June 26, 2020 — As a leading cause of adolescent death, suicide is a constant focus among mental health researchers and clinicians. But the coronavirus, in some ways, may have made it tougher for youths to get the help they need.
A recent commentary in the Journal of Adolescent Health discusses what the pandemic may mean for individual adolescents. Time away from usual social settings can help or hurt their mental health, depending on the safety and support of the home, the authors say. Remote schooling, the economic downturn, and potential sickness also play a role in stress and risk levels.
Author Hannah Szlyk, a postdoctoral research scholar at the Brown School of Social Work at Washington University in St. Louis, says mental health providers must be sensitive to these things. The bottom line, she says, is “if there were problems at home to begin with, they are definitely going to be heightened during this time.”
A 2019 study in the journal European Child & Adolescent Psychiatry found three main things that increase the risk of suicide among young people: Psychological factors, like depression, anxiety, and drug abuse; stressful life events, such as family problems and peer conflicts; and personality traits, including neuroticism and impulse problems. All of these stressors may be at play during the pandemic.
“In children and adolescents, life events preceding suicidal behavior are usually family conflicts, academic stressors (including bullying or exam stress), trauma and other stressful live events,” the authors wrote.
How, then, can clinicians continue to treat adolescents with suicidal tendencies as they deal with both public and personal health crises?
Szlyk says remote resources are not new to suicide prevention, as mental health hotlines have been in use since the 1950s. The rise of the internet and smart devices gave way for online content, modules, and apps related to suicide intervention.
In-person individual, group, and family psychotherapy remains the leading adolescent outpatient treatment. These services are now adapting to the use of virtual doctor-patient communication, commonly called “telehealth.”
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“You have to think about the implementation of putting things into this different modality,” Szlyk says. “Using technology is not going to be a panacea for the issues we already see for mental health services.”
The Journal of Adolescent Health article explains that telehealth service disparities “may mirror or surpass the racial and socioeconomic disparities” seen with in-person services. Things like insurance coverage, phone and internet access, language barriers, and privacy complicate the access of remote treatment for many adolescents.
“The question becomes ‘do we have the infrastructure to support this for everyone?’” Szlyk says.
The researchers remain confident that “mental health care providers, no matter their current comfort with virtual care, have years of experience supporting people through crises. We have the tools to weather this storm.”
For parents and caregivers, though, the challenge may be unfamiliar.
Szlyk and her colleagues say that as “the frontline for youth suicide prevention,” parents play a key role in their child’s suicide risk.
One simple way to support at-risk adolescents during and after the pandemic is to practice open and authentic expression in the home through casual communication. “Create spaces for dialog, even when the adolescent does not engage in the conversation.”
The Child Mind Institute, an organization dedicated to youth mental health, reinforces this idea in its tips for “Supporting Teenagers and Young Adults During the Coronavirus Crisis.”
“Give them room to share their feelings and listen without judgment (or without reassuring them that everything will be fine),” it reads.
The institute also encourages parents to help adolescents set up healthy habits, such as a consistent sleep schedule and a balanced diet.
Like most parts of the coronavirus pandemic, the relationship of the outbreak to the rate of adolescent suicide isn’t clear. But what is known is that by actively listening to adolescents, parents and clinicians can help ease the stress of their new reality.
National Suicide Prevention Hotline: 800-273-8255
Journal of Adolescent Health: “Coronavirus disease 2019 takes adolescent suicide prevention to less charted territory.”
Hannah Szlyk, PhD, postdoctoral research scholar, Brown School of Social Work at Washington University in St. Louis.
The Child Mind Institute: “Supporting Teenagers and Young Adults During the Coronavirus Crisis.”
European Child & Adolescent Psychiatry: “Psychosocial risk factors for suicidality in children and adolescents.”
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