Quick Take:

Young people are experiencing an alarming increase in mental health challenges, the U.S. surgeon general has said. Here’s what you should know.

U.S. Surgeon General Vivek H. Murthy issued a public health advisory last week on what he called an alarming increase among young people reporting certain “mental health challenges,” a surge that was exacerbated by the pandemic.

Whitney Brammer, clinical psychologist for the division of adolescent and young adult medicine at Children’s Hospital Los Angeles, said it was reassuring to see the surgeon general’s warning to promote more awareness of this issue. “As a psychologist here at the Children’s Hospital,” Brammer said, “we’ve been seeing such a heightened need for behavioral health sufferers, especially with our teens and young adults.”

It’s important for parents, she said, to learn what warning signs to look for in their kids and how to reach out for additional support. Here are some suggestions offered by mental health experts.

Warning signs

David W. Bond, director of behavioral health for Blue Shield of California, cautioned parents against trying to diagnose their child by themselves or with the assistance of the internet. Nevertheless, some behavioral shifts can raise red flags that should prompt a parent to seek help.

Experts interviewed by The Times, including school social workers and counselors, listed a number of behavioral and emotional changes that, if sustained, could be a sign of a more serious problem:

  • An increase in truancy, tardiness or resistance to going to school.
  • A sharp change in focus or difficulty concentrating, a lack of motivation, or falling grades.
  • Feeling anxious, sad or low all the time, or frequent mood swings.
  • Withdrawing from friends.
  • Indications of self-harm.
  • Frequent nightmares and sleep disturbances, whether it be sleeping too much or not sleeping enough.
  • Changes in eating habits.
  • Sharp changes in social media habits.
  • Peer conflict.
  • Physical symptoms, including frequent headaches, stomach aches or body aches.

Alma Lopez, the school counselor coordinator at Livingston Unified School District and a counselor at Livingston Middle School, said the telltale signs in younger children tend to be changes in behavior, because they often can’t verbalize what they’re feeling yet. As kids age, she said, the emotional issues become more apparent.
When parents come to her for advice, she said, “I tell them, ‘You are the expert. You know your child…. If it doesn’t feel normal, let’s ask a few questions.”

Bond offered four questions to ask when trying to decipher whether a child is going through a typical adolescent issue or something more serious:

  1. When did it start?
  2. Was there an event or something that caused the change?
  3. What’s the frequency of the behavior?
  4. What’s the intensity of the behavior?

Bond said a child can feel stressed or sad from a breakup or a challenging test at school — that’s normal. But there may be a number of other forces layered on top of that, Bond said, including the pandemic, injustices, racial and cultural issues and LGBTQ-related stress.
It can be hard to discern between the normal and abnormal in a developing young person. But if a teen has intense feelings that last more than two weeks or has the intense feelings for most of a two-week period, that’s a sign of something more serious afoot.

When the conversation begins, Bond said, parents should stop talking and listen. Many parents make the mistake of asking questions that suggest the response the parent is looking for, he said — for example, “Are you struggling with depression?” or “Do you feel this way?” What parents should do is keep themselves open to whatever the child might have to say.

If you reach out to your teen and they brush off the subject or don’t want to talk about it, Bond said, try again at another time but don’t force the conversation. But he added, “Sometimes you’re not the right person for them to talk to, even though they’re your child and you might feel left out or even hurt.”

In that case, Bond said, a parent should find someone who has an influential presence in their teen’s life, such as an uncle or an adult at school or church.

“If your [teen] is having active thoughts of harming themselves or suicide, calmly dive into that right away,” Bond added. “We don’t want that to go on.”

What help is available at your child’s school

Although the resources vary from district to district, parents looking for help can find it at their local school. Most campuses have at least one person with mental-health training — a counselor, a psychologist, a social worker or a nurse — and your child’s teacher can point you to the right person.

A handful of LA schools have programs that monitor every student’s situation on a daily basis, which helps them identify potential emotional or behavioral problems at a very early stage, said Loretta Whitson, executive director of the California Assn. of School Counselors. But this is not common.

Typically, the responsibility falls on parents to bring problems to the school’s attention. “My advice to parents is, don’t be passive,” she said.

In addition to plugging the child into the programs the school provides, Lezya Weglarz, vice-chair of the California Assn. of School Counselors, said counselors can connect families with services outside of school. “We’re happy to walk a family through the steps needed to get that support,” she said. “We help families navigate those conversations, even with a child’s pediatrician.”

Paul Brazzel, president of the California Assn. of School Social Workers, suggested that parents ask for a meeting at their child’s school. Typically, he said, schools will set up a “student success team” meeting for the parents (and the child, if developmentally appropriate) with teachers and the school social workers or counselor to discuss the child’s background and strengths, then build a plan to address the family’s concerns. “That’s a really nice place for families to start that process,” Brazzel said. It can document the issues, hold people accountable, and identify the resources available to help.