Guest Post: A Possible Role for Books in Teen Mental Health

I'm very happy to welcome Dr. Alicia Hendley to the blog today, for a Psychtember guest post! First, a bit about her:

"Alicia Hendley is a clinical psychologist (currently works at a university counselling centre), mom of four, and writer of fiction and poetry. She obtained her Ph.D. in Clinical Psychology from the University of Windsor (Ontario). Her first novel (A Subtle Thing) was published in 2010 (Five Rivers Chapmanry) and depicts a young woman's experiences with depression, beginning in adolescence. She has also written a novel for adults about bullying as well as a middle grade novel geared for girls (both unpublished). Alicia can be found at aliciahendley.blogspot.com."

And now her post!

 

When it comes to mental health, adolescence is not necessarily a carefree time of sunny skies and calm seas. According to results from a recent survey of over 10,000 teens across the USAⁱ, over 30% of participants had met criteria for an anxiety disorder in their lifetime, with about 14% having experienced a mood disorder and about 11% having experienced a substance use disorder. The average age for an anxiety disorder to begin was six-years-old (I will say this again—six-years-old!), with age thirteen as the average age of onset for a mood disorder and age fifteen for a substance use disorder. Elsewhere, in a study that followed over 1400 children for several years ⁱⁱ, it was noted that by age sixteen, over 35% of participants had been diagnosed with at least one mental disorder. Such rates should raise the hackles on the necks of any concerned adult.

What should raise the hackles even more is this sobering fact: a significant proportion of teens who are struggling with mental health difficulties do not seek out help, even when such help is available.

Why would this be? I would argue that for many teens, there is a sense of shame and isolation associated with what they are experiencing, be it thoughts of suicide, binge-eating, or self-mutilation. It’s hard to give a voice to your psychological pain when you worry that others may label you as different, unacceptable, or even worse, crazy.

Another factor to consider is whether or not the teen feels truly ready to make the changes that may be involved in recovery. When I speak of change here, I refer to both general change, such as deciding to start going regularly to psychotherapy, as well as more specific change, such as learning how to cope with intense pain without cutting or purging.

When thinking about such changes, many health professionals use the Stages of Change framework ⁱⁱⁱ. This framework views change as a process involving several phases, including pre-contemplation, contemplation, preparation, action, and maintenance. While this model is commonly used with substance use problems, I see it as a helpful general framework to use when considering how ready someone is for active work in therapy.

As a psychologist, most clients enter my office in the contemplation or preparation stages. They are likely struggling with certain concerns and may be thinking seriously about trying to make a change. When in those stages, information about one’s difficulties, whether found in magazine articles, news items, or even in novels, can play a positive role in terms of whether or not the process of change actually continues.

Speaking from my own clinical experiences working with hundreds of young people, I have repeatedly had clients tell me that a book they have read impacted their decision to seek help. Some of these books have been novels, some memoirs, some have been directly geared to the young adult reader, some not. Regardless, I have witnessed this phenomenon enough times to know that there is something to it. On more than one occasion, I’ve had a teen client confide in me that they had believed what they were going through was so “crazy”, so “disgusting”, and so “abnormal” that they were too ashamed to tell anyone, until they read about others who were going through the same thing and realized that maybe they weren’t quite so different, after all. It seems that these books did what I try to do with my clients—they helped to give words to emotional pain and to normalize what can feel so terribly, horribly wrong.

Does this mean that anything goes in terms of YA literature written about psychological difficulties? Of course not—and to me that it where the role of a good, professional editor comes in, to ensure that the content of the manuscript in front of them is worthy of its most vulnerable readers. But keeping in mind the rates of mental disorders amongst adolescents, I would argue that even if YA books written about psychological concerns ultimately play only a small role in helping more teens decide to seek help, they are worth their weight in gold.


Thanks very much, Alicia, for sharing your perspective on this topic!


Readers, what do you think about the role of books for teens struggling with mental health issues?

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ⁱ Merikangas, K.R., He, J.P., Burstein, M., Swanson, S.A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Commorbidity Survey Replication—Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10),  980-989. 

ⁱⁱ Costello, E.J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837-844. 

ⁱⁱⁱ Prochaska , J.O., & DiClemente, C.C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.