Teen Mental Health: What’s a Parent to Do?

Claustrophobia (2022) by Ruchi Arekar

Source: Ruchi Arekar/Creative Commons/CC BY-SA 4.0

According to Mental Health America’s August 2024 report on the State of Mental Health in America:

“The nation’s youth continue to present cause for concern. One in five young people from ages 12-17 experienced at least one major depressive episode in the past year, yet more than half of them (56.1%) did not receive any mental health treatment. More than 3.4 million youth (13.16%) had serious thoughts of suicide.”¹

What tools are available to help teens cope? Matt Hirshberg is a research psychologist with the Center for Healthy Minds. In my second interview with him, we discuss his research into innovative techniques designed to improve teenage mental health.

Dale Kushner: As a research psychologist who studies well-being, what models would you suggest parents teach their children for better mental health? Did your research yield any practical advice for parents or teachers of teens?

Matt Hirshberg: Step number one is for parents to take good care of themselves. It is no surprise that adolescent mental health has been declining alongside adult mental health. The best first thing a parent can do is try and be a good model—this means being honest about one’s own wellness and struggles and modeling adaptive approaches to working with our challenges. An important point is that we don’t have to be perfect or perfectly happy to be good models for our kids; we just need to be honest and embody useful ways of working with the challenges that life inevitably throws at us.²

Dr. Matt Hirshberg

Source: Matt Hirshberg/Used with permission

DK: Why do you think it would be more useful to focus on “teenage flourishing” rather than on “teenage mental health”?

MH: I’m not opposed to talking about teenage mental health, but flourishing includes mental health, and more. I like flourishing because it is not defined—mental health flourishing for each person will differ based on their interests and proclivities; it means each person gets to choose what brings them the greater meaning and purpose in life—choice and agency are important for everyone, but particularly so for teens.

DK: One of your important studies investigates mindfulness-based interventions (MBI) in pre-teens.³ As a researcher, how do you define mindfulness and mindfulness-based interventions (MBI)?

MH: The intervention we are studying includes mindfulness but also many other contemplative techniques that we believe are associated with well-being.

Mindfulness is most commonly defined as paying attention, on purpose, to the present moment, with an attitude of acceptance or non-judgment. In my view, a mindfulness-based intervention (MBI) is an intervention that includes training in contemplative techniques intended to strengthen mindfulness.

There is debate in the field, though, about how to define these interventions. At the moment, the most prevalent view is that MBIs must primarily focus on mindfulness meditation practice. I don’t agree with this view, in part because there is not strong evidence linking the amount of formal meditation practice with positive outcomes.

There is increasing evidence that relatively little practice combined with training in contemplative mindsets can result in robust positive impacts.

Especially for youth, who are not likely to practice a lot of meditation, I believe it is critical to structure contemplative or meditation interventions around introductions to a variety of contemplative techniques and contemplative mindsets.⁴

DK: Can you explain why you focused on preteens?

MH: I am actually focused on teens, and high school teens, because I think that it is around puberty that we develop the cognitive competencies to engage in a serious way with meditation practice.

There is accumulating evidence that late childhood is a period amenable to mindfulness-based intervention, but the evidence is equivocal about preteens in general, and there is strong evidence that if the implementation approach to preteen MBIs is not developmentally appropriate (e.g., if classroom teachers have only limited training teaching mindfulness in their classrooms), MBIs may be harmful for some kids (or at least not helpful).

I have chosen to study a broader framework of meditation-based interventions because mindfulness is just a small sliver of contemplative techniques and is focused on cultivating a narrow set of skills. There are other techniques and skills that may be helpful to teens.

In addition, the intervention I am studying includes a roughly equal amount of contemplative mindset training, which we believe is an important component of how these interventions support improved well-being.

Adolescence Essential Reads

Redefining Youth: Economic Pressures and Shifting Values

Reframing Adolescence: Empowering Teens Beyond Stereotypes

Factors that can shape the mental health of young people, from The U.S. Surgeon General’s Advisory on Protecting Youth Mental Health (2021)

Source: U.S. Department of Health and Human Services/Public Domain

DK: What are the critical developmental periods in late childhood? Do these critical periods occur across race, class, and gender?

MH: I don’t think that there is much evidence that critical development periods differ by demographic or cultural factors. Adolescence is a second very critical period of brain development, when the brain starts to integrate longer-range connections between regions and increases in efficiency.

Part of this process is called pruning, which eliminates connections between neurons in the brain that are not regularly utilized. The high level of plasticity during this time has led many researchers to speculate that if we could engender positive habits of mind and behavior during adolescence, the underlying function and structure of the brain would be shaped to accommodate these positive habits.

DK: What are “social competencies” and “social emotional learning”? How do they differ from cognitive learning?

MH: Social-emotional learning (SEL) is a bit of a misnomer because the competencies included in SEL include cognitive competencies. SEL sort of arose in opposition to an educational agenda that myopically focused on standardized metrics of learning, but what it is really pointing to is a whole-child approach—the understanding that in order for adults to live happy, meaningful, socially productive lives, they need to be socially, emotionally, educationally, and physically well.

DK: What is “executive function” and why is it important in preteens?

MH: Technically, executive functions (EFs) include executive attention and inhibitory control (being able to control what we attend to), working memory, being able to hold in mind and manipulate information, and cognitive flexibility, or the ability to adaptively switch between different sorts of tasks or instructions. EFs are important for everyone, but it is during the preteen/teen stage that these competencies rapidly develop and reach adult levels. EFs are critically important for school as well.

DK: Can you extrapolate the results you found in preteens to adults? In terms of brain plasticity, is it never too late? Is the adage, “You can’t teach an old dog new tricks” untrue?

MH: It is never too late. Studies have shown significant brain plasticity based on changes in the behavior of individuals in their 70s. It is also the case that well-being on average rises and reaches its apex during senescence, which may have something to do with a more informed perspective on life’s challenges and changes. Everyone is capable of positive change!