Youth in crisis often have both personal and family issues that contribute to the onset of their crises. Communication struggles, unhealthy coping skills, substance abuse and technology overuse are common contributing factors.
More than just a bad day, feelings of persistent sadness or hopelessness, or suicidal thoughts and actions indicate a true mental, emotional and/or behavioral crisis.
What Causes a Crisis?
Today’s youth are struggling like never before. Tweens and teens — those on the cusp of adulthood — live in the wake of a frightening global pandemic, face academic pressures, and are the first generation to grow up with social media as a constant presence. They also struggle with financial insecurity and are at risk of abuse.
Added to this is the fact that many children and teens don’t have access to mental health services. “The issue isn’t a shortage of care, but rather that treatment is too hard to find,” says Schleider, who works in the Lab for Scalable Mental Health and seeks ways to deliver mental health services in the form of single-session interventions aimed at young people.
If your child seems more sullen, quiet or irritable than usual, it could indicate they are in a mental health crisis. They may be exhibiting signs of self-harm or severe agitation and hostility. This is a life-threatening situation that requires immediate intervention.
Identifying the Crisis
The dramatic rise in anxiety, psychological distress and depression during adolescence and young adulthood represents an emerging global public health crisis. The cause is complex and rooted in many potential factors, including climate change, family environment, educational pressures, socio-economic precarity, the use of social media and intergenerational inequality.
A recent U.S. surgeon general’s report cites mental health problems as the leading cause of disability and poor life outcomes among youth. A variety of factors contribute to this trend, including structural racism, income inequality and a lack of affordable health care.
Psychologists are working to identify and mitigate these factors to address the mental health crisis that often lands youth in the justice system. Their work includes developing and disseminating best practices for reentry case planning, including community-based supports to prevent crises that may lead to future involvement with the criminal justice system. These efforts are informed by research and lessons learned in collaborations with partners in the community, law enforcement and behavioral health systems.
Assessing the Acuity of the Crisis
A youth in crisis can experience a wide range of challenges, especially during times of high stress. These include a disruption to their normal routine caused by the Covid-19 pandemic, loss of family members due to the pandemic, social isolation and academic disengagement, strained relationships with caregivers, heightened expectations about their future, increasing rates of bullying and online bullying, societal polarization, climate change, and political tensions.
Many of these factors show varying trends over time. For example, increasing trends have been seen in feelings of sadness and hopelessness, suicidal thoughts and behaviors, homelessness, and housing insecurity. In contrast, some stable trends have been found in areas like family stability and parenting stress.
Regardless of the underlying factors, the goal of the crisis stabilization process is to help the youth and their family feel safe and supported. This is accomplished by establishing trust, creating safety plans, engaging in clinical discussions, and connecting the youth to appropriate long-term treatment and recovery resources.
Stabilizing the Youth
When a youth experiences a mental health crisis, it is essential that they receive immediate care. The youth should be stabilized, referred to treatment providers and connected with community resources that will support their recovery. A psychiatric evaluation and risk assessment should be conducted.
A safe environment with structured, predictable routines is important for stabilization. A dedicated youth crisis stabilization facility offers round-the-clock care in a warm, welcoming setting where the teen can be listened to without judgment. The ability to engage in therapeutic activities and coping strategies will also help the teen focus on something other than their crisis.
Mobile crisis services are another way to quickly connect young people to care. One approach is a two-person team composed of a clinician and a relatable age peer who provides crisis support. Often, youth will respond more positively to this approach than when they are approached by law enforcement. Ideally, a family member should be present during this process.