Oregon teens struggle with mental health more than ever, according to state survey
December 30, 2017 | Molly Harbarger-The Oregonian/OregonLive
In Oregon, the kids are increasingly not all right. A report from the Oregon Health Authority shows that middle– and high school-aged children feel they struggle more with mental illness and cope less well with the stress of their lives than was the case as recently as two years ago.
Compared with 2015 and particularly 2013, more eighth– and 11th– graders reported they have unmet mental health needs on the biennial Oregon Healthy Teens Survey. This year, almost 19 percent of eighth–graders and 22 percent of 11th–graders reported that unmet need on the survey, given to more than 12,000 students in each grade at public schools throughout the state last spring.
A quarter of eighth–graders said their emotional or mental health was fair or poor. A third of 11th– graders did.
At the same time, fewer students reported that they know how to cope with everyday stress and anxiety — a measure of resiliency that officials use to take the mental temperature of Oregon teens.
More than 40 percent of students in both grades survey did not meet the state’s benchmark for coping ability. About a third said they felt so sad and hopeless, they had stopped doing normal activities. Up to 18 percent said they had contemplated suicide.
Nearly 9 percent of eighth graders reported they had in fact attempted suicide in the last year and 7 percent of 11th graders did.
While the survey didn’t search out causes for why teenagers feel hopeless, sad or anxious, experts in child psychology say the high proportions of Oregon teens who reported stress and turmoil — and no way to combat them — aren’t surprising.
Terrorism, cell phones and increased economic insecurity for Oregon families all play a role.
Dr. Ajit Jetmalani, director of child and adolescent psychiatry at Oregon Health & Science University, said the he and his colleagues see a confluence of relatively new challenges that parents and national health care policy are just now confronting.
“I think we’ve reached a place where there’s a fork in the road: There could be movement around what’s best for kids based around obvious negative trend lines,” Jetmalani said. “I don’t think it’s going to come from a national level. It’s going to come from a local level.”
Virtually all the teens who took the survey were from 13 to 17 years old. They grew up in the aftermath of the Great Recession, which reshaped the economy into one of heavily low-wage and freelance jobs with a historically wide gap between the very rich and the poor. These children‘s parents spent a large portion of their lives in the fear-filled years after 9/11.
The fallout from those events have imprinted themselves on children, said Jetmalani.
“These kids now are the product of an environment where people were incredibly distressed and were frightened about safety, were frightened about economic security,” Jetmalani said. “We know when people are preoccupied or stressed or experiencing trauma, that can impact the relationship between family members and that can impact a community.”
Statewide, half of Oregon students qualify for subsidized school meals, indicating they come from families living below 185 percent of the poverty line. Some of those experience extreme deprivation and lack of security, with 22,541 kids found to be homeless at some point during 2016-17.
When parents are focused on where and when their children will eat or sleep, they have less capacity for their kids’ emotional needs, according to studies. That instability shows up in how those kids function as well. They often lose sleep, perform poorly in school and act out, which often leads to punishment.
Up to 40 percent of students reported they had missed at least one day of school for mental health reasons. About as many skipped school for any reason, according to the survey.
The report does not draw conclusions or link the results, but state analysts say that many of these trends are related. For instance, the increase in teens saying they have mental health issues that haven’t been addressed corresponds closely to their decreasing ability to cope in tough times.
“Those are two rates that are corresponding,” said Wes Rivers, adolescent health policy assessment specialist for the Oregon Health Authority. “As those increase, you would expect unmet need to also increase.”
Rivers said that the trend line is the same – possibly suggesting that all are related.
Students live in a relatively novel era when they have access to smartphones and social media at an age no other generation has, and both are a near-constant presence in many teens’ lives.
Jetmalani said the biological traits that make adolescence tough in any era — lack of impulse control, heightened emotions, puberty — are exacerbated by the speed of smartphone technology and the sense of isolation it can provide.
He said that almost every child who comes to his office, alone or with family, complains of the pressures social media. Social media opens the door for bullying, researchers say. It also closes adolescents off from crucial learning developments that can only be achieved through person-to-person interaction.
For instance, fights between friends can play out completely over text messages and Instagram comments, rather than through face-to-face interactions that allow friends to see how much they hurt each other and learn empathy and restraint.
“If you’re neurologically wired to need human contact and interpersonal exchange and we disrupt that through these electronic pathways, we disrupt resilience over time,” Jetmalani said.
Parents also grapple with how much they use their own phones and computers. The parents’ overuse of screentime can negatively impact their teens.
Jetmalani warned that school bans on smartphone use might not go far enough. Parents and communities might be headed toward making stricter decisions about how old children should be to have access to the internet without supervision — and whether adults need to temper their own technology usage.
Social media usage fosters a sense of competition that teens are particularly susceptible to. Many social media users create a carefully curated version of their online selves skewed toward their best looks and best days. Jetmalani said many kids compare their lives to the lives of others as presented through social media — and conclude that they haven’t achieved as much or traveled enough or had as much fun as most others their age.
And it’s not just that competition that is damaging, Jetmalani said. The tone of national politics has filtered down to make youth feel they must pick a side in everything — politics, friendships, what they like and don’t.
“The polarization of information is so wide, and instead of being focused on the greater good, there’s haves and have-nots and Republicans and Democrats — and there’s not a sense of what’s best for all of us,” he said.
Jetmalani said the stressors, anxiety and depression facing so many teens can be tackled best with more investment in mental health services at early ages.
“I don’t think all is lost. We just have to make a decision. We have to do this work and do it systematically.”