice system or have trouble at school.
Many substance abuse treatment options are available. A teen’s treatment plan should be regularly reviewed and adjusted to address their changing needs. Family-based approaches, such as Multisystemic Therapy, emphasize full family engagement from caretakers to siblings and offer services like parenting skills training and adult mental health support. Treatment may also involve community-based supports, such as peer recovery networks. Medications are often used in combination with counseling and behavioral therapies.
Trauma
The trauma experienced by youth in crisis can impact their mental health, including PTSD, and cause or worsen chronic health conditions. It can also lead to behavior issues, including self-injurious or destructive behaviors and substance use disorders. People who have a history of trauma can present with physical symptoms, so primary care providers may be the first line of treatment.
Individual reactions to trauma can vary, but some common responses include depression and isolation, lack of concentration, heightened arousal and confusion, anxiety or panic, sleep disturbances and gastrointestinal, cardiovascular, neurological, musculoskeletal or respiratory problems. People who experience traumatic stress can become more aggressive and reactive, and often seek out destructive or risky activities to relieve their distress.
Some groups of people are at higher risk of experiencing trauma, including those who are homeless, exposed to domestic or community violence, refugees, veterans and those who work in emergency services or the military. Women experience trauma at twice the rate of men.
Family Issues
Having close relationships with family members, who are willing to listen and communicate with each other, can help teenagers manage their mental health. A lack of this support can contribute to poor emotional regulation and risky behaviors.
Many youths in crisis have experienced family issues that can contribute to their stress and anxiety. They may have lost a caregiver to Covid-19, struggled with financial challenges or felt like their family didn’t accept them for who they are.
This can lead to depression and a desire to hurt themselves. They may also struggle with substance abuse and become involved with the justice system, where they experience even more trauma. Psychologists are working to understand these problems and develop and disseminate solutions. This includes supporting peer advocates, who are trained and credentialed to help youth in crisis. They provide a safe space for youths to express their concerns, needs and worries without judgment. They can also offer strategies to address the root causes of their challenges, so they can avoid them in the future.