Mental Health and Youth Risk

May is Mental Health Awareness Month. With routines upended around the world, everyone’s mental health could use some extra care right now, especially that of our youth.

One in five youth will have a serious mental health disorder at some point in their life, and half of all mental health problems begin by age 14.

Many youth are at even higher risk now without the support they might normally receive from school based health and counseling. Mental health can often be connected to other risk behaviors, all of which may not be initially apparent.

In a review of Adolescent Mental Health in the United States published by the National Center for Children in Poverty, Susan Wile Schwarz describes the complicated relationship between mental health and risk behaviors in teens:

“Mental health and social and emotional wellbeing – combined with sexual and reproductive health, violence and unintentional injury, substance use, and nutrition and obesity – form part of a complex web of potential challenges to adolescents’ healthy emotional and physical development.”

Schwarz cites a series of negative outcomes associated with untreated mental health issues, including “poor school performance, school dropout, strained family relationships, involvement with the child welfare or juvenile justice systems, substance abuse, and engaging in risky sexual behaviors.”

The World Health Organization takes this further, declaring mental health problems to be the largest cause of morbidity among youth, and points out the role of mental health as a contributing factor or determinant in youth risk behaviors: “Poor mental health can have an important effect on the wider health and development of adolescents and is associated with several health and social outcomes such as higher alcohol, tobacco and illicit substances use, adolescent pregnancy, school dropout and delinquent behaviors.”

Screening is one of the best measures for helping identify and address risk factors in youth including mental health issues. The Rapid Adolescent Prevention Screening© (RAAPS) is a standardized, validated youth risk screening and health education solution developed to support professionals in reducing the risk factors impacting the health, well-being, and academic success of youth 9-24 years. RAAPS has also been validated as a depression screening tool.

“One of the most alarming things we found [through screening with RAAPS] is that across the board 30% of our students are flagging positive for depression,” shared Sandy Rowe, Executive Director of Pender Alliance for Teen Health’s (PATH), whose mission is to make healthcare accessible for children and teens in Pender County North Carolina. “One of the guidance counselors spoke to a girl who had flagged for suicidal ideation and was referred for follow-up counseling. She shared she had a plan and thought about it every day. The guidance counselor had been working with this young girl for a long time and she had never said anything about suicide before. When the counselor inquired as to why, the girl responded: ‘No one ever asked me the question.’ This girl was under the radar. Nobody knew she was thinking about it – no one with the capacity to help her (her parents or her guidance counselor) knew she was at risk. And she was not an isolated incident, of the over 4000 kids we surveyed – 440 flagged for suicidal ideation.”

As harrowing as those numbers may sound, the amazing result is that hundreds of kids received help they may not have otherwise sought out. And PATH is not an isolated instance. When asked about their integration of adolescent risk screening using RAAPS in a North Carolina school-based mental health collaborative, Stephanie Daniel, Ph.D., Executive Director for the School Health Alliance for Forsyth County (SHA), a partner and supporting organization for the Winston-Salem/Forsyth County Schools (WS/ FCS), said “We’re using RAAPS data to better and more precisely inform program development. That’s really helping us fulfill our mission: improving the health, safety, and academic success of our students. It’s been a true partnership across counties—and I think it’s been a tremendous success.”

For more information, check out the full case study with the School Health Alliance for Forsyth County.