It is hard to talk about mental health problems when everyone, no matter what their situation, is struggling with the challenges caused by the coronavirus. It is an exceptionally hard time for us all. Everyone will experience anxiety and stress as a result of these circumstances.
For young people there are particular issues that they are having to face. There is a huge amount of loss. This is partly because the normal structure of their lives has disappeared. But also because many of the opportunities and good things that they might have expected this Easter and this summer have simply been swept away.
It is not surprising that some young people feel cheated and angry. It is difficult to know what to do with such feelings. For a small number of teenagers these feelings will be expressed in behaviour that is worrying for those around them, especially their parents.
If you have a teenage son or daughter who is experiencing mental health problems, it may be difficult to get help in the normal way. Clinics are under huge pressure, and people in the helping professions are having to work extra hard to provide assistance to their clients.
I have heard of a number of young people who are really struggling at this time. I will just highlight a few of the situations that have come to my notice.
Here they are:
- A 16 year-old girl who cannot stop crying. She cannot say why this is happening to her.
- A 15 year-old boy who vandalized a neighbour’s car, something that he has never done before. All he can say is that he feels angry with the world.
- A 17 year-old girl who has started cutting herself. She says she hates herself.
- A 17 year-old boy who has gone to bed, and won’t get up and won’t talk to anyone.
- A 14 year-old girl whose anorexia has got worse since the virus appeared. She says she needs to take control of her life as everything else is out of control.
It is very hard for parents
The suggestions I make here will not be easy. One of the key challenges for parents who are at home with their teenager will be to find a way of managing their own anxiety. The more anxious you are as a parent, the harder it will be for the young person to accept any help or support.
There is a reason for this. We know that young people worry about the effect of their distress on their parents. In most cases they want to be able to protect their parents, no matter how troubled they are themselves. They also go through a stage when they want to keep things to themselves. This is a normal part of teenage development.
Parents will be more able to provide help if they show that their anxiety is under control. It is so important to try and take a neutral position, as far as this is possible.
So here are some suggestions.
Acknowledging their distress
Find a way of letting your teenager know that you are aware of their distress, and that you want to help. However, it is important to avoid any words that can add to the teenager’s sense of guilt.
It is also important to avoid any wording that implies that you understand how they are feeling. Teenagers hate that, as they say it is patronizing. The usual response is: “You can’t understand me”.
So, what words to use?. “My heart goes out to you”. “I feel so sympathetic”. “I can see this is very hard for you”. “I want to help, if I can”.
Reassurance
This is about letting the young person know that you won’t be shocked, frightened or damaged by their thoughts and feelings. One of the fears that young people may struggle with is the idea that their problems will have a terrible effect on you, the parent.
Somehow you have to find a way of letting the teenager know that, however shameful or frightening their thoughts, you are strong enough to cope. However bad it is, you can bear it, and you will try and help.
Being there for them
Another important message is that you will be there for them. They need to know that you love them, and that no matter what happens, you will do your very utmost to help. Teenagers need to know that you will stick with them, and you won’t reject them because of their distress.
If is possible, think about actions that will let the young person know you are wanting to offer support. Could you make their favorite food?. Could you give them more responsibility in the home?. Could you get out old family photos to emphasize good experiences that you have had in the past?. Could you play games with them that they would enjoy?. Being available is the most important message.
Things it is best not to say
If at all possible, try to avoid begging or pleading with the young person. Try not to lecture. Try not to criticize. Try not to judge the teenager’s behavior.
Why do I say this?
Because all these approaches represent your views, and your agenda. At this time the teenager cannot cope with your agenda. The only way to open up communication is to find a way into their own agenda. And to show that you will be really, really listening to them.
Of course, this is not to say they will talk. But you can be sure they won’t talk if you plead, judge or criticize.
The role of the school
Although schools are closed at this time, many parents will have a contact within the school system who may be able to give advice. This may be a Head of Year, a pastoral lead, or a Head of Well Being. Schools vary in their support structures, but most will have some way of providing a link to helping services. Some may also offer telephone guidance for parents on the best steps to take if one of their students is showing mental health problems.
The very worst thoughts
The possibility of suicide is the worst fear of any parent. There are many myths about what to do and what not to do if you worry about this. It is also of course incredibly hard for any parent to open up this topic.
However, there are ways of showing that you won’t be shocked, and of showing that there are ways to get help if this is something the young person is struggling with. You might say something like:.
“I know people who are in distress sometimes do think about death, about ending it all. If you do. have thoughts like that, there are people you can talk to. You may not be able to talk to me, but there are others who will listen and try to help you”.
This does two things. It acknowledges the distress. It also shows that you are not frightened by the distress the young person is experiencing.
What next?
You will notice I have mentioned talking a lot. Since it may be difficult to get professional help at this time, finding a way to encourage your teenager to talk is something you may want to try.
The first thing to note is that they may not be able, or not want, to talk to you. However, if they can do so, that will be a good thing. So, you can try, and keep trying. If the first or second attempt does not work, just make it clear that you are always going to be available to listen.
Here are some things you might want to say.
“However hard it is, talking about your thoughts and feelings will help you.”. “ I know it’s difficult, but it is worth having a go”. “Putting your thoughts and feelings into words really will help you.”. “You may feel ashamed, or worried about talking.”. “It may be hard for you to talk to me, but perhaps we can find someone else you can talk to.”
If they can’t talk, don’t want to talk, or say it is a waste of time
If this is the case, here are some other options.
Perhaps your teenager might be able to send you a text or email?. Or message you in some way about their feelings?
If this is not appropriate, you might want to suggest simply writing down thoughts or feelings. This might be a good start. Sometimes it is helpful to get ideas out of your head and onto a piece of paper.
If none of that is possible another option is to try and find someone in your family network who might be a possible listener. If there is no one like that, then perhaps someone who is known to the young person in your social network.
What to say when you don’t know what to say
Because of the situation we are all in, it may be hard to know what to say when your teenager is clearly distressed. Keep in mind that you don’t have to say anything. In a difficult situation we often feel that we have to say something, we have to respond. In fact, just being there, being available to listen may be all that is needed.
What services are available?
If none of the above is appropriate then there are helplines and on-line resources that might be a possible route for seeking help. There are also apps that young people can download on to their phones that provide guidance about managing things like depression or anxiety. There is a list of sources of help at the end of this blog (see Appendix 1). If your teenager is taking medication and you need advice about this, your GP should be available on the phone or on-line.
Another option to encourage communication between you and your teenager
At the end of this blog I have included a very short quiz. This does not address mental health problems, but it does ask some questions on young people’s feelings about the virus and about their present situation. It may be possible to start a conversation with your teenager through the use of the quiz. (see Appendix 2).
Social media
There has been a lot of publicity about the negative effects of certain websites on the mental health of teenagers. Fears have been expressed that some sites encourage harmful behavior such as self-harm or anorexia. However, there is another side to this. Research has shown that, for some, the on-line world does provide support and reassurance. This is not true for everyone. But there are certainly those for whom social media enables them to get in touch with others who are helpful to them. The lesson for parents is that not all social media is harmful. If at all possible, try and keep an eye on what your teenager is doing on-line. Don’t be afraid to ask about this. The more you can keep the conversation going about what your teenager is doing on-line the better.
Getting help for yourself
The situations I am imagining here will be extraordinarily stressful for any parent to manage. So, it is important to think about getting support yourself. This will be good for you, and will of course enable you to provide more help for your teenager. There are a number of organizations now that offer support for parents in your situation. Some are virtual support groups through platforms such as Facebook. Others provide helplines and chat rooms. A list of these can be found at the end of this blog (Appendix 1).
Talking and listening might not be enough
This will depend on the nature of the distress that is being experienced by the young person. For some circumstances talking will not be enough. You may want to know how to manage behavior that appears destructive or damaging to other people.
Firstly, it is essential for you to be able to set boundaries in relation to behavior that is harmful to your teenager or to others in the family. If you believe these boundaries are being crossed then you must act. This is the time to seek help from the emergency services. You can also call the helplines detailed at the end of the blog.
Secondly, there may be things you can do to keep people in the family safe. Identify any potentially harmful substances in the house, or any knives or weapons. Give some thought to the domestic arrangements around you. Ask yourself if there are things you can do to reduce the risk of harm to any members of your family.
HELPFUL RESOURCES
There are many helping organisations which offer support to parents and teenagers. I will select three for teenagers and three for parents here.
For teenagers
The Mix. Essential support for under 25s. This provides support through many media, including group chat, discussion boards and so on. Telephone 0808 800 4994. www.themix.org.uk
Shout. Again, providing support in many different formats. Text Shout to 85258 or email info@giveusashout.org
Childline. The most well- known support organization for young people. Telephone 0800 1111.
For parents
Family Lives. Provides a comprehensive range of support services, including an informative website. Telephone 0808 800 2222. www.familylives.org.uk
Rollercoaster Family Support. A specialized organization which provides support for parents who have teenage sons or daughters with mental health problems. Telephone 0741 538 0040.
Young Minds. A mental health charity having a specialized helpline for parents. 0808 802 5544. www.youngminds.org.uk
THE QUIZ (a tool to get you talking)
For teenagers – complete this by circling a number that represents your feelings. Share the reasons for your answers with someone in the family who you are able to talk to.
I FEEL SCARED ABOUT THE VIRUS. . (1 = I feel very scared, 5 = not scared at all)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .
I HAVE LOTS TO DO NOW I AM AT HOME. (1 = I have lots to do, 5 = nothing to do)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .
I FEEL ANGRY ABOUT WHAT HAS HAPPENED (1. = I feel very angry, 5 = not angry at all)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .
I THINK THERE IS MORE I COULD DO TO HELP MY FAMILY. (1 = there is more that I could do, 5 = I am doing all I can)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .
I FEEL CHEATED BECAUSE OF THE VIRUS. (1. = I feel cheated, 5 = not cheated)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .
I FEEL CLOSER TO MY FRIENDS NOW. (1 = I feel closer to my friends, 5 = not as close to my friends)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .
I WORRY ABOUT MY FAMILY BECAUSE OF THE VIRUS. (1 = I worry a lot, 5= I do not worry about my family)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .
I FEEL LONELY NOW THAT I HAVE TO BE AT HOME. (1 = I am lonely, 5 = I am not at all lonely)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .
I AM ANXIOUS ABOUT WHAT THE FUTURE HOLDS FOR ME AFTER THIS VIRUS IS OVER. (1. = I am really anxious about the future, 5 = I am not at all anxious)
1 . . . . . . . . . . 2 . . . . . . . . . . 3 . . . . . . . . . . 4 . . . . . . . . . . 5 . . . . . . . . . .