‘Worried About Teenagers’ Mental Health’

Lia Gaggino, MD, FAAP

May 22,2020

As a general pediatrician interested in mental illness and suicide, I have been worried about teenagers’ mental health since the start of the pandemic. 

Data from our Patient Health Questionnaire (PHQ) is usually very consistent — same numbers every month. But that changed in April when we saw a noticeable increase in depression among our practice’s teen patients.

The number of teens with a PHQ-A score of 10 or greater climbed from 23% to 33%. Scores for suicidal ideation increased from 15% to 25%; the national average is 17%.

The pandemic has upended routines that can help teens feel a sense of security and normalcy. 

Anecdotally, there’s so much more sadness, isolation and loss of motivation. Teens’ schedules are a mess, and online school provides a limited amount of activity. Many are holed up in their rooms sleeping all the time or playing video games for hours.

Some teens were grappling with depression even before this happened, so it’s not surprising that they are struggling even more so now. This is a significant concern and a reminder that we need to be vigilant.

It is more important than ever for pediatricians to assess risk. You can use the Columbia-Suicide Severity Risk Screening Scale or the Ask Suicide-Screening Questions. And always ask teens and their parents about access to firearms.

Developing action plans to bring some routine and normalcy into the day helps, as does encouraging family activities and movement. I recommend the self-care advice of psychiatrist-author Bessel van der Kolk, who offers suggestions on how to ease the stress associated with isolation and feelings of being out of control. More info can be found here.

Also, I was interviewed on a podcast about how parents can talk to kids about suicide. You can listen to it here.

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*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.

About the Author

Lia Gaggino, MD, FAAP

Lia Gaggino, MD, FAAP, is a past president of the AAP Michigan Chapter and is retiring after 31 years of practicing medicine, most of them as a general pediatrician. For the last five years, she was medical director of behavioral health services at Bronson Methodist Hospital in Kalamazoo, Mich. During her retirement, she plans to provide primary care one day a week and do consulting work.