The Dayton Daily News’ Path Forward initiative investigates the region’s most pressing issues. Today we launch a new Path Forward project focused on the Miami Valley’s mental health — starting with the youngest victims.
RELATED: Suicide, depression rates among teenagers growing
The series will explore what’s at the root of problem. We will also dig into the cost of not addressing youth mental health on schools, public safety and families, as well as potential solutions and who should be responsible for implementing them.
We also want to engage the community in talking about an issue that carries a lot of stigma, and help parents learn how to address mental health with their children.
Leigh Ann Fulford, founder of the suicide awareness group SAVE US Dayton, said she offers the same advice to all parents.
“Please treat mental health as you do dental and physical well-being and take your children to a mental health professional or counselor for ‘check ups,’” she said.
That way they will be comfortable and familiar with where to turn for help when mental health issues arise.
The problem
Incidents of anxiety and depression disorders among children, adolescents and young adults have increased significantly nationwide over the past 10 years, according to Greg Ramey, pediatric psychologist and executive director for the Center for Pediatric Mental Health Resources at Dayton Children’s Hospital.
And youth who experience those mood disorders are more likely to engage in self-harm or suicidal behaviors.
“If you asked me in 30 seconds to describe the biggest challenge to us in the mental health arena, it would be that area,” Ramey said.
- 125 youth ranging from age 8 to 19 died by suicide in Ohio in 2017 — a 50% increase from the previous 10-year average. In 2018, that number rose to 128, according to Ohio Department of Health data. In 2000, when the state began more closely tracking child deaths, 70 youth in Ohio died by suicide.
- In 2018, 7.4 percent of teens in the U.S. said they tried to kill themselves in the past 12 months. For LGBTQ teens that number was 35 percent. Local numbers mirror national trends, according to Ramey. "These are extraordinarily high numbers," he said.
- Dayton Children's has seen a 200% increase over five years in the number of kids coming to the emergency room for mental health-related issues and a 300% increase in the number of children being admitted for mental health problems.
Why the increase?
Researchers have found correlation between increased anxiety and depression in teens and the rise of social media and smartphones.
“The research on technology and social media is now complete. It is a major factor leading to mood disorders in teenagers,” Ramey said.
Not all technology is bad for all kids, he said, but beyond a tipping point time on social media is significantly related to mood disorders.
“The more time you’re spending on social media, you’re not interacting in person,” he said. “So you’re not building up the relationships that get us through our tough times.”
RELATED: Options growing to treat children's mental health, but gaps still exist
Teens now spend more time on their devices than interacting with each other, psychology professor Jean Twenge says in her 2017 book “iGen.”
“It’s not an exaggeration to describe iGen as being on the brink of the worst mental-health crisis in decades,” she said. “Much of this deterioration can be traced to their phones.”
She defines the “iGeneration” as those born after 1995, who have had access to smartphones their entire adolescence.
Previously common teen activities have decreased, including dating, working part-time jobs, getting a driver’s license and hanging out with friends, her book says. Negative activities like teen drug use, pregnancy and homicide also have decreased.
“As teens have started spending less time together, they have become less likely to kill one another, and more likely to kill themselves,” Twenge says in her book. “In 2011, for the first time in 24 years, the (national) teen suicide rate was higher than the teen homicide rate.”
A new study led by researchers at Nationwide Children’s Hospital in Columbus indicates a particular piece of media might have had an impact on teen suicide numbers in 2017 — The Netflix series “13 Reasons Why.”
RELATED: Kettering moving some youth behavioral services to Children's
The suicide rate among 10- to 17-year-olds increased significantly in the month immediately following the release of the show about a girl who dies by suicide, leaving cassette tapes for her friends to explain her reasons, according to researchers.
“Caution regarding the exposure of children and adolescents to the series is warranted,” the study’s conclusion says.
Researchers estimated 195 additional suicide deaths occurred among 10- to 17-year-olds in the nine months following the release of the series than would have occurred according to prediction models.
Ramey sees technology as just one of the reasons behind youth mood disorders.
Another, he said, is helicopter parenting.
“Well-meaning and loving parents have over-protected our kids and not allowed them the gift of dealing with failure and frustration at a younger age,” Ramey said.
Kids are then ill-equipped in their teen years to deal with stress and challenges.
“The end result is since I’ve never learned to get up after falling because my parents never let me fall, when I do fall I think, ‘Oh my goodness, the world is coming to an end,’” he said.
Perfectionism — the feeling among teens that they are expected to be perfect — is also a contributing factor to increased self-harm, Ramey believes.
A University of Chicago professor who studied one affluent community that had 19 students or recent local graduates die by suicide between 2000 and 2015 found that intense pressure to succeed in academics or athletics can increase suicide risk when coupled with the stigma of close-knit social circles.
“It’s not just the pressure: It’s the pressure combined with certain community factors that can make asking for help harder to do,” study author Anna Mueller told the American Sociological Association in 2016.
One parents story: ‘Be very honest’
Julie Gillespie, of Troy, is one of the grieving parents behind the rising suicide statistics. Her 15-year-old son, Liam, died by suicide in October of 2015.
She didn’t see that her quiet, scholar-athlete son was struggling, Gillespie said, despite her job as a teacher and her degree in counseling.
“You don’t get an instruction booklet with kids,” she said. “So you don’t know what’s normal or not normal.”
Since her son’s death, Gillespie has devoted time to researching youth mental health and how to prevent suicide.
RELATED: Mental health a major focus for local schools
The keys for parents, she said, are listening and communicating.
“Be very honest about mental illness and different feelings,” she said. “Listen to their emotions.”
It’s important to be direct when you believe there’s something wrong with your child or your student, Gillespie said. Mental health professionals say asking directly if a young person is thinking about harming themselves is the best approach and won’t put ideas in their head or otherwise make things worse.
It can be hard for parents and teachers to connect with kids who live much of their social lives online, Gillespie said. She’d like to see more programs be youth-led so that teens connect with people their own age in their own way about mental health.
What are local groups doing?
The Path Forward series will explore potential solutions to reduce the negative impacts of youth mental health issues in our community. Some schools and organizations are already tackling this problem. These are just a few of the newest programs being implemented. We will dig more into these and other possible solutions over the coming months.
Whole Child at Wright State University
Wright State University’s Whole Child initiative works with seven local school districts to pilot ways to reduce mental health issues in their schools.
The project, paid for by a $500,000 Ohio Higher Education grant, is looking to expand statewide.
“We all know we can’t do our jobs if kids aren’t healthy,” said Kevin Lorson, professor and health and physical education program director at WSU.
READ MORE: WSU, local schools work on health barriers to education
Educators have so much on their plates already, Lorson said, so the initiative aims to find ways that partnerships can help.
“Schools can’t do this alone,” he said. “They need to have a partner.”
Wright State’s role is to facilitate those partnerships and improve communication between schools and outside agencies tackling the mental health problem.
“The system doesn’t talk very well,” Lorson said. Agencies often get grants to provide specific services and the money doesn’t cover communicating with other groups, he said. And both schools and medical professionals have privacy laws they must follow that often hinder open communication with each other or outside groups.
Dayton Children’s
The hospital has added more mental health professionals and several major initiatives.
• Any child 10 or older who comes through Dayton Children’s ER is asked a set of questions to screen for suicide risk. It’s one of only a few pediatric hospitals that does so, according to Ramey, but that’s becoming more standard.
• Mental Health Resource Connection is a phone line for parents to get referred to services by a trained social worker, who also follows up to overcome any barriers to treatment. It’s grown from less than 1,000 referrals five years ago to an expected 6,000 this year.
RELATED: Kettering Fairmont mourns death of student from suicide
• The Behavioral Health Crisis Center is adjacent to the regular emergency department but allows children with mental health needs to be seen in a safer, less chaotic environment. They expect to see about 1,600 patients there in 2019.
• In July a 24-bed inpatient mental health facility will open for youth ages 11 to 17. Currently few inpatient beds are available in the community for kids in need of that level of treatment. Children’s has had to send kids as far away as Akron and Kentucky.
ADAMHS
Montgomery County Alcohol Drug Addiction and Mental Health Services has several initiatives to combat youth mental health issues.
• More than 2,500 students received mental health screenings through ADAMHS’s partnership with six school districts in the past year. About 6% of those screened were referred for mental health treatment.
• Students in eighth through 12th grades at three county schools get a class on the signs of suicide and how to help.
• Youth mental health first aid classes are available to anyone in the community who wants to learn how to spot potential problems, how to approach a child about mental health and how to deal with crisis situations.
• The agency is working with the Montgomery County Educational Service Center to develop an incentive program where schools would earn medals for implementing evidence-based mental health programs.
Suicide Hotlines
People in need can call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor.
The national crisis text line can be accessed by texting CONNECT to 741741.
An online chat option is available by going to suicidepreventionlifeline.org/chat/ and entering your zip code.
Warning Signs of Suicide
- Talking about wanting to die
- Looking for a way to kill oneself
- Talking about feeling hopeless or having no purpose
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious, agitated or reckless
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Displaying extreme mood swings
The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide but might not be what causes a suicide. — American Foundation for Suicide Prevention
What to do
If someone you know exhibits warning signs of suicide:
- Do not leave the person alone.
- Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt.
- Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255).
- Take the person to an emergency room or seek help from a medical or mental health professional.
ABOUT THE PATH FORWARD
We have formed a team to dig into the most pressing issues facing the Miami Valley. The Path Forward project, with your help and with that of a 16-member community advisory board, seeks solutions to issues readers told us they were most concerned about, including the Miami Valley’s mental health.
Follow the project on our Facebook pages and at DaytonDailyNews.com/PathFoward and share your ideas.
Read more from Dayton Children’s psychologist Greg Ramey on what parents can do to prevent and handle mental health issues on the Ideas & Voices page.
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