Hospital admissions for #teenage #girls who may have attempted #suicide have increased 50% nationwide. Texas does not have sufficient #mentalhealthresources to help them.

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BY ELEANOR KLIBANOFF

For 24/7 #mentalhealthsupport in English or Spanish, call the #SubstanceAbuseandMentalHealthServicesAdministration’s free help line at 800-662-4357. You can also reach a trained crisis #counselor through the #NationalSuicidePreventionLifeline by calling 800-273-8255 or texting 741741.

Growing up, Charley Tennen was rarely alone. The youngest of seven #kids in a loud, busy house in El Paso, she was always out at a party, shopping with friends or organizing a road trip.

Even after she was diagnosed with a chronic illness and had a feeding tube inserted, she kept her bubbly personality, her mother, Michelle, said.

But when #COVID-19 hit Texas in March 2020, all of that suddenly went away. Charley went from attending #school with a few thousand #students to sitting alone in her bedroom, doing virtual classes. She and other family members were immunocompromised, so they fully isolated themselves, terrified of getting sick.

Then, in April 2020, Charley’s beloved father died unexpectedly from complications of a chronic illness.

“She was so isolated, she had nowhere to turn,” said Michelle. “She told me every single day, ‘I want to die. I want to be with daddy. I don’t know what’s on the other side, but at least I won’t be in pain.’”

Michelle leapt into action. She got Charley a #psychologist. They created a safety plan. She found an inpatient treatment facility with open beds. She kept Charley in her sights constantly, even sleeping with her at night. She asked #teachers, #doctors, #family, #friends and — after Charley attempted #suicide the first time — even the #police for help.

“I could barely get through each minute. I was petrified,” said Michelle. “You can’t pin yourself to somebody 24 hours a day, but I really tried.”

Despite her mother’s tireless efforts, on the night of July 4, 2020, Charley Tennen died by #suicide. She was 17 years old. Michelle held her second virtual funeral in three months.

“Losing , I thought would be the hardest thing I’d ever go through,” she said. “But burying my baby girl — there are no words for burying a #child. And a #child that should still be here. This never should have happened.”

The riptide of despair that caught Charley Tennen and carried her away from her family is only strengthening as the #pandemic enters its third year.

Across the country, #teenage #girls are attempting to end their own lives at staggering rates, driving a 50% increase in #girls being admitted to the hospital for suspected #suicideattempts between early 2019 and 2021.

Although #teenage #boys remain more likely to die by #suicide, #teenage #girls are more likely to attempt it.

The surge in extreme #mentaldistress has left #parents, #schools and #healthcareproviders scrambling to get urgently needed help from a broken #mentalhealthcaresystem.

And it’s an indicator that there’s a much bigger crisis looming as the #pandemic drags on.

“For most #kids, you’re not going to see #suicidalideation or #suicideattempts,” said Kim Roaten, a psychiatry professor at the University of Texas Southwestern Medical Center. “Instead, you're going to see withdrawing from #friends or dropping grades or more argumentative at home, things like that. What we want, ideally, is to prevent the escalation.”

#Pandemic increased #isolation, #grief

Michelle Tennen had raised six other #children. She knew how to navigate the minefield of #adolescence. But nothing prepared her for helping a grieving #teen through a #pandemic.

“It’s just so hard to be a #teen #girl at any time,” said Michelle. “But to then be isolated and going through a #pandemic, too. It’s the #isolation, in my daughter’s case, that was the big problem.”

Charley would sit in her room, looking at the same four walls or mindlessly scrolling through her phone. Michelle would encourage her to call friends.

“She’d say, ‘No, I don’t want to talk to them,’ or ‘They don’t want to talk to me,’” she said. “As the months went on with the #pandemic, you could see the change in her and how much more isolated she got.”

Even before the #pandemic, researchers were documenting alarming increases in #anxiety, #depression and other #mentalhealthconcerns among #teenagers. There are some positive trends — young people appear more open to discussing their #mentalhealth than previous generations.

But it’s also just hard to be a #teenager today, with increased internet access, academic pressure, limited access to #mentalhealthservices and economic and social stressors.

During the #pandemic, #teens had to navigate those challenges amid increases in #isolation, screen time, #grief, caregiving responsibilities, economic insecurity and #school interruptions.

Molly Lopez, the director of the Texas Institute for Excellence in #MentalHealth at the University of Texas at Austin, recently convened a focus group of #teenagers to talk about #mentalhealthconcerns. She said they all shared the difficulty of focusing on #school work and normal milestones when they, their families and their communities were experiencing so much #stress.

“They were really struggling with feeling like their #teachers didn’t understand what they were going through,” she said. “We’re using the same playbook as before the #pandemic, with the same expectations.”

#Schools are also having to help #students navigate #grief, as many have lost loved ones to #COVID. One in 450 #children in the #UnitedStates had lost a #parent or #caregiver to #COVID, as of November 2021, according to researchers at the University of Pennsylvania.

All of these factors have created a “stressor storm” for #teenagers, especially as #schools return to in-person learning, Lopez said.

“Some #kids may act on those challenges in ways that are hurtful, so you may see more violence or interpersonal problems,” Lopez said. “Then, some #students who are at risk for #suicidalthoughts, that increases their risk.”

Lopez said, ideally, #schools would have a three-tier system for helping #students with #mentalhealthissues. They’d have resources to help all #students talk about and improve their #mentalhealth; they’d have systems in place to identify and intervene early if #students start showing signs of #mentaldistress; and they’d be prepared to handle #students who are actively in crisis.

While #school districts have been investing more in building these systems in recent years, the #pandemic made all of that much more difficult at a time when the need has only escalated.

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Challenges to getting help

Michelle Tennen knew that Charley was struggling with #isolation and #grief. But it wasn’t until she saw, through a shared iCloud account, that her daughter was looking at photos of coffins online that she realized how serious things had become.

Charley began speaking very openly about her desire to kill herself, shocking her mother. But Michelle was just as shocked by how difficult it was to find help for her daughter.

“I did not stop trying to get help from her until the day she died, and I could not get help,” said Michelle. “It’s unbelievable that in a country like this … the #mentalhealthsystem is in the shape that it is.”

Michelle said she heard time and again from #doctors, treatment facilities and even the #police that Charley didn’t “seem suicidal.” When she met with #doctors, #therapists or treatment facilities, Charley would deny being suicidal to avoid being admitted. One psychiatric hospital where Michelle tried to get Charley admitted said they could only keep her for 72 hours without her consent.

“I was very worried that I would take Charley to the psychiatric hospital, they’d release her after 72 hours, and then I’d be in a worse position because she’d want to die and be mad at me,” Michelle said. “I didn’t want to give her any ammunition.”

Michelle thinks a lot about how difficult it was seeking treatment for a #teenager actively expressing #suicidalideation — and what that means for #teenagers who need help before they even get to that stage.

In Texas, nearly three-quarters of #teens experiencing serious #depression do not receive any #mentalhealthtreatment, according to a report from #MentalHealth America. Texas ranks last among the states in access to #mentalhealthservices.

Statewide, there is a significant shortage of #mentalhealthresources — inpatient beds, outpatient treatment spots and #mentalhealthproviders. Every county is served by a local #behavioral health authority that can help people in immediate crisis, but ideally, #teenagers would get help well before that point.

“In a crisis situation, help is available, no matter where you are in the state,” said Greg Hansch, the executive director of the Texas chapter of the #NationalAllianceonMentalHealth, in a December interview. “But the ongoing, robust services that so many people need and will need in the days to come are spotty across the state. We need ongoing efforts to address that shortfall in capacity.”

Unless the #mentalhealthsystem scales up significantly, #teenagers are going to fall through the cracks with tragic consequences. A 2021 advisory from the U.S. Surgeon General warned that it would be “a tragedy if we beat back one public health crisis only to allow another to grow in its place.”

There are some bright spots: The #pandemic has helped usher in a new era of telehealth, increasing #mentalhealthresources in many underserved communities, and some researchers hope that the increase in emergency room visits for #suicideattempts may be driven, in part, by greater awareness among #parents.

“#Kids are constantly with their #parents right now, particularly when we were in the virtual period,” said Roaten. “It may be that there have been more conversations between #adolescents and their #parents about distress and #mentalhealth.”

Having the tough conversations

Experts agree that the best thing #parents can do if they are worried about their #teen is to have the conversation, early and often.

“I think for #parents, it’s really frightening sometimes to wonder if your #child might be having thoughts of hurting themselves,” said Lopez. “#Parents need to normalize having a discussion with a young person about how they're feeling, and being able to help them put words to the emotions that they may be feeling, and the stressors that they may be feeling.”

Michelle Tennen is glad she was able to have those conversations with Charley before she died. She feels she did everything she could to try to help her daughter, but, she said, “#parents can’t do it alone.”

After attempting #suicide just a month earlier, Charley ended her life in July 2020 by crushing up medication and putting it in her feeding tube.

After Charley died, Michelle Tennen remembers seeing that a family friend had posted on #socialmedia, saying that it had been a #suicide. She asked them to take it down.

“Then an hour later, after I’d had time to digest it, I realized my mistake,” she said. “I tried to squash something that we needed to bring attention to. That was a big lesson I learned from the #teenagers.

“We don’t squash it. We talk about it.”

Since then, she’s been sharing Charley’s story in hopes it will help people realize they’re not alone with these struggles. At least once a week, she hears from other #parents who are watching their #children go down a similar road — #anxiety, #depression, #isolation, #suicidalideation.

They couch it in nicer terms, but Michelle knows what they’re really asking: How can they avoid the nightmare she experienced?

“I tell them … just keep knocking on doors, yell as loud as you can until you get somebody to listen to you,” she said. “But I replay what happened with Charley over in my head every single day, some days more than others. And I don’t know what I could have done differently to change this outcome.”

Disclosure: The University of Texas at Austin has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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https://standingabovethecrowd.com/2022/08/jamesdonaldson-on-mentalhealth-in-pandemics-isolation-an-alarming-number-of-teenage-girls-are-attempting-suicide/