31 December 2022

Youth Mental Health Crisis - A Parent's Survival Guide


It has long been known that New Zealand has the worst youth suicide rate of all 41 OECD nations - here in Godzone our young people are struggling. The pandemic has surely made things worse - isolation, disruption to lives, friendships, sports, and the added pressure of trying to learn online has heaped extra weight on our kids. So many young people are battling with hopelessness, overwhelm, suicidal thoughts, self-harm, depression and major anxiety. 

Having a child who is struggling with their mental health, watching your precious kid in intense emotional and mental pain is surely one of the worst things a parent can go through. Knowing how to respond, how to help and support them through it can be a confusing and lonely struggle. (Sadly, there is still so much stigma around mental illness, and it can be hard to reach out for help).

I am writing this from the trenches, for fellow parents of young people who are struggling. For the past four years, this has been my battle too. And now finally, I can see clear water ahead, and feel like I can share what I've learned.


I am not writing as any kind of clinical expert - but I have lived experience, I have tried all the things, and I have learned some keys along the way. 

Getting our heads around what it is

Sometimes as parents we can mistake genuine mental health struggles for adolescent moodiness. It's easy to read lack of motivation, loss of interest in favourite activities and opting out of life as laziness, but in many cases, these are some of the first signs that our kids are struggling.

What causes it? There's no one thing that triggers a mental health slide; it's usually a combination of:

  • mental overwhelm
  • emotional trauma
  • battles with self-esteem, body image, social issues, identity
  • a feeling of hopelessness and believing that things won't change
  • a loss of control over their lives - feeling backed into a corner

Our kids who are neuro-divergent seem to be more at-risk than others, and kids who have experienced significant or prolonged trauma (e.g. abuse, family violence, bullying) are even more at-risk.

Some kids are expert at masking their mental health struggles in front of peers and teachers, but let it all out at home. 

One of my kids did this for nearly two years, which we now refer to as "white-knuckling it". Nobody had a clue they were struggling; at school, they were the life of the party. At home they were withdrawn, moody, their emotions on a hair trigger. I thought it was just an unpleasant case of puberty blues and didn't read the signs right. Until one day they called me from a school bathroom in the middle of a panic attack and asked me to come get them. On the car ride home, they admitted that they'd been struggling for ages and had self-diagnosed using the depression.org.nz quiz as having depression and anxiety. On New Year's Eve 2019 they attempted to take their life - "I just can't take another year doing it all over again mum. I just don't have it in me..." 

White-knuckling it for nearly two years had burnt up all their inner resources and so began a three-year battle to keep this kid alive.

I missed the signs. You might have missed the signs. So here they are.

The Signs (from Suicide Prevention Website):

  • Lack of energy and/or motivation
  • Temper outbursts and/or violent episodes
  • Easily irritated
  • Sleeping too little or too much
  • Little or no appetite, or eating too often
  • Withdrawal from friends and family
  • Loss of interest in activities usually enjoyed (including school activities)
  • Feelings of fear (even if there is no conscious reason)
  • Feelings of extreme guilt or shame
  • Sadness (with or without crying)
  • Anxiety
  • Inability to concentrate
  • Poor memory
  • Increased use of alcohol or drugs (self medicating)
  • Worsening grades
  • Skipping school or classes
  • Self-critical remarks
  • Feelings of helplessness to change a situation*
  • Feelings that things will never get better*
  • Comment(s) about death or dying*
  • Writing, drawing, or listening to music about hopelessness or death*
  • Threatening suicide (even in a joking manner)*

When 4 or more of the above are observed or suspected for more than 2 weeks take action.

*Any time one or more of the last 5 signs or symptoms are seen or suspected, immediate attention is necessary

Source

Navigating the overloaded Mental Health System 

Our mental health services are overloaded in this mental health epidemic; it was inadequate and underfunded to begin with and even though the Government promised $1.2 billion towards mental health, none of that money seems to have made any difference so far.

Medication:

When you are struggling with significant depression and/or anxiety, appropriate medication helps an awful lot, to stabilise/even you out. I know lots of people are against medicating kids, but for me, the first priority is "keep my kid alive". When medication works, it makes a huge difference - the way putting a cast on a broken leg holds the bones straight so the body can heal itself. Medication helps hold the thoughts straight so things like counselling and other tools can do their work. But getting access to it for teenagers is tricky. If kids are under 18, they have to be seen by a Psychiatrist to be prescribed medication.

Accessing Mental Health Support:

The usual way to access Mental Health services is through your GP. Once you become aware your kid is struggling, take them to your doctor who will make a referral. The good thing about the public service is that it's completely free. The bad thing is that the system is overloaded.

Waiting lists for public mental health services are ridiculously long, and unless they deem your kid at imminent risk, you'll probably have to wait for months to even be assessed. If you're rich (or know someone who is) you can alternatively pay megabucks to see a private psychiatrist, but even then there is a waiting list due to the current mental health crisis.  

I have navigated public mental health services for two of my children on multiple occasions and I have learned that when your kid is in crisis (self-harming/suicidal threats) you can access help most quickly by:

  • turning up at the emergency room with them
  • calling the Mental Health crisis team in your area (google the number) and telling them all the scary things they are saying (if it's concerning enough they will expedite an assessment)
  • calling the Police (111) i.e. if they have barricaded themselves in their room and you have concerns for their safety. Our NZ Police are actually amazing at de-escalating situations and are trained for this stuff. If you're worried, call them. They can also expedite a referral in the system and help get your kid seen a bit faster (depending on the risk level).

I have had to do all these things to try and get help, with mixed results. The quality of care in the public health system depends on who you get - there are some dinosaurs in the system who are burnt out and lack empathy; there are also some wonderful people who genuinely care.

The worst one was the public psychiatrist who told one of my kids, "Well, we've tried all the medications we have available for you, and since nothing seems to help, I recommend just getting on with it and living your life the best you can." To a suicidal teenager. Thanks for giving them hope, Doc.

In the end, dad offered to pay for a private psychiatrist, who gave an accurate diagnosis and put them on the right medication. That was the beginning of things starting to improve for that child.

Counselling:

Finding someone your kid can talk to definitely needs to be part of the healing process. This is probably best to come later once they are stable. There are many different services out there, but sometimes it's hard to know where to begin to find a good counsellor, and counselling is expensive. 

Each of my kids have benefited from the amazing I Am Hope free counselling service funded by Gumboot Friday. This genius service is provided free for anyone under 25. You choose from the hundreds of registered counsellors by reading the bios on the website and make contact with the one you like the look of directly through the enquiry form. Within a day or two your kid will be talking to a counsellor - Gumboot Friday picks up the bill for the first three sessions. You can apply to WINZ for financial assistance with counselling costs in the meantime.


What We Can Do as Parents

I remember the moment that I realised it was up to me to keep my kid alive, the system didn't have any answers for us. It was scary. I was on suicide watch, and the best advice the helpful people at the Mental Health Service gave me was "hide all the sharp things" and keep a close eye on my kid. It was a dark, scary moment.

How do I get my kid to want to stick around? If they are determined to end it, they will bide their time and find a way. So the trick is to help them see life as something they want to live. That became my goal. 

1. Adjust our own attitudes

As parents we naturally have high hopes for our kids. When we held our newborns we dreamt all the possibilities - there were no limits to what this little bundle could do one day, and surely, with our encouragement and support they would succeed in life because we were going to get it right as parents. All the things our parents didn't do for us? We were going to do all those things. Our kid was never going to end up in therapy talking about how we messed them up - right?

And now we are here with a child who is struggling in the worst possible way. We might be blaming ourselves and beating. ourselves up - where did we go wrong?

We might be blaming others - their other parent, their teachers, the bullies at their school.

We might be secretly blaming them - what is so defective in them that they feel this way? Why aren't they coping with school/life? (Can't they just toughen up?)

Blame has no place here. It's not about whose fault it is, blaming is not going to help you or them.

We might also be struggling with internalised stigma around mental illness. We might be feeling shame, embarrassment, fear of others' judgement. We need to realise that there is no shame. And others' opinions and judgements don't matter one bit.

We need to silence all these negative internal voices, tell them to shut up and go away (as many times as necessary). Because this is a battle for the very life of our child, and as their parent we CAN make a huge difference in how this turns out.

We are not experts, clinicians or psychiatrists, but we are uniquely placed to be the one that never gives up on our kid, even - especially - when they have given up on themselves.

We have to focus on THIS battle for the life of our kid, not waste our energy battling those unimportant things.

We need to realise that we are not alone in this struggle - there is no shame in it. So many other parents are also fighting this same fight for their kids. And feeling just as alone. We need to find them. You probably already know a bunch of them, but just don't realise you're in the same fight. 

So silence shame, silence blame. Find allies, arm yourself with knowledge, join online support groups, become the squeaky wheel that gets the oil, become the advocate for your kid, the parent that annoys the mental health service until you have knocked on every door to get the resources and support you need to stay strong and be there to fight for your kid. You can do this.

2. Remove the pressure

This is the big one - mental/emotional overwhelm and a feeling of hopelessness is huge in this scenario. The treadmill of school, study, exams and expectations can be a significant stressor and the worry of "what am I going to do with my life" can be a very big weight our kids carry. 

As parents, we need to remove the expectations for our kids to stay on a pathway to a life they don't want to live, that feels impossible to them. The most important thing is that they are alive and that they want to live. 

Opting out of "normal" school might feel (to both them and you) that it's copping out or failure. But by prioritising their mental health, and giving them the mental breathing room to get well, you will increase their ability to bounce back quicker. There are other options and other pathways for the kid battling anxiety, panic attacks and major depression, who can't cope in the school environment. There are pathways like Correspondence Schooling (100% free entry for students over 16), free youth courses (in smaller learning environments, once they are better) and bridging courses to University if they decide that is what they want to do later on. 

Put the reins in their hands - let them know that we support them in designing the kind of life they want to live. They don't have to follow a prescribed path. The most important thing right now is that they get their joy in life back. I've done this with both of my older kids in different ways. 


My Experience:

One kid managed to get Level 2 NCEA before the mental health crisis (and the lockdowns) derailed them. One of the things that anchored this kid was their sport, so they stayed in school to play sport and be with friends, but the pressure of trying to get Level 3 was taken off them. Since then, they have worked a number of jobs before finally settling on a career path and enrolling in a sports training programme. But the most important thing is that they have built up their inner resources, gained tools for coping with their anxiety and are now able to go out and live their life, and bounce back from difficulties. 

The other kid couldn't cope with school at all; the noise, the crowd of 3000 teenagers, the overstimulation caused massive panic attacks whenever they attempted to re-enter. We ended up putting schooling on the back burner until the major depressive disorder, social anxiety and generalised anxiety disorders were under control, but they did take up their favourite childhood sport again, and this helped build confidence, give them a goal and an outlet, and increase social contact at a manageable level.

Eventually they completed a youth training course and gained enough Level 2 credits for NCEA. As their confidence and coping skills built, they were able to take on a part-time job. They are now not just competing but coaching in their sport, and working part-time. They have a great work-life balance, and the tools and inner resources to cope with setbacks and manage their anxiety without white-knuckling it. 

Both kids still deal with anxiety on a daily basis but they have a life they want to live and the tools to live it. 


3. Help them find an anchor

Having something or someone worth sticking around for is a critical part of helping our kids find reasons to live. I know this to be true in my own case - when I was struggling with my own mental health battle, it was my kids that kept me here.

Knowing this, I wanted to give my struggling kid something similar, so I got them a puppy of their own. This puppy became my child's anchor. An endless source of laughter, unconditional love and a distraction from spiralling thoughts. The puppy was depending on my child to walk her, bath her, feed her. Later on, my child told me that the puppy helped them get through that endless lockdown in 2021. "Without her, mum, I don't know if I would have survived it..."

A puppy isn't the answer for everyone - although it is proven that animals have a wonderfully therapeutic effect; snuggling them lowers the heart rate in people with anxiety. 

Whatever might be an anchor for your kid - a sport, a hobby, a friendship, a travel goal - encourage and support that thing whatever it is. 

I can't recommend sport enough - if your child loved sport but lost interest, try to encourage them to take it up again. Sport has so so many benefits:

  • physical activity releases endorphins and helps with mood
  • team sport provides positive social contact, reducing isolation
  •  sport provides structure & purpose e.g. regular training sessions, team games which give them something simple to aim for.


4. Look back

If you've ever climbed a hill, you might know that moment when you feel like you can't take another step. You've been sloggin away, one foot in front of another and you still aren't at the top. Everything aches, your heart is racing, breath ragged - you're done in. And then you pause to catch your breath, and look back at how far you've actually climbed - wow! Look at the view! You're higher up than you realised! Motivation renewed, you find you can carry on after all.

Looking back at how far we've come is really helpful on this journey - regularly reminding our kids of the progress they've made. They can be so hard on themselves, lacking the resilience to bounce back from disappointments, so taking stock/looking back at our progress is something I do regularly with my kids. When they are bemoaning their current struggles I point out to them the things they are now doing that they once considered too hard.
We remember back to this time last year when they had never had a job, thought they'd never get their license, hadn't successfully navigated public transport etc. We reflect on all the progress, big and small, and wow, does it lift their spirits, every time. 
These types of conversations now happen frequently - "looking back" is in our toolkit.

Keep in Mind

  1. This can be a long haul - three steps forward two steps back
  2. One good day doesn't mean we are out of the woods yet; one bad day doesn't mean we're back where we started
  3. Eventually the good days will string together and the bad days will be less frequent
  4. This is probably the hardest thing you've ever done
  5. You need support, laughter, friends, prayers, encouragement to keep going - look after yourself and reach out for help
There is honestly so much more to say and this post is already waaay too long. Most of all what I want to leave with you is that there is hope. And that we as parents can be part of the answer. If we adjust our expectations, love our kids relentlessly and refuse to give up on them.

They might be thoroughly unlikeable for a while. You might wake up every morning with a sick knot of dread in your gut. 

Hang in there. Hold on to HOPE. 
When our kids have no hope for their future, we must hold it for them. When our kids can't see things improving or imagine themselves happy again, we have to see it for them. Speak words of life over them, to them and about them. Remind them how far they've come - they are still here and you are with them.

Kia Kaha.



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