An obvious or even subtle mood swing, withdrawing from a favorite social activity, or isolating oneself from a close group of friends or family could be all it takes to prompt the simple question.
Are you doing OK?
It’s a query Lily McCann-Klausz says she thinks about more after her involvement in the latest YouthZone mural project in Glenwood Springs.
The mural was designed to depict a young person’s journey from negative to positive mental health.
“A lot of people today are struggling with a mental health issue, especially teens. But it’s difficult to reach out,” McCann-Klausz, a junior at Rifle High School, said. “Often, you know something’s going on, but it’s so personal that it’s hard to talk about it.”
It’s hard to get there on your own, she said. But with help and support from those who recognize that something is wrong and take a chance by reaching out, it’s possible to get back to that positive place.
“Our hope is that, by putting this mural out there, it will inspire anyone who is having a problem to seek help or be able to walk that path by themselves …
“And, to help anyone who notices that someone is struggling to be able to offer help.”
Teens in crisis
The statistics are troubling.
According to the National Alliance on Mental Illness (NAMI), 20 percent of youth ages 13-18 nationally live with a mental health condition of some sort, ranging from mood or anxiety disorders to behavior or conduct disorder.
If those early conditions go unaddressed for many years, the data suggests it can lead to bigger problems heading into young adulthood and later in life.
The average delay between onset of symptoms to intervention is eight to 10 years, according to NAMI. And 50 percent of all lifetime cases of mental illness begin by age 14, and 75 percent by age 24.
If they make it that far.
Suicide is the third leading cause of death among youth, defined as age 10 to 24, according to the NAMI statistics.
And 90 percent of young people who died by suicide had an underlying mental illness.
Taking a collective approach
The work in progress on the wall at the new YouthZone facility at the corner of Blake and Ninth in downtown Glenwood Springs is meant to show the journey young people in particular take between positive and negative feelings.
In the mural, a girl is being led by a caring person from a burning forest — symbolizing anxiety, depression and pain — to a lush, healthy forest on the other side — symbolizing a healthy mental well-being, McCann-Klausz said.
She and several other young artists from the area worked with Glenwood Springs artist Vallee Noone to create the mural — part of a larger project funded by the Embrey Family Foundation.
It’s just one small part of a growing effort among multiple entities in the Roaring Fork Valley and Garfield County in recent years to address mental wellness and behavioral health in teens.
“We can’t really make a difference unless we are all working collaboratively,” said Sonja Linman, a longtime educator in Glenwood Springs schools.
She now directs the Roaring Fork School District’s program to provide prevention specialists and mental health professionals in as many schools as possible from Glenwood Springs to Basalt. Aspen schools have a similar program, and the effort has extended to the Garfield Re-2 schools, as well.
It’s a network that involves not only the schools but youth advocacy organizations such as YouthZone, family service agencies, health care providers, local governments, social workers, law enforcement, churches and parent groups, Linman said.
“We’re stronger by working together,” Linman said. “It all has to work together effectively, so that we really see the dial move on something as complex as mental and behavioral health.”
Heeding the signs
Earlier this month, a group of educators, crisis workers, counselors, parents and others concerned about the rate of teen suicides participated in an eight-hour Youth Mental Health First Aid Training in Glenwood Springs.
A similar training sponsored by the Garfield County Suicide Prevention Coalition — made possible with funding from the state taxes collected on legalized marijuana — was offered in the Garfield School District Re-2 in the spring.
The goal is to provide tips on how to recognize when a young person is struggling and intervene when it appears necessary.
The discussion covered a wide range of underlying issues that can contribute to poor mental health and suicidal thoughts in teens — from low self-esteem, bullying, drug use and family problems, to just plain coping with teen pressures such as keeping good grades, making friends, fitting in and preparing for early adulthood.
Whether there’s an underlying mental illness that can be clinically treated or not, it’s important to watch for the red flags, especially with youth, said Courtney Dunn, prevention specialist for the Aspen schools who presented the training along with Linman.
“Any drastic change in behavior is an alarm,” Dunn said
The Roaring Fork School District now has a prevention specialist to help address behavioral health in each middle school in Glenwood Springs, Carbondale and Basalt, and expanding to Riverview School this year.
In addition to implementing a substance abuse prevention program in the schools, the prevention specialists look for other behavioral health issues in young teens. They also help reduce barriers by pointing families to treatment and counseling services in the community.
In addition, all elementary schools in the district have counselors who are trained to deal with behavioral health issues, and all high schools now have mental health professionals on site.
Through the Valley Marijuana Coalition and with funding from local marijuana taxes, mental health services have been extended to the state charter Two Rivers Community School, St. Stephen’s Catholic School and the multi-district alternative Yampah Mountain High School in Glenwood Springs.
Community liaisons in the schools can help point families to counseling and clinical resources in the community. Among them are Mind Springs Health, which provides psychiatric and psychological counseling services in the region, and the Hope Center, which provides suicide crisis intervention.
Various health care providers, such as Mountain Family Health Centers, the Valley View Hospital family clinics, and a growing number of school-based health centers are also part of the behavioral health safety network.
“What we’re doing very clearly and very carefully is expanding our response to kids and families to access support [that] students need to be successful in school and beyond,” Linman said.
“To me, in all the years I’ve worked with kids and families, it’s the most systemic approach I’ve seen, and we must make it sustainable.”
One obstacle to that will be to find long-term funding for the school-based resources, which are now dependent on grants, she added.
Roaring Fork schools have also adopted a wellness curriculum designed to help students self-regulate, manage emotions and develop an appropriate response to stress.
Self-regulation is a crucial behavior to learn at a young age, Linman said, because it means making choices that aren’t self-destructive.
Restoration means moving beyond poor choices they may have made and evolving to become stronger, healthier people, she said.
Last school year, two films were also shown to middle school students and parents — “Angst: Raising Awareness Around Anxiety,” talking about healthy ways to deal with anxiety; and “Like,” a documentary about the impacts of social media. Public events were followed by panel discussions on the topics.
On Oct. 10, as part of the Fall Connections Campaign sponsored by the Garfield County Suicide Prevention Coalition, the film “The Ripple Effect,” about what many professionals refer to as a teen suicide epidemic, will be shown at a free community event at the Glenwood Vaudeville Revue theater.
Mental illness in youth
According to Gary Schreiner, family therapist and head of the behavioral health program for Mountain Family Health Centers, across the age spectrum, approximately 65% of patients who come in to visit a primary care physician have some type of behavioral health issue.
But great care is taken in diagnosing children and teens with a specific mental illness or behavior disorder.
“A lot of the real significant mental illnesses you really can’t pick up on until the mid-teens, when personalities really start to form,” Schreiner said.
Oyen Hoffman, also a family therapist and part of the behavioral health team at Mountain Family, explained.
“We try to make the diagnosis as accurate as possible but as benign as possible,” Hoffman said.
When it comes to anxiety in children and teens, it may not rise to the level of a disorder.
“We all have anxiety,” Hoffman said. “It’s there to keep us safe and keep us protected. But it’s when it really starts to disrupt our lives that it becomes a disorder.
“A lot of times people will think of anxiety as a bad thing, and it’s really not, it’s just how we manage our nervous system. … It is a manageable emotion.”