Destigmatizing Mental Health and Cultivating Resilience

Executive Summary

Our team of licensed psychologists, physicians from diverse branches of medicine, and public policy leaders have developed a plan to expand mental health access, strengthen mental health equity, and promote the well-being of our youths. Under the plan, all students within a particular age bracket — in this case, seventh- and eighth-grade students — will learn evidence-based resiliency skills that cut across a range of challenges. In so doing, we aim to provide young people with the emotional building blocks needed to thrive, initiating, from the heart of Houston, a vision that can be spread across the nation and ultimately the world.

Mental Health Crisis

This vision was born out of the national and global growth in mental health issues facing young people today. Rates of depression and anxiety have increased steadily over the past two decades (Office of the Surgeon General 2021). The COVID-19 pandemic — with all the isolation, disruptions, and anxieties associated with it — only served to exacerbate the problem (Slomski 2021). Recent data indicate that 1 out of every 6 adolescents struggles with significant depression, and nearly 1 in 3 have an anxiety disorder. These rates increase to 50% when we include individuals reporting lower levels of generalized distress (Office of the Surgeon General 2021). Importantly, these mental health challenges are associated with substantial problems in school and a decline in general well-being (Wood et al. 2012).

The most alarming outcome associated with our youths mental health crisis is suicide. The Centers for Disease Control and Prevention has reported a 25% increase in rates of suicide in the past decade. In fact, suicide accounts for more deaths among youths than all natural causes combined. It is the second leading cause of death, following accidents, for adolescents (Centers for Disease Control 2014). In recent years, emergency rooms have experienced a 30% increase in mental health-related visits, many for suicide attempts (Kalb et al. 2019). 

Barriers to Getting Help

To make matters worse, 50% of youths with mental health difficulties do not receive treatment from a mental health professional. Youths from diverse and socioeconomically disadvantaged backgrounds are even less likely to obtain services (Kataoka, Zhang, and Wells 2002). Practical barriers, including the high cost of mental health services, lack of insurance coverage, unavailability of professional help, time constraints, and competing priorities, are widespread. Critically, many individuals are reluctant to access mental health care because of stigma and negative beliefs associated with seeking help (Radez et al. 2021; Aguirre Velasco et al. 2020). 

Even among individuals who start mental health treatment, only a small minority complete a recommended course of evidence-based therapy. Indeed, the average delay from the onset of mental health problems to needed treatment is 11 years. Moreover, in the absence of effective standardization of best practices, treatments that lack demonstrated efficacy are all too often pursued. 

Role of Social Media

With the widespread availability of technology and over 90% of teens ages 13–17 years old reporting social media use, any discussion about the mental crisis affecting youths must acknowledge the role of social media (Anderson and Jiang 2018; Twenge et al. 2018). There is strong evidence showing an association between time spent on social media and increased rates of anxiety, depression, and suicide-related outcomes among adolescents. Social media use has been linked to poor sleep quality, body image issues, and lowered self-esteem for youths — with girls experiencing more pronounced negative effects (Holland and Tiggemann 2016; Vogel et al. 2014).

While existing research demonstrates correlation, not causality, the common relationship between greater social media use and a variety of negative mental health outcomes is cause for concern. However, social media can also provide external support and connection for young people struggling with mental health issues (Bessière et al. 2008; Odgers and Jensen 2020). Potential interventions that seek to address the mental health crisis must integrate information about social media, including guidance for parents, families, school staff, and mental health providers. Future goals may include efforts to inform public policy related to the use of technology and social media for youths.

New Path Forward

These are staggering realities and statistics. One in every 2 young people suffers in silence, experiences agonizing anxiety or loneliness, and may even feel deep insecurity stemming from a sense of desperation, sadness, anger, or confusion. Many will want to run from what causes fear or pain. Although their lives are circumscribed by the severity of their anguish, traditional mental health services are often not feasible or appealing. Over time, the possibility of living rich and fulfilling lives seems ever more remote.

We believe that there is another path forward. What if all our youths were given equal access to the same evidence-based social-emotional training, such that mental health was destigmatized and disparities minimized? What if we expanded the education offered in schools, affording young people a “gateway” mental health system that taught core emotional competencies and promoting healthy growth and development (Villagrana 2010)? What if we could bridge the gap between science and practice to help adolescents transform their stance toward difficulties, and plant seeds of commitment to values-driven, rewarding lives? 

Decades of scientific research in the field of emotion, cognition, and behavior has revealed the fundamental transdiagnostic processes associated with mental illness and mental health —rigidity and flexibility. Our team at the Baker Institute is committed to translating this scientific knowledge into practice; to use this knowledge to inform the resiliency training curricula of our students; and to ensure that these competencies are uniformly and effectively implemented for all youths.

LIFE HACS (Life Hacks with Acceptance Commitment Skills)

Our team has developed a scientifically-based, fun and interactive program for young people in 7th and 8th grades — LIFE HACS (Life Hacks with Acceptance Commitment Skills). This program will be implemented in school settings to ensure that all students in these grades obtain the key skills needed to build their resilience and well-being.

LIFE HACS consists of five, 45-minute sessions that are interactive and engaging. It is strength-based, flexible, and applied to universal human challenges. The overall goals are 1) encourage youths to do things that are meaningful and important even when it may be hard or uncomfortable, 2) teach them how to manage difficult thoughts and emotions by growing their strengths, and 3) help them live out their full potential.

Overall Goals of LIFE HACS

1. Accepting: How to manage strong and difficult thoughts and emotions.
2. Clarifying: Who and what is most important?
3. Taking Actions: Behave in ways that are consistent with what matters most.

Conclusion

Our youths are facing a mental health crisis. Unfortunately, most do not have the resources needed to get help, and/or do not know where to turn for support or guidance. It is critical to take a multitiered approach to tackle this issue. LIFE HACS is a program designed to teach our youths scientifically-based skills to approach life with grit — informed by a public health and preventative approach to enhancing mental wellness among adolescents. Providing a resiliency program for all children in a school allows equal access to important skills and strategies. By teaching them how to face difficulty emotions and thoughts and to live with purpose, LIFE HACS can help our youths thrive in the face of challenges.

 

References

Aguirre Velasco, Antonia, Ignacio Silva Santa Cruz, Jo Billings, Magdalena Jimenez, and Sarah Rowe. 2020. “What Are the Barriers, Facilitators and Interventions Targeting Help-Seeking Behaviours for Common Mental Health Problems in Adolescents? A Systematic Review.” BMC Psychiatry 20, no. 293 (June). https://doi.org/10.1186/s12888-020-02659-0.

Anderson, Monica, and Jingjing Jiang. 2018. “Teens, Social Media and Technology 2018.” Pew Research Center, May 31, 2018. https://www.pewresearch.org/internet/2018/05/31/teens-social-media-technology-2018/.

Bessière, Katherine, Sara Kiesler, Robert Kraut, and Bonka S. Boneva. 2008. “Effects of Internet Use and Social Resources on Changes in Depression.” Information, Community & Society 11, no. 1: 47–70. https://doi.org/10.1080/13691180701858851.

Center for Disease Control (CDC). n.d. “About Multiple Cause of Death, 2018–2021, Single Race.” Accessed January 2023. http://wonder.cdc.gov/mcd-icd10-expanded.html.

Holland, Grace, and Marika Tiggemann. 2016. “A Systematic Review of the Impact of the Use of Social Networking Sites on Body Image and Disordered Eating Outcomes.” Body Image 17 (June): 100–10. https://doi.org/10.1016/j.bodyim.2016.02.008.

Huang, C. 2017. “Time Spent on Social Network Sites and Psychological Well-Being: A Meta-Analysis.” Cyberpsychology, Behavior, and Social Networking 20, no. 6 (June): 346–54. http://doi.org/10.1089/cyber.2016.0758.

Kalb, Luther G., Emma K. Stapp, Elizabeth D. Ballard, Calliope Holingue, Amy Keefer, and Anne Riley. 2019. “Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US.” Pediatrics 143, no. 4 (April): e20182192. https://doi.org/10.1542/peds.2018-2192.

Kataoka, Sheryl H., Lily Zhang, and Kenneth B. Wells. 2002. “Unmet Need for Mental Health Care Among U.S. Children: Variation by Ethnicity and Insurance Status.” The American Journal of Psychiatry 159, no. 9 (September):1548–55. https://doi.org/10.1176/appi.ajp.159.9.1548.

Odgers, Candice L., and Michaeline R. Jensen. 2020. “Annual Research Review: Adolescent Mental Health in the Digital Age: Facts, Fears, and Future Directions.” Journal of Child Psychology and Psychiatry 61, no. 3 (March): 336–48. https://doi.org/10.1111/jcpp.13190.

Office of the Surgeon General (OSG). 2021. Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory. Washington: U.S. Department of Health and Human Services. https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf.

Radez, Jerica, Tessa Reardon, Cathy Creswell, Peter J. Lawrence, Georgina Evdoka-Burton, and Polly Waite. 2021. “Why Do Children and Adolescents (Not) Seek and Access Professional Help for Their Mental Health Problems? A Systematic Review of Quantitative and Qualitative Studies.” European Child and Adolescent Psychiatry 30 (February): 183–211. https://doi.org/10.1007/s00787-019-01469-4.

Slomski, Anita. 2021. “Pediatric Depression and Anxiety Doubled During the Pandemic.” JAMA 326, no. 13 (October): 1246. https://doi.org/10.1001/jama.2021.16374.

Twenge, Jean M., Thomas E. Joiner, Megan L. Rogers, and Gabrielle N. Martin. 2018. “Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among US Adolescents After 2010 and Links to Increased New Media Screen Time.” Clinical Psychological Science 6, no. 1: 3–17. https://doi.org/10.1177/2167702617723376.

Villagrana, Margarita. 2010. “Mental Health Services for Children and Youth in the Child Welfare System: A Focus on Caregivers as Aatekeepers.” Children and Youth Services Review 32, no. 5 (May): 691–7. https://doi.org/10.1016%2Fj.childyouth.2010.01.005.

Vogel, E.A., J.P. Rose, L.R. Roberts, and K. Eckles. 2014. “Social Comparison, Social Media, and Self-Esteem.” Psychology of Popular Media Culture 3, no. 4: 206. https://psycnet.apa.org/doi/10.1037/ppm0000047.

Wang, Philip S., Patricia A. Berglund, Mark Olfson, and Ronald C. Kessler. 2004. “Delays in Initial Treatment Contact After First Onset of a Mental Disorder.” Health Services Research 39, no. 2 (April): 393–416. https://doi.org/10.1111/j.1475-6773.2004.00234.x.

Wood, Jeffrey J., Sarah D. Lynne-Landsman, David A. Langer, Patricia A. Wood, Shaunna L. Clark, J. Mark Eddy, and Nick Ialongo. 2012. “School Attendance Problems and Youth Psychopathology: Structural Cross-Lagged Regression Models in Three Longitudinal Data Sets.” Child Development 83, no. 1 (January/February): 351–66. https://doi.org/10.1111/j.1467-8624.2011.01677.x.

 

 

This material may be quoted or reproduced without prior permission, provided appropriate credit is given to the author and Rice University’s Baker Institute for Public Policy. The views expressed herein are those of the individual author(s), and do not necessarily represent the views of Rice University’s Baker Institute for Public Policy.