CHAPTER 133
Caring for Our Young
A look at the issues our children face today and ways we can help
The David Lawrence Centers in Naples recently delivered this truth: “For many adults, the first two decades of existence are associated with memories of being carefree and adventurous. Sadly, the reality is that youth today often do not feel these positive thoughts about their lives, and their mental health is suffering.”
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The world’s future is in the hands of about 56% of our bright and budding young stars. The remaining 44%, reports the Centers for Disease Control, experience feelings of persistent sadness and hopelessness. But there is hope.
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We also address school refusal in childhood, six ways to reach girls in crisis and tips for successfully working from home when the kids are there.
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Children are the future, and we, as their guardians, are long overdue for an intervention for their sake and their future. The task won’t be easy, but we also know that nothing that’s worth anything comes easy.
in this issue
Our kids’ collective state of mind is in crisis.
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“The COVID-19 pandemic era ushered in a new set of challenges for youth in the United States … but U.S. children and teens have been suffering for far longer,” reports the American Psychological Association.
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According to the Centers for Disease Control (CDC) and Prevention, in 2009, 26% of high school students experienced feelings of persistent sadness and hopelessness. In 2019, it was 37%. And in 2021, it rose to 44%. By 2018, suicide became the second leading cause of death for young people ages 10-24.
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The Situation
“ADHD, anxiety, behavioral issues and depression are the most commonly diagnosed mental disorders in children,” reports the CDC. And, alarmingly, the National Alliance on Mental Health (NAMI) notes that the average delay between the onset of mental illness symptoms and treatment is 11 years.
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This is evidenced in the emergency services department of David Lawrence Centers (DLC) in Naples, as reported by Jessica Liria, its community outreach specialist.
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“Often, individuals in the emergency setting did not seek treatment when signs and symptoms first presented, or they didn’t recognize the need for support at that stage and waited until the need for help was so great, it warranted an emergency intervention.”
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For young people, increasing numbers of mass shootings, peer pressure, family stress, unmet goals and failures (real, imagined and/or self-imposed) and learning disabilities can be powerful psychological and emotional triggers.
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Compounding these issues, young people today face crises brought on by easy access to toxic social media influences, something that can result in habitual bullying, criminal mischief, abandonment of healthy relationships, erosion of self-care, addiction and suicide.
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The Role of Adults
Southwest Florida licensed mental health counselor Stacey Brown has 30 years’ experience in providing family assessment and counseling. Brown works with young people with anxiety, depression, ADHD, PTSD and other disorders — and, importantly, she works with their families.
Stacey Brown
“As a society, we’re finally acknowledging [the realities of mental illnesses],” she says. “And if parents know about it, they can parent differently and get the help their children need. Everything depends on how grown-ups react.”
Getting Help
The three most common therapies for teens are cognitive behavioral therapy, interpersonal therapy and dialectical therapy.
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The CDC describes cognitive behavioral therapy as a treatment that “helps the child change negative thoughts into more positive, effective ways of thinking.”
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“Some kids come into the world with a more sensitive central nervous system,” Brown says. “Cognitive behavioral therapy gives them the ability to think about their situation differently.”
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Often used to treat teens suffering from anxiety/depression, eating and psychiatric/substance use disorders, interpersonal therapy focuses on a teen’s interactions with other people and how that affects his or her mental health.
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Dialectical behavior therapy is a combination of cognitive behavioral therapy and mindfulness, primarily used to treat young people who have emotional dysregulation, such as suicidal thoughts and self-harming behaviors.
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Education
May is Mental Health Awareness Month, and a good way to understand kids’ mental health is to take advantage of educational programs offered here.
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Southwest Florida’s David Lawrence Center and Golisano Children’s Hospital offer classes and community learning opportunities, a few of which are listed below.
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The Power of Community (Question, Persuade, Refer [QPR] Suicide Prevention Training)
Saturday, May 20, 10 a.m.-12:30 p.m.
This in-person presentation features an overview of mental health, common challenges and warning signs, how to discuss concerns with others and available resources. Each attendee will be trained in QPR: an evidence-based suicide prevention certification. To learn more or to register, visit DLCenters.org/events or call 239-455-8500.
Youth Mental Health First Aid
Friday, May 26, 9 a.m.-2 p.m.
Through this in-depth interactive training, attendees learn to identify concerns by better understanding signs and symptoms and risk factors and earn a three-year certification. By focusing on real-life scenarios, participants will develop and practice the skills learned to support and intervene in crisis situations. To learn more or to register, visit DLCenters.org/events or call 239-455-8500.
Mental Health First Aid for Youth
This informative session identifies common mental health challenges for today’s youth and reviews typical adolescent development. It also provides a five-step action plan for helping young people in both crisis and non-crisis situations. For dates and time, contact Gabrielle Sholes, gabrielle.sholes@leehealth.org or 239-343-7839, or Lorena Rodriguez, lorena.rodriguez@leehealth.org or 239-343-7741.
“Children respond to the energy around them, but parents forget to try to see things through the eyes of a child,” she emphasizes. “Adults need to be role models in mental and physical wellness to help the children in their lives.”
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It is vital for parents and caregivers to demonstrate their love and support, ensuring they will be there for the children in their care no matter what, and that they will navigate difficult times together.
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Indeed, UNICEF urges adults to employ four ways to support a child’s mental health:
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Encourage them to share their feelings
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Take the time to support them
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Work through conflict together
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Care for yourself
MIND MATTERS
Are Our Girls OK?
Six steps concerned parents can take
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by Dottie DeHart
A report by the CDC has confirmed what many parents already suspect: Teenage girls are in crisis. The 2021 survey of more than 17,000 high school students found that 30% of the girls had considered suicide.
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That said, mental health and substance misuse expert David Magee says parents must connect with teens now more than ever. Magee is a bestselling author and director of operations of the William Magee Institute for Student Wellbeing at the University of Mississippi.
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The 30% rate for girls is twice that of boys. It’s also about 60% higher for girls now than it was 10 years ago. Besides the unprecedented rise in suicidal behavior, the report shared other grim findings on sexual violence, substance misuse, depression and other mental health issues.
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Still, the news isn’t all bad for parents, Magee says. Our girls are reachable.
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“I’ve engaged with some 20,000 middle and high school students throughout the country in the past year,” Magee says. “I can’t tell you how many times I’ve been talking about my own depression or my daughter’s eating disorder and looked out into the audience to see girls wiping away tears. It breaks my heart, but it also warms my heart because they are reachable. A critical key is to be there with them and for them — really see them and hear them."
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The question is, how do you reach your teenager? Magee offers these six tips:
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1. Educate yourself. Young people face pressures their parents can’t relate to. That’s why Magee joined with the University of Mississippi’s Thomas Hayes Mayo Lab to create The Mayo Lab Podcast, a weekly program featuring thought leaders in mental health, drug misuse prevention and parenting.
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“The idea is to offer research-based insights and guidance to equip parents, educators and students,” Magee says. “If we don’t know the realities our children face, we can’t talk about them in a meaningful way.”
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2. Have regular conversations. Make it a priority to engage with your teens over meals and activities. Broach conversations on subjects you might suspect they are dealing with, such as bullying, eating disorders and substance misuse. Don’t be afraid to state blunt facts. Just remember the goal is to engage your teens regarding what they may be feeling, not to lecture, corner or shame them.
​“Your teens may seem to prefer sitting in silence, but don’t let them,” says Magee. “Too often parents just follow their children’s lead because it feels uncomfortable to force the conversation or because we don’t know what to say.”
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3. Ask open-ended questions. Too many parents preach to or hold one-sided conversations with children. Resist this urge. Instead, ask questions focused on how they feel, rather than thrusting your angst and fear upon them.
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“Studies show young people need to be seen and heard to become whole,” says Magee. “Open-ended questions open your child’s mind and yours. Their responses hold the capacity to inform and surprise and even deeply delight.”
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4. Listen closely for clues. Magee calls anxiety the “safe word” for today’s generation. While they may not admit to substance misuse or depression, they will often claim anxiety. This is your cue to continue asking open-ended questions, such as, “When do you most often feel anxious? What does it feel like?”
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5. Resist the urge to tell them how they should feel. As parents, our instinct may be to say things like, “You have so much to be happy about!”
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While we may do this with pure intentions, it is not helpful, says Magee. If we really want to know our child, we must do less telling and more listening. Often, telling our children how they feel is a reflection of our desires, rather than helping them explore what brings them joy.
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6. Share relatable stories when appropriate. “When parents tell teens about their own struggles — with substance misuse, for example — it can be incredibly powerful. Likewise, you might tell stories of others who have had success in treatment or recovery — friends or family members who don’t mind being used as an example.
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“Engaging with your teens this way is just as important as putting food on the table,” Magee says, adding that parents must nourish mental health. “These conversations, along with ensuring that teens get plenty of sleep and exercise and limit their time on social media, go a long way toward changing their reality.”
CONNECTING
Is it Moodiness or is it More?
When Your Child Refuses to go to School
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by Amanda Bacon-Davis
We all have days when getting out of bed can feel like a Herculean task, but we, as adults, know how to move through it. Our children do not.
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My daughter had extreme school refusal, defined as when school avoidance turns into something much more ominous. It may build from resisting getting ready in the morning to tears, tantrums, hiding, shutting down and physical aggression. It can start to consume your child and your home life.
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From kindergarten through third grade, my daughter’s school refusal escalated every day. As it intensified, we experienced her jumping out of a moving car, running barefoot into snowy woods and breaking everything in her room. She’d beat me and school officials when we tried to console her. She ran away once, and when I found her, she fought me the entire way home, kicking, biting, hairpulling and screaming she was being kidnapped.
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It was living hell, and I slowly stopped recognizing her behavior as a little girl with anxiety (school refusal) and started seeing a misbehaving child because I just couldn’t understand what was triggering her. I was in constant communication with the school, her therapists and primary care physician. The advice I received from everyone was the same: Once school refusal starts, you must force your child into school or they will stop going all together.
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Every day, against every cell in my body telling me to do the opposite, I’d force her to get dressed or dress her myself. I’d take her to school, where I’d have to carry her in (often with help), kicking, screaming, biting and begging not to leave her. It broke me. I’d sit outside the school listening to her scream inside. The next day, we’d do it again.
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One day early last year, things hit an all-time low when she refused to get out of the car, and expressed that she didn’t want to live. That was the turning point.
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We obtained additional help from a psychiatrist, and my fourth grader now attends school every day. These are the tools that worked for us.
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Coping Strategies for Your Child
When your child is regulated, share what anxiety means. Recommend coping strategies that give them a sense of control. A child who has anxiety who understands the value of healing tools can practice them daily. The more they practice, the better prepared they will be when the fight/flight/freeze of anxiety and school refusal begins.
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Keep morning stimulation (light and noise) to a minimum, having prepared as much as possible the night before. Remove any rushed or annoyed energy from the home. Give them the space they need to safely and privately have their feelings without an audience. This will help your child put one foot in front of the other — literally.
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You cannot negotiate with a dysregulated child. A child having a meltdown will not respond to threats of punishment, yelling or bribes. The more you can meet them in a place of compassion and love, the sooner you can help de-escalate the situation.
Coping Strategies for You
If mornings are when your child is showing signs of school refusal, clear your morning calendar as best you can. When you can remove stressors for you, you are creating space for your child.
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Find your calm. School refusal is very stressful for caregivers, and your child will pick up on that energy. Take time to remind yourself that you can do this. You can be present with your child and help them achieve regulation.
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When it’s over, give yourself some grace to catch your breath before moving on to the next thing. Connect with other parents and caregivers. You may feel isolated, but you are not alone.
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Know when to ask for more support, whether it be emotional or medical. For my family, we had doctors, therapists and school officials helping us every day. But ultimately, we knew we needed to bring in a psychiatrist. That extra help is different for every family, but there’s always room for more support.
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Ultimately, have faith in your instincts. You have the deepest understanding of your child.
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Looking back, it’s hard to fathom how many days, which then turned into years, I persisted with the same routine hoping for a different outcome while my daughter's anguish — and that of my family — continued to increase.
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Keep in mind that there's always a novel approach you can experiment with, and have confidence in your abilities to instill them.
Amanda Bacon-Davis is not a medical or mental health professional, but she is the mother of a child who has suffered from extreme anxiety and school refusal. Davis is the author of a two-time national award-winning children’s book, “This Thing has a Name.” The book offers guidance to children and their loved ones on how to navigate anxiety and school refusal, and concludes with a list of helpful resources, many of which the author herself utilized.
FEATURE
Young Minds in Crisis
The mental health of America’s youth: no longer an afterthought
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by Kathy Grey
BALANCING ACT
Momma’s Gotta Work
Tips for successfully working from home when the kids are not in school
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by Kimberly Blaker
Moms who work from home may be trying to juggle that responsibility with caring for little ones or school-age children on school and summer breaks.
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This work/family dynamic can make it seem impossible to get anything done, but the following practices might help.
Create and follow routines
Children of all ages thrive on consistent routines, so make a list of what your family needs to accomplish throughout the day, such as completing tasks, meals and chores. Be sure to include some time for fun, as well.
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Start filling in a schedule with the activities that occur at set times and work in other responsibilities and activities to create a family schedule. Include your kids in the planning so they feel involved and more willing to follow the routine. Then post the agenda where the whole family can see it. Also, be sure to adjust the design of the schedule for the age of your kids. Younger children benefit from straightforward visuals using bright colors, precise times and pictures to make the plan clear.
Set clear expectations
Kids and adults tend to do better when there are clear expectations set beforehand. Agree on a set of rules and expectations for the day regarding your work time. With older kids, sit down and make a written contract. If you have younger kids, work together to create a poster with visuals. To make it clear, talk about what different parts of your schedule, especially your work time, look and sound like, and what everyone should and shouldn't be doing.
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Set up a visual reminder to let your kids know when you cannot be disturbed — except for emergencies. Create a sign outside your workspace that clearly states your work hours. This can help kids to be more patient. For younger kids, use a countdown clock so they can anticipate the end time.
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Designate a workspace
Creating a space that feels like going to a workplace can get you into a better routine and improve your focus. Try to create your workplace away from the main areas of your home and, if possible, with a door you can close. This will help remind your kids not to disturb you when you’re in your workspace. You can also play music or wear noise-canceling headphones to reduce distractions if another adult or older child cares for the younger ones.
Ask for help
This isn’t the time to try to do everything yourself. If you have a partner at home, take turns spending time with the kids so you can each have uninterrupted time to focus on work or time to yourself to recharge. If you are feeling overwhelmed or are struggling to get something done for work, talk to your boss or team about the situation before things become too difficult.
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If you're struggling to balance work and being home with the kids, try talking to them at their level. Kids are more aware and understanding than we often realize.
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To improve productivity, it may also be necessary to hire a babysitter to come to your home or where you can send your kids, at least for part of the day.
Be flexible
Unexpected things will come up in your work, with your kids or other aspects of your life. Try to build in some wiggle room because you’ll likely need to make changes as you go. For example, if the day is going really smoothly, perhaps work a little longer to accomplish a bit more in case things don’t go smoothly tomorrow.
Stay positive
Focus on the positive aspects of being home with your kids, and remember, there is finally a light at the end of the tunnel. Try to balance work and quality time with your family. The effort you make can help your family bond and turn a challenging period into one filled with good memories.
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Kimberly Blaker is a freelance writer. She also owns an online bookshop, Sage Rare & Collectible Books, specializing in out-of-print, scarce, signed and first editions; fine bindings; ephemera; and more at sagerarebooks.com
