“I wish my parents understood that being sad doesn’t mean I’m being lazy.”

“I wish they knew that online school isn’t as easy as it seems. I really am trying.”

“I wish my family knew that I am struggling with my mental health even though I don’t show it. Most days I don’t even want to get out of bed.”

These are real responses from teenagers in the Yakima Valley in a survey their teacher and I gave about mental health. Their answers were brutally honest: I’m struggling. This is hard. I need support.

As a pediatrician, I have seen youth mental health struggles become more and more common over the past years. Pre-COVID, at the end of 2019, the numbers around youth mental health were already bleak: 1 in 5 teens had a mental health diagnosis such as anxiety or depression, with 80% of those not being adequately treated. Suicide rates were up by 50%, and tripled in children under age 14. Things were bad. 2019 was a year of crisis for youth mental health.

And then 2020 happened.

The past year has brought stress and chaos to all our lives. But our children may have felt that distress most of all.

More than half of struggling children receiving counseling previously did so through their schools, and such counseling overwhelmingly disappeared as schools moved online. Other benefits also disappeared: caring teachers, close contact with friends, structured schedules. For children who were already struggling, the loss of those support systems was profound. For children who may not have struggled before, their emotional lives were upended along with their daily routines.

From March to October 2020 in Washington, the proportion of Pediatric Emergency Room visits for psychological distress increased by 30%. In the month of September, over half of children ages 11-17 reported having suicidal thoughts nearly every day of the last two weeks. Some months this past year, the proportion of pediatric ER visits due to a child suicide attempt was double that of 2019. Double.

Our children are hurting. Our children need help.

If you are a parent or family member of a young person, I urge you to talk with your child about mental health and let them know they have your support. Talk with them about what they can do if they are feeling overwhelmed and in crisis. Talking does not put ideas into a child’s head; rather, it may give a struggling child the opportunity to seek help from those that love them.

I also urge you to think about the safety of your home. Are all firearms kept unloaded and locked, separately from the ammunition? Are pills, both prescription and over-the-counter, kept locked and stored safely? These safety measures may save a child’s life.

Listen to how teens say their parents can help:

“Ask and try to understand how I feel. Tell me positive things about the effort I am putting in, instead of always focusing on the negative.”

“Sometimes I just need someone to listen to me, not to judge me or think like a parent or fix everything. Just listen. Let me know they are there for me.”

But this job cannot be on the shoulders of parents alone. Washington lawmakers must make big, bold investment in youth mental health now, as part of a COVID relief plan. We know that struggling children become struggling adults without appropriate treatment and support. One of the children said it best when they described what they needed from the adults in their life:

“Stop trying to pretend I can make myself better. Find me someone who can help.”

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