Most parents (and other adults) want to be able to talk to teenagers and young adults about mental health and mental illness. But, uncertainty and awkwardness often stop well-intentioned people from broaching the subject.
In this episode, we discuss how to have these conversations with the young people in our lives by inviting Dr. Laura Erickson-Schroth, chief medical officer of The Jed Foundation (JED). Dr. Erickson-Schroth gives practical tips and hints on how to have these sometimes awkward conversations and what to do if a teenager doesn’t want to talk back.
Dr. Laura Erickson-Schroth (she/they), Chief Medical Officer for The Jed Foundation (JED), is a psychiatrist committed to improving mental health through education and resource creation. She provides guidance on how individuals, families, schools, communities, media, and other youth-serving organizations can take actions to protect mental health and prevent suicide in teens and young adults, ensuring that all young people are being served in data-informed and culturally responsive ways.
Dr. Erickson-Schroth joined JED in 2022 after providing crisis intervention and mental health support to thousands of patients in over ten emergency rooms in New York City, including as an attending psychiatrist and associate professor at the Columbia University Comprehensive Psychiatric Emergency Program. Much of her career has focused on LGBTQ mental health, and she continues to see clients at Hetrick-Martin Institute for LGBTQIA+ Youth. Dr. Erickson-Schroth is the editor of “Trans Bodies, Trans Selves” (Oxford, 2014, second edition 2022), a resource guide written by and for trans communities. She has appeared on NPR’s “Fresh Air” and “On Point.” She is a former board member of the Association of LGBTQ+ Psychiatrists and of GLMA: Health Professionals Advancing LGBTQ Equality.
Dr. Erickson-Schroth obtained her medical degree from Dartmouth Medical School. She completed a psychiatry residency at New York University, public psychiatry fellowship at Columbia University, and consultation-liaison psychiatry fellowship at Mount Sinai.
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.
Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without.
To book Gabe for your next event or learn more about him, please visit gabehoward.com.
Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.
Gabe Howard: Welcome to the show, everyone. I’m your host Gabe Howard and calling in today we have the chief medical officer for The Jed Foundation (JED), Dr. Laura Erickson-Schroth. Dr. Laura obtained her medical degree from Dartmouth Medical School. She completed a psychiatry residency at New York University, Public Psychiatry Fellowship at Columbia University and Consultation Liaison Psychiatry Fellowship at Mount Sinai. Dr. Laura, welcome to the podcast.
Dr. Laura Erickson-Schroth: Thank you so much for having me.
Gabe Howard: I love that the younger generation is so open about their mental health. It sincerely provides me with a lot of hope for the future of mental health advocacy. But while the younger generation is very open, many of their parents, many people my age, I’m 46. If I can disclose, we’re still playing a lot of catch up. And in fact, I did a little nonscientific polling of fans of this podcast on social media. And I learned that one of the top reasons parents give for not tackling mental health issues with their children is, quote, talking to my teen is going to be awkward, and I just don’t know how. How can parents get over that?
Dr. Laura Erickson-Schroth: You know, I think that’s exactly what we’re seeing, is that younger generations are really ready and willing to talk about mental health issues. And it’s their parents or their aunts, uncles, people older than them, who, we didn’t grow up with this kind of conversation. And so, we don’t necessarily sort of know where to start.
Gabe Howard: Now, if I can go back to my little nonscientific polling, another thread that came up very often was What problems do teenagers really have? There was this, this general and in a very good way, right? I’m not. I want to be very clear. I’m not bashing parents. This was a very respectful and open discussion. But they’re just like, hey, you know, I pay for everything. I’ve got the stability, I’ve got their shelter, I’m looking out for them. What mental health problems could they really have? Aren’t I a good parent? What do you have to say about all of that? Because I got to be honest, a lot of parents were just sort of incredulous that their teens could have any mental health issues at all.
Dr. Laura Erickson-Schroth: I do think that that’s what is the crux of all of this, is that adults don’t necessarily understand what young people are struggling with right now. I think they’re dealing with things that are really unique to their generation that we don’t necessarily see. We sort of say exactly what you said. They have a roof over their heads. I went to high school. It was hard, but I made it through. But they’re going through things that are really different than we were. And they’re dealing with a level of information overload that no other generation has ever faced. So, there’s been a five times increase in the amount of information that a person takes in in a day over the past 20 years. And it’s way more if you look back decades and they’re living their lives online, they’re socializing, they’re formulating their identities as they’re getting older online and they’re missing out on opportunities to be involved in person, to be to feel like they’re connected to making the change that they want to see in the world. And that’s really affecting young people and it’s affecting their mental health and it’s affecting sort of how they interact with each other.
Gabe Howard: Before I ask you this next question, I want to self-disclose that I live with bipolar disorder. I’m a mental health advocate and I’m guilty of this. A lot of times the kids in my life and I’m really lucky, I have a lot of kids, teenagers and young adults in my life. I just think that everything that they do is so dramatic. Now, some of that is because there’s just a lot of drama with being a teenager and a young adult. You know, they’re getting their footing and they’re learning it out. And I can see where a 46-year-old man and a 20-year-old young adult are not going to be on the same page. But then there’s my question. I can’t just ignore everything or I’m going to miss a mental health issue, but I can’t assume that everything that that they do that I dislike or that annoys me or that is even concerning to me or that I think is dramatic is proof of a mental health issue. How are parents supposed to even begin to separate this out?
Dr. Laura Erickson-Schroth: Yeah. So young people really are different, right? They do have, teenagers have emotions that go up and down in ways that are not as typical for adults. And that’s because they’re going through a time in their life where they really are forming their identities and they’re sort of exploring who they are and their brains and their frontal lobes. Actually, if you look at research, the frontal lobe of the brain, which is what controls our ability to make good decisions, to avoid taking risks that we shouldn’t take, those are still forming the frontal lobes. And so that’s happening until they’re about 25. So, teenagers and young adults really do look different. But there are some things that we can pay attention to. And I would say the most important thing to pay attention to is changes. And so, we all know our own children, the young people in our lives, and we know when they’re acting differently or seem to be feeling differently than they usually feel. So, you might notice things like they’re sleeping a lot less or a lot more than usual for them, right? So, teenagers need more sleep. That’s just that’s biological. And so, it’s kind of torture that we wake them up at 6:30 in the morning to make it to school because they actually generally need more sleep than we do.
Dr. Laura Erickson-Schroth: But if you’re noticing that for the young person in your life, there’s a dramatic change and its recent, that’s a difference to notice. If they’re eating much less or much more than usual and there doesn’t seem to be a reason, they haven’t just joined the wrestling team, you know, if they’re kind of withdrawing from the friends in their life or the social activities that they used to like, if they don’t seem to be taking care of their personal hygiene. And it’s a change, right? So young Some young people, this may be sort of like what they go through as teenagers. If you’re noticing an increase in their use of alcohol or drugs. That’s concerning. If they seem to be acting differently, seem to be very anxious or irritable or persistently sad if they seem to be numb to what they’re experiencing or say things about feeling hopeless or like a burden. These are all signs that might indicate that something is going on. And it’s also possible that someone may be going through mental health issues and not showing any of these signs. A lot of times people keep those kind of things in purposefully. But the bottom line is, if you notice something that you’re concerned about, you need to trust that instinct and you need to reach out.
Gabe Howard: If a parent suspects that their child might be suicidal, what should they do? How should they intervene?
Dr. Laura Erickson-Schroth: Absolutely have a conversation. It’s a myth that talking about suicide is going to increase the likelihood that someone will act on it or give them ideas that they weren’t already thinking about. Actually, research shows that bringing up suicide provides a sense of relief, typically, and it can lead to increased help-seeking. So, you bring it up and you talk about it and you do it in a setting where the young person and you can have a good conversation. So, you have it in a setting where you can both focus. You say, I want to talk to you about something important. I’m going to put my phone down. We’re going to have a face-to-face conversation and really talk to each other. And then young people can often, and older people too, dodge vague questions. We’ve all heard teenagers say, I’m fine, I’m fine. And so, what you really need to do is bring up concrete examples of what you’ve noticed. Say something like, you used to be really into lacrosse or soccer or whatever it is that they’re into. And, you know, I noticed that you haven’t been as excited about it or you used to see this group of friends quite a lot, and you don’t seem like you want to leave your room and go hang out with them.
Dr. Laura Erickson-Schroth: I’m worried about this particular thing. And then give them a chance to explain. Listen to what they’re going through. Because a lot of times I think we don’t, we don’t actually know. And it might be something that has nothing to do with anything that you had thought of. It might have to do with a friendship at school or a relationship that they’re in that we didn’t even know about. And it’s really important not to shut down conversations. So, if they do disclose that something’s going on with them, you want to avoid saying things like everything’s going to be all right or we’re going to fix this, we’re going to figure it out. A lot of times people, you know, young people and adults are just looking for someone to listen and not necessarily provide advice right away. And if they’re not ready to talk right now, it’s okay. You can show them that you’re ready in the future if they’re available, you can let them know that you’ll check in with them and then do check in with them a couple of days later. Say, I know we had that conversation and I just wanted to check back in with you and see how you’re doing.
Gabe Howard: One of the things that I personally struggle the most with is I love to give advice. I love to talk. It’s not an accident that I’m a public speaker and a podcaster for a living. I, I really enjoy my work. And whenever a young person comes up and tells me, well, I just broke up with my significant other, I immediately want to launch into a story about something that happened 25, 30 years. Man, I’m old. That happened a long, long time ago before they were even born. And then I pat myself on the back that I fixed it because after all, they broke up with somebody and 30 years ago, I broke up with somebody. I told him a relatable story and now I move on. Now, on one hand, it’s not the worst thing in the world. I am engaging and I’m having a conversation, but, you know, from talking to folks like you, Dr. Laura, I really learned that, oh, shoot, I made it about me. I told a story about me and I didn’t ask any follow-up questions. It’s hard. I don’t know what to say. So, the only thing that I can do is share that relatable story and move on. What can parents do to get over that?
Dr. Laura Erickson-Schroth: I think you’re getting at one of the essential questions about having conversations. I would say with anyone, a young person or an adult about something difficult that’s going on, it’s really hard to hold ourselves back from going straight to advice for lots of reasons. I think it’s uncomfortable to sit in silence or to wait. Listen, if you’re not really sure what’s going to come out or if they’re saying something that’s really difficult to hear, you kind of want to help right away to fix it. But it is really important to slow things down and to listen. And some of the ways that I’ve found that are most helpful to really be able to listen well and to provide someone a space is to ask questions, be curious. So, we all have our own experiences that we might be thinking of in our heads and we can bring those in if we think that they’re helpful to another person. When I’m speaking with a young person, I think about is what I’m thinking about telling them about my life? Am I doing that because I want to talk about it, or am I doing that because I think it actually will give them something to latch on to or something to go from? So that’s one thing. And then it’s listening and being curious in a way where you bring out in them what they are thinking about, where you are actually learning about their world. And I think young people have really fascinating worlds, so they’re experiencing all kinds of things that we never experienced. And I’m genuinely curious and I think a lot of adults are genuinely curious about what young people are going through. How does that game work? How does that social media app work? What are you talking about with your friends? These are things that we’re not privy to. And if a young person is willing to open up and talk with us about it, it’s really fascinating what you can learn.
Gabe Howard: Now, I want to flip the script for a minute because as quick as we are to tell the stories about our first breakups or our first job loss or our first financial setback, often parents describe that they’re unwilling to share their own mental health issues or their own mental illness diagnoses, or even that they’ve sought therapy or are in therapy. How do we get over that so that we’re not accidentally stigmatizing the young people in our lives by not sharing that, hey, we are in fact going through the same thing, which I would think would be a big protective factor? I felt better when I knew that my father also had mental health struggles, but he hid that from me for a very, very long time, making me think that it was alone.
Dr. Laura Erickson-Schroth: It is so important for adults to talk with young people about their own mental health. And this should happen from a young age. And I think that’s how you make it sort of a normal routine part of your life is if you have younger children, you start talking with them early and it doesn’t need to be about sort of the big things, right? It can be about smaller struggles that you deal with every day. So, you might say, oh yeah, for me, when I have to wait in line for a really long time, I get really frustrated and then my body feels like this, and then I don’t always know what to do with myself. And then you say, and this is what I do to help deal with this. So here are my coping skills. I make sure that I get enough sleep. When I get upset about something, I go for a long walk or I talk to a friend or a family member. When the world starts to overwhelm me, I think about ways that I can volunteer for causes that are important to me. So, you’re demonstrating to the young person in your life that you also experience difficult emotions and that you have ways that you deal with, that you have coping skills and that you are helping them to develop their coping skills.
Gabe Howard: And we’re back with the chief medical officer for The Jed Foundation (JED), Dr. Laura Erickson-Schroth. Dr. Laura, what should a parent do if their, if their teenager, their young adult, their child just flat out refuses to talk to them? Is there any way that they can convince them that they’re on their side?
Dr. Laura Erickson-Schroth: You know, I think this is where it’s important to think about other adults in a young person’s life. A lot of times parents want to be the first person that a young person that their child goes to when they’re struggling with something. But actually, young people first go to their peers, to their friends and their roommates, and after that often are more willing to speak with other adults in their lives that are not their parents. So, one of the things parents can do is help to cultivate those relationships for their children. So, is there an aunt or an uncle who they really connect with, a coach, a teacher, someone else in their life who they might be willing to open up to at times when they’re not quite ready to speak with their parents? Those are the kinds of people that you want to look for and help your children to connect with.
Gabe Howard: Let’s talk about young people’s peer groups for a moment. When I think about my own support system that I’ve built up over the course of my lifetime and I could not live without it, it is absolutely enhanced my life. And some of these supports I’ve literally built since childhood. And that’s a real, real plus that I don’t want to see young people lose. But I also want to acknowledge that a lot of young people share misinformation, they share inexperience. They repeat things confidently as facts, and they believe it. And then when adults in their lives try to correct them or lead them in a different direction, they’re very, very loyal to their peer groups. What should parents do about that?
Dr. Laura Erickson-Schroth: I think that young people, we get scared that they are having a lot of conversations that might take them in the wrong direction. And I think those are the ones that we hear about the most. But actually, most of their conversations with their friends and their peers at school are helpful and help them to figure out who they are, what their identity is going to be, how they’re going to exist in the world, what kind of things are going on around them that they hadn’t heard about. So, we hear about this sort of more scary things where they’re learning about things that we may disagree with or think are not true. I think a lot of the time they’re really helping each other to learn and grow. And when there are things that come up that they’re discussing with their peers that seem to be going in a direction that we don’t necessarily want them to go in, that’s where we want them to be surrounded by many different people in their lives. We want them to have us. We want them to have other adult family members, coaches, teachers, people around them who they can go to and talk about these things that are coming up, ask questions, compare what they know to what the other people in their lives know. So, we want to surround them with a community of people so they don’t feel like their peers are the only people they can go to.
Gabe Howard: As a mental health speaker. I talk to parents all of the time and they ask me, they’re like, hey, I suspect that something’s going on with my child. Mentally, I’m afraid that they’re having a mental health crisis or they might even have a mental illness. And I don’t know what to do. And I say, well, have you had them evaluated? And I get a lot of pushback on that. And they’re like, Well, I’m not sure yet. And I say, well, but if you suspected that your child had a physical problem or was sick, would you go to the doctor then? Oh, absolutely. I’d want to get that checked out. And I would say, well, it’s the same thing in mental health. And I would love to say that that works 100% of the time. But I got to tell you, it doesn’t even work 50% of the time. They’re like, well, it’s different. It’s not the same. I wouldn’t even know where to begin. It’s there’s just a lot of pushback on this idea of seeking mental health help for your children. If you can’t diagnose them before you seek that medical attention. What are your thoughts on that?
Dr. Laura Erickson-Schroth: I do think that parents are more likely to bring young people in for physical health issues than for mental health issues. And I think there are a few things going on behind that. One is the real stigma around mental illness that I think still exists, even though it’s improving quite a bit. Another is that I think parents just aren’t as familiar with the systems for seeking help when there’s a mental health issue going on because we’ve all gone to providers about physical health issues and we sort of know how the triaging process works and what are the next steps. And we don’t all necessarily know how that works for mental health issues. And so, I think there’s a fear that we’re going into the unknown that I don’t really know how this how this works. Is there a diagnosis process? What would happen if there was a diagnosis? What would be the next steps and who would be we would be referred to and that kind of thing? So, we can do a lot of educating people about what the steps are. I think the bottom line is that if you’re concerned, you know, you want to seek out help. And if the answer is everything, that is fine, that the, you know, the young person’s developmental process is kind of just proceeding as it should, that this is maybe a normal part of what young people go through at this age. That’s actually great news.
Gabe Howard: It seems to me that parents internalize a lot of their children’s behavior and they believe that if their child has a mental health issue, that it’s somehow their fault. And that’s really anchored in in decades of stigma against particularly moms. We used to think that mental illness came from having a bad mother. My family believed it. Lots of families believe it. Can you talk about that for a moment? Because I know that a big barrier to parents seeking out care is they’re afraid that their children will be taken away or they will afraid that they will be told they’re bad parents or there’s just even the well, how sick could my child be? I’m a good mom. I’m a good dad. I’m a good guardian. And I think we have to get away from that sort of thinking that there is a blame aspect to mental health issues or mental illness.
Dr. Laura Erickson-Schroth: There’s certainly a historical feeling about mental illness that we’ve brought forward with us. That is the idea that parents are what sort of create mental health issues in young people, and that makes parents less willing to bring young people for help. But there are just so many things that contribute to young people having mental health issues that absolutely parents cannot blame themselves if there’s something going on with their child that they’re worried about. Of course, there can be family dynamics, but there are also genetic components that we don’t have control over. And also, the world that young people are living in. They actually are spending most of their awake time at school, not with their families. And school is places where they can run into anxiety about academic issues. They can run into issues with bullying or feeling socially isolated or not feeling like they have groups of friends and certain groups of young people struggle especially, even if they have supportive parents. So, LGBTQ young people. There are state laws now. There’s the Don’t Say Gay law in Florida. We know that states that have supportive laws that protect LGBTQ people in those states, people have lower rates of mental health issues. We know that youth of color are going through quite a bit in our country. So, studies of black teens show that they’re reporting five instances of racism every day and that students who are reporting racism are more likely to experience mental health issues and less likely to feel connected to their schools. They’re seeing police violence against people of color depicted on TV every day. This can be really traumatic. All of these things are outside issues that are happening in society that are contributing to young people’s distress. And parents can really play a role in helping their children to figure out what are the things they need in their lives to sustain and improve their mental health.
Gabe Howard: Dr. Laura, it really seems to me that your primary message is that this is an ongoing conversation that needs to take place often, and not just when you suspect there’s a crisis or think there’s a crisis. We just really need to be more open about mental health, mental health issues and mental illness in our homes with our loved ones and especially with young people. Is that the overall message?
Dr. Laura Erickson-Schroth: I would say absolutely that the most important thing is that we’re having these open conversations about mental health issues. And I think young people are leading the charge in that. If you look at the research, it shows that young people are more open, more willing to speak about mental health issues, and they’re kind of dragging us along with them.
Gabe Howard: Dr. Laura, thank you so much for taking the time today. Now, I know that you work for The Jed Foundation (JED). The Jed Foundation (JED) has a lot of resources. Can you share those with our listeners?
Dr. Laura Erickson-Schroth: Absolutely. So, The Jed Foundation (JED) is actually a national nonprofit, and our goal is to protect emotional health and prevent suicide for teens and young adults. And JED was founded by a couple named Phil and Donna Satow, who lost their son, whose name was Jed, to suicide while he was in college. So, one of our big programs is that we work directly with high schools and colleges to help them strengthen their mental health and suicide prevention programs. One of our campaigns is called Seize the Awkward, which has videos featuring young people and celebrities, and it helps young people to learn how to reach out to each other, support each other’s mental health. We also have a mental health resource center, which is for young people, for their parents, for educators to learn about all kinds of topics having to do with mental health, things like transitioning to college.
Gabe Howard: And where can folks find The Jed Foundation (JED) online?
Dr. Laura Erickson-Schroth: We’re at JEDFoundation.org.
Gabe Howard: Thank you, Dr. Laura, so much for being here. And a big thank you to our listeners as well. My name is Gabe Howard and I’m an award-winning public speaker who could be available for your next event. I’m also the author of “Mental Illness Is an Asshole and Other Observations,” which is on Amazon. Or you can grab a signed copy with free show swag or learn more about me just by heading over to my website gabehoward.com. Wherever you downloaded this episode, please follow or subscribe to the show. It is absolutely free and can you do me a favor? Recommend the show whether it’s on social media in an email, friends and family at work, hell send a text message. Sharing the show is how we grow. I will see everybody next Thursday on Inside Mental Health.
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