Behavioural health counselor Kate Park discusses an adolescent mental health crisis, and shares teen parenting advice to help keep teenagers healthy and happy
Experts have warned that there is an unfolding crisis in young people’s mental health linked to increased pressure to do well at school, body image issues, the influence of social media and difficult family backgrounds.[i] It seems that hardly a week goes by without a news story reporting at least one tragic suicide. Admittedly some have been in the news due to their celebrity status – Robin Williams, Kate Spade, Anthony Bourdain in recent years, for example. But sadly some have been brought to our attention because the victim has been so young. So should we as parents be worried? This was a question I asked Kate Park as I chatted to her on the sofa at her clinic, Tucker Health in Novena.
She explained that teenage behavioural health (the term the pros prefer to use) is something that we as parents, and schools, should all have on our radars. Schools should be discussing it, and we need to be talking about it – to each other and to our children. Plus, we need to be encouraging our kids to be open with their friends about it, too.
She shared a story about an international school in Singapore that recently held an assembly focusing on teenage behavioural health. Six of their most popular, academic, sporty senior students stood up in front of the school (having spoken with their parents about it beforehand) and admitted that they struggled with anxiety every day and were seeking help.
‘I am in the football team’
‘I get great grades’
‘Sometimes I struggle to get out of bed and go to school in the morning’
‘I’m terrified of putting my hand up’
‘I suffer from anxiety’.
Kate says that the effect was HUGE on the kids listening to their friends. Why? Because kids are struggling in isolation. This kind of shared discussion eliminates the stigmas surrounding mental health issues and encourages openness.
It’s ok to ask for help. “We know people recover better when there is a sense of connectedness in their community”, she says.
Where does this embarrassment come from? Well, you only have to think about our own way of dealing with our mental health. How often do you share with your husband/friend/co-workers about your own stress/anxiety/depression? Does your husband ever openly talk about what worries him or keeps him awake at night? Would you/he feel happy about seeking help? Possibly, but most of us just soldier on, preferring to pop that awkward subject into a box in the back of our minds and shut the lid! So our kids do the same.
Ben West, from Kent in the UK, has made it his mission to help raise awareness of mental health issues with teenagers with his PROJECT WalkToTalk. His family knew about his 15-year-old brother Sam’s depression. It had even been diagnosed, but Sam didn’t want anyone else to know. He was embarrassed to talk about it, even with his family. In January of this year, he tragically took his own life. PROJECT Walk to Talk was set up to encourage everyone to get outside and to discuss mental illness. The main message: IT’S OK NOT TO BE OK!
How you can help your teen
So how do we as parents make sure our kids are happy? As Kate acknowledges, this can be very hard when you are perhaps receiving little or no communication from your teenager! One point that Kate is keen to emphasise is that adolescence is the transition from childhood to adulthood, and that requires moving towards independence and self-initiated learning. This includes learning from mistakes.
“It’s sometimes too easy for parents to take this personally when it can just be part of the attempt to transition to independence”, she explains. (I’ll definitely be holding onto that golden nugget for future years!)
There are apparently three core principles when it comes to communication with adolescents:
- EMPATHY – Whether the problem is small (to you) or big, show them that it is important to you and that you recognize that it’s worrying them. I understand that would make you feel upset/stressed/worried
- EXPLORE – What happened? How did that make you feel?
- EMPOWER – Try to be the ‘guide on the side’ and help them find their own solutions to things when possible. Share that it happens to other people, too, that it might have even happened to you.
She advises that there are also 4 benchmarks or pillars of health and wellness, which parents can look out for and monitor in their child:
S – SLEEP
S – STRESS MANAGEMENT
E – EXERCISE
N – NUTRITION
Are they sleeping well/enough? Amounts vary but as a guide a teenager should be getting 9+ hours of quality sleep a night.
They should also be following good sleep hygiene: going to bed at a similar time, turning off devices at least half an hour before sleep (blue light interferes with production of melatonin), and ideally reading a paper book (or listening to an audiobook or gentle podcast). Children’s attention spans are reducing due to their use of devices, but it is possible to retrain the brain!
Read more: How much sleep your child needs (by age)
Look out for their reading light going back on. Are they grumpy in the mornings? Are they reluctant to go to school? Ask them if they are sleeping well. One of the signs of anxiety in kids is disrupted sleep.
In a new study published this week, researchers at the CHEO Research Institute have found that children aged 9 and 10 who meet recommendations in the Canadian 24-hour Movement Guidelines for physical activity, screen time and sleep time have superior global cognition. In children aged 5 to 13 years, the daily guidelines recommend at least 60 minutes of moderate-to-vigorous-intensity physical activity, no more than two hours of daily recreational screen time, and 9 to 11 hours of uninterrupted sleep.[ii]
Are they managing stress in their lives? Do you know what stresses your kids out or causes them to be anxious? Signs of stress/anxiety are varied, and so it’s hard sometimes for parents to recognize what’s not normal. They might be showing increasing emotional dysregulation – both with family or peers – or school avoidance, obsessive behavior, perfectionism, disrupted sleep, and withdrawal from social activities amongst other things.
One of the greatest barriers with adolescents is that parents don’t really know what their kids are experiencing. Establishing a dialogue is key but this can be easier said than done! Kate advises small steps to start with. When they fly through the door and stomp up to their bedroom, pop upstairs and ask if they are ok “It looks like you’ve had a tough day? Anything I can do? Dinner is at 7.30…”
Try using anecdotes (especially for younger kids up to pre-senior school), or peer empathy (older kids) to create a calm space for further dialogue to happen. An example of this could be a chat over dinner:
You: I got really stressed today in the car. I figured out why. Some guy was trying to rush me when I was blocked on both sides by the other cars and I ended up shouting at him! Probably not my finest moment…Anything bug you today?
A suggested scenario which works with older kids could be watching a teenage TV programme together. ‘Wow, she really lost it when her boyfriend broke up with her didn’t she? I felt so bad for her…’
Or try closer to home. This could perhaps be chatting about a situation that has occurred with one of your friend’s children. “Has that ever happened to you?’, ‘You also seemed really disappointed when xx happened the other day. How did you cope with that?”
As we are all aware, bullying is a major cause of anxiety and unhappiness in adolescents. As well as verbal and physical we now have to think about exclusion via social media. This is one of the biggest causes for concern for Kate, as she is seeing more and more children’s health suffering because of this. She says where possible keep chatting to your child – empathising, exploring, empowering, as it’s often really hard for parents to see what’s happening in their children’s online world or access devices to find what is going on. Plus, we can show them that there is a world away from phones and devices by modelling some good behaviour ourselves! Have you for example thought about having a phone-free Sunday in your house?
One of the other ways Kate suggests to try to avoid/tackle stress in your child is to establish a family goal for spending time together (and therefore communicating). Decide as a family what would be a satisfactory minimum amount that you should all be together.
This might be dinner around the table 4-5 times a week. Perhaps choosing a shared activity to do as a family every weekend. This might be a board game, a walk, a game of tennis or going for a stand-up paddle boarding lesson at the beach together. As PROJECT WalkToTalk advocates, simply going outside for 30 minutes a day has been proven to improve mental health. All these things help provide places where a child can feel safe and supported and hopefully ready to talk if the need arises. Plus, being outside can be a great place to start a conversation as it’s less claustrophobic and your teen won’t have to make eye contact!
Exercise and Nutrition
These should not be viewed by adolescents as a tool for weight loss or appearance. Exercise is for mental and cardiovascular health and muscle building. Eating nutritious food is for optimal physical, mental and emotional health. Kate says parents should remember to model this. Parents need to think about the way they talk about food and exercise in front of their kids.
Obsession with exercise, skipping meals, eliminating food groups, counting calories, heading straight to the bathroom after food are all causes for concern in young people and may warrant professional help. Check out www.insideoutinstitute.org.au for some helpful resources for eating disorders.
According to the NHS guidelines in the UK, teenagers should be consuming the following calories (see table below), depending on gender and importantly how active they are. These shouldn’t be loaded up purely by consuming high sugar, trans-fat or processed, unhealthy snacks, but instead a healthy three meals a day plan with 1-2 snacks throughout the day.
A healthy, balanced diet rich in omega-3, monounsaturated fats, vitamins and minerals (especially iron and calcium) is so important for young people as they continue to grow. Stocking up on ‘good for you’ snacks really helps — wholemeal bread, nut butters, trail mix, a variety of fruit, granola bars, cheese, avocado, yogurt and hummus with wholegrain crackers are all great to offer as alternatives to more unhealthy crisps and sweet treats, as well as ditching the fizzy drinks in the fridge and instead offering water, skimmed milk, small amounts of fruit juice or no-added-sugar cordial.
Dinners of oily fish, lean meat, quinoa, wholegrain pasta or rice and plenty of salad or vegetables (especially broccoli and carrots) will also set them up well for their busy active lives. For more ideas check out Sassy Mama’s recipes page.
|13||10,100kJ / 2,414kcal||9,300kJ / 2,223kcal|
|14||11,000kJ / 2,629kcal||9,800kJ / 2,342kcal|
|15||11,800kJ / 2,820kcal||10,000kJ / 2,390kcal|
|16||12,400kJ / 2,964kcal||10,100kJ / 2,414kcal|
|17||12,900kJ / 3,083kcal||10,300kJ / 2,462kcal|
|18||13,200kJ / 3,155kcal|
10,300kJ / 2,462kcal
If sport isn’t being played 3-5 times a week at school, then try to get your child active at home. A walk after school, a bike ride together or football in the park — whatever your activity of choice, it’s just important to get outside.
So when should alarm bells ring and when should you seek help?
Kate says that when you see behaviours you think are unhealthy, or if any of those four pillars of health and wellness are becoming unmanageable, then talk to your child and if need be, seek help. All behavioural health issues can be helped enormously with early intervention. You could start by asking for the advice of your school counselor. Or see your GP. He or she can organise a referral to a psychiatrist if necessary. Alternatively find a recommended counselor, psychologist or therapist who has training and experience in this area. Click here for more help and advice on talking to your child.
In more extreme cases, problems may manifest as self-harm or suicidal ideation. Always take talk, threats or preoccupation with suicide and death seriously and seek professional help.
“One of the biggest misbeliefs is that if we ask someone if they are thinking about suicide we can encourage it. This is a myth,” Kate says. “When we ask someone how they are doing it gives them the opportunity to share, rethink, vent, connect and can diminish the sense of being overwhelmed or feeling hopeless.” (Click here for more information on facts vs myths.)
If you know what to look for, there are usually signs that a person is at risk of suicide. Indicators are:
- Isolation, especially from friends and family members
- Stress in romantic relationships
- Challenges in peer relationships
- Difficulty in functioning at school
- Changes in behaviour: anger, resistance, tearfulness
- Giving away possessions
- Seeming distracted or bored
- Drawing images or writing about death
- Staying away or running away from home
- Changes in appetite and eating
- Changes in sleep patterns
- Changes in personality and/or appearance
- Substance abuse and behavioural disorders
- Increase in risk taking behaviours
- Talk of death and/or suicide albeit in a non-serious way.
(American Academy of Pediatrics)
In emergency situations, the Accident and Emergency rooms of the hospitals in Singapore will refer to a psychiatrist. While there is provision in the Penal Code for suicide attempts, in practice the Emergency rooms will provide care for someone who is emotionally overwhelmed and not coping.
Some books mamas of teens might find helpful:
Skills-Based Learning for Caring for a Loved One with an Eating Disorder: The New Maudsley Method by Janet Treasure, Grainne Smith and Anna Crane
9 Ways to a Resilient Child by Justin Coulson
How to Talk So Kids Will Listen and Listen So Kids Will Talk by Adele Faber and Elaine Mazlish
Parenting from the Inside Out by Daniel J. Siegel
It’s Complicated: The Social Lives of Networked Teens by Danah Boyd