Every mass shooting over the last three months has been a trigger for fear and anxiety among young people, says one psychiatric nurse in Miami-Dade about the kids he sees. 

“The numbers are appalling,” said Eddy Molin, a psychiatric nurse manager at Jackson Health System in Miami.

“In the last two months we have seen a rise in hospital admissions. Most of the kids have been coming with anxiety and disruptive and impulse control behaviors. Clearly we can attempt to connect those with some of the events that have happened in the country, like shootings,” he said. 

Eddy Molin is a Nurse Manager at Jackson Health System based in Miami.

In a world where things are a long way from okay, adolescents often react with anger and defiance. Empathy, not punishment, is the way to reach them. Molin said parents should be preemptive in identifying things that are going on with their child.

“Adolescents brains are still developing. We cannot expect them to reason or to cope the same way as an adult would. If you have a kid who used to be around in all activities and they’ve started to isolate themselves we need to pay attention to that and try to see why,” Molin said.

A decline in personal hygiene, staying longer in bed, disengaging from family and friends are signs of trouble.

Teen Suicides on the Rise

“The suicide rate for 15-19 year olds was nearly 60% higher in 2020 than it was in 2007,” said Beth Jarosz, Deputy Director for KidsData. Even worse, Jarosz said the suicide rate for 10-14 year olds in 2020 nearly tripled the 2007 rate.

Jarosz crunches numbers. She said teen suicides rose 33% in California from 2010-2020. New York’s rate barely changed. Rates in Texas rose by almost 80%. Rates in Florida rose by more than 100%. Jarosz said White and Asian teens have the highest suicide rates in Florida; Black and Latino rates are about the same. 

Beth Jarosz is the U.S. Programs and Deputy Director for KidsData at the Population Reference Bureau (PRB). She joined PRB in 2013. Her focus is on subnational demographic and socio-economic trends, estimation and forecasting, and trends in child well-being.

“Rates for Black youth are rising fast. They have doubled in the past two decades.  Most of that increase was just in the last ten years,” Jarosz said. 

Indigenous youth are at high risk. So, too, are transgender youth. Kids who have have been traumatized, homeless, or bullied are likely to commit suicide. Youth who know someone who committed suicide or died from a drug overdose are often depressed and need intervention. Too often, they don’t get it.

“There is an incredible unmet need for mental health services,” Jarosz said.

One in six youth, ages 3-17, have a mental health problem like ADHD, anxiety, behavioral problems, or depression. Yet only half have gotten any mental health treatment in the past year.

What Can be Done?

“We can de-stigmatize and expand access to mental health care,” Jarosz said.

She said states should look at places like New York where there hasn’t been an increase in youth suicides and replicate what works. She said reducing childhood adversity would help.

“We know that discrimination and difficult life circumstances increase the risk of mental health challenges later in life and we can make those changes and break the intergenerational cycle of violence,” she said. 

People on the front lines—therapists, advocates, teachers, and parents–say it’s important to center efforts on youth most at risk and to break the silence about people with mental health problems.

People used to be locked up in insane asylums where they were hidden away and forgotten. Mental illness was considered a shameful personal failure and best not talked about. 

Peer Counselling Works

Estephania Plascencia suffered from anxiety and depression most of her life. After she graduated from college, things really fell apart. She stopped texting her friends and didn’t leave her house for six months. 

With medication and therapy she got better. In 2017 she volunteered with the Miami chapter of the National Association of Mental Illness (NAMI). As a NAMI “Ending the Silence” presenter,  Plascencia shared her life story with middle and high schoolers. In 2019, she became the NAMI Miami-Dade Youth Program Coordinator.  She is currently studying for her M.P.H., with a concentration in Biostatistics, at the Stempel College of Public Health at Florida International University.

“NAMI played a really important and fundamental part in my recovery. First of all they helped me realize I was not alone. They became part of my support network/family,” she said.

She said NAMI gave her support and validation and allowed her to work with others in similar situations.  Sharing her story with medical students and high-schoolers, Placencia got a lot of questions. Answering them became the best part of her job. Since the pandemic she said that kids are more curious. 

Estephania Plascencia joined the National Association of Mental Ilness (NAMI) in Miami as a volunteer in 2017. She became an Ending the Silence presenter and in 2019, she became the NAMI Miami-Dade Youth Program Coordinator.

“These questions are frequently about ‘how can I ask for help especially if my parents won’t believe me?’ questions about depression and anxiety, questions about how to help with friends and what to do if these friends do not want to get help… Just observing it for myself, I do know our youth definitely needs help,” Plascencia said. 

Ending the Silence in Tennessee

Teen suicides in Tennessee have been consistently higher than the national average since 2012. On the bright side, the Tennessee Suicide Prevention Network reported 1,220 suicide deaths in both 2019 and 2020. Since the state’s population increased in 2020, the suicide rate of 17.7 is slightly less than in 2019 (17.9 per 100,000 population). 

“There is a stigma related to saying ‘I have a mental health condition’ and a lot of people don’t want to see anybody or talk about it because they may be embarrassed or people may make fun of them or you’re supposed to pull yourself up by your bootstraps and it’s not recognized as a problem,” said Jeff Fladen, NAMI Tennessee Executive Director. 

“Ending the Silence” is a program for middle and high schools or a youth group. It is about the warning signs of mental health conditions and what steps to take if you or a loved one are showing symptoms of a mental health condition. A presenter like Placencia can come to your school or it is available on line here: https://ets.nami.org  

In addition to the stigma, Fladen said the other big issue attached to mental illness is health coverage. “If they work for a large employer there is a thing called EAP, Employee Assistance Program and that’s free. But then if you have insurance, trying to find a provider who will see you, can be hard,” he said. 

Jeff Fladen is the NAMI Executive Director in Tennessee.

Cognitive Behavioral Therapy and medication are the two most common treatments for mental health conditions. Studies show either method can be effective and some people, like Plascencia, benefit from both. If you have insurance, Fladen said to call to see what it will cover before seeing a counselor or therapist. He noted that a family doctor can prescribe antidepressants.

“There are organizations with sliding scale fees as well. Churches, mental health clinics, and various agencies around the state have sliding scale counseling but there’s not just one number to call. You have to google where you live,” he said.

In Nashville you can call 211 and United Way will tell you about resources and local mental health services in the area. 

“If they don’t have TennCare there is still a mental health safety net for low income people and it covers certain mental health services,” Fladen said. 

“We’re ahead of a lot of states with our Department of Mental Health. Not that everything’s perfect but we’ve got a lot of good things…most schools have what is called a mental health laison and school social workers. So there’s more counseling in the schools than there used to be in Tennessee, so that’s a good thing.” 

The Jason Foundation trains teachers in suicide prevention and has affiliate partners all over the U.S. and Puerto Rico. Clark Flatt started the Jason Foundation in 2007 after his son committed suicide. 

“One of the things we’re most proud at the foundation is that it all started here in the state of Tennessee in 2007,” said Brett Marciel, Jason Foundation Communications Director.

Twenty-one states have passed the Jason Flatt Act which requires certified teachers to take two hours of training every year. The foundation raises the money.

“We’re proud to say we train about 60% of the state’s teachers,” said Brett Marciel, Jason Foundation Communications Director. 

Brett Marciel is the Jason Foundation Communications Director.

Teachers can complete their continuing education requirement with other programs. They don’t have to use the Jason Foundation program or its materials. 

“Over the last five years we have provided more than a million educator trainings on the subject of suicide prevention and awareness,” Marciel said.

“For all of the great strides we have made in suicide prevention, the suicide rates continue to climb after COVID-19 with elevated level of depression and anxiety in young children. I‘m concerned about where that’s leading,” he said.

The Mental Health Cooperative has several locations in Tennessee. It has been helping adults with severe mental illness and children with serious emotional challenges free of charge for more than 25 years. More information on line here: https://www.mhc-tn.org.

The Department of Mental Health has a Fast Facts webpage here: https://www.tn.gov/behavioral-health/research/fast-facts.html

The department also has a “Be the One” suicide Prevention Campaign available here: https://www.tn.gov/behavioral-health/research/fast-facts.html

Crisis services for children and youth has a statewide crisis line here:https://www.tn.gov/behavioral-health/need-help/children-and-youth.html

Tennessee Suicide Prevention Network has resources and crisis lines here: https://tspn.org/number-of-suicides-in-tennessee-held-steady-from-2019-to-2020/

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