Professor Dr. Nick Allen is a Director of Clinical Training at the University of Oregon. His area of expertise is teenagers and mental health.

You can learn more about Dr. Allen here.

The overall morbidity and mortality rate increases 300% from childhood to adolescence. This is related primarily to the control of behavior and emotion including suicide, accidents, alcohol, violence, eating disorders, etc.

The typical age of onset for a mental health problem is during the teenage years (12/13-early 20s). Most people who are going to have problems throughout their life will experience the first stages during adolescence. This is why Dr. Allen is researching healthy development away from the more negative trajectories.

Mental Health is not primarily associated with high income countries like the United States. The middle and low income countries are just as big a problem in the middle east, Asia and Africa. However, there are not as many resources in those areas for dealing with problems.

Adolescence is defined as the awkward period between sexual maturation and the attainment of adult roles and responsibilities. You can physically have a child but not really support it.

Puberty has changed over the years. The age of puberty is dropping. In the 40s, the average age of the onset of puberty was 17 and now it is 11-12, possibly due to better nutrition. However, the average age of attaining adult roles and responsibilities is happening later and later. More people continue their education. Less people get married young. More young adults live with family. Therefore, adolescence is a longer period of life.

Trauma and homelessness in youth is a huge problem. There are 1-1.7 million runaway and homeless youth in the USA. The long proportion of young people living on the street have a history of maltreatment whether sexual, emotional, or physical. This puts them at risk for a variety of mental health issues. On the streets, they are often subjected to further victimization, which is a double whammy. So what we see are complex forms of PTSD which result in depression, difficulty with interpersonal relationships, addictions – and all of these serve to contribute to the length of time an adolescent remains on the street. This is an area where more services are needed, both to prevent and help the adolescents who are at risk or caught in the cycle.

Adolescents will be generally moody around their parents and that is normal. How do you know when to seek help?

  • Look for long lasting depressed/irritable/anxious moods. Is it most of the day, more days than not, and lasting for at least 2 weeks?
  • Do you see it happening with friends and at school?
  • Does the teenager no longer enjoy anything?
  • Is the teenager extremely self critical, hopeless about the future?
  • Is there self harm (much less abnormal in this modern day) or talk of suicide?

What can families do?

  • Be supportive and consistent. Recognize they know how to push your buttons and work around it.
  • Parents still need to help teens make decisions, but in a different way. They absolutely still need the parents in their lives. It’s more of a negotiation. “Because I said so” doesn’t work.
  • Be honest and direct about difficult issues like sex, drugs, alcohol, smoking. If you want to know, ask. Don’t be afraid to talk about touchy issues. Choose your moments. (Idea: Capture them in a car. They don’t have to look at you and there is an end, and they can’t walk away.)
  • Promote family time.
  • Develop a relationship that promotes your teenager talking to you when they need you.
  • Get to know your teens friends. Insist if you have to.
  • Pick your battles and know that sometimes, acceptance that it is more important than providing direction.
  • Teenagers tend to sleep poorly so encourage good sleep habits and physical activity.
  • Be especially supportive during relationship breakdowns. This is the NUMBER ONE EVENT prior to a suicide event or mental disorder.
  • Seek a balance of fun vs. achievement.

Remember to enjoy your adolescent. They are interested in exploring new things and taking risks and can remind us that life doesn’t always have to be the same. Find new things you can try together.