Mental Health Issues in Children,
Youth and Adolescents
Family and Children’s Service of Greater Lynn, Inc.
Linda Demerjian, LICSW
Jackie Trahan, M. Ed.
Lauren Harless, LCSW
Maria Alvarado, BA
The What and Why of Mental Health in Youth

What is mental health?
Mental Health can be defined as a state of well-being in which every individual
realizes his or her own potential, can cope with the normal stresses of life, can
work productively and fruitfully, and is able to make a contribution to her or his
community (World Health Organization, 2001).

Why is it important?
Mental health issues in youth may lead to 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.
Youth Mental Health Statistics

1 in 5 Children, currently or at some point in their life, have had a seriously debilitating
mental disorder.

Half of lifetime cases of mental disorders begin by age 14.

In a given year, only 20% of children with mental disorders are identified and receive
services.

About 50% of students age 14 and older who are living with mental illness drop out of
high school.

Almost all teens who think about or have attempted suicide have a mental disorder,
including depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD)
or problems with drug or alcohol abuse.

Suicide is the third leading cause of death in youth ages 10 to 24.

According to a 2012 survey, 25 % of middle school youth and 14% of high school
youth in Lynn, MA have “ seriously considered suicide”.
(National Alliance on Mental Illness, 2010)
(National Institute of Mental Health, 2010)
(Northeast Center for Healthy Communities ,2012)
(Nock et al., 2013)
Depression

Depression is a serious health problem that can affect people of all ages,
including children and adolescents.

Depression is generally defined as a persistent experience of a sad or
irritable mood as well as “anhedonia,” a loss of the ability to experience
pleasure in nearly all activities.

Major depressive disorder, often called clinical depression, is more than just
feeling down or having a bad day. It is a form of mental illness that affects
the entire person.

Depression changes the way one feels, thinks and acts and is not a personal
weakness or a character flaw.

Children and youth with depression cannot just “snap out of it” on their
own. If left untreated, depression can lead to school failure, substance
abuse, or even suicide.
Indicators of Depression

Grumpy, sad, or bored most of the time.

Does not take pleasure in things he/she used to enjoy.

Weight loss or gain.

Change in sleeping patterns.

Feeling hopeless, worthless, or guilty.

Having trouble concentrating, thinking, or making decisions.

Thoughts of death or suicide.

Lack of energy.

Headaches, stomachaches, loss of interest in friends and activities.

Slower speech or movements.
Anxiety

Anxiety is the feeling of intense, fear, distress and apprehension that appears
out of proportion to the situation. While all children and adults experience
this at one time or another, an actual anxiety disorder is an intensified
reaction of fear or apprehension that affects daily functioning.

Risk factors may be genetics (a predisposition), family history (substance
abuse), traumatic of scarring events, poverty and so forth.

If untreated, the negative experiences of the anxiety compound fears and
symptoms over time.

Anxiety disorders that persist into adolescence and adulthood have a high risk
of substance abuse (American Psychiatric Association, 2000).
Indicators of Anxiety

Fear

Difficulty concentrating

Emotional/physical distress

Irritability

Body Tension

Restlessness

Self-defeating cognitive and
behavioral rituals

Nightmares

Clinging behavior

Sleep and appetite disturbance

School refusal

Feeling out of control

Poor memory

Difficulty effectively coping

Clumsy or accident prone

Sense of impending doom or
danger

Periods of losing time

Startle Response
Attention Deficit Hyperactivity Disorder
(ADHD)

A persistent pattern of inattention and/or hyperactivity-impulsivity that is
more frequently displayed for at least six or more months and is more severe
than is typically observed in individuals at a comparable level of development
(American Psychiatric Association, 2000.)

ADHD is one of the most common childhood mental health disorders.

The symptoms of ADHD begin in childhood and often persist into adulthood.

The causes and risk factors for ADHD are unknown, but genetic factors likely
play a role.
(U.S. Department of Health and Human Services, 2011)
Indicators of ADHD
Inattention
• Often does not give close attention to details or makes careless mistakes in schoolwork, work,
or other activities.
• Often has trouble keeping attention on tasks or play activities.
• Often does not seem to listen when spoken to directly.
• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties
in the workplace (not due to oppositional behavior or failure to understand instructions).
• Often has trouble organizing activities.
• Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long
period of time.
• Often loses things needed for tasks and activities.
• Is often easily distracted.
• Is often forgetful in daily activities.
Hyperactivity
• Often fidgets with hands or feet or squirms in seat when sitting still is expected.
• Often gets up from seat when remaining in seat is expected.
• Often excessively runs about or climbs when and where it is not appropriate.
• Often has trouble playing or doing leisure activities quietly.
• Is often "on the go" or often acts as if "driven by a motor".
• Often talks excessively.
Impulsivity
• Often blurts out answers before questions have been finished.
• Often has trouble waiting one's turn.
• Often interrupts or intrudes on others.
(American Psychiatric Association, 2000)
Trauma

Trauma can be defined as a physical or psychological threat or assault to a
child’s physical integrity, sense of self, safety or survival or to the physical
safety of another person significant to the child (Vermont CUPS Handbook,
2005). Children may experience trauma as a result of a number of different
circumstances, such as

Abuse, including sexual , physical, emotional

Exposure to Domestic Violence

Severe natural disaster (earthquake, flood, fire, and tornado)

War or military actions

Abandonment

Witness to violence in school setting, neighborhood

Personal attack by another person

Kidnapping

Severe bullying

Medical procedure, accident, serious illness or surgery
Indicators of Trauma







Difficulty sleeping
Hyper alert and a heightened startle response
Agitation
Avoidance of physical contact or eye contact
Terrified responses to sight, sound that remind the child/youth of the
traumatic experience (example, the smell of alcohol, police siren, a dog)
Re-enactment of the traumatic experience
Substance Abuse (adolescents)
Who is at greater risk?
 Children and youth who are victims of physical and sexual abuse, usually by
trusted caregivers.

Children and adolescents who are victims of domestic violence in their
families or in a school or community setting.
Risk Factors for Mental Health Issues
Biological
Psychological
•Genetic defects
•Low birth weight
•Chronic physical conditions( i.e. deafness
or blindness)
•Illness (i.e. diabetes or asthma)
•Physical trauma, or exposure to toxic
chemicals or drugs while in the womb
• Low IQ
•Learning difficulties and deficits in sensory
perception
• Previous diagnosis of a mental health
disorder
Social
Familial
•Extreme poverty
•Homelessness
•Over-crowded living condition
•Inadequate schooling
•Neighborhood violence and
disorganization
•Poor peer relations (i.e. bullying)
•Poor prenatal care
•Young parents/caregivers
•History of family criminality
• History of family mental disorder
•Severe marital discord
•Poor parental supervision and/or discipline
•Childhood maltreatment
(Community Action Network, 2010)
What can we do?
Individual Level







Educate self further about mental
health (know the warning signs).
Monitor youth’s behaviors.
Take into consideration youth’s
developmental stage.
Thoroughly access youth’s
background and situation.
Develop relationships and/or consult
with mental health professionals
(psychologist, psychiatrists and social
workers).
Contact caregivers when
concerns/warning signs arise.
If possible, openly discuss mental
health with youth in the schools,
classroom, program, center etc.
Community Level

Conduct meetings, presentations,
conferences and/or conversation
around mental health to increase
awareness and reduce social stigma.

Train staff, childcare workers, school
faculty, parents etc. to recognize the
risk factors and warning signs of mental
health issues.

Collaborate with mental health
professionals to implement or improve
programs.

Consider and support policy that
improves access to mental health
services.

Promote tolerance and understanding
of those suffering from mental illness.
Assessment of Youth and Substance Abuse

In adolescents, substance abuse highly correlates with mental health issues, especially
trauma (National Child Traumatic Stress Network, 2008).
Determine if substance abuse is occurring
- During the past 12 months, have you:
Drank any alcohol (more than a few sips)?
Smoked any marijuana or hash?
Used anything else to get high? (includes illegal drugs, over the counter and prescription
drugs, and things that you sniff or “huff”.)


-
Gain history of the substance abuse
What kinds of substances are/were used?
How often and under what circumstances? (frequency and pattern)
Has anyone expressed concern over your use of alcohol and/or other substances?
Do you have concerns about your use?
Do family members or friends use? Under what circumstances?
Make an appropriate referral
Research recommends treating substance abuse and mental health issues concurrently.

(Massachusetts Department of Public Health Bureau of Substance Abuse Services, 2009)
Mental Health Providers
Determine if substance
abuse is occurring.
Gain a history of the
substance use and
examine for underlying
issue(s).
Make appropriate
referral(s)- substance
abuse counseling and/or
mental health counseling.
Non-Mental Health Providers
Determine if substance
abuse is occurring.
Gain a brief history of
substance use.
Make a referral to a
general mental health
clinician for further
assessment.
Local Youth Mental Health Resources

Lynn Community Health Center,
Behavioral Health Services
20 Central Ave., Lynn MA 01902
(781)477-7222

Elliot and Community Human
Services
95 Pleasant St., Lynn, MA 01901
(781) 581-4400

Family and Children’s Service of
Greater Lynn, Inc.
111 N. Common St., Lynn, MA 01902
(781) 581-6614

Children Friends and Family
Services
112 Market St. 2nd Fl, Lynn, MA 01902
(781) 592-5691

Catholic Charities
117 N. Common St., Lynn, MA 01902
(781) 593-2312

Psychiatric Associates of Lynn
270 Union St., Lynn, MA 01901
(781) 268-2200

Mass General at North Shore
Medical Center
57 Highland Ave. Salem, MA 01970
(978) 354-2700
Discussion
Questions?
References
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References Continued
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