Breaking down the stigma obscuring youth mental health issues

With the first day of the school just around the proverbial corner and the lockdown environment of the pandemic in the rearview mirror, one might assume that children and teenagers are moving back to a pre-pandemic state of behavior. However, the damage created by the pandemic”™s protocols, coupled with other issues that predated Covid”™s arrival, have created a greater level concern for the mental health of today”™s youth.

In an interview with the Business Journal, United Healthcare”™s Chief Medical Officer Dr. Greg Carnevale offered his insight on how parents can identify and address mental health concerns impacting their children.

The first question is a bit of a broad question: Just how severe is the depth and scope of children’s mental health issues today?

The age group that we’re talking about ”“ children from adolescence to the teenage years ”“ are struggling, and they’re doing so in a lot of different ways. Based on statistics from 2022, more than like a third of high school students reported poor mental health, with about 44% reporting feeling persistently sad or hopeless in the past year. It is a large growing problem, and that gives you a level of what we’re trying to tackle.

It is easy to understand how the disruptions of the pandemic created emotional chaos. But is there more to the problem than that?

There are contributions from different phases of life. Certainly, age plays a role and different races have higher incidences of mental health ”“ there are disparities in ethnicities and gender. But then you bring in more of the social aspects ”“ isolation, both in your community, family or school, is a big reason for having mental health issues. And can you even bring it down to a primary function of life ”“ having a safe place to live is oftentimes a reason why mental health comes into play.

If you don’t treat the mental health early, what happens is over time as you progress into the adult years is that you end up basically carrying those problems left untreated. I think it makes treatment for those problems worse as you age. We know that 60% of youth with major depression don’t receive treatment.

How can parents spot that there’s something going on that needs to be addressed? After all, there’s the stereotype of teenagers being surly and not wanting to talk to their parents. How do they know when problematic behavior is going beyond being the stereotypical teenager?

Yes, the irritability and mood swings that are frequently present in the teenage years are a “warning sign,” but it might be typical for that teenager. Other things to look at include changes in appetite, issues with sleeping habits, changes of academic performance, new anxiety, difficulty communicating ”“ if parents are actively listening, it is important to address these issues and have conversations with their kids.

We know that supporting your child’s mental health comes from building routines that they can do ”“ afterschool sports, hobbies that they’re interested in doing. And then, if you admit you don’t know what’s going on, seeking professional help should be advocated.

Is there still a stigma attached to mental health?

Unfortunately, yes, and that goes back to the statistics of 60% of young boys and girls with major depression who don’t receive treatment. I think there’s a stigma of saying there’s something wrong inside my head that that lends itself to avoidance and internalizing the problem, which is only making the problem worse.

Do young people feel that if they talk their mental health concerns on social media that it puts them at risk when they are applying for schools or applying for work?

Unfortunately, we’re dealing with an age of instant communication, and that sometimes can be inappropriately used. In the social media networks, if you were to say that you’re having difficulty and not realizing as a public chat line that could propagate to others who are less sincere in terms of your relationship with them, then I think there’s a risk or fear of opening up to that level.

You can prevent people from taking advantage of those situations. And we know that oftentimes, jobs and probably schools do a social network poll of information for their likely students or employees, and that could give them a sense that this applicant has a problem.

You mentioned different demographics earlier. Are you seeing situations where young people either lower income households or within certain racial or ethnic demographics have less access to mental health services?

Yes, and they could have less perceived access in a lot of ways. For example, transportation might be the access issue for those patients. Technology might be the issue, as well as finances to afford some of the treatment opportunities. Those are just some of the ways that the demographics play into that issue.

What can companies do to ensure that their workers know their health care coverage extends for their children dealing with these issues?

For employers, the best thing to do is to find out what services are covered by their health care plan and then to advertise that. They want to guide people to the right care at the right time to provide solutions. And that applies to their employees differently ”“ some people want to do self-help-type efforts with digital tools and some prefer in-person visits with specialists.

If we were to revisit this conversation a year from now, where do you see this environment? Do you see the mental health of young people improving over time?

I would be optimistic and say I would like to see it improve. I think there are challenges in society that will make it very difficult to overcome.

I think we have to first address the fact that it’s a real problem, and that we are trying to address the causes of that problem. Without addressing the causes, we’re never going to make progress in treating the problem.

I’m not pessimistic, I’m just realistic that it’s going to be a hard slog. But we must tackle it because it’s at the forefront of health care and affects everything associated with health care. And it’s the right thing to do.