Vital Signs
3,693 parents with kids 11-19 took my poll last week and 61% of them, up from just 18% three years ago, say they are worried about suicide … thing is, the striking jump is not even the troubling thing.
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For some context, let’s rewind first to circa 1980. Parents didn’t have the same worries exactly when I grew up then, but they did have struggles and pain and, not unlike today, kids growing up then sought an escape. The Huffy was a right of passage for kids of my generation, our escape and freedom. Before skateboards and 10-speeds, there was this dirt bike that made you feel like you were on Fonzi’s motorcycle. Having it even for a summer meant you were cool and that your parents were cool for getting it. Sure, I may have had a bowl haircut, polyester bell bottoms, and the beginnings of a 5 o’clock shadow which is rare and awkward for an eight year old, but that bike gave me street cred. Bobby Lynch and Ben Elleck, both a year older and 5 inches taller, were suddenly looking up to me. Even Bobby’s older brother Mike stopped teasing. “That yours?” he’d say gruffily. Then he’d nod his head, almost to say, “You’re okay Cote.” I decorated my Huffy for the July 4th “horribles” parade around Archie Lane that year, decked it out with cray paper and signs made from oak tag scraps held together with 5-layers of scotch tape. I rode in the center up-front position just like E.T. and Elliott. Bobby and Ben flanked me, all of us holding red, white and blue popsicles. I put a lot of miles on my Huffy, at least a hundred that summer I bet, rode it through the back woods with a walk-man hooked to my shorts, playing track 1 from my Survivor cassette tape “Vital Signs”. We set up jumps over quick sand Mom told us to avoid, crashed into dirt piles, dusted off our cuts and scrapes and got right back on. I went everywhere on that bike. It was our freedom from the noise in our homes and in our heads, our escape….
….If the Huffy was my generation’s right of passage, the way to be free coming of age in the 80s, it’s becoming tragically clear that this generation’s way to be free coming of age in the 2020s is not a dirt bike but a word only just now making its way into the mainstream – suicide.
Missing The Signs
Maybe coincidence but the “Survivor” band I listened to religiously on those bike rides through the backwoods named their first album “Vital Signs”. For parents today, the signs of suicide aren’t always clear but sometimes they are and we just don’t want to see them.
The Stats
3,693 parents with kids 11-19 took my poll last week and 61% of them, up from just 18% three years ago, say they are worried about suicide. The striking jump is not even the troubling thing. About two thirds say their concerns, drawn from watching their kid’s behavior changes and reports of rising incidence of suicide, have not propelled them to get their child into therapy – many saying they have questions about whether it works and questions about what it says. I asked Joe, a 44 year old dad from Delaware, if he was worried about what therapy might say about his 16 year old. “It’s not what I think it would say about him…I’m worried about what it says about me – what have I done wrong, why is he struggling so much, why can’t he be like others.”
Interestingly, 96% say they very much want their kid to go to college - they buy them an SAT prep book, some even buy sessions with an SAT class, but many have not yet given their kids an outlet to talk with a therapist or psychologist, not as a standard of care for raising a kid, not as a kind of requirement for those before they transition to college. Because shouldn’t it be?
What’s The Right Therapy?
“We’ve tried to focus on getting our kids more active, out of their rooms and the screens - I think that’s the issue, it’s not that they need to sit and talk with someone once a week through a screen,” said Barbera, whose daughter has low self esteem. Barbera’s perception of therapy isn’t universal as many parents have seen amazing things therapy can do for their kids mental health. But it does speak to a lingering stigma.
“I hear about so many parents with kids doing well and doing all these activities – they look really happy – I want that for my daughter,.” she said. But are those kids really happy? About one quarter of parents have gotten their kids into therapy at some point – typically with a social worker – but only 4 in 10 of them say it’s worked and 6 in 10 said things are worse after the experience. “I think the therapist was well intentioned but didn’t get to the root,” said Paul, 45, whose 14 year old spent 2 weeks in a hospital earlier this year for attempting suicide. Many said the therapy seems to work much like a good run raises your serotonin level, but then it doesn’t stick. “It’s like another friend to talk with, but I’m not sure it’s really getting at the core of what’s wrong,” Maggie, a mom of 2 boys from Georgia, said. “I question the training.” Many of the families acknowledge they have struggled to find their child the right therapy. Some have tried more intensive programs only to find that their kids are intermixed with other teens with different needs. Others say their kid is on their 3rd or 4th therapist and, increasingly, the parents are looking for more advanced help, like from a psychologist. Problem is very few are available. Of 370 in the poll who sought one out for a specific kind of expertise, just 49 were able to find one who had an opening and in a majority of those cases the cost per visit was $250 to $400. “At $400 I can see the value, but it’s got to be at least 4, 8 maybe 20 sessions - my wife and I don’t make that kind of money,” said Bill, who manages a grocery store in Iowa.
Some progress has been made in specialized care for suicide. Vita Health is a relatively new business in its third year but unlike many other companies more generally focused on mental health conditions or substance use, Vita focuses solely on suicide care, training clinicians on how to do it, and meeting the patient where they are, says its medical director Neil Leibowitz. This sort of very specialized care is where the mental health field probably needs to move and probably will – not unlike targeted therapy cancer…because no tumor is the same.
Like cancer, the number of parents who know someone whose kid took their life is staggering – nearly 42%. 71 of the 3,693 in the poll say they lost their son or daughter to suicide and interestingly 52 of them say they saw the signs. “Taking this poll is kind of my therapy, because there’s not a day that goes by that I…just want to go back and hug her,” Patricia, 52, wrote, reflecting on her daughter’s life. About half in this group said their kids were in therapy at one point but, looking back, wonder if it was the right kind. Did they need something and someone more acutely focused on suicide?
Families in the poll overall say it’s difficult to parse out what therapy is needed, most noting their kids have more than one problem but, even then, a lot of days are good. A handful say their sons have compulsive behaviors but also mood swings. Most of the therapists are social workers who have varied experience in these things, many with training around substance use not compulsion, so finding the right fit at the right cost is difficult. Policy makers have made advances in coverage but it is clear that parents remain conflicted, even guarded about what’s happening with their teen – in some ways hoping to avoid the crisis, pushing their kids to be more like others, waiting for things to be normal, trying to be parent and therapist.
Editor’s note: The full results of this poll and the entire “Coming of Age in the 2020s” series will be available soon. Reach out if you have questions.