 Lovett founders of the organization that I'm a new employee of are here, so I would like you to spontaneously applaud every time I say anything. So I'm Cindy Button, I'm a clinical psychologist and I work at the Jed Foundation. I'm a senior clinical director for a high school program at Jed and I've been here for about a year. I have been working with adolescents in real school news and young adults and their families for about 30 years now for a long time. And so what I'm going to do tonight because there are so few of us is have this be a little bit of a conversation. So what we're going to talk about is mental health and young people, teens and young adults. So the first one I wanted to know is what brought you to this program? Before we sort of start with my field, why are you here? What appealed to you about the title? We've been to other presentations here and found them very helpful. I'm a retired principal from the city. We pay to aid and we are happily here. We have 10 grandchildren, one paralyzed with the thought of moving ahead. And one unable to graduate, so all information is helpful information. That's the two oldest and there's eight more beyond. There's a thing going on. We're very, very interested in your presentation. Yeah, good. And so we'll try and talk a little bit about what are some of the ways you can help young people right now. It's a particularly challenging time for young people. Can we have a junior? High school? I saw a presentation four or five years ago and we were just starting set to go. And just thought that was a brilliant way to frame high school launch. And we're from neighboring town and work with you. We have a DFC coalition, a community coalition, mental health is a key part of that. And we're also parents. Yeah, right. Of teenagers? We both have a youngest who graduated high school in 2020. So interesting and challenging time to do that. And then I have three others going up to 26. So for those who don't know, we'll talk about set to go. Set to go is a curriculum that helps young people prepare for a successful transition into college and sort of build self-care and life skills during those first few years of college. I'm going to show you sort of a screenshot of it and show you the link that you can go to later on in the talk when we talk about some of the skills we want to help young people have as they move into and through that college experience. And it was developed by the JED Foundation among other resources. I have a daughter who also graduated in June of 2020. She did start school, but everything was remote. So she hasn't gone to campus yet. She has done everything just remotely and so we're anticipating changes. So she'll head back in person. Do you know for sure that she won't? Good. Okay, great. Yeah. Do you want to introduce yourself? Well, I mean, I'm here because of the JED Foundation, but also I have all three of my children struggling with issues. And presently my elder two, my eldest is the one who has serious issues, but actually I don't want to suffer anyone right now. I'm a junior who's struggling in Australia. I've got two young ones who are struggling right now. So thank you for being here and thank you for being open about that because a lot of young people are struggling right now. And we don't want to be embarrassed to say that out loud, right? We're going to talk in a few minutes about modeling our own openness about needing health and our own non-stigmatizing language around challenges with mental health, right? So that was a great example. What brings you here tonight? I'm proud to you. I've seen you count this time on Zoom, but in all this time I've never had a chance to actually physically give you a hug. And that's why I'm very grateful for this opportunity and very happy. I just would say for many years the JED Foundation is focused on college students, our high school students, is relatively recent this year. I'm not just kicking you off, but I'd say it's happy that Sarah invited you. It's a lovely community. So filling on our being very humble, they are the founders of the JED Foundation. And they founded the foundation 20 years ago now when they lost their son, JED, to suicide. And JED has done an incredible amount of work long before I came along, really working on the national scene to promote emotional health and more being and to protect young people in terms of working to prevent substance misuse and to prevent suicide. And so JED, as Phil said, has done a lot of work on the college campus scene. Over 300 colleges now across the United States are JED campuses. And when we work with campuses at JED, we collaborate with them to take a look at their systems and their practices and their policies to create a community of caring people on campuses. And now we're moving that work into high schools as well. So we are about a year into our first cohort of partnering with high schools across the country. Again, asking them to take a good look. What are their practices? What are their policies? How are they working with young people to promote social and emotional well-being and how to prevent substance misuse and prevent suicide? JED also has lots and lots of nice resources that I'm going to show you at the end of the talk today that will allow you to sort of pull from some of the curricula and some links that you can use that your young people can use in different ways. So we're going to talk about the young people that we love and their mental health. And we're going to talk about how to help support that and nurture that and strengthen that. So what do we mean when we say that? Can you hear that term, emotional well-being? Self-regulation? Yeah, right? The capacity to manage normal stressors and emotional difficulties, right? So mental health, right? This is a great definition of mental health. This is the World Health Organization's definition, right? It takes into account some of what we just said, right? It's actually a state of well-being in which folks can cope, right? In which you can learn and you can grow and you can realize your potential. But notice it also says you can cope with the normal stresses of life, right? So folks said emotional regulation and coping ability, right? And the whole goal of supporting mental health is so that the young people we love can work productively, can be part of their community, right? Can learn and grow and have a successful transition to adult, right? Notice, though, that this is not, right, a static state. But mental health is not a black-and-white state, right? It's something that we all strive for a lot like physical health, right? So raise your hand if you put on some weight during COVID. Anybody? Right? So we have challenges to our physical health and they come and go in our life. And we have challenges to our mental health when they come and go in our life. So we want to think about when you're working with the young people that you care about, right? When you're caring for them, you want to think about that as a continuum, right? That they're going to be stressed with this transition. And some youth are going to be more stressed than others, right? So how do we build a net of coping and capacity for them as they work toward these stressful transitions? Or in the case of many young people right now, what we're seeing is that as COVID, but we're all hugging and we're all excited to be here without masks. But we've seen actually that now that people are feeling safer, some young people are starting to feel more emotional distress and more mental health challenges, right? Now happen with teenagers and young adults and with children actually, right? That once the danger settles down, they'll begin to feel the emotion. So we want to think about how we can support them as these things unfold. So just a couple of things about mental health in use right now. Some of the trends that we're seeing, right? Even pre-COVID, we were seeing rising levels of anxiety and depression, right? As Sarah mentioned, she's got a couple of young people who are struggling, right? A couple of other folks mentioned that, yeah, that's been going on for a while. We have a lot of ideas about why that is. Some are research-based, some are not, right? Young people are experiencing a lot more stress, right? They're exposed to a lot more information, okay? There's a lot more going on in the world, right? And so we're not really sure exactly what it is, but I do have a theory, right? And my theory is that brain development is actually not where it needs to be to manage the emotional stress and pressure and information that young people are exposed to. So we have to try and help them, right? Manage all the stress and pressure. We also see rising rates of suicidal ideation. Now, interestingly, death and suicide has dropped a little bit in young people in the last two years, just a little bit. But we're seeing that youth are thinking about suicide, thinking about criminal reasons, no frequent life. They're presenting to emergency rooms with these kinds of thoughts more frequently, and suicide remains the second leading cause of death in youth 10 to 24 years old, right? So what we will also talk about tonight is not being afraid to talk to your young people about suicidal ideation and about the impulsive harm, and what can you do if you think that you're adolescent or young adult is at risk, or children too, right? I also want to point this out, right? What we're finding is that youth of color, LGBTQ plus youth, right? Particularly in students who have other stressors like international students, first generation, immigration family students, and other students who are marginalized have additional mental health stressors, okay? So sometimes what happens, right, is that experiences of oppression or invisibility can be traumatizing and can increase mental health stressors. So we also want to be thinking about making sure we see and we understand all of the complexities that go into mental health challenges. Now let's talk a little bit about the good news, okay? This is actually a generation that's very open to talking about their mental health, and what we also have found is that COVID opened that up even further, right? In some ways, right, that opened up for the whole culture, right? There isn't anybody in the room who didn't experience some kind of worry or anxiety, right? They're also as a generation much more culturally accepting and they want to have open discussion about these issues we just talked about, right? And they're really wanting to talk about mental health and deal with their mental health, okay? They want honesty, they want genuineness, and they want to help their friends, okay? When we look at, for example, we ask young people in our surveys of high school students, we ask them, if you had a friend who was hurting or had a mental health challenge, would you want to help them? 90, 95% of them say absolutely, neither would I judge them, nor would I agree that we want to reach out. So they are a generation that really wants to help. So let's talk about how you can help your teen, all right? Given that we talked about there are some stressors, right? There are some concerns that we have about youth mental health, and some of you are working with young people who are struggling right now. What are some of the ways that you can help? So I want you to start by thinking about your perspective, right? Okay, so first of all, we talked about their parallels between mental health and physical health, right? So what do you do if you get a stomach ache, or your teenager gets a stomach ache? It's the first thing you usually do. What are some of the reasons that you're, you know, personally... You don't agree that you eat something bad, that you're going to feel sick, trying to get to the bottom of it, right? Trying to get to the bottom of it. But you just ran through a list of sort of normative causes, right? So you don't start out with an alarmist sort of a sense, right? You start out with, okay, the body is responding to some stressor or germ or bio, right? So mental health is kind of like that, right? When you see your young person getting stressed or distressed, you want to try and help them cope and get to the bottom of it, right? You want to sort of normalize it, because problems are part of growing up, stress and distress is a part of growing up, right? And so we want to provide, we don't understand that stress and distress provide young people with opportunities to grow and mature, and we can scaffold them through those opportunities with the right supports, okay? So I'm going to talk about some of the key areas that I want you to be thinking about with your young people. And the first one is connection, okay? When we're talking about mental health challenges and we're talking about the idea that, right, some challenges to mental health, some stress and distress is normal, right? We want to think about connection as a way to buffer stress. When we talk about mental health challenges, things like anxiety and depression, connection is also key there. We find that young people who have anxiety or depression tend to be able to cope better when they have strong care relationships, when they have caring adults in the family, or when they're able to bond with adults outside the family. So grandma and grandpa, you can make a huge difference in the presence of, in the life of your grandchildren, right, by being some of those caring adults that are present for them, okay? But what usually happens when your teenagers distress? Yeah, you're smiling, so what are you thinking? What usually happens? Sometimes my daughter actually pulls away, you know, like she pulls away from me instead of coming to me as open as my husband and I have at least perceived that we've always been. She still tends to draw in your work. And we're okay with her going to others, but sometimes I think one of the things we've been concerned about is going to like the social media and people, she doesn't necessarily know in person, so that's been a big thing at our house. Turning to people you really know, people you know out there. Right, right. And some of what you're describing, right, is developmentally normal for an adolescent, right, turning away from your parents and trying to find connection elsewhere, right? But it's a tricky edge that you're describing, right? Others can relate to this, yeah? It's hard sometimes to reach out to an adolescent, right? And sometimes family members feel like, well, I want to help, but I don't want to be too intrusive. I want to respect the privacy of my adolescent. I'm not really sure what to do, but what happens in these moments then, right, is the adolescent is left with a vacuum of support exactly at the moment when we need it. So we want you to think creatively about facilitating connection. Social media is an interesting example, right? I like to encourage parents and trust me, this is a hard one for me, because I used to be very anti-social media, but I actually am a late-in-life parent. I'm 14-year-old twins. And one of the things that they have taught me is social media is part of their life. I'm not going to get them not to use it, right? But you can shape how they use it, right? So at Jed, for example, we have a number of youth-facing social media campaigns that are healthy places to go when you are stressed or you have a mental health challenge, right? And I love your suggestion of, okay, who are the people you context, right, when you're struggling, okay? So when you think about facilitating connection in your adolescent, I want you to think creatively, right? So some of it is capitalizing on adolescent narcissists. That's a fancy term. Does anyone not know what I mean when I say that adolescents are narcissistic, right? They are the center of their own drama, right? And actually, this is a brain issue, okay? Because adolescents do not have a fully-developed prefrontal cortex yet. The prefrontal cortex is the part of the brain that allows us to take perspective, to delay gratification, to manage our emotions, and to think about the consequences of our action. So they have lots of intense emotion, they have lots of strong opinion, but they have very low perspective, right? So we actually want to take that and we want to play with that and calculate it, okay? So when you want them to be connected, you want to ask them, right? What's a good relationship look like to you? Who are your role models in social media and why? And when they say something positive about what they like about... I don't know, who's somebody on social media who doesn't have all the influencers in my head, right? Somebody who they like, we say, oh, who are the other people that you know who have that characteristic? Who are people in your life who you know who have that characteristic? Let them teach you about connection, right? I don't want to talk about this, Mom. Okay, you're right. This happens to me at home a lot, right? Because what do I do for a living? So what do you think happens if I... This happens if I try and ask anybody how they're feeling? I'm fine, Mom. I'm fine, okay? So I have to say to them, well, what helps you connect to other people? Who do you want to talk to? Or who do you want to be with, right? I let them take the lead and drive that piece. But I make them talk to me about who they're going to connect to. And what is meaningful connection? And why is this social media bigger? The other thing to do, and this sounds counterintuitive when your kids are struggling, is to practice small. But to dealing with your boys, okay? Why do you think that is? Let me tell you. Make them comfortable. They're just not good at it. They're not good at it, right? Adolescents, and particularly now with social media texting, they don't know how to do small talk. So I have a good friend who raised nine kids and she said that they would sit at the table for an hour every night and everybody had to talk about their day. They didn't have to talk about anything meaningful. They just had to talk about their day. So practice small talk with your adolescent. And the reason I want you to do that is because connection is key. And we want them to learn to make connection in the world. And when they go off to college, we want them to learn to make connection, okay? So practice. Role model, right? So what do I mean by role model? When I'm thinking about connection, narrate a little bit your own connection. You know what? I'm going to go for a walk with my friend Mary tonight. I had a rough day at the Judd Foundation and I need a friend right now. Role model managing your emotions and role model prioritizing connection. Do not hold your phone. One of my pet peeves is families on vacation and one of them is on the phone, right? Put your phone down during family time, right? Make sure there's no phone at the dinner table. It's not allowed, right? So start to role model the prioritization of connection in your family and with friends and with other important people. And use reflective questioning, right? Really ask them, who's the person you really talk to the most? Who's the friend that you care about the most? Who's the person in your life who's the most important to you, right? And don't offer any opinions about what they say, right? But really get them to start thinking about their internal sense of connection and making priorities, right? Remember, validation is not agreement, right? So when you say, who's the guy from the... Who's the guy from the reality TV show who would they cut open the junk of the storage containers and who's all tattooed? He's just a crazy looking guy, right? And my son told me that he really thinks he's great, right? He's got tattoos and he's a boss. So I had to take a deep breath and say what do you like about him, right? As opposed to what are you talking about, right? So get them to reflect on who they admire who they care about, right? Who the people are in their role that they want to talk to. Because that actually just shining a light on that prioritizes in their head connection and gets them to start sorting through who good friends are and why they care about certain people. So use reflected questioning. And also in this moment, someone used the word paralyzed. Remember, right? Scaffolding and curating social connection with Pierce is important right now, okay? For younger teens, it's particularly important why. They were just beginning to build their own... text their own friends and make their own plans and it all got frozen in time, right? And so we need to sort of give them a little scaffolding and scaffolding is just enough support for them to do it on their own, right? So do you have a friend you want to play frisbee golf with today? I asked my son on Sunday because he hasn't been reaching out to his other friends, right? And with an older teenager, can I drop you off in town this weekend and you'll meet a friend, right? Just start giving them a little boost because it's been a year and a half and a lot of them are out of the habit of doing anything other than digital connection, okay? So curated a little bit. The next one, welcome, is for my partner who is 10 years older than I am and who sometimes prefers that our kids don't hang around with some of the kids they want to hang around with. Welcome all friendships and welcome all comers, okay? The time with a 16-year-old, a 17-year-old, an 18-year-old for you to be able to decide who their friends are and who their friends are not is past, right? So welcome those peers into the house, right? And remember, if you see a friendship that's not working, step back to the reflective questioning. Don't give your opinion, right? Show some trust in their judgment and help them flesh out their judgment about what good connection looks like. And the other thing is never be afraid to appoint a special hearing adult, right? So I'm an older parent. There are parents in our community who are younger than me and hipper than me. And I sometimes have to say to them, can you check in with Lolly, who's my daughter, about X, Y, and Z, right? So make sure that you appoint people outside of the parent dynamic, right? Your friends, your family, your neighbors, people who you trust to check in on your kid and be those additional parents. All right, so that's connection. What's number two in terms of facilitating and transition to adult life and also dealing with mental health challenges? No surprise. There are some key sets of skills that we know. Number one, predict success in young adulthood. And number two, predict better outcomes when a young person has a mental health challenge like anxiety or depression, okay? And here they are. If we have to sort of put them into three very simple groups, they are skills, right? Social and emotional skills. Lots of people named them at the beginning of the talk, right? Regulation, coping, stress management, right? Independent living skills. How do you take care of your laundry? How do you feed yourself? How do you manage money? And general coping, right? All of the complex problem-solving skills that you need in life, right? These are skills that young people need in college and they need them in young adulthood. But also self-knowledge. Remember on the last slide when we talked about reflective questioning? Validation is not agreement. No matter what comes out of their mouth, if you validate it, that builds their self-knowledge, right? The more metacognitive capacity, the ability to introspect and understand oneself, you can facilitate it in your young person. And finally, here are some of the protective factors that you actually can build, right? As the caring adults in your life, okay? So caring community we just talked about, all kinds of ways to facilitate connection. Reducing external pressure. Right? This is an important one, right? Kids are generally putting a lot of pressure on themselves these days. We don't need to put more pressure. And so we can find ways to change the way we talk to young people about their goals, their grades, their friends, their achievements, right? That put the onus for deciding how far they want to go and what they want to achieve and don't put our own pressure on them. Open acceptance of young people. Remember what I said before about LGBTQ plus, right? So one of the biggest predictors of strong outcomes in LGBTQ plus youth is their family's acceptance of them when they come in, right? So the open acceptance of differences in the young people that you're raising from your own opinions and your own lifestyle choices is a really important predictor of success and help seeking behavior, okay? Which, you know, we're not going to go into this really deeply, but when you look at adolescents, asking for help is one of the things they're worst at. In the aggregate, when we study adolescent help seeking behavior, they're terrible at it. They don't know how to do it, right? So you can role model it. You can normalize it, right? But we can sort of teach them a little bit about LGBTQ. So what do you think you can do as a parent, a community member, a grandparent to facilitate some of those skills? Simple, simple actions that you can take to help with life skills, protective factors, self-knowledge. What are some of the things that you can do? A lot of the arenas do last for your kids. Amen. Can I get an amen? Amen. So, right? Chores are an important place where young people can learn some of these things, okay? One of the issues that's going on, we find, nationally and particularly in upper middle class and affluent families, right? Kids are actually not having to do enough for themselves these days, right? That the conceptualization in our middle class culture really is that school is their job and so we don't make them do a lot, right? So this summer, if they're going to college in the fall, just, you know, run them like cattle. Make them work all summer, right? Chores are great places for problem-solving, for executive function, for practicing skills that they have to learn in the real world, right? These are really important things that they can do. And instead of doing it for them, scaffolding. So scaffolding is an ancient concept. It was sort of coined by an old expert in the 40s named Bogotsky, who talked about the fact that parenting is about giving young people just enough support to do something on their own. So when they do a chore, you may need to scaffold them into the chore and it may be maddening for you to do that, right? Because how much common sense do most adolescents show? Very little common sense. So you have to figure out a way to set them up, right? So when your teenager says to you, where's the laundry soap? You could say, I'm going upstairs to get it for you, or you could say it's in the cabinet right above the washer where anybody would find it, or you could say, you know, why don't you go up and take a look again around the laundry room and see if you can find it, right? That's scaffolding. That is neither identifying the location of the laundry soap nor saying, do you have eyeballs? It's something in the middle, okay? So doing a lot of scaffolding, okay? In anticipation for college and for challenges in life, you can promote organizational skills through a scaffolding approach, okay? So a great example of this goes back to chores. If your child is going to do a complex project like paint the porch or garden or do the laundry, ask them to make a list of the steps first, okay? Get them to start planning and organizing themselves. Now, the steps may not have half of what you would think about as an adult going at that project. That doesn't matter, right? It's the practice of organizational skills we want to help them do. They don't have to do it to our standard. I'm 58 years old. I've done all these projects many, many times. I know what needs to be on the list, right? The goal is for them to make the list and then apply the list and then see how the list did and didn't serve them, right? The goal is not for us to write the list for them and questions and curiosity. So how did that work? How did that, you know, how did that list work for you? How'd the gardening go today? It sucked, right? It sucked. What sucked about it? As opposed to, you know, you ground it, okay? So questions and curiosity, you know? Come home from school, this happened to me last week. My son got a 70 on an algebra test. He showed me the grade and he said, Mrs. Doherty doesn't like me. Now, what I wanted to say was, did you study for the test? Because I know we didn't, right? But what I said was, what makes you think she doesn't like you? Right? And what ultimately came out was that he had asked her for help on quadratic functions and she had just given him another worksheet and he's a 14-year-old boy. He was embarrassed to say, I can't figure out this worksheet either, right? But that's what he meant by she doesn't like me, okay? So questions and curiosity when there's a problem, not solutions, not judgment and not reaction, okay? And role modeling, right? Role modeling, role modeling. When you're solving a problem, narrate the problem, right? When you have an organizational skill that you, an organizational project, write the list, right? When the family is gonna clean the house together, write the list before you do it, right? So you're doing what you want them to do. We're gonna talk next in a few minutes about Mount Health challenges specifically, right? And so the biggest piece you can do while you're building these skills in your young people is to reduce stigma around distress, right? That when they have a big reaction because something is difficult for them, you don't say, well, you just calm down, right? You say, you seem stressed, what's up? How can I help, right? Also role modeling about how you're managing your own distress, right? Boy, this has been really a tough year for all of us, hasn't it? I've been feeling a little down. Let's all go for a bike ride, okay? So starting to understand that while you're scaffolding, while you're building these skills, the way that you message about mental health challenge and distress is also equally important in terms of when they do hit some of the mental health challenges that they may hit, or they may be hitting now because a lot of kids are struggling, right? You've already said things that are non-judgmental and caring and self-disclosing around distress. So before we talk about mental health challenges, I just want to point this out. You mentioned set to go, right? Set to go has so much to offer in the way of what I've just described. I love that someone's taking a picture of the website. Feel free to take that picture, right? There's a lot in here, specific lessons and curricula and strategies that young people can use themselves to, okay? But lots more specifics on this. Okay, so now I want to talk a little bit about mental health challenges. Some of you have mentioned that some of your young people are having these challenges, and so I want to talk about, right? We talked about on a continuum. All of the things we just discussed can help build skills and manage normative stressors, but they also can help improve outcomes for mental health challenges too, okay? So we're going to now layer on another piece, which is what do you do when you think your young people might need a little more help, okay? And how can you reach out to your team if you're worried and your team is pushing you away? We're going to talk a little bit about that before we stop tonight. So just a quick review, right? Remember, right? We are talking about looking for changes that are different than a teenager's baseline. So you know your team, right? You know your team well, and so you want to be looking at some of these basic functioning areas, right? So when we're talking about mental health challenges, we're talking about mental health issues that are interfering with functioning in one or more ways, okay? So are you seeing changes in the way your young person dresses or takes care of themselves, right? Their hygiene habits, right? What they're sort of looking like when they come down the stairs or go out at the house in the morning. Are they seeming more down, hyper-energized, more withdrawn, more lethargic, more angry and irritable, right? Really important. A lot of times with teenagers, when we see angry, irritable teenagers, so that's just adolescence, that's actually not true. The depression can manifest itself as irritability, right? As anger, okay? So are they more angry and irritable than mutual, okay? Are we seeing changes in their speech patterns? Are they getting very, very quiet? Are they getting very, very hyper-talkative, okay? What about their behavior? Has it changed? Is it different from who you've known them to be, right? And what about their relationships? Are they withdrawing from you? Not even adolescent, like, I push you away sometimes, Mom, but I come back, right? And I come back on my terms because I'm the center of the universe, but they're really withdrawn from you, okay? What are these kinds of changes that we see? And you can see some of the other areas of functioning, right? We really want to be looking for changes. Trust your gut, right? If you see something here that's different than baseline and you feel like something's up, you don't need to be a diagnostician. You don't need to be a clinician. You got to trust your gut and check in with your young person, okay? So always when problems in functioning are lasting too long, right? And so we like to say by too long, if you see a mental health challenge that's interfering with functioning last more than two weeks, that's time to sort of probably reach out for a little more help. But we'll talk about different ways you can do that, right? So for example, a teenager may break up with a significant other, right? And they'd be really, really emotional for a couple of days. And they'll have intermittent experiences of emotion because of it for a couple of weeks. But we shouldn't see their functioning really get interfered with for more than a week or two for a normative stress disorder, okay? So we really want to think about that. Are they too intense? So what do you think I mean by too intense? That's kind of an ambiguous term. What's too intense? If you see an emotional reaction from an adolescent or changes in their behavior, that's too intense, both of them. Something that's not different from the level that seems like what should be different relative to what the issue is. Exactly, right? Too intense, out of proportion to the stressor, right? Out of proportion, that's what we mean to the stressor, okay? Too disruptive, getting in the way of their functioning, getting in the way of academic functioning, their relationships, their eating, their physical health, their sleep, their well-being, right? Continuing to get worse or gets better comes back, gets better comes back, gets better comes back, okay? And certainly if there's any dangerous behavior, right? Attempts at self-harm or high-risk behavior, that's one we really want to take action, right? And if none of these are going on, but something inside is gripping you and you feel like something's happening, trust your gut, don't let anyone tell you that something's not going on. So, when's the last time you were worried about your teen and you tried to reach out to them and have a discussion about it? My son called a therapist two weeks ago after we hadn't talked to him about it. I was surprised. He said, yeah, I have his number on my phone. I was really surprised and I thought that maybe he was just waiting to get me to say, I think you should follow him, which I thought was strange since we talked about this about all the time, but he was just kind of, just, and I was seeing him three times a week. So, is that clear? But what I'm hearing between the scenes is you had multiple conversations over how long about that. How long did you plan to see? This issue that he's been having for about six weeks and he, I kept saying, you know, maybe it's time to, and he didn't, I don't really talk about that, but then suddenly he came in one night and he was more weepy than he was moving. I mean, more weepy than he was kind of despondent and he, I just said, maybe, sure, okay, that was it. It was just one turn. So, what's lovely about the story is, right, Sarah had to do it again and again and again. She had to continue to come around and come around and come around and then he had to feel like he got their hopes up. What else happens with your adolescent when you try and talk about a concern? Sometimes they just blow you off and then all of a sudden they hear it later. What else? Mine get angry because they think I'm trying to solve their problem when sometimes all they want is for me to listen. Yeah, they're very touchy about you offering any solution, right, and they spark up if you try to. I think that tends to totally derail. Just derails the conversation. Me actually at my house had a conversation, so we finally kind of figured all that out and so now my daughter kind of defines it ahead of time and she could come and she'll just say, I just need you to listen and I really don't want you to say anything. I just want you to listen. I don't want your advice. I don't want your opinion and that has been really helpful that she's gotten to a point where she can practice it that way now. With my daughter, especially when she was younger, I would always answer a phone call from her saying, am I just listening or are we interacting? That's great. The other one I love is when you're driving adolescence with their friends and you're sort of like, am I the chauffeur today or am I expected to participate? That's beautiful, right? So what folks are saying is that it can go awry if we try and put our stamp or our direction on it, it can seem that they're blowing us off, right, and they can get furious with us if we offer solutions. This can make one feel a little bit backed into the corner when one is concerned about one's adolescence now. That's a difficult position to be in. So we have a couple of suggestions for you in terms of how to approach it. Explain why you're concerned with specific behavior. So, you know, I'm noticing that this example is you've been missing meals and looking sad a lot and saying you're stressed. Another example might be, you know, you've gotten angry at me a couple of times this week and you seemed really angry, and I'm not sure what's happening with you, right? But notice you're not saying you seem too angry, you're a pain, right, which is one of the things that sometimes we want to say to our teenagers, right? I notice you're working out a couple of times a day and you're not eating a lot of food at dinner and I'm wondering what's up with that, right? You notice how this is a descriptive narrative. It has none of my judgment and none of my values in it, right? It's really just opening the conversation, right? And showing compassion to them and not worried about them. I love you. Again, keeping my values and keeping my judgment out of it. And you all identified the third bullet, which is just listen and don't solve the problem, right? That's going to open the door. And here are some other tips, right? Validation is one of the things that I really like to talk about with parents the most, right? So this is something you should all, well, nobody has pens and pens anymore of these things, but validation is not agreement. Text it to yourself. Validation is not agreement. Do you know that there's now research that says if I validate something that you say to me, your blood pressure will come down? Did you know that? Blood pressure comes down. Heart rate goes down. Skin conductive studies say that suddenly the skin relaxes, right? Interesting. So when someone comes home and says, I am going to kill the principal and we say, no, you are not, right? That brings up whatever that feeling is. And when we say you're really angry at the principal, what happened to them? That brings that up, right? So validation is not agreement, okay? But case in point, if something makes you angry or frightened, go back to the earlier slides when we talked about role modeling. You know what, Sam? I'm having a little reaction right now and I don't want to put my reaction on to you. So I'm going to go in the other room and take 10 deep breaths. I'm going to come back in and I'm going to be a better listener, right? It's not like you have to be a zen dog, right? It's that you have to be able to role model that sometimes some of what your kid says is a little bit challenging for you. And as Sarah said, don't give up. Sometimes it feels like, you know, drops of sand on the beach, right? But really they are listening to you. They can't always show you that they're listening to you. But it is having an effect. And before we stop, I want to make sure we talk about, right? We talked earlier tonight about the fact that we're seeing that young people are experiencing suicidal ideation and increasing rates, right? And so we just saw a new study from the CDC that came out that said that particularly adolescent girls are presenting to emergency rooms at a much higher rate right now with suicidal ideation, right? And we know that most people experience suicidal ideation if they're asked about it, it's healing. You cannot put suicide into somebody's hand. You cannot make them do it by asking about it. Everything we know tells us the opposite. That if we ask about it, right? It often helps it feel better. And then if we find out a young person is thinking about harming themselves, we want to get them some professional support, right? How can you do it and write how do you ask about it? So here are some of the signs to notice, right? There are some typical signs. Now no one person is going to necessarily show all of these signs and not all of these signs are definitely linking to suicidal ideation. But if you see one of these, it's a good time to sort of think about opening the conversation, okay? So, right, I don't need to read them to you, but these are some of the pieces that we worry about, right? It's really essential that if a young person expresses the impulse to die by suicide, that we take action, right? That we do something to help them, okay? And so, we want to have a conversation that's validating and compassionate, but we want to make sure to get them connected to an evaluation, okay? We don't want to look the other way, right? Most people who express suicidal ideation, right? They are not looking for attention. Even if they were looking for attention, that kind of attention-seeking suggests that they don't have the relational skills that they need, so we still would want them to seek help, okay? But we really want to take it seriously. And again, right? Don't be afraid to talk about it, right? Be specific. So, you're telling me that you've been thinking about hurting yourself and I'm really worried about you, okay? What's going on that makes you want to end your life or hurt yourself, right? Have you thought about how you would die by suicide, okay? Really keep the conversation open. And again, this is where, right, when we love a young person, we can get very gripped and this can be a tough conversation to have. But often, right, it can be healing and helpful if they get to say something about it and then we can get them out. If they mention suicidal thoughts or behavior, we want you to take them seriously, ask them questions, get the information that you need, right, and get them help, okay? Don't leave a young person who's expressed suicidal ideation alone. Stay with them until you can get them help. And I also always like to make sure that families understand this concept of lethal means saved through because one of the most powerful things families can do to keep a young person saved who's experiencing suicidal ideation is to make sure that they don't have access to the means to harm themselves while we're getting them the treatment, okay? And we don't talk about this enough in our business, okay? So one of the things you want to think about is, right, how do you implement it at home and how do you implement it at college? Well, you can't implement it at college, but we'll talk about that in a minute, right? So at home, we want to think about safe medication storage and safe firearm storage, okay? That young people who died by suicide with a firearm usually use a firearm from home, right? So if you're a firearm owner, you want to make sure that's locked up. We want to make sure prescription medications are locked up and that we don't have large amounts of over-the-counter medication in our home, right? It's better buy smaller bottles or lock up the bigger bottles and have a smaller bottle that's accessible, okay? When you're young, people go to college, right? You can ask the college about their policies around safe campuses, right? You can suggest that they become a Jed Campus because one of the things that Jed Campus does is ask them to do an environmental scan to make sure that your students don't have access to them. All right, and there are just a few more things that I want to mention about scaffolding your teen's transition out of high school, right? A few other pieces of information to keep in mind. Remember, when your teen turns 18 and is off at college, you will no longer have access to information about your teenager. So if some of you have mentioned that you have teenagers who have mental health challenges, right? You want to be having with that teenager a communication planner and agreement, okay? Because they will not... they will have to sign a paper for you to have access to anything about their treatment at school, okay? Even if your young person doesn't have a mental health challenge, you should have a communication plan and agreement with them when they go to school or when they move out of the house, okay? What are some of the things that you should contact before? What are some of the things that you think you could handle on your own? Again, here, I'm not saying what I think. I'm asking them to sort of flesh it out a little bit. I might tweak it a little bit here and there, but we'll say I want them to think about it. Who are some other people that you can lean on if you're in a situation where you're not sure what to do, right? On the way here, I just had a friend of mine's teenage daughter call me because she got in a car accident and she couldn't find her mom. I'm the backup mom for that family, right? So I'm going to make sure that your team has those kinds of supports, okay? You want to think if your teenager is receiving professional mental health support about a formal transition of care. On the JED website, there actually is a transition of care plan. So if your young person is going off to school and needs a transition of care plan, you can help walk them through it with a document, okay? And make sure, in any case, and this is whether or not you think you're raising a young person with a mental health challenge, you should know what your resources are at home and know what the resources are where they're going, right? Crisis resources, on-campus mental health resources, right? Emergency rooms, right? You want to know what's available to you. And actually, this is a national database, right? I encourage you to take a picture of it, findhelp.org, right? This used to be called AntBirth. Some people know it as that. They've mercifully changed it to something that's more universally understandable. You can search by the zip code where your young person is going and get a list of resources that you might need. Don't wait for an emergency to get these numbers, right? Make sure you have the campus security number. Make sure you have all the numbers that you need. And I also just want to sort of really point out that the JED Foundation website has a wealth of resources for families. And someone, again, is taking a picture. If you had this slide deck, and you can email me, my email is going to be on the last slide. I can send you the slide deck if you'd like it. All of these are live links, right? But there are lots of resources here to continue the conversations with your team, to know when there's a problem and how to respond to it, resources for your young person as well, right? And there are also a lot of resources for them about how to start conversations with their peers when their peers are in distress, right? We often can get a young person to learn about help-seeking behavior by teaching them to be help-givers, right? And our Seize the Awkward campaign is a great example of that. That's an online... a YouTube and online campaign that helps them start different conversations, right? And teenagers just learn so much better in the third person how to do something for themselves if they think they're doing it personally. Here's another slide to take a picture of. Crisis Text Line, I can't say enough good things about it. The Crisis Text Line is a digital version of the National Suicide Prevention Lifeline. It is working really well. They just came out with a national report on some of the data on how many young people they've helped in the last 24 months. National Suicide Prevention Lifeline, you should make sure your young person has it. There are also special lifelines for LGBTQ plus and trans youth, right? And those are great numbers to make sure that your young person has a picture of this line on their phone, okay? Because often, right, adolescents will reach out to someone they don't know. There's a level of self-consciousness that is protected by anonymity. So we want to shape that social media behavior to make sure that they have credible places to go on their own stress. And you can sort of take a picture I think of my email. If you want the slide deck. If you want to connect Jed to your campus, to your high school, if you want any of the resources we mentioned or any of the research I alluded to, feel free to shoot me an email. I'll send you some resources. If you want to follow up, follow up for a week. Let's you go out into this beautiful night. Yeah. I just have a question in listening into everything you were presenting. I've worked for many, many years with kids with special needs. And so I'm thinking most particularly about kids on the spectrum and how some of this comes into play. Are there any programs or things that you're doing through Jed that might... Yeah, I know we talk a lot about scaffolding and that's like a big term in special ed that we use all the time. But I'm just thinking about how the language processing, the inability to infer that it can be compounded with kids on the spectrum. Even kids who are very mild have just like a nonverbal learning disability and so I'm just wondering if Jed has anything like that might even be a little more geared toward that point. We don't, although it's a really great idea. But I do have a lot of places I could point to. Because one of the pieces with the autism spectrum is a lot of what we're saying might not apply. It's a different set of conditions. Often emotional life is portrayed when you're on the spectrum more through behavior. And analysis of behavior and compassionate and effective response to behavioral expressions is a way to go when a young person is on the spectrum. That's a whole set of skills that parents should be taught. But sometimes, particularly in the United States, we're not there yet with that conversation. Canada is like so they're already, you can sort of medicate bill for functional behavior analysis in the home. It's starting though. There are some places in New York State where communities are offering in-home functional behavioral analysis. Which is a way to sort of like if you don't know what that is it's a way to sort of watch the behavior cycle of the young person, learn what they're trying to express or cope with through behavior and then respond in the behavior cycle to promote success. It's a different way of sort of doing what we've just described because some of the direct relational work can be very challenging for a young person on the spectrum. So if you shoot me an email I can point you to a lot of different resources. But it is a great it's a great idea for Jim to sort of start thinking about that a little bit for high schools. Yeah, and for families. That's a great question. Suzy on that question I just wondered if autism speaks wouldn't have a special program on this first place that I'm not think that you may be familiar with them but I would think that they do it. Yeah, that's a good point. And the other thing too is the American it's an English it's not the American there's a British podcast about child and adolescent mental health it's run by the College Hospital of London it is filled with great resources on autism as well. Thank you. Any other questions? Any other questions? Just a thought I'm thinking you had to tell my kid goes to college you know along the way he's had a therapist and he's had tweeters and it dawned on me at some point that maybe you always do that as reacting to a problem that's come up the idea of setting them up going into college with the tutor like taking it as a gift like you've got somebody to turn to because the studies are going to be so much more intense for another four years and that it doesn't need to be kind of a problem solving solution it should be something when you open this conversation we talked tonight about how would you open that conversation I think it's a really great approach you don't want to send a young person who's had challenges off to college and wait for them to struggle before you bring resources to bear to give them those supports it's always better to have the supports away from the supports around learning challenges that's okay too so how would you open that conversation we've talked about it how do you sort of open that door without putting your make it sound like it's their idea how are you going to do that right? yeah yeah there are also colleges more I've looked in the last few years because I've got a contract just to apply in the last few years there are a lot of them with writing centers and things like that when you apply everybody can go and get a certain amount of time but if you actually say I require time you can set up like two hours a week you get the writing center time you're booked in if it's something you have decided there are universities that already have them in place so you wouldn't have to go outside of the school to get there and they're apparently like I know certain schools have that in the math centers too they have a math center so you might build a PC together within a school if you look at certain schools and there are schools for colleges that are really restructuring their semesters and they're those kinds of things are more embedded in the life of the student in the first two years because we understand that when a kid goes to college they don't always want to go to the writing center or the reading center so how do you just make it part of day-to-day college life that every student on campus gets the special support so I know on the website for colleges there is sort of the list of best practices for a gen campus for a college do you guys have a similar piece for high schools like if you go to the website is there a piece that says this is what you know in order to be a gen approved high school campus these are the things you should have in the city if you go to the four high schools part of our website you'll find the downloadable document called the comprehensive approach to mental health promotion suicide prevention in high schools and that is a long document but at the end of each section there are key recommendations now we're going to be turning that into shorter more bulleted documents in the next year but you can sort of skim through to the last section of each domain it'll say where should a school start what are the best practices and you can see them listed there it'll iterate into what you're able to find easily for gen campus in the next 12 months is that I'm sorry is that I should know this already but do we have things on there for you know lethal means for high schools I mean is that something we're trying to get to we're getting there all the way there yeah yeah in the comprehensive approach there's a whole section on it and one of the unique pieces that we talk about for high schools is lethal means counseling right for families it's just a this is a fill sort of soaking into my brain really to be honest but lethal means is something we don't talk enough about it's one of the most powerful practices right so we're going to try and get high schools to make sure the counseling staff know how to do it because we know that when a kid is in distress and a non-help professional gives lethal means counseling to a family 65% of families will go home and lock things up that's a powerful number guess what though only about 15% of high school counselors know how to do it so we're really starting to push high schools to say hey you know this is actually there are free online courses to learn how to do this counseling right there's a really beautiful version it's called CAMS if you're everyone's working in high school and wants to get people to do it right so yeah we're working in that direction we're trying to get them to make sure the windows only open all the same campus stuff right the environmental scans right but we add the component of outreach to caregivers and families so that they really learn what they can do at home that's great it's not a thing as Susie said it's more important because it can be expensive because it's a capital expense to make changes and close off high places in a high school or a college there's a tendency for the institutions not to pay enough attention to that so there's something that has to be one but it's made a huge difference in famous places like for now within that some of the bridges we don't pay as much as you would well thank you everybody for spending part of such a beautiful summer night with us thank you please email me with questions or if you want resources I'm here to help we have to do it again with the whole place