This week on our nationally syndicated radio show, we talk with Pulitzer Prize-winning journalist Matt Richtel. His latest series for The New York Times takes a long look at the mental health crisis affecting American teenagers. This is not a tale of COVID disruption, although COVID has made it worse. This is a story of a generation, starting around age 10 and continuing through college graduation at least a decade older.
Matt Richtel points out that the public health risks for adolescents in the US were predictable until a few decades ago. Health authorities worried about teen pregnancy, alcohol misuse and potentially dangerous experiments with marijuana and other drugs.
The risk landscape has shifted dramatically in the 21st century. Fewer teens than ever report having drunk alcohol or smoked marijuana lately. Even rates of teen pregnancy have fallen. But our adolescents are struggling terribly with depression and anxiety. Some have turned to self-harm or find themselves obsessing about suicide. Suicide rates are also up dramatically.
Matt spent a year interviewing adolescents and their families. Teenagers told him about cutting themselves in seeking to relieve their distress. Parents shared their frustration of not knowing how to help their youngsters effectively. He found that pediatricians’ offices have been overwhelmed with young people in crisis. Moreover, he learned that hundreds of suicidal teens sleep in emergency rooms for days or weeks on end because they cannot be discharged safely. At a time when we need facilities to treat mental illness more urgently than ever, a large number of these institutions have closed their doors.
One contributor to the problems we are seeing is that kids are entering puberty at younger and younger ages. We don’t know quite why that is. Nutrition may be playing a role. Exposure to certain environmental chemicals might also be encouraging early puberty. But although the body and the reproductive system appears to be maturing more quickly, the brain has not kept up. Figuring out how you fit in to society is just as important as ever, if not more so, but it’s more difficult with a disjunction between body and mind. In addition, the big changes in society over the last several decades also make it more challenging for young people to get a clear picture of their possible path.
Is digital technology to blame? The science is not clear. What seems most likely is that, like the pandemic, social media and online offerings may exacerbate an existing problem. When they spend a lot of time online, kids are sleeping less and having less in-person interaction. They spend less time outdoors, which otherwise could be a good safety valve to help manage stress and anxiety.
Matt interviewed a Milwaukee teenager he calls M, a person who prefers to be referred to as “they” or “them.” Although M is an intelligent person who did well in grade school, high school led to severe anxiety about school as well as social isolation. The consequences were severe depression, self-harm and a suicide attempt. M’s parents were at their wits’ end, frightened and frustrated because they did not know how to help their child.
Youngsters in the midst of a mental health crisis need coping skills. Learning ways to cope is probably going to be easier when a person is not in crisis mode, so it makes sense to figure out how to teach all young people the coping skills they need. We also need to create ways for youngsters to access therapies that work, such as CBT (cognitive behavioral therapy) or DBT (dialectical behavioral therapy). Currently, there are not enough therapists trained in these modalities to treat everyone who could benefit. We’ll need to put our creativity to work figuring out how to change that.
Matt Richtel is a best-selling author and Pulitzer Prize-winning reporter for The New York Times. He is the author of several books, including his most recent, Inspired: Understanding Creativity: A Journey Through Art, Science, and the Soul.