Worried about a teen’s mental health? Go ahead: Ask.
Arecent World Health Organization report points to depression as the leading cause of illness and disability worldwide in 10- to 19-year-olds. Suicide by teens is ranked as the third leading cause of death in this age group.
Obviously, someone should ask teens how they’re doing. But who? And will teens mind?
As a University of Texas Arlington professor and a pediatric nurse practitioner in private practice, I have found that teens do not consider “prying” questions to be a violation of their privacy. In fact, they want us to ask about their mental health. Teens believe their feelings and emotions are just as important as their grades, diet or physical activity.
Ask questions
Many teens could easily be helped if signs of depression are identified early enough. Most times, symptoms are overlooked by parents and health care providers as “just a phase” or dismissed as a normal part of puberty.
Almost all of these teens have been seen by a healthcare provider who could have easily identified symptoms of depression. But most teens are never asked about how they are feeling — whether they are happy or sad, tearful or angry and irritable.
And it’s no wonder: In the rushed 10- to 15-minute standard office visit, there’s hardly enough time to handle mental health concerns. Most providers do want to ask, but they are afraid the teen may reveal something they do not know how to handle.
The school environment seems to be a great place to pick up those teens at risk; mental health officials support widespread screenings in school as a way to identify at-risk teens. The goal is to provide early identification and early treatment to help decrease the number of teen suicides.
Some parents and students, however, feel that school screenings are a violation of their privacy. Some argue that school is no place to discuss mental health; and that in fact, screening may lead to an incorrect conclusion or diagnosis and a “labeling” of the teen in question.
Attorneys have also argued that screenings in schools violate the constitutional rights of the parents, especially when screenings are conducted without parental consent.
Because of the backlash from parents and teens, the U.S. Preventive Services Task Force (USPSTF) released an update this year, stating screenings should take place in the healthcare provider’s office and not schools.
Teens want to share
So, screening for depression and other mental health problems is slowly being implemented in emergency rooms and doctors’ offices.
In 2009, the USPSTF recommended screening adolescents for depression when services for confirmation of the diagnosis are available as well as treatment options.
In my descriptive study, conducted in a private-practice setting in a suburb of the Dallas-Fort Worth metroplex in 2011, I screened teens (12 to 18 years of age) for depression, using a simple 15-item screening tool. I found that not only could teens at risk be identified easily, but that they also wanted to share their concerns.
Teens may not want to respond if they are directly asked but may feel more comfortable completing a paperand-pencil questionnaire privately. I found teens’ symptoms of depression can be identified much sooner with this scientific screening tool. Positive results mean further evaluation of these symptoms is warranted.
More often than not, teens want someone to ask about their feelings. Teens did not consider asking these questions an invasion of their privacy. Often, parents overlook their teens’ symptoms.
In my practice working with teens, I have discovered teens want their opinions to be heard and their feelings to be validated. For example, a 12-year-old male patient was angry over his parents’ divorce.
He was hiding his feelings because he did not think he was supposed to be angry with his parents. Once this was discovered and he was told it was okay to feel this way, his symptoms of depression began to go away.
With a few counseling sessions, he was able to work through his anger and be happy again. There were similar other such cases. The key to successful treatment of mental illness is to identify symptoms early and start treatment. Many times, counseling may be all that is needed if a problem is