Youth Mental Health: Raising Awareness and Overcoming Challenges

Jennifer Rojas-McWhinney, Ph.D., CFLE
/ CFLE Network, Summer 2019

Jennifer Rojas-McWhinney
Jennifer Rojas-McWhinney, Ph.D., CFLE

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Mental health challenges continue to be a concern within the United States, with both personal and social implications. Many people have some level of experience with mental health problems, and this experience often comes from personal challenges and those of family and friends. On the basis of data from the National Comorbidity Survey—Adolescent Supplement (NCS-A), approximately one in four to one in five youth (ages 13–18 years) are diagnosed with a mental disorder with severe impairment. Of disorders identified, the most common is anxiety (31.9%), followed by behavior disorders (19.1%), mood disorders (14.3%), substance use disorders (11.4%), and eating disorders (2.7%); co-occurring disorders were present in approximately 40% of youth with a diagnosed mental disorder. According to an article published by Merikangas and colleagues (2010), the median age of onset for disorder classes was earliest for anxiety (6 years), followed by 11 years for behavior, 13 years for mood, and 15 years for substance use disorders. Additionally, the Centers for Disease Control and Prevention (2017) reported that the second leading cause of death for youth is suicide. Such statistics indicate that it is imperative for families, schools, and communities to address the mental health challenges of youth. However, difficulty in identifying services and appropriate professionals must be overcome by the fact that most of the United States is considered a Mental Health Health Professional Shortage Area (HPSA), based on data provided by the Health Resources and Services Administration (2018).

Given the existing barriers to accessing care, it is vital to consider alternative approaches to alleviating mental health challenges and crises. With the amount of time youth spend in school settings, it is essential that educators and administrators are knowledgeable about mental health problems and appropriate ways to respond. A program that is gaining national and international attention is Mental Health First Aid, which originated in Australia in 2001 and has expanded to  26 countries. The adult model was introduced in the United States in 2008, with the youth model coming out in fall 2012 (Youth Mental Health First Aid). There are more than 17,000 instructors certified as facilitators; within the United States, there are more than 1.6 million people trained as Mental Health First Aiders. According to the National Council for Behavioral Health (the operating body for the program within the United States), the program has been field tested through community trainings and has been updated based on participant feedback. Youth Mental Health First Aid USA was developed with experts at the National Technical Assistance Center for Children’s Mental Health at the Georgetown University Center for Child and Human Development and is listed in the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidenced Based Programs and Practices. The program is an 8-hour in-person training (like traditional First Aid or CPR) designed to give participants the skills to help adolescents aged 12 to 18 who are developing a mental health problem or experiencing an emotional crisis. The course uses role-playing and simulations to demonstrate how to recognize and respond to warning signs and connect young people to professional, peer, social, and self-help care.

The training does not teach participants to diagnose mental illness or how to provide therapy or counseling. Instead, the program is designed to increase understanding of mental illness, reduce stigma, and provide resources for people learning to support youth. This is done, in part, by applying a five-step action plan, “ALGEE”:

  • Assess for risk of suicide or harm
  • Listen nonjudgmentally
  • Give reassurance and information
  • Encourage appropriate professional help
  • Encourage self-help and other support strategies

As a certified Youth Mental Health First Aid USA instructor, I have worked with families, educators, community members, and church leadership to improve mental health awareness, connect people with valuable resources, and offer guidance on supportive responses. When partnering with schools, trainings may be opened to teachers, administrators, and support staff. In addition, future educators and administrators may be trained through partnership with universities. Specifically, connecting with departments of education and training faculty, staff, and students offers a unique opportunity to prepare a network of people striving to work with youth or partnering with professionals who are training others to do so. Trainings may also be structured within community settings for parents and family members, staff and volunteers at youth serving organizations, and youth ministry teams. Youth Mental Health First Aid is a practical and meaningful tool to increase the capacity of schools and local communities in identifying and addressing youth mental health needs.

According to a report by the Substance Abuse and Mental Health Services Administration (2018), 3.2 million youth (ages 12–17 years) received mental health services in an education setting. According to Kessler et al. (2005), 50% of all lifetime cases of mental illness begin by age 14 and 75% by age 24; thus, we need to increase our awareness and be prepared to act when we recognize the signs and symptoms of mental health challenges in youth. As Kessler and colleagues (2007) noted, early detection and treatment are key. Interventions that occur early on help reduce the persistence and severity of mental health problems. Equipping educators and school administrators is essential to effectively serve youth and their families. Educators may be the first to notice warning signs of an impending mental health problem. With only 26.10% of the national mental health care workforce being met (Henry J. Kaiser Family Foundation, 2018), Family Life Educators can assist in expanding the capacity to serve through the implementation of programs such as Youth Mental Health First Aid. Training school personnel and members of our communities helps to create an environment with increased awareness, identifiable resources, and informed responses.

As a Youth Mental Health First Aid instructor, I have had countless interactions with trainees who have expressed the value of attending this training, stating that it has given them confidence to implement the action plan within their personal and professional lives. Although training facilitation requires a strong commitment, I am invigorated by the overwhelmingly positive feedback people share after completing the training. There is a sense of relief that comes to teachers, staff, and administrators when they feel better equipped to respond to the ever-present mental health challenges of the students within their schools. With millions of youth struggling with mental health problems and thoughts of suicide, Youth Mental Health First Aid provides an opportunity for people to be the one to make a difference in someone’s life.

 

References

Centers for Disease Control and Prevention, National Vital Statistics System, National Center for Health Statistics. (2017). 10 leading causes of death by age group, United States – 2017.  Retrieved from https://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_by_age_group_2017_1100w850h.jpg

Health Resources and Services Administration, U.S. Department of Health and Human Services. (2018). Mental Health Health Professional Shortage Area (HPSA). Retrieved from https://data.hrsa.gov/hdw/tools/MapTool.aspx?layerid=A070102

Henry J. Kaiser Family Foundation. (2018). Mental health care Health Professional Shortage Areas (HPSAs). Retrieved from https://www.kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merkangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DMS-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593-768.

Kessler, R. C., Matthias, A., Anthony, J. C., Graaf, R. D., Demyttenaere, K., Gasquet, I., … Üstün, T. B. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry, 6, 168–176. doi: 10.1001/archpsyc.62.6.593

Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989. doi:10.1016/j.jaac.2010.05.017

National Council for Behavioral Health. (2019). Mental Health First Aid®. Retrieved from https://www.thenationalcouncil.org/about/mental-health-first-aid/

Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/

 

Jennifer Rojas-McWhinney, Ph.D., CFLE, is a Visiting Assistant Professor in the Department of Human Development and Family Studies at Texas Tech University. As a certified Mental Health First Aid instructor, Jennifer works with community members, school personnel, and church leadership to improve mental health awareness, reduce stigma, and connect people to valuable resources.

[email protected].