Adolescent Mental Health: Early Intervention and the Youth Perspective


Hey everyone. Good evening. Thank you all for
being here tonight. My name’s Steve Adelsheim. I’m a child psychiatrist
in the Stanford Department of Psychiatry and
Behavioral Sciences. And I’m also lucky
enough to be the director of our Center for Youth
Mental Health and Wellbeing. And tonight, we
want to thank you all for coming out for this
presentation really focused on early intervention
in youth mental health. And we’ll be hearing
tonight, actually, from most of the
members of our center as well as some of
the young people who are working with
our youth advisory group on one of our programs. So what I want to
do initially is ask the members of
the people of our team that are sitting up here in
front to just quickly introduce themselves. And they’ll tell you
just briefly what they’re going to be speaking about. I’m going to make some
introductory comments and then we’re going to
hear from our panelists. I would ask if you
think you might want to ask us some questions
at some point during the evening tonight, take one of the index
cards write your question down. We’ll be collecting them
from you from time to time, and then we’ll
pull the questions and answer them after
we’ve heard briefly from our speakers. OK, so who are you? Hm? Let’s see. Testing. Here. This one’s on. Hi. My name’s Vicki Harrison. I’m the current manager of the
Center for Youth Wellbeing. And I’m going to
talk a little bit about media and mental health. Hi, everyone. My name’s Rochelle Ogundele. And I’m the supportive
education and employment specialist with the center. And I’m a social worker. I’ll be talking today just
about some of the myths that we have around students
and their experiences in school. Hi, everyone. I’m Steve Sust. I am an early
parent/child psychiatrist. I graduated from the
program here in in 2016. And I wear a number of hats. I work at Stanford
with the Center, and then I also work in San
Mateo County’s Behavioral Health and Recovery Services. And then I also work at Santa
Clara County’s Valley Medical Center and psych emergency room. I will be talking about
schools and the prevention and early intervention piece. Thank you. [NON-ENGLISH SPEECH] My
name is Ana Lilia Soto. I am the youth outreach
specialist for the center. I apologize for my
voice and if I sneeze. I have a little cold. And I will be talking about
youth voice, lived experience, and how that connects
to the awesome work that these young
ladies are doing in the youth advisory group. You want to just
turn that off for me? So I’m just going to give
a brief overview of some of the issues related
to youth mental health and why we focus on
this work and why we’re so glad you’re
here joining us tonight to talk about it. As many of you know,
when we look at really what are the primary health
issues for young people between the age of 10
and 30, the major issue that young people
are facing in terms of any kind of health issue are
really mental health issues. For the most part, young
people between 10 and 30 are really quite
physically healthy, but this is also
the time when we tend to see more mental
health related issues develop. And in fact, you know, one
of the important things that we’ve come to
recognize over time is in fact that half of all
mental health conditions have their onset or their
early symptoms beginning by the age of 14 years of
age and 3/4 of the time, by the age of 24. And so really part
of the issue becomes, how do we have support
and ways for young people to get that early care? At the same time, we know
that many parents, you know, find it very difficult to be
able to access mental health support for their young
people even when they often realize that you’re dealing with
a mental health related issue. And in fact, we know that
20% of our young people between the ages of 12 and 18
may have a mental health issue that’s a serious condition. And when young people get
to the ages of 19 to 25, it goes up to
actually almost 30%. At the same time, we also
realize that young people are not very good at getting help. And when we think about
our children moving from the pediatrician’s
office to what’s next in terms of
health care, we don’t have easy access points for
our young people to get care, whether it’s medical care, but
also then especially mental health related support. And so we also realize
that young people really between the ages
of maybe 15 and 25 are really not very good at
accessing the mental health care that they
often really need. In California, when we look
at sort of mental health related issues, what we find is
that one in eight young people may be dealing with a
depressive related issue. But even in our
state that actually has more resources than
many, less than one third are receiving treatment. And that may be because
other people don’t know there’s a mental health issue. The stigma issues
can often make it really difficult for families
to feel comfortable getting care for their young child as well. And there are also
workforce issues. We often don’t
have enough people who are trained in child and
adolescent mental health issues to be able to be easily
accessible to provide the care that our young people may need. So part of the reality
often is that it’s really hard to find treatment. And so people talk about
building access to care, but in reality, it’s
often very, very far hard to find it, whether
someone has health insurance and they’re looking
at their long list of potential providers
and they’re calling them all to see which one is
accepting new patients or for people that are
dealing with insurance through our county
systems or uninsured. Sometimes the waits
are very long. And access isn’t easy,
particularly for young people. In our community here,
particularly in Palo Alto, we’ve been dealing with serious
issues related to depression and youth suicide
to the point that we have been given national
attention based on this issue. We had the Center
for Disease Control here sort of studying this issue
in our county in Santa Clara. They really actually
found that compared to other counties in
California, our actual rates of youth suicide
are really better than most of the
counties in the state and better than
the county average. At the same time, we
continue to struggle with this issue at
times and really still need to build additional
resources for our young people. But also, frankly, for young
people all over the state, this remains a huge issue. One of the things that
we have been focusing on is really looking
at how do we create sort of a public mental health
continuum for our young people. When we think about
the notion that it really, if half of all our
young people by the age of 14 are really starting to
develop mental health issues, the question
becomes, well, where are they supposed to get care? And how do we find those young
people early and link them to early treatment
for mental health just like we would for asthma
or diabetes or any other type of medical condition? And the fact is,
in this country, we really don’t have
a public mental health system in place that really
allows for those early services to happen. So one of the things that
we’ve been looking at is how do we create,
in the community, sort of this continuum of
care to be able to build on those services? So, as you’ll be hearing from
some of the folks on our team, we’re working at, how do we
build partnerships with schools and develop expanded school
mental health related supports? And the counties are looking
at doing that across our state, as well. And then we’ll be
talking briefly about some of these
integrated youth mental health
programs that we’ve been working to develop
that become really one stop shop for young people to come
in and get early mental health care. And we also work
with some programs around early
psychosis, psychosis being sort of the mental
health condition where young people might start
to wonder if they’re hearing voices or losing
touch with reality or their brain is
playing tricks on them. There’s been a lot of
interest, nationally and internationally,
in developing these early intervention
programs for psychosis, because the data is actually
very clear that the earlier we can identify young people,
even with an early psychotic illness, the better they will
do 10, 15, even 20 years later. So really, we’re
trying to work out how do we create this
early continuum of support, and then be able to
build out the systems that young people need. So as I mentioned, one of these
integrated youth mental health programs is the
head space program, which is based on a
model out of Australia. And in fact, Australia has
110 of these walk-in clinics for young people with
these early services that are designed with
a look for young people that advertise directly
for young people 12 to 25 to go in for mental
health, physical health care, early addiction treatment,
and other types of support in terms of school
and education. And you know, Australia,
having 110 of these, is half the population
of California. But it’s a nation that
really has made a commitment to early intervention. One of our partners that
we’ve been working closely with recently is the Foundry
program out of British Columbia that’s developed
a similar model. And they now have
six of these programs across British Columbia. They’re going to have 11
by the end of this year. Ireland has their
version of this. They have 13 jigsaw
programs across Ireland. These are being built out across
Ontario and France and United Kingdom. And we’re really looking
at starting the very first of these sites in
the United States here in Santa Clara
County, and we’re very excited to be working with
the county and other partners on doing that. As we’ve been working
on and thinking about, like, what do these sites need
to look like here in the United States and in this
county, part of the issue is that our youth advisory group
has been thinking about with us and with our partners at
ideo.org who are working with us on the
design are like, what are the issues young
people are facing and how do we
design these places in a way that will be
comfortable and meaningful for them? And I think one of the things
that our IDEO partners have also learned and I
think we’ve learned as well from our conversations
with our youth advisors is that the young people
in our communities are running around a lot
and trying to keep up with everything and to some
degree are really struggling with how to manage
all the things they’re being consistently asked to do. And in terms of the
design of the facilities we’re looking at
here, what’s coming up is this notion of being able
to pause and catch your breath and have a space where young
people can do that and then maybe think about what
kinds of conversations young people then want
to have with friends or with other concerned adults,
what kinds of activities they want to do, and
then again what kind of health, mental health,
and other supports do our young people need to stay
healthy and on track as well. So I will stop here and
turn things over to Vicki. All right, so I was just going
to take just a few minutes to talk a little bit about
media in mental health, which is one of the areas
that we’re really interested in for
a lot of reasons. And you can see from this slide
that media is a broad term. So there’s really
three major categories. Steve showed a slide with
that Atlantic magazine cover on it already, which
some of you may have seen, that came out in 2015. But some of you may not know
that there is a contagion effect to the way that suicide
is reported on in the media, that there’s lots
of research that has backed that that shows that
the way that it’s publicized, reported on, the types
of images you show, the frequency of
reporting, can actually lead to copycat suicides. This happened after Robin
Williams’ death, Marilyn Monroe’s death, and it goes
back many decades before that in terms of research on it. So it’s something that
we’re concerned about and have been looking at. Social media I’m going to talk
a little bit more about it in a minute. And entertainment
media, some of you probably know which
show this image is from. “13 Reasons Why” on Netflix
was pretty problematic and got a lot of attention from
mental health professionals because of the guidelines,
the safe reporting guidelines, that we have to minimize
the contagion effect. And this seems to
violate a lot of those. It raised a lot of concern about
kind of glorifying suicide, showing a very graphic
depiction of suicide. Yet it was also a very,
very popular show. So there’s a lot going on
with regard to mental health in the media that is just
worth paying attention to. And something that we did, I
realize I didn’t test this, but I wanted to show you a
five minute video that some of our local teens produced. We had a convening
about a couple of months ago around
mental health and suicide reporting for local
news and journalists. And I’ll let you just hear
from them if this works. Some of you may have seen
this article that came out I think at the end of last
year, December 2017, which got a lot of attention, this
“Have Smartphones Destroyed a Generation?” Some research from Jean Twenge,
from San Diego State, where she tracked the rise
of depression, anxiety, in relation to the rise of
smartphone use around teens. And so it’s not a causation,
but there’s a correlation there. And so she had pointed that
out and a lot of people really paid attention to that. And some people, you know,
are skeptical of that, but it’s just yet another
point to the concern that is being raised around social
media and mental health. So there’s a lot more dialogue
happening around that. And as parents in the audience
or concerned community members, I mean, there’s
a lot of concerns that come up with
adolescents with regard to their social media use– body image issues, sexting,
pornography, video game usage, bullying, self-harm. There’s just a lot that
people are concerned about. So it’s an area that
we’ve been looking at. But I also wanted to
point out that there are some benefits to it. I think people just want to kind
of put their head in the sand and say, don’t use it. And that’s not necessarily
the right approach. It’s not going away. It’s a big fabric
of our lives now. And so I’m going to give
you some guidelines for how we would recommend handling
social media with adolescents. But these are just
some of the benefits that people derive
from social media use, and it’s really opened
up a lot of opportunity for people that previously
didn’t have access to a lot of
information, connecting with people across the world. It’s encouraging a lot
of self-expression. There’s a lot of young
people blogging, expressing their opinions, their interests. And it’s providing leisure and
connection for a lot of people. And really for
adolescents, there’s not a difference between their
offline and online lives. It’s all kind of blurred. So they’re connecting with their
friends both on and offline, and that’s very normal and very
OK if done in a healthy way. So these are just some
general guidelines. And really, the bottom
line around this is that it’s something that
you should guide your children through as you would with
anything– with healthy eating, with learning how to drive. It’s really just something that
you need to help guide them on. So familiarize yourself
with the technology that your children are using. I think a lot of people
are kind of intimidated by the number of apps out there
and they evolve very quickly and, you know, young people
switch from app to app. And so just, you know,
have dialogues about it, talk about it. Understand what they derive
from it, why they like it. Talk about what rules and values
you want to set as a family. Do you want to set limits
on what is OK to share? Are you OK with them
posting pictures of everyone in your family? Some people use rules
like only post something that you’d be OK with
your grandma seeing or your teacher seeing or
your future employer seeing. So have some conversations about
those types of limit setting. For younger kids,
it’s often OK to try to rely on some of the
monitoring technology. There are apps and
ways that you can monitor usage which could
actually be helpful, especially if you are worried about
the amount of time people are spending online. You can set limits. You can set timers. You can actually download
things that do that. And also model your
own healthy habits because it’s not going to– it’s going to fall
flat if you’re setting limits for
your young people but not following them yourself. And there are some
resources which I’ll post on here in a minute. And really, just keep
the dialogue going. These are just two key points
that I would say, again, healthy online lives rely on
the same skills and values that you want people to
use in their offline lives. And I think I already kind
of covered all of that. So I’m going to leave you
with a couple of resources. There’s some good resources for
parents==Common Sense Media, Connect Safely, several things
that you can Google and find. There’s also been– probably if
you’ve been following the news, you’ve been seeing that there’s
a bit of a backlash happening. A lot of it came out of
privacy concerns in general, but some of the
technology companies are really starting to try to
pay attention and put some more controls and safety in place. So they’re starting to create
parent centers, safety centers. There’s a YouTube Kids app
that is filtered so it’s only supposed to show safe content. So there’s things that are being
developed that you can try. And if it’s that in an issue
that you’re passionate about and want to advocate
for, there’s a lot of people
that are starting to look at using technology in
healthy ways like the Center For Humane Technology. There’s a reverse
hackathon happening in San Francisco in
two weeks, which is all designed to try to find
healthier ways to use tech to improve upon
some of the products that we’re currently using. So I’m going to stop
there, because there’s a lot of other
good speakers here. And I’ll turn it
over to Rochelle. All right. Hello, everyone. I will not be using slides. So the rest of us
here, I just want to prepare you that we
will not be using slides. We just want to have a
conversation with you and, you know, share like
human beings in this space. So I wanted to
take an opportunity to talk with you all just
about some of the myths that we have around how young
people transition in education and what are some of the
things that we believe about what schools can do. What we know is that
young people spend most of their waking
hours with their teachers, their school administrators,
the lunch staff, the janitor, the security guard,
the groundskeeper, more-so than they are at home. That is what we know
about young people. And so a lot of the
times, the people that know young people the
best are the people at school in various capacities. And so one of the things I
wanted to talk to you today about are a myth. So let’s say. One of the myths
that we believe are if children are having
a hard time in school, they just need to work harder. I’ve heard that before. I’ve heard, you know, parents
talk to their young people about, you know, why aren’t
you getting an A in math, for example? You need to work harder. You’re not studying hard enough. And that’s not
necessarily the case. And I think some of us really
know that deep, deep down on the inside. And sometimes we
don’t always want to believe that that’s the case. And so the reality
is, young people are working really, really
hard to be successful. And so sometimes, they just
need to learn a new skill, to identify– maybe they need
to identify a new math skill that they need to work on. Maybe they are more
concerned with social skills, and that’s what’s getting in the
way of them being successful. And so there are a lot of things
that young people are doing at school that they
need to learn in order to be successful that are both
academic and social skills. Another myth that
we have is schools know what our
children need, right? Because they’re at
school all the time. And schools are the expert
on our young people. And that’s not always
necessarily the case. What we know is
that there are a lot of young people at a school. And yes, schools do
their best to make sure that they address
every student’s need. But in fact, we know
that some students fall through the crack, right? Some of us have students
in this room that maybe should have been
identified a long time ago and maybe weren’t identified
as the young person that maybe needed some additional services. So what can we do to make sure
that our young people are being identified early on as needing
support and giving them the support when
they do need it? So we have red flags, right? So some of the red flags that
we know identify a young person as maybe needing some additional
support are behavior issues. And some behavioral
issues are my kid talks too much in school. You need to stop talking. You need to pay attention. Some other behavior
issues are, you’re always getting kicked out of class. You’re always getting
sent to the office. And we’re always like,
you’ve got to behave. You’ve got to sit in your seat. You got to listen. You got to pay attention. And sometimes, there are
other things going on with our young
people that we need to inquire a little further
and figure out, what is it about this class? What is it about
what’s happening for you that makes it so that
you have to get kicked out of class all the time? We need to dig deeper
and ask them some more questions versus kind
of making demands about what they need to do. Because they know
what they need to do. They hear you say
it all the time. They hear us say
it all the time. We just need to dig a little
bit deeper and figure out how we can investigate this some more. So those are some red flags,
but then there are other flags. So suspension– you know, when a
young person gets suspended one time, two times, typically,
it’s similar behavior. And again, we want to
point to the young person and blame them. They need to get it together. But we also here
in this situation should potentially look
a little bit deeper and see how we can
support this young person and figure out with school staff
where they’re doing things well and maybe apply some of
those positive behaviors to this other
behavior to improve where they’re struggling. Myth three– you have
to wait on the school to decide whether
your child needs special educational services. Can I have a raise of hands? Who believes that, that you have
to, like, wait on the school? OK, all right, great. So that’s good. They need to find all of you? Yeah, we all know the
answer to this question. But you do not need
to wait on the school to identify your young
person as someone who needs special education. And so all a parent has to do
is send a letter to the school administration identifying
what the issue is that they see that their child
is struggling with and that they do need
their child to be evaluated for special education services. Schools have within 60 days to
respond to a parent’s request. So at that point,
that starts the cycle of when a parent can
start to figure out the special education
services or an evaluation that a student might
need at school. And myth four, the last one– special education is only for
children with obvious need. And so a lot of the times we
think that a child’s disability is obvious. Like, it’s clear that the
child has a disability. If you can’t see it, then
the child doesn’t need it. And that’s not
necessarily the case. One of the learning disabilities
that we know is invisible is dyslexia. A lot of young people go
a very, very long time without learning to read
because we can’t see it. And they don’t know that
they’re not supposed to see the way they’re seeing. And so again, checking with our
young people and figuring out, you know, where are they having
challenges and how we may best support them. And that is all I have. I know that you guys are all
doing a really, really great job at being parents and
providers and teachers and social workers and
principals in the room. So this is not to
say that you all aren’t doing really
great work, but it’s just a reminder that
for those of you who are doing really
great work, there are some young people and some
families that really don’t know what their
rights are and don’t know how to navigate them. And it’s important for us
to share this information with those folks as well. Thank you. Hi, everyone. I’m going to try
to make my comments brief because my
favorite part of this is actually the Q&A part. But just so to say that
I’m a child psychiatrist. I’m a rare breed. There’s just not
enough of us out there. And part of the
reason why I actually chose to be a child
psychiatrist was this dream that if we were to intervene
a little bit earlier, then, you know, could we somehow
limit the amount of troubles that they run into
later on in life? And after working 60 hours
a week, I got to tell you, you know, you’re always
constantly thinking about how to make things
a little bit easier, how to intervene a
little bit earlier. And that first brush
with the school system actually happened while
I was in training. I met these two high
school students, and they wanted to
have more mental health resources on campus. And they wanted to do
a campus wide survey. And I took that
moment to sort of talk with them about setting up
like another kind of survey sort of asking, you know,
who– if you were given a list of, like, the different
resources at your school– the principal, the
teacher the classmate, groundskeeper, et
cetera, and psychiatrist. That was also included on there. And you know, how would you
rank those different resources in your life? I was really sad
to find that I was next to last as, like, this
highly trained person is second to last. I beat out the suicide
hotline, though, so I take pride in that. But so to say that
kids are not– you know, they’re just
like you and me, you know? They’re not going to spill out
their life story to somebody they don’t really know and
who is not very accessible. And so, you know, one of the
great things that I’ve really appreciated about working
with the schools around here is this opportunity for the
prevention, early intervention piece. I love working with schools
that want to sort of peel this letter back because there’s
a lot of really good stuff that’s considered
low hanging fruit. You know, I don’t want to get
off on too far of a tangent, but there’s this
Romeo and Juliet book that all of your kids
have read as freshmen or are going to
read as freshmen. And you know,
wouldn’t it be great if we could actually
teach the story as a series of missed
opportunities to potentially change the ending? Great way to sort of sneak
that into the curriculum. But that’s, you
know, yet another project that I’m looking forward
to starting at some point, but so to say that there’s
a lot of opportunities for early interventions
and a lot of really cool stuff happening out there. The survey that I ran– well, sorry, that I didn’t
run, but the students ran and I helped them with– highlighted the
importance of peers looking out for one another
and just how important that is. You know, we’ve done
something like this before with, you know, drunken driving
and the idea of the designated driver. You don’t let
people drive drunk, and now that’s,
like, just something that’s de facto standard. People just expect that. And there was a lot
of help with media back in the 80s in
sort of promoting this kind of pro-social
watching out for one another. But I’m hopeful that with
the help of the community and the schools,
we’ll get the chance to sort of show again the power
of the unity of our youth. They’ve already really,
really inspired me in a way that I never thought I’d be
able to see in my lifetime. And I think that if we
don’t get the chance to work more with the
youth at the school before they come
to my clinic, we’ll miss this massive
opportunity for them to be the better friends that
I know they all want to be and I know that you
all want them to be. So there’s a lot more
about the school stuff, but I want to keep this short. So thank you. I always want to clap
after Steve talks. It’s like, oh, my heart. Thank you. So my name is Ana Lilia Soto. And I’m the youth
outreach specialist. And I get to talk to your heart
today in terms of the work that we’re doing. But first, I really wanted
to acknowledge the youth in the room because
there is no way, had I been 16, 17,
a youth, and my mom said, hey, let’s go to
this talk at Stanford to hear about adolescent mental
wellness that I would be here. So much props to the moms
that brought their children and to the children
that actually said yes. So I definitely
appreciate you guys being here along with our
youth that are here as well. And so I’m a little different
in terms of my background. I’m a community worker
through and through. I’ve been working with
youth for the last 17 years going on my 18th. Whoo-hoo. And it’s really– what
I’ve learned in terms of, and I’m really loving
this work that I’m doing here with the Stanford
Center, is that half of my time whether I was an outreach
specialist, whether I was a case manager, whether
I was doing programs in schools, whether I was
doing community programs, half of my time was, one,
when speaking with a youth and building those
relationships, seeing the need that hey, we need to
get you to some therapy. This isn’t just a conversation
that we could have. There is some other
signs that I’m seeing that we need to get support. Half of my time was that. Half of my time was helping
parents see their children behind those behavioral
symptoms of stress. So being able to share with
parents, like, hey, there’s some actual needs
here versus you see what Rochelle
was talking about. They’re getting
kicked out of class. They’re talking too much. They’re not paying attention. They’re not doing their work. They’re not connecting with you. And so being able
to reach both is, I think, the strength
of what we’re trying to do with that space
and including the youth. But that’s what I kind
of wanted to talk about and how that’s what
I’ve been seeing. There’s a general hope
that exists, I think, with all parents,
all teachers, is that we hope that the only
issue that our youth are going through is school, you know? My mom used to tell
me, your job is school. You don’t have to worry
about nothing else. I’ll make sure
that you have food. I’ll make sure that
there’s a house. Your job is school. But my youth here,
my youth over there, and all of you who’ve gone
through these systems, you understand that
that’s not the case. You know, sometimes,
most of the times, they’re also worried
about you as parents. Are they OK? Are they stressed out? If I tell them what
I’m going through, are they going to connect? I don’t want to trip
them out anymore. And so what happens is that
with this general hope, we also know that there’s
a fear of judgment of sharing that
kind of information as well too, whether it’s your
parents because you don’t want them to worry about you, whether
it’s your friends because you have the social appearance
and this influence that you want to hold,
whether it’s violence that they’re seen now
in the communities and that we’ve
seen more and more. There’s all these things
that they’re going through. So how do we support this? And so these are really easy
lessons that I’ve learned. And as parents,
you probably have– you are the experts in having
children and working with them. But you engage your
youth by providing a space free of judgment and
listen for their direction. And I think this is
the biggest issue because we have a
lot of people in here that were solution driven. I hear a problem,
I want to solve it. You need food, I will
find you a food bank. You need housing, I will
connect with everybody in the community to make sure
you have a place to stay. You want to talk to somebody, I
will sit there and talk to you. But am I finding my solution? Am I finding my youth solution? So that’s a step back
then we’re asking parents to take in terms of
being able to develop those kinds of relationships
where you step back, where you normalize
help seeking behaviors, where you acknowledge the
difficulty of voicing something that is challenging. And sometimes, and my
youth will feel me on this, sometimes these feelings
don’t have words. There are words that we
can’t, as youth, express yet. But in order to provide
that youth voice, in order to support that,
what we’re doing is these candid discussions. And that’s what we’re asking
you as parents, as teachers, to be able to follow through. So it’s one of those
things that most of my work and the
progress that I made and the awesome thing
now that having worked for so long in the community,
having a 17-year-old youth when I was 25, and
now that youth is 32. One of my youth is 32. Trip out on that. But being able to
support successful adults is what we’re trying to do. I learned really early
on, especially when I was doing this teen
pregnancy program, we’re not raising children. We’re raising successful adults. And what are the things that
we need in order to do that? And so the goal of
meeting youth where they are, learning to listen, to
guide, and to hear their voice validated and
acknowledged is in reality the common goal
for all of us here. And so what we have
seen, especially in youth engagement– and this is
the exciting work of what we’re doing with
Headspace and our youth– is my job is to make sure
that we validate that voice, that we validate that
lived experience. And so one of the things
to understand, especially with youth, and we’ve done this
in our youth advisory group, is acknowledging that we are
different with every kind of person. As a young woman,
I talk to my mom differently than I talk to
my partner, my boyfriend, my girlfriend, that
I talk to my friends, that I talk to my teachers. There’s all these different
identities that we hold. And so the powerful
thing about being able to support our
youth advisory group is that we get all
of those identities. We get all of those in
terms of lived experiences. We validate those and we
see the youth as the expert in providing this feedback. And so what we’ve been able
to do with the Headspace is that in November, we launch a
very extensive outreach effort. We have received 52
applications 33 youth went through a very extensive and
rigorous interview process. And now we have 26 youth that
have only met total nine times. But for each of
them, it’s only six. With IDEO, we’ve met over 17
times in terms of with one on ones, meeting out
in the community, meeting in our youth
advisory group meetings, but trying to get
those feelings of when you walk into the space, what
do you want it to feel like? When you want to
talk to somebody about this kind of sadness, what
do you want that to feel like? When you want to talk to
somebody about your grades and that they’re going
to be in the mail and you know your mom is
going to pick those up, where do you want to go? And so being able
to have that is that the youth advisory
board members are going to have a
say in everything that we develop from the
ways that place is going to look to the feel, to the
services, to the clinicians that we’re going to have. And they’re going to be
able to provide all of that. What I believe is
that not only are we asking for their
expert advice and opinion because they’re
the youth experts, but we also want to provide
a space for them to share. They’re also going through
a lot of the things that your youth
are going through. And so being able to
provide that is really going to help our center
really be a space where youth can come in and get support. And now if we can have my
youth advisory group members come and join us. So what we thought is
what better way for you to get access to
adult mental wellness? Drs Steves– because
there’s two of them– will provide you with as
much information as you want. We have really great stuff. But we feel that
the youth really are going to give us more
of a glimpse as parents what you’re looking for to
hear in terms of a youth. So I asked each
of our three youth to answer three questions– name, school affiliation, age,
so you know where they’re at. And my first question
to lead us off is going to be in terms of
communication, what would you have wanted your
parents to know, right? OK, so– and right now, this
is also audience participation. So if you guys have
those index cards, please feel free to
write some questions, whether it’s to our
youth, whether– Rochelle will be
picking them up– whether it’s up to our staff. Please feel free. This is a very
interactive process. All right, so why don’t
we start off with my left? Because we know that’s a rule. [INAUDIBLE],, you want to
come up or get us a mic? Hello. OK, hello. I’m [INAUDIBLE] Hermanez. I am 22. I’m an [? SO ?] state
graduate, with a BA in psychology, minor
in sexuality studies. I’m currently working
for Citizen School in San Jose, Sheppard campus. And I joined the YAG,
because, growing up, I struggled a lot
with my mental health. I’m your typical wounded healer. Like, I struggled
through it, and now I want to help youth
so that they don’t have to struggle through the
same things I went through. And joining this YAG was a great
opportunity for me to do this. I kind of just
fight, and I took it. And I hope that I can really
make a change for youth in the future. So just answer the– Answer those two, and then
we’ll go back to the question. OK. I think what parents
can do to kind of like strengthen their
communication with their kids is kind of just listening. One of the big things is
listening without judgment. A lot of times, it’s easy
for parents to listen, yeah, but at the same time, they’re
also saying, like, well, what do you have to worry about? Like, you’re just a kid. And I even hear
that where I work where there’s
these middle school kids talking about how they’re
so stressed out about life. And the teachers
are saying, well, you’re just in middle school. Like, you’re just starting. What do you have to worry about? And the thing is,
like, at this point, like, youth, their brains
aren’t developed all the way. They don’t understand that the
pain they’re feeling right now isn’t permanent. It’s going to
eventually go away. But it’s also going
to go away if they get the help that they need. So if you just
negate that and just make it seem like what they’re
going through is so trivial, they’re going to see that, oh,
if everyone else is doing OK and I’m struggling, like,
what’s wrong with me? And what am I going to do
to make myself feel better? And they’re not
going to reach out to you if they feel
like they can’t even come to their own parents. So I think a big
thing is just listen and don’t judge and,
you know, give them the support that they need. Hi. I’m Phoebe Cox. And I’m a sophomore
at Gunn High School. I’m 16 years old. And I’ve been really fortunate,
I’d like to say, for my family because I grew up in a household
where my mom was a psychiatrist and my step-dad
was a psychiatrist. So mental health really
wasn’t something that was super foreign growing up. But it didn’t really hit
me until freshman year of high school,
especially at Gunn, with all of the suicide
problems that we’ve had. And I really think
seeing my friends deal with issues like
depression and anxiety, like, really changed
the way I viewed it and the way that I
felt about it, I think, and I think the
parents can really, like what you were
saying, realize that although it might
seem minor to them, it’s really not for, let’s
say, a middle-schooler or a high-schooler,
these things. Although they might not
mean anything in 20 years, it changes the person
you are and it changes the way you deal with
relationships and interactions and social experiences. And it can really
traumatize people in high-school
and middle-school, and those things will
carry all the way throughout your adulthood. And I really think
it’s about, yeah, like, creating an adulthood
for somebody where they can actually support
others in the future and not have it be so
negative and not have to be such a bad thing to talk
about because I really think every kid should be able
to know what depression is at the age of five and be
able to say, like, yeah, it’s just like
breaking your arm. It’s not something
that you did wrong. It’s not something that
you can just snap out of or just don’t deal with
it like you’re fine. It’s not like that. It’s really something I
think parents can help with. Yeah. Thank you. Hi, everyone. I’m Casey– well, Casey
Ellen [INAUDIBLE].. I’m 25 years old. I currently work in
tech [? action. ?] I grew up in San Jose. So for me, this
is home, Bay area. I went to UCLA, graduated in
poli sci and communications. We moved back to work in
tech three to four years ago, which is wild. So for me, I wanted to join
YAG, because my lived experience was a bit different
maybe than others. A couple years ago, my mom went
through a very depressed state, where she was an empty-nester,
and she was really, like, what do I do with
my life without you guys? I really need you. She attempted suicide. And for us, that was
a big wake-up call. Well, this is something
that we should all be really talking about. And I think for me
in the Asian culture, I’m first generation American. So there’s a huge
stigma and, like, I don’t want to talk about it. I’m not crazy. So for me, YAG was
a great opportunity to get involved early
on to really be like, we should talk about this in
the community where, you know, it’s OK. Just like you broke your
arm, just like you sprained your ankle, like,
I’m depressed or I’m feeling this way and that way. And that’s fine. So for me with
parents, I wish my mom and my parents
talked about it more. I wish they talked
about their feelings and they were really
candid about it. Like, they don’t have to hide
the fact that they’re stressed or, you know, they’re tired. They’re going through
this and that. Like, I think with kids,
they realize more than not that you’re also human and
it’s OK to show that that’s your feeling right now. So I mean, that’s
kind of my story and why I’m really passionate
about youth mental health, and I think there’s a
lot we can do, especially in the area given that
there’s a lot going on here, with everything, from being an
adult, to trying to find a job, to graduating and
going to college, or going to the right college. There’s just a lot going on. So I think we can open it up. I have a couple of questions
from my youth and for our staff if any of you have questions. Right, I think we want people– Yes. This is a good time to start
writing down questions, and then we can start
collecting them– Sure. –if people have them, and
they want to particularly ask. Awesome. So one of the questions
what I have for you ladies– thinking back to high school– for those of you that
are still in high school, thinking of school right now– what are some key insights that
you three can offer to parents about talking with their
teens about the issues that they’re hearing about
that are going on at school? Like, how would you say– like, if I was your
mom, Casey, and I heard that something
happened at school, how would you want me to ask? You know, would you be
like, Casey, darling, I need to ask you a question? Or how would do
you as a youth have taken any kind of communication
from your mom about stuff? Yeah. I guess I could start. Because you have the mic. Yeah. So I think, thinking
back to my experiences, I always felt like
I knew when she was coming to talk to me
about something important. Like, it was like ah,
hey, do you have a second? [LAUGHTER, GROANING] And it kind of set the
tone of like, OK, like, I don’t want to talk
about it, right, because I know you’re going
to ask me something serious. I don’t want to answer. Like, I don’t feel
comfortable answering it. How would I want
her to address it? Oh man, I don’t know. I feel like it goes back– it’s
just kind of like, for me, I wish my mom talked
about her experiences as much as she wanted
to know about mine. I feel like she’s always prying
about, like, how’s school? Like, how’s dance? How’s this? How’s that? And it’s like, it’s great. It’s fine. Like, but she never
told me like, oh, at work, like totally
stressed right now. We’re like, oh, you know, I
went to hang out my friends, and we talked about this,
and what they’re working on or what they’re traveling to. I think now she’s
making more of an effort to really talk about things
that she plans on doing herself, which I think helps the
relationship because it’s not so much like, how do you feel
like, what are you doing? Like, constantly, it felt
like she was, you know, questioning me 24/7 and– Nice. Any of you want to– Yeah. –answer that question? Please, sweetie. I think, don’t
minimize the problems, because, if your kid comes up to
you, that’s a really big deal. Because I know, like, more
than half of my friends will not go to their
parents, because they already have a set mindset about what
the reaction is going to be. It is going to be bad
They’re going to judge me. They’re going to
treat me differently. And it’s amazing
if they come to you and want to talk because I
know from my experiences is that they always want
to talk about something. They always got
something on their mind. But if you ask them
in a direct way, they’re not going
to want to tell you, which does make it
more difficult to approach the question. And I think, yeah, comparing
your childhood to your child’s childhood is way, like– it’s not good at all. Yeah, I know my mom grew up in– she was first
generation American. And her family was very
strict about it’s school and then home and that’s it. And so any time my mom would
compare my life to her life, she’d say, oh, well, you’re
lucky you can have a friend over because when
I was your age, and that turns the
conversation off. Nothing’s going to
get resolved at all. And there are so
many more issues that kids are dealing
with these days, especially with social media. And I think kids have to grow up
way quicker in this atmosphere, and the demand has
increased dramatically, I know for a fact,
especially in Silicon Valley. And I think parents
should totally be aware of the kids are
dealing with right now and just open your eyes and be
more aware and less demanding and comparing and just realize
your kid’s an individual and even not doing
anything and just saying, hey, do you want to
go get ice cream, like, that can be enough. Thank you, Phoebe. I think maybe just when
coming up and talking about an issue, come in with
an open mind and kind of don’t be upset if you don’t
get the response that you want. I know that would happen
a lot with my mom. She would come in
and how Casey said, like, hey, how’s it going? Do you want to talk about this? And I would be like, no. And then she would get angry,
and then be like, well, why don’t you want to tell me? Like, you know, I’m
here to talk to you. And you know, if you come in
with– even if you don’t get the answer that you want, just,
if you say like, well, when you want to talk about it, like,
I’m here to talk about it, and don’t forget that. Coming at it in that sense,
instead of being angry and turning it
into a fight, then that would be a better
way of getting some sort of communication started. Thank you, sincerely. The final will be– Are we going to
take some questions? Yeah. Sure. Before I do, I just
want to thank you guys. You’re really wise and we’re
really glad you’re here. And you know, I think– I just want to echo
some of your comments because, you know, there have
been times when I sort of get asked similar questions,
in particular, as it relates to issues of stigma. And you know, one of
the things that we also talk about sometimes, you know,
particularly with families in this community, and I
will share with you that I am the father of four girls. My youngest is, I
think, pretty much today finished her junior year
at Gunn High School. And I think one of the things
that I would say that I think is very important is, you know,
we also, you know, as a parent trying to not put too
much pressure on my child and let her know,
you know, and let all my kids know that I
love them no matter what. But I think to one of
the points that was also made is that it’s
one thing to say, you know, we love
you no matter what and you don’t have to be perfect
in everything that you do. But you know, I think
like for my daughter that has this dad that’s this
child psychiatrist at Stanford and a mom who works at
the law school at Stanford and has this idea
of, yeah, whatever I do is fine but,
like, you know, aren’t I supposed
to be just like you? Really? And aren’t I supposed to
work here just like you? And so I think part of what
also becomes important is, you know, the conversations
that we have about, like, all the times I’ve screwed
up and all the things I’ve done wrong and all the things
that have embarrassed me and all the times
when I got depressed and when I really struggled
with stuff with my parents and my own family. And I think to
your point, really being a human
being with our kids so that as much as the
message is, you know, you don’t have to be perfect
and look at all the times we had not been perfect
too and really being human with our own
children in that way becomes very important, I
think, in giving my daughter’s permission to sort
of be who they are and to explore on their own
and to give them space to try and to fail and to fail to
fail until they figure out sort of their course. And so I just think it’s
a really important part of what these young people
are also sharing with us. And I think as parents, it’s
sometimes very hard for us to do. But I think it’s
a really important for us to keep in mind. So I just was
thinking about that in relation to
some of the things that you guys were
sharing and wanted to thank you for that as well. I want to answer a couple
other questions that have come up so far. One of them was are
there pediatricians for teens or general
practitioners at our center. And unfortunately, we don’t
have specific primary care clinicians that are
working in our center. We partner with some, though. And one of the questions
was, you know, where do we find other primary
care people that focus on physical and mental health? So for example,
as we are looking at creating these integrated
health, mental health spaces, like this Headspace
program, as we’re looking at putting
one of these sites in the north part of Santa Clara
County, one of the partners we’re really hoping to work with
is our own adolescent medicine clinical team, here, at
Lucille Packard in Stanford. You know, they do a lot of
work around eating disorders, but they also have general
adolescent health clinics. And so they are a good place
to check out within the, you know, primary care clinics
and both internal medicine and family medicine that have
started within our system as well. There are many clinicians
that are really interested in adolescents
and young adults too. So those are the ones that
we’re sort of working with, as well as people at some of
the federally qualified health centers in the community. We’re looking at our
site in San Jose, having actually some
of the primary care specialists from the county as
the other primary care partner that we’ll be
working with as well. So that’s just a couple of
suggestions of the people that we’re sort of arguing
with on the primary care side. One of the other questions
that I’m going to try at is, how would you
approach another parent if you see red
flags in their child that the parent
seems to be missing? You know, and again, I think
about this as a parent, but I’m– part of the problem is I’m
a child psychiatrist, right? So when I go to the
other parent and say, you know, I’m concerned
about your child, it’s a little bit of
a weirder conversation than it might be if some of
you had that conversation. I think part of
the issue sometimes is being able to have the
conversation initially in a way that– I mean, in order to do it
in a non-stigmatizing way. Because I think one
of the issues that causes so much stigma, around
and with mental health issues, is there’s this
sense that really is common in our
communities, which is, what’s the matter
with that child? What did that parent do
wrong that their child is having this issue? And there must be
something about how they were raised wrong or
something that they did. And we don’t give a lot
of room for this notion of neurobiological illness. We don’t give a lot
of room for sort of the health and
mental health aspects, of having mental
health conditions. We don’t care what as it relates
to trauma and issues related to that as well. And so I think in having
these conversations what might be important
is for one even to first acknowledge that as we
were saying before, you know, I know this has been an
issue that either we’ve been dealing with
within my family or that I’ve been dealing
with or finding some way to normalize the
issue even right up front so the parent’s not
feeling like they’ve done something wrong
right as you start talking to them about
the concerns you have. And I think there
are also ways that we can have these
conversations that come out of a place of love and concern
for other kids and families, and there are ways to
get that message across. And with that, one
can raise the question in a wondering
and supportive way and being very
clear that there’s no intent in terms of blame. But really, whether it’s
your child has noticed this or having their child
at their home sort of leaves you wanting to be sure
that everybody’s doing OK. It also raises for me one of
these other questions where, you know, I think with at least
three of my four daughters, I’ve had to call
parents, you know, at 11:00, 12:00, or
1:00 in the morning and tell them about the text
messages from their child to my child about whether
or not their child might be thinking of hurting
themselves or killing themselves. And you know, and so the
conversations I’ve had at home have really, you know,
been with our children around having a low threshold
for coming to us when they’re worried about something their
friends are telling them around us. And then at the same time,
when they had to do that, for our kids, it’s
really been a struggle because they’re
worried about what’s going to happen
with their friend, if their friends knows
that they’ve told us, and we’re going to
tell the parents, and these struggles
around, you know, would you violate your
friend’s confidentiality to save their life. And having those conversations
up front sometimes seems really important. And then, you know,
what I would say is that there have been
some times where we’ve done those calls,
either my wife or I, and some have gone much
better than others. And you know, sometimes, it’s– you know, my daughter’s right
here next to me in the room. She seems totally fine. I’m not sure why
you’re bothering us. Everything’s really OK. Thank you very much
for your concern. Bye. And you know,
sometimes, they have very difficult
conversations around, well, you know, these
are things– you know, we’ve been worried
about her and I’m glad she’s talking
to your daughter. And sometimes, then
asking me, because they know that, wondering, what do
you suggest we do, where do you think we should
go, and then being able to have a different
kind of conversation. But I think there are ways to
have these conversations that can happen in a form of
supporting how normal it is that our kids are struggling
with these issues, having these conversations in
a very supportive and kind way and in a way that
you’re ensuring that these parents
don’t feel blamed or that they’ve done something
that they shouldn’t have done or are causing something bad. But really, it’s out of
concern, and that you know the young person will
get better if they actually get the support that they need. OK. I don’t know if any
of you want to speak to any of these questions. I was going to ask one. OK, we have a couple more
questions from the audience, and this is for the youth. And this one is
kind of the same, so I’m just going
to read one now. What are the kind of
issues that make you feel stressed or depressed? And other way of
saying that would be, what are the big things that are
stressing you out these days? There’s a long list. I think I was really
anxious as a kid, and I didn’t really know what
anxious meant until I started kind of thinking about
it a little more, maybe eighth or ninth grade. And it was like, I didn’t
want to go out of the house because I was scared I’d see
someone I knew and then what if they tried to
talk to me, just like little elementary
school stuff. And that stuff really followed
me throughout high school. I still have social
anxiety going into, like, bigger events and stuff. So there’s social
anxiety, and then there’s also stressed with school,
because, apparently at Gunn, a B is failing. So that’s pretty,
like, intense, I think. And most of my friends have
GPAs, like, above a 4.0 and that’s expected. And it’s scary that that’s
what people are shooting for, and I’ve seen people literally,
like, tear their lives apart trying to get to that goal. And when they get there,
nothing’s changed. They’re still unhappy and,
yeah, I tried to achieve that and I had a really
hard time reaching that and it didn’t fulfill me at all. And trying to find meaning
and sense in a world that your parents are telling
you that, just focus on school, it’s OK, and you’re
still trying to find your individual identities,
it’s really tough. And then I’ve also
got friends going through a lot of problems. I have a friend whose
parents are getting divorced, and that’s really
intense realizing that your parents
aren’t invincible and they have problems too. That’s something that really
I think affects a kid, and it hits you pretty suddenly,
the fact that not everyone that you’ve grown
up with is perfect and you’re not the only
one that has problems. And I think definitely
talking to your kids and making sure that they
know you’re human too, that they can’t just yell
at you and, like, expect you to just bounce back,
that it takes a toll on you too and just kind of trying to
help that power differential and don’t be condescending
towards your kid because otherwise,
they’re never going to see you as a person
they can talk to ever. It won’t be equal. So, yeah, family, school,
friends, all of that, the future. Thank you, Phoebe. I think she touched on
everything I was going to say. [LAUGHTER] I feel like I’m stressed
about different things now than I was when I was in
high school and then college. I mean, when I was
in high school, it was all about getting
into a really good college and where are you going
to go and where are you going to take your life,
like, which way you’re going. And it was all about
grades, getting good grades, but also doing
extracurricular activities so, like, you stand out– starting clubs, joining sports,
and doing all these things to get into a good college. And then once you’re in college,
it’s all about surviving. And a lot of people drop
out their first year because they go in not
knowing what to expect. So, like, then once
I was in college, it was just about,
like, staying in there, getting good grades there. And then, now that
I’m out, it’s lonely. Because, I mean, a
lot of times, you lose a lot of resources
when you leave college. You come into the
workforce and it’s about where you’re
going to work. And like, for me, I was
living in San Francisco. And when I moved back home, all
my high school friends, like, I hadn’t really re-connected
with them in like four years. But then all my current
friends were back in San Francisco,
which isn’t that far. But still, if I’m working here,
I can’t go back every day. So kind of changing
from being a student my whole life to suddenly, like,
working, that’s a huge change. And it all kind of ties together
because at the same time, there’s also family
things going on– like, relationships with
my mom or, you know, people getting
sick in the family, you know, also being a good
role model for my siblings. So it’s all these things
going on all at once that sometimes you feel
like you can’t take a moment to take a breath
because if you do, you’re going to fall behind. So yeah. Do you want another question? This is a great question. Great question–
you’ve given some great examples of what not to
do or say and how not to ask. Can you give any ideas
or examples of how we– and I’m assuming we is parents– can learn what a teen’s
life is like in 2018 when asking directly
is off the table? Great question,
whoever wrote this. Do you want to take it? Go for it, Phoebe. Yeah, that’s a hard question. I know that there’s definitely
a weird change and shift in the dynamic between
a parent and a kid, especially when you reach
adolescent stages of life. I think it hit me when
I was more like eighth and ninth grade and I always
had kind of a close connection with my family, my parents. It was easy for me
to talk to them. But then starting
school, like, at Gunn, and then all the changes
in friend dynamics and just realizing that my
parents couldn’t keep up with my social life where, like,
my friend would do something mean to me. I wasn’t friends
with them anymore. But then they’d ask me about it. And you’d just like
kind of freshen the wound more of
whatever fight I had. And it would just
make everything worse. And I think just don’t do it– wait. I said, don’t do don’t. What do you do? Be more of an equal to your kid. And I know that’s not
necessarily the best way to approach every situation. You can’t be an
equal to your kid because that’s just
not how it works. But trying to put it in a way
that you don’t know everything. You’re not superior to
them it’s always the fact that you can provide a house
and food and resources– not relevant to this. Just try and make
sure they realize that you’re not trying to
be condescending by asking and that they maybe
don’t need help. Just talk. Just– does that make sense? Yeah, just try not to condescend
and try not to fix the problem. Just listen to the problem
because there’s definitely an issue in mostly
Silicon Valley, I think, that’s immediate satisfaction
and gratification. And that’s just not
something that you can do when it comes to relationships. It’s not something that,
oh, it’s going to fix. You’re going to build this
connection with this person like just like that. And things change
really quickly. So I think just being
able to support them throughout the issue and
not try to resolve it or come up with the solution. We have a clarifying question. So I’m going to pass
the mic to someone in the audience really quick. So I have heard and
read that sometimes if you want to get sort
of a snapshot of what’s going on with your own child– so I’m wondering if this
sounds like it would be reasonable to you– to ask
your child about their friends, not necessarily
how are you doing. Get at how their
social group is doing or ask a question
about a friend that I’m aware of that was
struggling with something or broke up with
their boyfriend. And that might prompt you to
then share your own experience. I don’t know, just that. I think that bringing
up specific individuals is not necessarily
the way to go. I found it’s easier to do
a really open-ended prompt, like I’m– We can tell you’re a
child of a psychiatrist– Yeah, my mom’s over there. Yeah, everyone look
at her real quick. [LAUGHTER] Prompting– I think
an interesting way to do it is like,
just every day, ask for a bud, a
thorn, and a rose. A rose. Yeah, and I– Cool. Yeah, it sounds confusing. A bud is something that– You’re working. –you’re working towards
or you’re excited about. And it kind of promotes
the idea of, like, looking forward as opposed
to being stuck in the moment because that’s sometimes hard to
just see that every day, you’re going forward and you’re
going to go somewhere and it doesn’t have to– this is
not a defining moment for you, that there are things
you can work for but you won’t achieve right away. And a thorn is
something that may have sucked that day or
just didn’t go as planned. But it doesn’t necessarily mean
it’s going to completely cut the whole rose off. It’s just something that
maybe got in your way. And then a rose is the highlight
of your day or something. And I think that’s
an interesting way to kind of approach it
because that’ll get them to start talking about,
oh yeah, and then today, like, so and so came
over to me during lunch and we had a conversation and
we really connected or whatever or like, oh, during class. Like, yeah, so I think a great
way to cut the conversation off is to ask about
a specific person or, how’s the friend
dynamic going? That’s– no kid feels
comfortable talking about, well, this girl shut me out
of the group today or, oh, they’re not talking to me
for some reason or, oh, my boyfriend broke up with me. It’s not necessarily
something that you’re going to just jump right into. Can I borrow that, real quick? Do you want to add, too? I was just going to say, like,
it also depends on your child. I can come up here and tell
you all what works with me. But the first step
is communicating with your child to see like,
oh, what’s not working here? What do you think
I need to work on? And maybe like talk
to them that way first because if you just
suddenly change your dynamic, that’s also going to
going to throw them off and they’re going to be like,
well, like, what’s going on? Like, what are you trying to do? So I mean maybe
trying to understand the kind of kids you have. Because, at least for
me, I would rather have someone be more
direct and ask me, like, OK, so I want to
talk to you about this. But for someone else, that
might be too intimidating. So I think it’s all
about, like, working with what you have at home. Is there another question? We’ve got some. Yeah, I have some. Yeah, answer some of this. Really? Yeah. I’ve been wanting
to say one thing. As a person who’s been put in
the mediator role with– you know, I would be the one
building the relationships with the students,
and then parents would ask me that question. Like, why does she talk to you,
but she doesn’t talk to me? How can I do that? And so there’s a couple
things that I’ve learned that I will tell parents. And one of them is
build a relationship. Again, every opportunity is
an opportunity to connect. Most of the work
that I really did didn’t happen in my work groups. It didn’t happen
in my one-on-ones. It happened on the
drives to someplace. They happened on the, hey,
I haven’t eaten today. Casey, come with me. Let’s go grab a burger,
because my mom said, if I’m going to eat, I
have to buy something for somebody else. And those conversations happen. So they weren’t so poignant. They weren’t so direct. But they kind of happen
on the on the sideways. And so building
those relationships, open it up, in terms of
being able to connect. That’s what normally say. Real quick, real quick. And I mean, Ana and I both work
with all of the young people that we work with. And one of the things
that I realized is I don’t realize when I’m
connecting with a young person. Like, I never get it. I’m like, how did this
all of a sudden happen? Like, why are they telling
me all this information? And it’s because I
ask questions like, so what are you going to do? And they have to tell me. I have no advice for you. I want you to tell me
what you’re going to do. Well, did you ask them? Like, what do they think? Do you think it’s going to work? And let them figure out
how to solve whatever it is that problem is
for them because they do have the answers. And sometimes, we give
advice and the advice is really, really bad. But they have the
information in themselves. We just have to, like,
kind of reel it out. And so we just kind of, you
know, fish around a little bit, see what’s going
on in their head. They’re usually willing
to give you information. And then all of a
sudden, you get stuck and you’re like,
OK, that’s enough. I’m good. Take it away, Steve. All right, I actually wanted
to hear more from the youths, so sorry. One of my questions
was, how can we differentiate between
normal teenage behavior versus depression versus
anxiety versus ADD? And I think this reminds me
of a question a friend of mine had about her 10-year-old kid. He came home from
school one day and she noticed he was just
more withdrawn, not quite as interactive. And you know, she sort of talked
about the mommy spider sense that you get when
something’s up with your kid. And I know for you
parents, you know exactly what I’m talking about. You’ve known your kids
your entire lives, their entire lives. And part of it is not
only paying attention to the very frank
shift in your kids sometimes but also having a low
threshold to sort of talk it over as mom and dad together. And then at some point,
if noticing that, this change is sustained
for a period of time. I don’t want to get into
DSM V diagnostic criteria, but quite frankly, you
know, parents are obviously paying attention to their kids. And if you are starting to
get concerned for a sustained period of time and
it’s even starting to affect, like some of
the basics of their lives like, you know, they’re not
taking care of themselves as much or they’re
more irritable and it’s for a sustained
period of time, I would argue it’s
probably a good time to start checking out some
more sources of information. Hopefully you’ve also nurtured
some kind of relationship with, you know, your child’s
friends, maybe their parents, and just trying together a
little bit more information if and at all possible. I think the other good place
to potentially check in on is just trying
to talk to them and just maybe even
considering trying to create an open space
to have that conversation if your child is feeling
comfortable enough to do that. And more often than not, as
they’ve mentioned, it’s not. And that’s OK. Sometimes it requires
a little bit of time, you know, walking together or
driving somewhere together. And that’s kind of
when you can start to have the beginning
of that conversation. And it might not be anything in
the way of a major depressive disorder, you know, general
anxiety disorder per se. But the simple fact
that you noticed it and you notice
early on I think is a great place to
start the conversation. And if it’s not
getting any better, I would argue that deep
down, your child doesn’t want to suffer for that long either. And this is a great time to sort
of bring it up as mom and dad together and trying to take
a more supportive stance and just trying to figure
out how to help them. Deep down, you know,
you and your child want them to self-actualize. Sorry, that’s from
Abraham Maslow. He has this hierarchy
of needs thing. And you know,
self-actualisation is when you want to reach, like,
your superstar potential internally. And you want to help your kids
reach that superstar potential. So if we’re all sort of on
the same page in terms of kid wanting to be a superstar
and you wanting your kid to be a superstar,
you know, why don’t we try to figure out together
what’s going on here? So the short of it is that
sustained period of time where you start to
notice the difference and it’s starting to get in the
way of their daily functioning. I think that’s kind of when
you need to start wondering, what’s going on? Do I need to talk with
a school counselor? Do I need to just check in? I don’t know, but
you definitely should try to talk a little
bit more and try to get more information. Trust your instincts as parents. Sometimes your kids might
not be able to talk about it, and part of it is just trying
to create the open space and trying to open
the conversation if and at all possible. So that was good. I’m actually going to piggy-back
on that with another question, because the answer is sort of
the same as what you just said. And then I’m going to
throw it to the youth. So one of the questions
was, how can parents tell when social
media is a problem and what are some ways teens
may respond or self-regulate? So I think how to tell
it’s a problem, I think, goes to what Dr. Sust just said. Trust your instincts. There’s a reason that you’re
wondering if it’s a problem. So you’re obviously probably
picking up on behavior change. You only want to
worry if they’re not taking care of themselves, if
it’s affecting sleep, eating. That’s when you want
to start to worry. Or if there’s something that you
are concerned about, dialogue. Talk about it. Don’t just, like,
being an observer. Just like you would
be concerned if they weren’t eating properly, you
just want to be involved. It’s just part of
the conversation. And I’m going to ask one
of the other questions, and then you can respond,
maybe, to either of those. So each of you has had a
bad social media experience at some point or another, most
likely– bullying, body image shaming, feeling depressed
after looking around. What tools did you
use or what can you suggest to our teen to
limit how deeply they are affected by these experiences? Anyone? There you go. Yes, definitely I have had those
experiences before in the past. I think, for me, what helped a
lot was just knowing that there was someone to go to. I was lucky enough to have a
really strong dance community. So it was a lot of people
that weren’t my parents, that weren’t my family, that weren’t
necessarily adults, but people that I trusted, that I
knew I could talk to, and they’d be really honest. And I’d sob and cry and just
really be emotional with them. So I think sometimes,
it’s not just you need to be the
resource for them. It’s just realizing
they might have really good friends out there
that will have their back and they can talk to. And that’s why it doesn’t
always have to be you. Thank you. Yeah, again, like,
I play soccer. So I’ve had a really
strong bond with my team, and I’ve had some
amazing coaches that I’ve been able to get support from. And I think, yeah, there are
ways that parents can support. But then there are also
ways that other people in the community can support. And I think having those
resources from a young age and forward, like,
extracurriculars are definitely something that is really
important for a developing kid. And yeah, I think I’ve
had the problem of, like, obsessively looking
at, like, someone’s story or seeing other people
hang out without me. And I think what
really helped was just putting my phone down
and living in the moment and living my life right there
because although people might be doing other things elsewhere,
it doesn’t necessarily mean they are having more
fun than me or it’s just an appearance. It’s not reality. So– Thinking back on, like,
one specific event that happened at my
high school, there was an Instagram page that was
made that basically attacked all the girls in my year. And it was my senior
year in high school. And I was part of them,
like posted on that page. So I know what helped
through that situation was that all the girls, who had
been attacked on the page, we kind of like rallied together. And we went and talked
to the principal and they ended up
figuring out who it was. And there were like– they did take action. I don’t know if they were
expelled or something, but at least with us, with girls
who were attacked on the page, we have guidance councillors
and psychologists that talked to us because there
were a lot of hurtful things that were said on
there and also people adding to it in the comments. So we had a meeting with us. And then we also had like a
school-wide anti-bullying kind of like rally too to talk
about, like, the incident. And I think honestly, like,
just the fact that the school had that for us– because I know some schools
would have just been like, oh, like, that’s not our problem. That’s on social media. Or a principal probably just
would have expelled the person and just left it at that. But the fact that my school
kind of took that extra step to, like, talk to us and, like,
see what we were going through, like, that helped. I know for me, my best
friend was a person who helped me through
that situation because I know I felt
really, like, hurt. And it affected my
self-esteem, like, pretty bad. But my group of friends
were very supportive. And I think honestly, like,
when it comes to that situation, the person you go to is your
best friend, unless it’s your best friend–
which that can happen– who is attacking you. Then it kind of just depends on
whatever other support system you have. But, for me, it was my
best friend at the time. I think that’s all
we have time for. And I just want to thank
our youth panel, especially. [APPLAUSE]

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