Concerns grow as national, state suicide rates climb.
When screening patients, the pediatrician looks for a few general health indicators that could trigger potential future mental health concerns. Adequate sleep is one subject he frequently discusses with patients and parents. Youth require nine to 10 hours per night, he says. He’s shocked at how many kids are only getting five or six hours.
“There’s a huge sleep deficit … and the lack of sleep increases the risk of mental health disorders. Having electronic devices in a child's room contributes to sleep problems. We strongly recommend the removal of all technology from the kid’s room. Kids rooms should be tech free,” Dr. Rey-Rosa added.
Pediatricians like Dr. Rey-Rosa are on the front lines of the teen mental health problem. For them, visits that start as concerns about ear infections and tonsillitis can suddenly evolve into mental health discussions.
As part of a national effort to battle stigma associated with talking about mental health, Kaiser Permanente created the “Find Your Words” program.
Sometimes, family dynamics stand in the way of a teen asking for help. For example, it’s far too common today for family members to be engaged with their phones during meals. Even though everyone may be sitting together, this can further promote feelings of isolation. Many pre-teens and teens will speak to you while in the car, so not allowing phone use during car rides might increase communication.
Some parents may bristle or have difficulty with the idea of changing their own technology use, Dr. Rey-Rosa feels it’s his job to alert families of habits that may inadvertently affect teens at home. He also warns families who have guns in the home to either lock them up or remove them from the home completely, especially if a teen is depressed.
Teen depression and suicide is a growing national concern. According to the Substance Abuse and Mental Health Services Administration’s 2017 National Survey on Drug Use and Health, 13.3% of U.S. youth, ages 12 to 17, experienced a major depressive episode in 2017, compared to 12.8% in 2016. The National Institutes of Mental Health estimates that 3 million adolescents between the ages of 12 and 17 have had at least one major depressive episode.
problem hits home
Only 20 years ago, we were all sitting in that living room and we were talking. Over time that connection has been lost and we need to find a way to bring it back.
Today, Dr. Rey-Rosa — in keeping with Kaiser Permanente Northwest’s 360-degree approach to care — takes a proactive approach to the problem and sees himself as partner with mental health professionals in solving it. He starts by closely monitoring kids in those preteen years where more and more children are demonstrating irritability, aggressive behavior and inability to self regulate — all precursors to depression and rising teen suicide rates.
If you were to ask me about this subject 20 years ago, I’d say maybe 3% to 5% of the patients had mental health disorders or depression. Today, it’s 20% to 30%.
Even though it’s a touchy subject, we have an obligation to talk to our kids about depression and suicide.
By: Brian Sodoma, for Kaiser Permanente Northwest
With nearly two decades of experience as a practicing pediatrician in the Mid-Willamette Valley, Dr. Alvaro E. Rey-Rosa has seen one major change in his practice: an exponential rise in the number of teen depression and mental health issues.
“Based on extensive research, a depressed teen with a gun in the house or other access to firearms has a much higher chance of dying by suicide,” he said. “Most often, suicide is a behavior of impulsivity. Some families are attached to their firearms and will express their disagreement on this topic but I will still give the message because I want the best for their child.”
Think about it, when we were kids, if someone bullied you at school, you went home and you were safe. Today, someone bullies you and it doesn’t stop. With social media, it goes home with you because of your phone or another electronic device.
Getting one hour of exercise daily and practicing mindfulness
can also improve mental well-being he added. Many parents wonder what are some of the signs or symptoms of depression. Those include appetite changes such as overeating or skipping meals, difficulty sleeping or sleeping excessively, cutting or self-mutilation, changes in personality for more than 2 weeks and changes in school performance.
Finding answers to
a multi-factorial problem
“Find Your Words” invites people across the country to help reduce the stigma around depression and engage in a conversation in order to better understand and address mental health issues. In addition to pointing teens to resources in both English and Spanish, there are tips for starting conversations, how to help someone struggling with depression and a depression self-assessment tool.
Locally, Kaiser Permanente Northwest created anti-stigma cards to help groups start conversations about mental health, help lesson stigma and build a culture of acceptance.
Stigma is one issue, according to Dr. Rey-Rosa, but the physician also says today’s children are under different types of stress that their parents may not entirely understand. “There’s more stress and anxiety, and I think social media can be a huge contributor,” he said.
After seeing a decline in the 1990s, teen suicide rates have been on the rise since the mid-2000s, according to the Centers for Disease Control and Prevention. A 2017 report found the number of girls, ages 15 to 19, who committed suicide doubled to 5.1 per 100,000, between 2007 and 2015. For boys, the figure climbed by 30% to 14.2 per 100,000 in the same time period. Suicide is the third leading cause of death for 10 to 24-year-olds in the U.S., and in Oregon it is the second leading cause of death for the age group. Locally, five Salem-Keizer School District students took their lives between February 2018 and February 2019 alone.
Digging deep into Oregon’s teen mental health challenges
Based on recent recommendations by the American Academy of Pediatrics, we now screen for depression at a child’s 11- or 12-year-old check-up.
Creative expression can actually help teens dealing with depression. Through a partnership with Bridgeway Recovery Services in Salem, one 17-year-old Kaiser Permanente member, Drew McMains, recorded a song to describe his feelings about battling substance abuse. He entered the song into a contest and won a trip to the Grammys.
“For me, writing lyrics about the things I’ve been through helps me let it go,” he told a Kaiser Permanente interviewer, “like opening a jar of pressurized air and letting it all out.”
To Dr. Rey-Rosa, who has been called upon to speak at local schools about mental health issues, we owe it to the teens in our community to create environments where frank talk about mental health is not taboo.
Kaiser Permanente Northwest serves the Mid-Willamette Valley with comprehensive medical, specialty and dental care services. For more information visit kp.org/northwest.
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