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Nieman: Health systems should prioritize mental resilience for youth


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A major headline that caught my attention less than a week ago was “As youth mental illness soars, Task Force recommends screening children and youth as young as eight for anxiety.”

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Around the same time, I talked to the mother of one of my patients and heard these words: “I just want him to be happy and healthy. I am worried about his future. I feel helpless and do not know what to do. It is tough enough to be a teen in this world.”

This has become a frequent utterance of parents who feel ill-equipped to support their suffering children. Many fear that the result may be suicide. Ask any pediatric ER doctor if they see more mental health challenges and suicidal ideation and over 90 per cent admit they have encountered such a patient in their ER in the past week.

It’s no wonder a coalition of child health providers recently declared that Canada is facing a national emergency in child and adolescent mental health. The American Academy of Pediatrics partnered with the American Foundation of Suicide Prevention and the National Institute of Mental Health in what is reported to be the first major interdisciplinary effort to highlight suicide prevention risk-reducing strategies, for pediatric care and youth community settings. The end product of their work can be further researched by visiting https://www.aap.org/suicideprevention

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Suicide is now the second leading cause of death among youths aged 10 to 24 years old.

The cost of the loss of young lives is hard to fathom. I am part of a group of parents who lost a child due to suicide. I never thought that my own son would lose his battle with depression and choose to end his life. But it happened on Jan. 1, 2020, before COVID unleashed itself on this planet. I often wondered how my depressed son would have coped during COVID. It is, of course, a moot point now.

But what is not a moot point, is that more and more data now arrive on our radar screens — one paper after another in peer-reviewed journals — almost like one marathon runner after another arriving at the finish line. These papers are painting a uniformly grim picture of how COVID made matters worse.

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Picture a fire before the COVID chaos. The fire is anxiety and depression. Picture someone pouring gasoline on the fire. Then on top of that, picture a strong wind — gusts of up to 100 km/hour, making that fire worse. And you have an image of the current mental health crisis.

There is no shortage of cooks in the kitchen. Recently, I listened to a podcast that blamed parents for being too soft. The podcaster — a doctor who is not a pediatrician — claimed that parents are too protective of their children and should let them suffer more; supposedly this will toughen them up mentally. Then, in a provocative Atlantic article, Derek Thompson expressed his views on why there is so much sadness and anxiety in North American children and youth: https://www.theatlantic.com/newsletters/archive/2022/04/american-teens-sadness-depression-anxiety/629524/.

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Closer to home, I am glad to share a great resource for parents known as the Breathing Room (www.breathingroom.me) A local child psychiatrist, Dr. Alan Donsky, recently did rounds explaining this tool and afterwards received very positive feedback from his peers. Other psychiatrists made comments such as, “What a wonderful resource” and “This is a great tool that goes beyond traditional psychiatry.”

In essence, The Breathing Room teaches children to become better at self-acceptance; to become more skilled at connecting with key people; to experience a sense of joy and purpose; to become more grateful; to learn that forgiveness frees one up to carry fewer grievances; to become better at reaching out to others compassionately; and to move forward, celebrating these new-found skills.

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This holistic program goes beyond the basics of mental health (biology, thoughts and feelings). It also addresses topics such as ethics, relating, spiritual consciousness and soul awareness. It has been peer-reviewed and researched and found to be worthy of a mention on the national stage of mental wellness: www.wellnesstogether.ca/en-CA

For personal reasons – having to cope with the reality of a dead child – and professional reasons, I am 110 per cent certain that the cultivation of resilience skills is where future research and financial support must be prioritized. Google “mental resilience podcasts” and one will find numerous resources easy to access and easy to listen to (more and more parents are finding books harder to read and prefer audio-educational versions). One of my favourite podcasts is Road to Resilience, based out of Mount Sinai in New York.

Via that podcast, I met Dr. Ginsburg who proposes that seven integral and interrelated components help us become resilient: competence, confidence, connection, character, contribution, coping and control.

Dr. Nieman has worked as a pediatrician for the past 35 years. He is the former president of the Alberta Chapter of the American Academy of Pediatrics.

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