A Crisis Among Us
SYDNEY LEWIS | DEC. 14, 2018 | FEATURES
Disclaimer: Due to the sensitive nature of the story, the names of certain sources have been withheld in order to protect their privacy.
Photo taken by Katie Stevens
Teenagers in modern America have grown up in a transforming society dominated by technology, acute social pressures and uncertainty about the future. These forces, research suggests, have produced a trend of deteriorating mental health among American youth. But while the number of teenagers suffering from mental illnesses continues to increase, the amount receiving treatment for mental illnesses remains disproportionately small. According to a study published in November 2017 by the Association for Psychological Science by psychology researcher Jean Twenge, the number of American teenagers who felt “useless and joyless” increased 33 percent between 2010 and 2015, while 80 percent of teens with a diagnosable anxiety disorder and 60 percent with depression are not receiving proper treatment. In the escalating mental health crisis, young adults are particularly at risk, making mental health a key concern in high schools such as Stanton College Preparatory School.
Societal misconceptions and a lack of involvement from the broader community can contribute to poor mental health, making the prevalence of chronic teen mental health issues more pronounced and damaging. Several students at Stanton suffer from such chronic mental health problems. An anonymous senior at Stanton has battled with clinical depression for over a year. His treatment program consists of the prescribed antidepressant Prozac and weekly therapy.
“Depression has changed my life completely. I’ve gotten better since I was suicidal, but those thoughts and ideas of suicide never completely leave you,” he said. “I feel a general apathy and disinterest in many things I used to enjoy, as well as not caring about the consequences of anything I do.”
Common misconceptions about mental illnesses can undermine the struggles of those suffering from them. Mental illnesses are a complex topic, yet are often oversimplified and thus misunderstood by those who have not experienced them.
“Society tends not to understand depression,” said the senior. “Many people think depression is merely sadness; however, it’s far more than that. It’s emptiness, hopelessness, despair.”
One anonymous junior has struggled with several mental illnesses since the eighth grade. The junior, who was diagnosed with generalized depressive disorder, generalized anxiety disorder and social anxiety disorder, has attended therapy and taken medication to help her cope. Yet her mental illnesses still influence her life, with the consequences ranging from constant unease to uncontrollable panic attacks.
“Depression has changed my life completely.”
“It’s definitely a struggle, it’s definitely hard. I feel like a lot of people generalize anxiety, but having an anxiety disorder like I have is something completely different,” she said. “It’s not necessarily just being nervous, and with me specifically, it’s that I’m nervous all the time about a ton of little things that shouldn’t bother me.”
For both the junior and the 6.3 million other American teenagers currently struggling with a diagnosed anxiety disorder, academic pressures may play a role in the severity of their disorders. While not the primary cause of anxiety, high expectations to perform well in school can magnify stress and contribute to existing conditions.
“I was diagnosed in eighth grade and it got to be really bad when I was worried about going to Stanton and living up to my full potential,” said the junior. “But I think being in such a stressful environment has also opened my eyes to what my depression and anxiety are really like.”
Both the junior and the senior believe greater awareness could lead to improved conditions for those with mental illnesses. Though society has advanced in understanding and treating mental illnesses, the importance of mental health is often downplayed compared to other issues.
“A good start would be to educate people on what depression actually is and how it affects people, as well as on treatments for depression,” said the senior. “We get so many presentations on sex, drugs, smoking and diseases, but nobody ever talks about mental health. It’s a taboo simply because people don’t understand it and feel uncomfortable.”
Photo taken by Katie Stevens
According to a report by the National Alliance on Mental Illness, the sensitive and stigmatized nature of mental illness may inhibit meaningful conversations about them, despite their prevalence among all racial and economic groups. In addition to the societal lack of understanding of mental illnesses, their inherent private and emotional nature can make it hard for people to open up, even to parents, friends and professionals.
“Stigma plays a huge role. It can be tough to talk about things that make us feel ashamed, embarrassed or awkward,” said Mr. Kyle Fessenden, one of Stanton’s guidance counselors. “There can be inflictions that are very deep and very painful that you never see.”
Though the junior and the senior were able to receive treatment, not everyone can afford or access resources such as therapy and medicine. In the face of such a disparity, the lack of community initiatives for mental health presents a distinct problem. While a licensed professional is not necessary for treatment, a lack of accessibility to even the most basic mental health services can have far-reaching consequences.
“I’m nervous all the time about a ton of little things that shouldn’t bother me.”
According to the Florida Policy Institute, Florida ranks 49th out of the 50 states in provisions for mental health services and Duval County is the last school district in the state for per-capita mental health spending. This suggests that Jacksonville high schools are among the lowest in the country in terms of mental health funding.
This does not indicate the number of mental health programs on local and state levels in Florida is insignificant. State funding for mental health programs comes from the Florida Department of Children and Families, under which the Office of Substance Abuse and Mental Health Services (SAMH) operates as the single state agency for the provision of mental health services. In 2015 and 2016, the SAMH provided Lutheran Services Florida, a private non-profit organization dedicated to behavioral health treatments and preventative services in North Florida, with $102 million. Of the funding, $53 million was contracted for community mental health services, which funds crisis, treatment and rehabilitative services.
The funding from the SAMH also provides Duval County public and charter schools with 60 school psychologists and a Crisis Management Team, which work together to meet the emotional needs of students with mental illnesses. The Crisis Management Team is usually utilized in the case of a tragic event such as a natural disaster or death of a classmate, but also for students who require immediate emotional counselling. However, these resources have not proven to be enough to curb the alarming increase in mental health illnesses among Duval County students.
Photo taken by Dani Brewer
Increases in mental health issues among students correlate with decreases in mental health funding and support services. The lack of community mental health initiatives manifests in low numbers of school psychologists and prevention programs. The secondary support team responsible for serving all Duval County middle and high schools consists of only seven psychologists. Stanton’s designated school psychologist, Ms. Deanna Zastrow, is assigned to 11 schools officially, and informally provides assistance to other schools as needed.
“Personally, I think society as a whole dismisses potentially serious symptoms as just ‘teenage behavior,’ which can delay treatment for these individuals,” said Ms. Zastrow. “It’s like we expect teenagers to behave like adults, but not experience the emotional or social consequences of actually being an adult.”
The National Association of School Psychologists recommends 500 to 700 students per school psychologist, but the average Duval County middle or high school psychologist is currently assigned to over 11,000 students, suggesting a fundamental problem in the way the district utilizes its mental health resources. It could also indicate that district leadership does not recognize the need for a psychologist and other comprehensive services during adolescence. Zastrow herself is assigned to 10,500 students, greatly curtailing her ability to provide proper and direct assistance.
“In my personal opinion, public education is facing a systemic crisis, especially in Florida,” said Ms. Zastrow. “We are underfunded, and morally and legislatively under-supported. Obviously, limited resources affect what supports can be provided.”
“We are underfunded and morally and legislatively under supported. Obviously, limited resources affect what support can be provided.”
Due to the lack of accessible psychologists and community outreach programs, people with mental illnesses often forego treatment until institutionalization seems to be the quickest option to stabilize them. Consequently, people with mental illnesses are often referred to outside agencies.
One such external provision is the controversial Florida Mental Health Act of 1971, also known as the Baker Act, which allows people deemed a threat to themselves or others due to mental illness to be involuntarily taken into custody for a minimum of 72 hours. According to the Florida Mental Health Act Fiscal Year Annual Report, in 2015 and 2016, there were 1,476 Duval County minors who underwent involuntary examinations under the Baker Act.
Although the Baker Act is intended to strengthen the community by preventing people from harming themselves and others, experts doubt whether the act is ethical or if it achieves the long-term goal of improving the mental health of the individual. The overall effectiveness of the law is difficult to determine because the circumstances vary for each case. While some Baker Act initiations may be justified and necessary, there are other instances in which the law is misused.
An anonymous sophomore at Stanton, who had no previous history with depression, was Baker Acted by law enforcement in the middle of the night. The death of his father provoked a bout of despondency that led to him being Baker Acted.
“I felt like a caged animal with no freedom,” he said. “Being locked up really didn’t help the situation.”
The sophomore stressed the importance of emotional support as a major factor in his recovery. He believes that for those from suffering from mental illnesses, especially depression, having someone to vent to can help alleviate their sorrow.
“My father passing away has taken a toll. It’s caused some depression, sometimes making me a bit moody. But other than that, I’m fine,” he said. “I depend on my mom for emotional support if I ever feel down because she’s always there for me.”
The sophomore was held in custody for three days, but received mental counseling for only one day so authorities could monitor his progress. Notably, another Stanton student was being involuntarily detained at the same time and institution as the sophomore, highlighting the fact that his experience is not isolated.
“My thoughts on the Baker Act is that it’s honestly kind of stupid,” said the sophomore. “If someone is really suicidal, locking them up for three days in a place where they get no fun or form of activities would drive them mad.”
For Stanton’s administration, addressing mental illness is a comprehensive process which requires cooperation from students, parents, guidance counselors and mental health professionals. Because the administration’s influence is limited to Stanton, open communication between a student and the school can provide the necessary link for proper accommodations to be made.
“Communication between students, their families and the school is very important. As long as that communication is there, that’s how plans can be supported,” said Mr. Matt Hemphill, one of Stanton’s assistant principals. “Input from all areas is essential.”
Though the presence of mental health issues among Duval County students is rising, the number of students receiving aid is decreasing. In 2015, 19 percent of Duval County high school students reported having attempted suicide, compared to 8 percent nationwide. The effects of the worsening mental health crisis are evident on a school level as well. In a survey conducted by the Devil’s Advocate in November 2017, 43 percent of Stanton students reported feeling hopeless or depressed in the last week. Despite the disturbing increase in suicidal thoughts and depression among students, the number of clients receiving children’s mental health services from Lutheran Services Florida dropped 40 percent between 2009 and 2016. The continuous decrease in the number of adolescents receiving mental health services may be the result of varying personal circumstances, but could also be indicative of a wider community issue.
“I felt like a caged animal with no freedom.”
Serious mental illnesses, when unresolved, can be harmful to both the inflicted person and those around them. Postponing treatment may lead to long-term mental and physical repercussions which come with their own set of problems, creating the need for more expensive services. The profound ramifications of untreated mental illnesses do not exclusively impact those struggling with them, but also their families, friends and communities. Despite the enormity of the mental health crisis, mental health professionals such as Ms. Zastrow believe localized advocacy can have a positive impact on a community’s approach to handling mental illnesses.
“Advocate! Show up to school board meetings and voice your concerns. Write and call lawmakers at both federal and state levels,” said Ms. Zastrow. “Get involved at the school level by writing grants to fund mental health initiatives.”
Treating mental health disorders and preventing their consequences is fundamental to a community’s well-being, as improved mental health leads to greater academic performance and lower rates of suicide, dropout and substance abuse. As a community, regardless of the resources provided by the district, it is important to be able to identify and treat mental ailments properly. Collective involvement aimed at raising awareness about mental health is a worthy and rewarding endeavor, but it begins with a thorough individual understanding of mental illnesses.
This story appeared in Volume 34, Issue 2 of the Devil's Advocate, published in December 2017. Read the full issue here.