major funding for this program is provided by the Quadra Cabrera family and safe School South [Music] Florida hello and welcome to youth in crisis a mental health Town Hall I'm your South Florida host Pam jantti thank you so much for joining us no doubt you've heard a lot lately about mental health we've seen Olympians and professional athletes succumb to mental pressures you've been told it's okay to not be okay but with all this awareness and talk are things really getting better and who is most at risk tonight we're going to take a closer look at our youth primarily those ages 10 to 19 and the state of their mental health this period of growing up known as adolescence is a formative time when a child transitions to becoming an adult it's a critical period for developing social and emotional habits vital for mental well-being and factors such as hom Life School their peers and social media all have an effect on shaping a Young Person's ability to cope it's also a time when any mental health challenges that pop up could have significant and long-lasting negative impacts if not properly addressed according to the National Institute of Health these mental health challenges are the leading cause of disability and poor life outcomes for young people including an increased risk of drug use experiencing violence and other risk-taking behaviors unfortunately in recent years youth mental health has reached critical levels according to the latest data from the CDC in 2021 42% of high school students experienced persistent feelings of sadness or hopelessness and for lgbtq plus teens the numbers are even higher with nearly 70% saying they had feelings of sadness or hopelessness and 45% having seriously considered suicide so what's driving this Mental Health crisis many experts point to coid lockdowns that kept our kids isolated along with too much scream time in June of this year the US Surgeon General released an alarming advisory warning of the risks of social media on youth mental health especially for teenage girls tonight we are going to explore these impacts we're going to discuss the warning signs of a mental health crisis in adolescence and ways for parents Guardians and their children to get the help that they need all right let's get started and meet our panel please welcome Dr Kadija boo Watkins she's the associate director of the Clay Center for young healthy Minds at Massachusetts General Hospital Dr David Ruby medical director of the Child and Adolescent Psychiatry program at Joe demaggio Children's Hospital part of the memorial healthc care system and Amanda copz a Certified Recovery peer specialist with nami of Palm Beach County that's the National Alliance on Mental Illness she's also a human trafficking clinician with fort ell's flight center which helps young adults who are aging out of Foster Care thank you all so much for being here we really appreciate having you all right so let's begin by looking at some of the causes of Youth mental health and the crisis we're experiencing and simply how did we get here we know coid and the lockdowns Were A disruption to Life As We Knew It school was moved to zoom extracurricular activities Sports were all cancelled so Dr Watkins I want to start with you how much of this was due to to what we saw during coid and did that really fast forward us to talking more about mental health there there's no way around that Co was tough for so many families but the reality is that we were experiencing and witnessing increasing rates of depression anxiety loneliness and suicidality uh among our young people well before coid um Co definitely exacerbated things and accelerated us to the place that we are now especially for our marginalized and more vulnerable you so you talked about some of the numbers but you know suicide is the second leading cause of death especially you know among black youth between the ages of 10 and 17 the rates of suicide is rising the fastest you mentioned the LBT the lgbtq youth they're struggling with depression and suicidality and so you know we have a long ways to go but what Co did do is allow us to begin to have these conversations more openly um without that Veil or or shroud of secrecy and shame and doubt that tends to have these conversations so I think we're having the conversations we're here talking about it so many people are talking about it and thinking together and collaboratively about Solutions so this is part of the the the reason as to why we're here but I think we have a long way to go to think about how do we get out of it Dr Ruby what is your thought on all of this did like Dr Watkins said Co really exacerbated it but it was already a problem before we got to co right uh thanks for having me tonight and uh so yes we have been experiencing significant crisis in terms of depression and anxiety primarily I know in our program here in Hollywood that's where we primarily have our focus and we've been busy on day one uh uh I uh I tell our uh Hospital administrators we're the only Department in the hospital who's not looking for patients unfortunately uh and with more awareness uh kids are seeking out more help which is interesting they're able to go now to their parents and say my mental health is not where it needs to be and uh so that's part of the advantage of you know programs such as this as well as being able to utilize more in the general vernacular uh about terms like depression or anxiety or anorexia or other issues so therefore kids are talking about it they're talking about it amongst themselves and they're they're kind of as what happens in every generation the youth move the adults so we're talking about it more we're talking about it tonight kids are more open about it as you both have said but Amanda how does a parent or how does a child even know that he or she is really in crisis I mean you have been very open that you experiened depression at some point in your life you have a daughter who attempted suicide which had to be horrific as a parent now you're a clinician so you're really working on both sides of this talk to us about what it is that people need to be looking for right thank you um first I want to say that um you know my daughter's attempt uh that she survived was seven years ago and she's worked really hard since then on her mental health is in a much better place and when I'm in a situation like this talking about our family's experience it's not only with her consent it's with her encouragement at home hopes that it can help other families you know know that they're not alone um you know looking back at the warning signs I dismissed a lot of early warning signs as a parent I was not a clinician you know I was just a regular parent and uh because I was someone who had struggled as a child and as a teenager um I normalized a lot of those warning signs whether it was uh disordered eating or self harm or insomnia I thought like oh I went through that as a teenager you know I'm not going to worry about my teens experiencing that when in reality those were significant warning signs so I've learned all of that obviously working in mental health and now when I talk to parents and they want to navigate what's typical teenage behavior and what's a warning sign you know we can look at sort of three things um intensity duration and the level of distress so for intensity we're humans we're going to sometimes feel anxious or sad but like feeling situationally sad is over here typical human debility ating depression is intense it's over here it's a warning sign um with duration you know if you have a kid that's feeling anxious about taking the SATs or about a midterm and then that anxiety goes away when the test goes away over here like anxiety has a function to keep us motivated if it doesn't go away if it persists you know that's a warning sign um and then level of distress you know as a kid my anxiety could be so intense that I wouldn't eat I couldn't fall asleep you know my perfection ISM was sometimes disabling that's a warning sign we often don't talk about um so the level of distress if it's impairing our living our daily functioning you know that's a warning sign that's something that parents and that kids can look for as well yeah Dr Ruby when it comes to Suicide you said that there are three levels you say ideation intent and action can you talk about that so very rarely does somebody uh attempt or commit suicide because they've had a bad day or there are no alternatives to be able to think about that um and unfortunately because it's talked about and kids will say you know in terms like bullying and those types of things you know maybe you should die and things like that we we've all witnessed on social media and we'll talk about that a little bit later um but in terms of evaluating you know dangerousness and risk you know whether a youngster needs to be hospitalized and hospitalization is taken very seriously because it's obviously taken out of the home most psychiatric units are are are locked so and uh that that's really the last resort so you want to be able to get an idea is somebody have ideation is it just something I'm thinking about am I so hopeless that I'm not sure that I see a path forward but do I really want to die I don't think so but it's sort of like it's something in my head um intent have I come up with a plan have I thought about how I would do it if I you know if I'm looking at the knives in the in the kitchen or I'm looking at the pills in the medicine cabinet or other types of things that I may be hearing about you know unfortunately Firearms you know uh part of our mandatory screening for kids so the question is have I thought about a a way or plan and do I actually intend to do that and then of course some sort of action and uh sort of also differentiating between between self harm uh which is parasuicidal or not necessarily lifethreatening and of course lifethreatening Behavior so do you talk to parents about and again kind of going back to Amanda saying like that this isn't normal teenage Behavior so you talk to parents about kind of those sorts of things like what to look out for that maybe this Behavior just is taken to the next level well right so adolescence is a time of angst there's frustra ation there is wild swings of emotions um there's drama that everybody talks about um uh so that's part and partial of experimenting with the intensity of your emotions as you go along uh so that you want to be able to differentiate between um what was or what is a child's personality and how they're behaving and interacting now so like social withdrawal they used to be so active their grades drop their concentration goes down uh friendships we used to have so many friends and now all of a sudden they don't seem to want to socialize very much so we look for changes in Behavior as well as their Baseline emotional level and Dr Watkins we mentioned at at the beginning of the program that lgbtq youth and youth in the black and brown communities are more at risk talk to us about that why is that the case what are they experiencing that pushes them toward thinking about suicide and suffering depression and anxiety more than other kids I mean these kids carry the extra burden on a daily basis of having to deal with racism and discrimination and violence and threats and not being accepted and not being included and that carries a extremely Hefty emotional toll that impacts their mental health you know it's stressful to be you know afraid and to be to be scared and to feel like you're not going to have opportunities um and when we think about you know stress in the brain like it impacts their ability to regulate their emotions it impacts their ability to make decisions and to feel confident and to take you know appropriate risk in terms of making friends and and work in school and so it just really WS havoc on their overall mental health and wellbeing and and we also know that mental health if your mental health is not well and you're not healthy there your your physical health follows suit and so really they just carry a burden that other people don't necessarily have to face because they're not faced with discrimination yeah Amanda we mentioned at the top of the program too that you work for the flight center talk a little bit about the flight center and what it does and the type of Youth that you are working with okay yeah thank you the flight center um Works primarily with uh youth that are aging out of the the foster care system and my role specifically is with youth that are either impacted by or at risk of human trafficking and it's not like it's depicted in the movies it's not the Hollywood version It's you know it's youth that are vulnerable and are being exploited because of that vulnerability and some of the vulnerability could be like what Dr Watkins was talking about um for a lot of our kids it's you know they're maybe in the foster care system or have some other um challenge related to their caregiver often times it's there's a trauma and that trauma predisposes them and makes them vulnerable and then they experience trafficking and then that's additional trauma so just like you know we were talking about the the brain on stress you know the brain on trauma is going to go into a fight ORF flight response and those kids aren't necessarily choosing that that's just their survival brain in action but when they're running that's an additional you know risk an additional vulnerability or they're getting involved in the criminal justice system which is you know an additional trauma so it it really um becomes you know a much larger issue interacting with a lot of different systems I mean and I think stigma is a really important part and piece of the puzzle we're talking about it as I mentioned we hear professional athletes talking about it saying it's okay to not be okay to seek help but if there's still this hindrance in a way that's still a that's a problem so how do these kids get help if they can't talk to their parent about it who might feel that there's some sort of stigma not my child I mean Dr Watkins talk about that that's tough I mean so I don't think we're talking about it enough and in the ways that we need we talk about other things so you can watch a commercial online and it'll tell you you know if you're think you're having a stroke these are the signs and symptoms and immediately call your doctor because minutes matter no one you don't see a ton of commercials in public you know campaign pains around mental health and the young people are really going to drive this they're going to talk to their parents their caregivers about their needs what they're feeling and they're going to wear them down and so you know they're like you said they're going to bring them along and and so but we need to have the information needs to be out there the parents need to be seeing it so you know even if it's through passive they're watching something else on TV and they see this commercial they see a billboard in the train station we need to be talking about this in a bigger way um and that's how we're going to get people to the places that they need to be to get the care that they need and one of the areas that we've talked about before too when we've done these types of stories is that there is a lack of and a shortage of mental health experts talk a little bit about that how hard is it to find people to work in the schools Amanda uh you know I definitely know that there's programs actively recruiting for that work you know it's it's challenging you know being a uh an mssw you know a lot of my peers went into a pretty significant amount of debt for their grad graduate degrees and then come out working you know in Community Mental Health where you know the pay doesn't necessarily pay their student loans so there it's a very it's a large systemic issue and it goes beyond just you know stigma we need really some major change we need legislative change we need investment of funds you know there's a lot of work to do in the system well one local organization is trying to help the Broward youth Coalition or byc is an initiative of United Way of Broward County's Commission on Behavioral Health and Drug prevention and it trains middle and high school students to become youth advocates for Substance Abuse Prevention and mental well-being here is one byc member what she had to say about some of the biggest challenges impacting youth mental health and how peer support actually helps to break down the barriers take a look I'm Ava I'm a current High School senior and I'm 17 years old I'm on the eboard for United Way Bard youth coalition and I've been a part of United Way for over 4 years now some of the biggest stressors for students in school right now or teens in general is definitely involving the stress with school and maybe even family life and so sometimes there's things beyond your control that you just feel so pressured or you just don't really know how to best express yourself and so when students are overloaded with homework or rigorous courses or even a sport that they're really passionate about that competitive nature can definitely get them to you know stretch themselves thin sometimes the peer-to-peer support and the tools really are relatable to my generation because you're with other students who are facing similar problems and it doesn't feel so authoritative at times you're able to just express yourself you're able to laugh you're able to cry you're able to really feel at home and the other students are able to relate to you as well and so having that ability to speak freely and also have relatable ways to practice mindfulness you know whether it's with a certain song that just was released and practicing yoga with that song so just having those contemporary references that you can relate to definitely helps in that whole process of trying to empower yourself seeing that students are taking initiative and really sharing about their feelings and their own struggles has made boc such an important tool because on social media or even in person just having the workshops and the presentations to show that youth want to have involvement in the say of how they're represented in schools or school districts and making sure that youth are able to be provided with resources so they can best feel comfortable and feel noticed and recognized for how they feel the ability to see that others are listening and that they're considering you know how you feel it empowers you to continue trying to find other outlets to best express yourself and so it's basically starting a journey where you're able to recognize you know hey like I'm not okay but other people are also not okay and now feel comfortable to really express myself and continuing empowering others to feel you know the ability to be vulnerable and to be recognized that it's okay if you're not okay let's dive into social media for a moment kids are all most of them have access to computers some actually do their school work on tablets they're learning on tablets most of them have cell phones they are with this technology all the time they're growing up with it in a way that most of us did not grow up with uh they're seeing things that we can't prevent them from seeing uh even like what's happening now with the crisis in the Middle East they're seeing images that we probably don't want them to see so Dr Ruby I know you have called technology or the phone the third parent in the room talk about that and how that's impacting our kids in ways that we never experienced before the uh it's there is a whole world uh that exists outside of the family and on some level it can be used for good and for more information and schoolwork the third parent in the room is there's what mom says there's what Dad says there's perhaps you know your church your synagogue your school principal and then there are the strange ERS right that we don't know who is saying what and the various car you know we idolize influencers well who are the people who are being influenced it's our children we adults can be guilty of it as well let's face it um but children are being influenced by whom nobody that I've said hey that's okay let's follow that it's really on their own so we have to be extremely mindful about what's going on and what those histories are are and sometimes I have to be the bad guy and say that's that smartphone needs to go away you know the reality is that social media is not going anywhere the internet's not going anywhere we cannot give the Chromebooks back to the school like they're here to say and so definitely we need to be more Vigilant and more aware of what our kids are doing and who they're talking to but also I think again back to education talking to them about media literacy what what is safe what's not safe you know how do you vet a resource to make sure it's reli like you're taking healthare tips from right so so that's really important but also being able to help them to be more self-aware how do you feel when you're online like how do you feel when you end you do you feel good do you feel worse do you feel more anxious but really giving them a little bit more of the power and the tools to make better again we're we're helping them to eventually not need us so much so giving them the tools that they need to be able to gradually make these decisions on their own and as parents and caregivers we need to be monitoring and supervising and and walking along this path with them yeah and you've called it a double-edged sword because they are positives or negatives talk about how it impacts lgbtq plus youth so there there is so much in the way of hateful and hurtful rhetoric and comments and words and sometimes uh you know very direct threats and and and it's a scary unsafe place for for a lot of those kids and on the other side of that you know for some kids who live in a community where they feel isolated they don't feel accepted they don't feel heard or seen they are also able sometimes on social media to find a group of people that where they feel like they fit in where they can share their experiences where they can feel supported so similarly you know to other kids who are more shy it could be a place where they can actually find kind of what I say you know their people the people that they feel like they fit in and acceptance and connection is so important and that's why in one one big reason why we struggled so much in Co we weren't able to connect in the way that we were used to and so we felt very lonely and isolated and so it can be really helpful for those kids so let's talk about ways people can get help resources out there Amanda talk about some of those resources that are out there for Youth and for parents absolutely so 988 is live you know as mental health Advocates that's something we've worked towards for many years so 988 is you know not just a hotline you can call but uh teens can text so those with anxiety like myself that don't want to talk to somebody you can text um they can send you resources local um 211 can as well so those are some resources uh connecting with the mental health professionals that we do have in schools because most schools do have some sort of mental health professionals and really you know for kids like we talked about you know the kids are pushing things forward sometimes with reluctant adults in toes so sometimes if a kid's really needing help and the first adult they go to doesn't support that they need to find another adult they might need to go through several I was going to ask ask you Dr Ruby I mean growing up kids tend to pull away from their parents as they should that's all part of the growing up process and becoming a young independent person but what about a child who wants to reach out and talk to we talked about stigma earlier so if a child feels they cannot talk to their parent they don't have anybody to talk to what do they do again kids are now talking to peers I know there are College Programs you know uh one of the colleges where I have a lot of patients uh they have Stomp the stigma programs to be able to um you know speak to peers in some way I I totally appreciate and applaud you know manda's work as a peer specialist there are people who are willing to listen sometimes it's a peer sometimes it might be a guided counselor sometimes it might be somebody in your local church or synagogue or it might be um you know the Neighbor Next Door who happens to notice you know or perhaps an older peer um but there are people who are willing to listen there are you know we we sometimes these programs we highlight some of the dangers but there are good people out there who are willing to listen and uh who want to listen yeah how do you start the conversation with your child without pushing them away You're yeah Dr Watkins yeah you know it really is about having ongoing conversations not in the time of Crisis but making these conversations normal no one wants to have a sit down meeting conversation so having these conversations in the cracks like when you're on a walk when you're driving in the car sometimes that's easier because kids maybe don't want to make eye contact so when you're driving hopefully you're not you know staring them down um but you know just finding these small little Windows of opportunities to have these conversations did you see what happened in the news like what did you think about it um when you're watching a movie what did you think about that what would you do if you were in that situation just having these natural ongoing conversations can be really helpful because then they know that you're not afraid to have these conversations these topics don't scare you and you care about what I have to say and you want to hear because you want to help me right and to build on that being mindful of the way we talk about mental health you know if someone has you know died by Suicide the words we use like our kids are listening so just how we interact with things going on in the world is impactful and then listening so as a parent like if our kids are suffering we want to just hurry up and fix we want to kind of like rush to a solution and sometimes we skip over the you know listening and validating part and that's crucial you know they want to be heard they want to be understood and so our discomfort with whatever they're going through like they can see that and they back off so really you know taking the time to fully listen to validate whatever it is that they're experiencing and then collaborate on what those Solutions are you know Empower them to be involved in in what kind of support they need thank you all so much we really appreciate it it was a great conversation tonight we all learned a lot so thank you and we hope that this conversation has helped to remove the stigma surrounding mental health and has provided some useful ways for parents and young people to communicate well about their mental well-being I want to thank our panel again for joining me for this important conversation and thank you for our audience who was joining us tonight we really appreciate that I'm Pam gigantti as always thank you so much for watching have a good evening [Music] major funding for this program is provided by the Quadra Cabrera family and safe School South Florida