New Study Identifies Barriers to Mental-Health Services for Young People

Typically, telephone hotlines have been promoted as a vital resource for youth who need to reach mental-health professionals. However, more young people than ever are using text messages and digital outlets to communicate. Shouldn't we meet them halfway?
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depressed teenage girl cover...
depressed teenage girl cover...

Co-authored by Dr. Susan Swearer, Ph.D.

I grew up in a really violent environment for the first 13 years of my life. I also struggled with being gay and coming out to parents who are conservative and wouldn't accept that.... When I was 14, my grandma died. She was the first person who I felt really cared about me. When she died, I just kind of gave up on everything. A little bit later, I attempted to kill myself.

The above words are from a young man -- we will call him "Mark" -- whom we met during Born This Way Foundation's "Born Brave Bus Tour." Fortunately, Mark found support from friends, mental-health professionals, and inspirational role models and has dedicated his life to helping others. The bus tour was conceived as a safe place where Mark and other youth could come together and connect with organizations in their communities where they can seek help in mental wellness, mentoring, civic engagement and LGBT services.

Whether gay or straight, urban or rural, in high school or in college, many youth face feelings of anxiety and depression that feel overpowering. Like Mark, most young people don't know what to do. So where can they turn? Typically, telephone hotlines have been promoted as a vital resource for those who need to reach mental-health professionals. However, more young people than ever are using text messages and digital outlets to communicate. Shouldn't we meet them halfway?

Rather than tell young people what's best for them, Born This Way Foundation and the University of Nebraska-Lincoln partnered with the National Council for Behavioral Health and the National Association of School Psychologists to survey 2,645 young people during our Born Brave Bus Tour, on our website and through social media to find out what youth prefer. And we heard them loud and clear.

What we found is that the telephone is the least likely tool that young people utilize to seek help, even though it is the most ubiquitous, particularly for suicide hotlines. Fewer than 16 percent of respondents ranked telephones as their preferred method of help-seeking communication. Furthermore, talking on the phone is the least preferred form of seeking help across all demographics: gender, grade, sexual orientation and anxiety/depression score. It is clear that if we want youth to have easy access to mental-health professionals, communication by phone is a barrier.

As an alternative to the telephone, face-to-face communication wins out in urban, suburban and rural groups (53.8 percent, 47.8 percent and 47.5 percent, respectively). Among various sexual orientations, individuals who identify as straight or gay/lesbian prefer to talk in person (56.2 percent and 50 percent, respectively), while those who identify as queer/questioning or bisexual prefer online or texting (47.3 percent and 43.7 percent, respectively). Based on these results, the mental-health field needs to broaden its approach and availability of help-seeking options.

Amongst young people, an eye-opening trend seems to be emerging that favors virtual contact over in-person contact. The younger our respondents were, the more they favored this type of outreach. Junior-high and high-schools students favored online and text-messaging (46.6 percent) help-seeking, while college and post-college individuals preferred to talk face-to-face (55.1 percent). Furthermore, those who are the most in need also prefer virtual contact. Of participants with the highest depression scores, a majority (48.1 percent) favor online/texting, while 40.2 percent prefer face-to-face communication and 11.7 percent prefer the telephone.

These data, which were recently presented at the American Psychological Association Annual 2014 Convention in Washington, D.C., clearly show that younger generations are more tech-savvy -- and less willing to pick up the phone. As these generations change their communication behaviors, the services we provide must reflect these changes.

Unfortunately, many states' mental-health policies limit online or text-messaging help, as the mental-health provider may be in a different jurisdiction than the individual seeking help. To combat this, our partner organizations plan to distribute the data from our survey to policy makers and service providers to encourage further discussion on improving mental-health access and modernizing current treatment systems.

Encouraging youth to love who they are and live their lives bravely means communicating with them in ways in which they are most comfortable. This study is a huge first step toward creating the adult scaffolding that young people need to thrive, and it validates the three pillars of Born This Way Foundation: safety, skills and opportunity. The next step must include a focused effort from mental-health providers and creative ideas for reaching younger and younger generations. The next time we hear "I need help," we would like to offer real solutions that include face-to-face help in addition to providing support where youth engage: in the digital world.

Cynthia Germanotta is the co-founder and president of Born This Way Foundation, which she founded with her daughter, Lady Gaga, to "empower youth" and "inspire bravery."

Dr. Susan Swearer, Ph.D., is currently the chair of Born This Way Foundation's Research Advisory Board. She has been a high-school special-education teacher for students with emotional and behavioral disorders and has worked as a licensed professional counselor with children, adolescents, and families in residential treatment, inpatient, and outpatient settings. She is a licensed psychologist in the state of Nebraska and the Director of the Nebraska Internship Consortium in Professional Psychology, and she is a supervising psychologist in the Counseling and School Psychology Clinic and the Anxiety Disorders Clinic.

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