Tami D. Benton, MD: When we talk about mental health, we're actually talking about, conditions that primarily affect the brain and mood. So things that, you know, things that affect your emotions, like we talk about depression, we talk about anxiety. Sometimes we use these words interchangeably, when we're talking about mental health. You know, we talk about emotions and mental health conditions as if they're one thing.

So people can have anxiety, but you don't have to have an anxiety disorder. When we talk about mental health conditions like anxiety, depression, what some people may know as manic depressive illness, also known as bipolar disorder, schizophrenia, those are disorders that really impair your ability to function.

And so if you're anxious enough that you can't perform in school or in work, that's when we start to consider those as mental health conditions that require treatment. When we talk about behavioral health, we actually are typically talking about situations in which changes in the environment and behaviorally focused interventions can change the outcome of a behavior.

So for example, when we talk about a condition like attention deficit hyperactivity disorder, it is definitely a neurologically brain-based disorder. But we also know that we can treat those conditions with medications, but we also need to modify the behavior in order to change the outcomes. So, for example, if you have ADHD, in addition to medications that can help, we also do environmental manipulations. We also do, some behavioral training to help you structure your time better. So behavioral health conditions are typically, we refer to them broadly in a lot of ways to cover everything. But the specific difference with behavioral health disorders is that they are conditions that where the behaviors are pretty obvious and they're very susceptible to changes using behavioral modifications.

Most of the signs are, you know, most parents notice when their children's behavior is changing, particularly changing in ways that are not healthy for them. And I don't, and even when you see those changes, your first call may not be to a mental health provider. I recommend that if you're seeing some changes that you're concerned about, for example, if your child is previously a fairly outgoing child and you notice that they're spending more time by themselves, not spending time with their typical social group, they may appear more withdrawn, not as interactive with the family as they have been in the past. Those kinds of changes are the things that parents should be concerned about, and it's just start with the conversation with your child. And if you're concerned after talking with your child or you're feeling like you're not able to get some conversation that provides you with some reassurance, I suggest contacting your primary care provider or talking with someone at the school that you trust, like the teacher. Because sometimes they can reflect for you something that doesn't require an intervention. But if in fact you're concerned about an intervention, talking with your healthcare provider, they can connect you with a professional who might be able to help you solve a problem. And it's important to recognize that every problem that's surfacing is not necessarily one that requires intensive intervention. Some do. If your youngster is talking about feeling like harming themselves or feeling suicidal or feeling like harming someone else. Or feeling so impaired that they can't leave home to go to school and do their normal activities. You probably wanna reach out to a mental health professional. Many times, what's required to even address those kind of problems, are something that can happen in your community. Sometimes your primary care provider can help you.

Sometimes a therapist would be the person that you would see. And typically, if in fact, there's more troubling conditions like, a diagnosis of pretty moderate to severe depression or suicidality or something else that's pretty serious. A child psychiatrist is the best person to see for those conditions.

So there are many treatment options and they typically involve, some community based intervention. When I say community, I mean like school. They oftentimes, the interventions can happen in your primary care provider's office. And then many times for kids who are having more significant mental health challenges, you would wanna seek help with a psychiatrist or a psychologist or another therapist who actually can provide the intervention that you need.

I do frequently recommend that, if you're not sure about what's happening with your child, I would really start with your primary care provider. And the reason your primary care provider is a good place to start, is that they have a longitudinal relationship with you and your family. And so, you know, the interventions that we recommend are usually, professionally focused, but also community focused. So for example, you know, families are busy. So it's not just young people who are struggling, but parents are struggling as well. And it's important for all of us to have a sense of community or a place where we feel a sense of belonging. Sometimes that's in social groups. Sometimes it's in athletic groups for kids.

Sometimes it's in your faith-based communities, like wherever you seek or find support for your family and for your own lives. It's important to seek those things out. And so our interventions typically involve, you know, some direct medical intervention, if that's necessary. We almost always recommend psychotherapy as a component for any treatments for any young people, and then community-based interventions and social supports, and any supports that are available to the family.

Most of the time when we're working with young people, because the biggest part of their lives is typically schools, we partner a lot with schools. And a lot of the schools actually provide, mental health treatment facilities for kids. In fact, where most young people receive their mental health treatment is in schools.

And so, you know, that's a important first place to start if you're concerned about your child. And typically, when parents notice a problem, the first problems are usually pretty evident in their school performance.

So I see a lot of positive trends as it relates to mental health. You know, the more, we're having more conversations, and I think it's really important, for all of us, to hear people who talk about their own challenges and are still quite successful and quite visible. I really appreciate the athletes who've talked about their struggles and then, you know, we see where they are. Which is a pretty clear indication that you can emerge from these situations and be successful and victorious in whatever you want to accomplish.

I also think that discussions about family stress, and the importance of community, and things that we can do in the environment to support mental health has been really important. So we've talked a lot more about things like green space, community engagement, family support, childcare. All of these things, are factors that are social factors beyond our control at times.

But we also know that, they also exist within communities. And if we're able to utilize those resources, all of those things support mental health. So I've seen a lot of positive change. I also think one of the things that's been really exciting is when you look at some of the athletes who have experienced significant adversity.

I mean, Simone Biles is one of them. I mean, she talked about her traumatic experiences and who would've predicted, with all those adverse experiences, that she'd be who she is today. And I think the take home message is that our adverse experiences don't determine who we are. With the right supports, with families, communities, all of those people around us, caring adults, young people can emerge from those things and reach their full potential.

Yeah, so we are experiencing a mental health crisis. I think it became more obvious to most people during the pandemic, when we actually were all feeling more stressed. And even though we've actually moved through the pandemic in many ways and we're in a better place, that crisis has not gone away.

And quite frankly, it existed even before the pandemic. What's available now is resources for families because the pandemic did provide us with a lot of opportunities to develop tools, and we developed a lot. I think the Surgeon General's advisory was really helpful because it really helped us focus on supporting children and supporting families.

And so at the current time, as a result of all this work, more resources are available in a multitude of places. There are resources available for families about mental health and mental health supports in schools, in the physician's offices, our primary care offices, and our subspecialty offices. So you could actually get this information from your medical providers.

The schools have expanded services. In addition to that, there are a lot more community based services, more community mental health services. I actually suggest that families go online. Most of the organizations that work with children like the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association, provide a lot of resources online. And almost any question that you have about behavior changes or emotional disturbances that you're concerned about, you can actually start to access some of that information, online yourself. And connect with a lot of the organizations that are more community facing, like Mental Health America provides a lot of resources as well. So there are many different places to get resources. We're finding that more community organizations, such as the churches and other faith-based communities are starting to provide resources for families about how you can get resources for mental health care.

But starting with your, medical providers, 'cause you know, when you're in a crisis, looking for resources online, does not feel helpful in the moment. And, you know, it makes a lot more sense to reach out to people that you trust, with just a phone call. For those who are experiencing an emergency crisis or if you really just feel like I just don't know who to call, you can call the 9 8 8 crisis line, which is easy, 9 8 8

Someone will answer the phone and they'll be able to talk you through what you need to do next. So, I think that's the quickest and the easiest way, but your trusted providers are also your best partners.

So 9 8 8 is staffed by first responders who could be community mental health providers, or they could be lay people who are answering the phone, who will direct you in the right direction, similar to when you call 9 1 1. And what, but the beauty of 9 8 8 is that, if you need to connect with someone to help you solve a problem that you're having right now.

So for example, if you're saying, I'm feeling a certain kind of way and I'm not sure what to do about this, sometimes you will be connected with the clinician who can actually help you in that direction. It's also really great if you're having an emergency or a crisis because you know, if you call 9 8 8 and it's clear that it is a mental health emergency that you're dealing with, rather than sending the police or 9 1 1, they'll actually get you the right kind of provider so that when you get to the location where you're gonna have the service, is specifically focused on what your needs are. So 9 8 8, they're immediately responsive. You can talk and text. A lot of times young people want anonymity around a problem that they're struggling with. You can actually get that with the 9 8 8 line, and if you're in crisis, they can actually connect you with the services that you need.

In many places, 9 8 8 can also connect you with the outpatient services that you might need and provide you with locations where you can actually get the care at the right level. So it's a really wonderful resource, for those seeking mental health treatment.