New Research Explores Adolescents’ and Parents’ Perceptions of Mental Illness

How do parents and youth in low-income areas distinguish between the “normal” ups and downs of adolescent behavior and something that might be more serious? How do parents respond when adolescents show signs of emotional distress or act out? Where do parents and adolescents go for help?

Finding the answers to these and other questions is the focus of a new study by HHD researchers. Long active in addressing health disparities, HHD was recently awarded a grant from the National Institute of Mental Health to explore how parents and youth in economically distressed urban environments understand, recognize, and respond to teen mental health problems. Eventually, it is the hope that results of this study can inform the design of prevention and intervention services for this population.

“We know that mental health problems take an emotional toll on families and can interfere with normal adolescent development,” says Ann Stueve, project director. “Yet, most adolescents experiencing mental health problems are underserved by the mental health service system. This is especially the case for economically disadvantaged African American, other black, and Latino youth in our nation’s inner cities.”

A growing body of research has documented racial, ethnic, and socioeconomic disparities in access to mental health services. However, information about barriers to or gaps in care is often based on the viewpoints of professionals, rather than people in need. Understanding how adolescents and their parents think about and address the often confusing signs of mental illness is a critical first step in addressing these disparities.

“The long-term goal is to provide more culturally relevant prevention programs for teens and parents,” says Lydia O’Donnell, co-investigator on the project and director of HHD's Center for Research on High Risk Behaviors. “We hope this project will provide insights about how people think about and respond to mental health issues—information that can be used to inform strategies to address unmet needs in an all too often unheard population.”

Adolescence is a critical period for promoting mental health and preventing mental illness. About 1 in 5 young people in the United States has a mental health disorder, and 1 in 10 has a serious emotional disturbance that interferes with their ability to function. Half of all psychiatric disorders begin by age 14. However, only a small proportion of people actually seek professional help, even when it is available. Families can play a pivotal role in helping to connect their children to professionals and other community supports that are equipped to help.

The study builds on earlier work by Stueve and her HHD colleagues that explored risk and protective factors related to suicidality, substance use, sexual risk-taking, and violence among residents of urban communities. In previous studies, they found that 15% of the youth surveyed had seriously considered suicide in the last year, 11% attempted suicide, and 4% reported multiple suicide attempts. Only half of those reporting a suicide attempt had talked with a family member or helping professional, and just one-fourth had reached out to a mental health professional.

“We were struck by the number of youth reporting these feelings and how few had sought help,” Stueve says. “When we went to the literature to try to get the texture and meaning behind these numbers, we were surprised at how little had been done. We expected there to be much more than we found.”

Over the course of this two-year project, Stueve, O’Donnell, and their team will conduct open-ended interviews with 100 parents and their adolescent children. Families with sons or daughters in ninth grade will be selected from two large public high schools in New York City that serve high proportions of economically disadvantaged black and Latino youth. The team plans to recruit a diverse array of participants that include native-born and immigrant families as well as families whose teens either have or have not had mental health problems or received counseling, medication, or other services.