Stigma Keeps Many Teens from Getting Mental Health Treatment

By Hugh C. McBride

Spend much time around teenagers and you won’t have trouble coming up with a number of adjectives to describe their attitudes and behaviors, but “shy” probably won’t be at the top of the list.

From attention-grabbing fashion decisions to passionate beliefs to a somewhat disquieting tendency to share intimate and outlandish thoughts and images with the world via the Internet, today’s teens seem to be fearless when it comes to expressing themselves on any topic that is important to them.

But on at least one important issue – depression – too many young people are remaining quiet.

Perceived Stigma Prevents Treatment

The June issue of the journal Medical Care contained a study from the Rand Corporation indicating that the stigma of depression and the potentially negative reactions of family members are the top reasons why depressed teens don’t seek treatment for their mental health problems.

According to a May 27 HealthDay News article, the Rand study included 368 teens (half of whom had been diagnosed with depression) and one parent or guardian for each teen. All study subjects (teens and adults) were asked to rate the following potential obstacles to receiving treatment for depression.

  • Cost of mental health care
  • Concerns over perceptions of others
  • Trouble making appointments
  • Time constraints and other responsibilities
  • Not wanting family members to know about the depression
  • Inability to find good care
  • Lack of desire to be treated

The teens who participated in the study listed worries about the stigma that is often attached to depression and the potential for negative reactions from family members as primary reasons why they have not sought treatment for their depression. “With teenagers, treatment decisions greatly involve other parties, especially parents,” the Rand study’s lead author, Lisa Meredith, said in the HealthDay News article. “For instance, teenagers often rely on adults for transportation. Doctors need a sense not just of what the teen thinks or what the parents thinks, but what both think.”

The Prevalence of Teen Depression

On an individual basis, any depressed teen’s reluctance to get treatment is obviously dangerous, but given the prevalence of teen depression in the United States, the problem of untreated teen depression appears to be a widespread concern.

According to a May 31 article by Mike Averill of the Tulsa World, more than 8 percent of U.S. youth between the ages of 12 and 17 (about two million young people) experienced at least one instance of major depression last year:

A major depressive episode is two weeks or longer with either a depressed mood or a loss of interest or sense of pleasure and at least four other symptoms that reflect a change in functioning, including problems with sleep, eating, energy, concentration and self-image. …

Left untreated, mental illness and depression can lead to self medication with alcohol and illegal substances that can turn into addiction.

“There are still a lot of people that won’t seek treatment because of the stigma. It’s still out there and is alive and well and kicking,” [Mike] Brose [executive director of the Mental Health Association of Tulsa] said.

The fact that teen depression is a widespread problem in the United States was established long before the recent Rand report, as was the degree to which teen depression has gone undertreated.

In an Aug. 9, 2007 essay that appeared on the ABC News website, Dr. James Potash wrote about the problem of undertreated teen depression and specifically addressed the role that stigma plays in the reluctance of depressed teens to get treatment.

“Major depression, or clinical depression, is a disease of the brain, much like asthma is a disease of the lungs,” Dr. Potash wrote. “And, as with asthma, it is no one’s fault that the disease occurs – not the fault of the person suffering, and not the fault of parents or others.”

Helping Depressed Teens

As the Rand study indicates, many depressed teens realize that they are suffering from a mental health problem, but are afraid to seek treatment due to fears of negative reactions from friends or family members. But this is not the only reason that many cases of teen depression remain untreated.

Many depressed teens may not even realize that they are suffering from depression. For example, teen depression often manifests itself in attitudes and behaviors that lead the depressed teen to be categorized as a “bad kid,” a normal teen just passing through a “phase,” or number of other categories that downplay (or ignore) the presence of depression.

Teen depression symptoms may include the following:

  • Mood swings, agitation, and anxiety
  • Altered sleep patterns (excessive sleeping or insomnia)
  • Loss of focus or inability to concentrate
  • Drastic weight changes (either gains or losses)
  • Fatigue or exhaustion
  • Loss of interest in hobbies, sports, school, or other activities that previously were important to the teen
  • Decline in academic performance, frequent absences from school, and skipped classes
  • Thoughts of death, expressions of wanting to die, discussions of suicide
  • Substance abuse (including the abuse of alcohol, illicit drugs, and prescription pills)

Treatment for teen depression can take a variety of forms. Some depressed teens respond well to outpatient therapy, others require short-term inpatient treatment, and still others may benefit from an extended stay in a mental health treatment facility or a therapeutic boarding school for teens.

One such boarding school for depressed teens is Island View Residential Treatment Center, which provides both a rigorous college preparatory education and a comprehensive range of support services for adolescents with mental health needs. Island View features individual, group, and family therapy, as well as an onsite psychiatric team.

Depressed teens face a number of misunderstandings and stigmas, but help is available. With effective treatment, teens can overcome their depression and pursue a happier, healthier, and more fulfilling future.