Does the San Diego Area Have Enough Mental Health Programs for Teens?

Last summer, Rady Children’s Hospital in San Diego shared a startling statistic with reporters from local radio station kpbs. At the midpoint of 2021, they’d seen a 25 percent increase in emergency room visits for acute mental health emergencies.

As mental health professionals, this caught our attention: we’re both alarmed and concerned.

However, if we’re being completely honest, we’re not surprised.

The last two years have taken a toll on us all. Adults face stress and uncertainty over almost everything in their lives. From worries about getting sick, to worries about getting friends and loved ones sick, to worries about work, the future, and the effect of the pandemic on their kids, stress and uncertainty abound.

If you have kids, you’ve probably observed an interesting phenomenon. They often internalize and then manifest the stress you, as a parent, experience. That’s not a statement of scientific fact. That’s an observation based on our collective years of experience as parents.

That means that if you’ve been stressed, and overwhelmed, and at the end of your rope, your kids have probably felt that, too. Especially if they’re teenagers. But that’s not the whole story. Kids and teens not only feel their parents’ stress, but they feel stress on their own. Over the past two years, their lives have been turned upside-down as well. They worry about getting sick and getting others sick. They feel the effect of social isolation, not being able to go to sports practices, band rehearsals, and of not being able to meet their friends and see a movie without jumping through a thousand and one hoops related to health safety.

Many of our teens are tired, stressed, anxious, and depressed about the whole situation. This leads us to ask this important question:

Are there sufficient psychiatric treatment programs in San Diego for teens who are troubled and need mental health support?

We’ll answer that question in a moment. First, we’ll offer some general statistics on the state of teen mental health in the U.S.

Special note for any San Diego residents reading this article: Rady Children’s Hospital recently opened a dedicated psychiatric emergency room for children and adolescents called the Copley Psychiatric Emergency Department. This new emergency room is staffed and equipped to handle teens in crisis, and offers high-quality emergency psychiatric treatment for San Diego adolescents.

Now – about those teen mental health statistics.

Adolescent Mental Health in 2022: How Are Our Teens Doing?

To understand where our teens are, we need to understand where they’ve been. We have an excellent resource to do just that. Unfortunately, this resource exists because our teens are in a precarious position right now, mental health-wise. Some mental health professionals say we’re in a teen mental health crisis. Others say we’re on the verge of an imminent crisis. Still others say we’ve been in an unspoken and unrecognized crisis for several years. But we digress. The resource we’re talking about right now comes in the form of an advisory issued by the Surgeon General of the United States at the end of 2021, called Protecting Youth Mental Health.

The advisory summarizes the state of youth and teen mental health leading up to the pandemic with the following data points.

Youth and Adolescent Mental Health 2007-2019: Key Statistics

• Suicide:
  • Suicide among youth age 10-24 increased 57% between 2007 and 2018
  • Suicidal ideation among high school students increased 36% between 2009 and 2019
  • Plans to commit suicide increased by 44% between 2009 and 2019 for high school students
• General Mental Health:
  • 20% of children and teens between age 3 and 17 reported an emotional, behavioral, developmental, or mental health disorder in 2019
  • 50% of the children with a treatable mental health disorder received the treatment they needed in 2016
  • The percentage of high school students with persistent feelings of sadness or hopelessness increased by 40% between 2009 and 2019
• Psychiatric Emergencies:
  • From 2011 to 2015, visits to hospital emergency rooms increased by 28% for:
    • Depression
    • Anxiety
    • Behavioral disorders

Keep in mind that researchers collected all those numbers before the pandemic. Now, to narrow in on the state of teen mental health in California, specifically, we have another resource: a policy brief released by the UCLA Center for Health Policy Research with the headline “Nearly Half of California Adolescents Report Mental Health Difficulties.”

Here’s the data they published on serious and moderate psychological stress among teens in California.

Pre-Pandemic Teen Mental Health in California: By Age and Gender

• Serious and Moderate Psychological Distress (age 12-17):
  • 45% of teens reported experiencing psychological distress
    • 29.7% reported serious psychological distress (SPD)
    • 15.7% reported moderate psychological distress (MPD)
  • Older and Younger Adolescents:
    • 35.9% of adolescents age 15-17 reported SPD
    • 22.9% of adolescents age 12-14 reported SPD
  • The Impact of Gender (age 12-17):
    • 36.6% of females reported SPD
    • 22.4% of males reported SPD
    • 36.4% of gender-nonconforming teens reported SPD
    • 27.7% of gender conforming teens reported SPD

And here’s the data they published in alcohol, drug, and tobacco use among teens in California.

Pre-Pandemic Teen Alcohol, Drug, and Tobacco Use in California

• Alcohol
  • 41.3% of adolescents who reported binge drinking reported SPD
  • 28.3% of adolescents who reported no binge drinking reported SPD
• Marijuana/Hashish
  • 47.6% of adolescents who reported using marijuana or hashish reported SPD
  • 26.0% of adolescents who reported no marijuana or hashish use reported SPD
• Tobacco (cigarette or vape)
  • 45.1% of adolescents who reported smoking or vaping tobacco reported SPD
  • 26.0% of adolescents who reported no marijuana or hashish use reported SPD

When we combine those pre-pandemic numbers with the reported increases in emergency room visits at Rady Children’s Hospital during 2021 mid-pandemic, both common sense and logic tell us that teens nationwide – which include California teens and San Diego teens, of course – face mental health issues at rates we’ve never seen before.

As mental health professionals, we know how to help. We want parents of San Diego teens to know what we know: treatment for mental health and addiction disorders works – and the earlier a teen who needs treatment gets treatment, the better the outcome.

A Quick Note on The San Diego Teen Mental Health Statistics

We want to address something from the kbps article we shared above before we discuss the types of psychiatric treatment options available to San Diego teens. Towards the end of the piece, the authors shared statistics on teen suicides in San Diego County. Those statistics indicated that the number of suicides were lower in 2020 than in 2018, and that the projected number for 2021 was on track to equal the number of suicides in 2020.

On the surface, that contradicts the assertion that California teens, and specifically San Diego teens, are in crisis. However, we encourage you to consider the increase in visits to the ER for psychiatric reasons and the decrease/plateau in teen suicides as evidence of overall progress in teen mental health.

Why?

The statistics tell the story.

An increase in visits to the ER for mental health reasons means parents are getting the message that it’s okay to seek support for mental health issues. The fact that they wait until an emergency means we still have work to do, because we know we can reduce mental health emergencies with timely, appropriate care. We want parent to understand they don’t have to wait for a crisis before seeking professional support for their teen.

Next, the decrease/plateau seen in the overall teen suicide numbers might – emphasis on might, because we don’t have experimental data to back this up – mean that among teens who did visit the hospital for psychiatric reasons, the support they received might have prevented them from attempting suicide at a later date.

That’s our take.

Now it’s time to discuss the resources available to San Diego families for teens that may be troubled, have an untreated psychiatric issue, or need mental health support.

Mental Health Treatment for Teens in San Diego: What Are the Options?

First, we’ll share two ways teens in San Diego are taking the initiative and meeting the mental health crisis head on.

Totes of Hope: Teens Supporting Teens in Psychiatric Care

A group of students at High Tech High initiated a program called Totes of Hope. To recognize, support, and offer solidarity to kids receiving mental health treatment at Rady Children’s Hospital, they decided to make unique tote bags and fill them with small gifts. One thing they put in each bag is a kind, encouraging hand-written note. We mention this effort because we know that when kids and teens are having trouble, simple acts of kindness and friendship can brighten their day – and sometimes all it takes is a single moment of hope to start a virtuous process. Hope begets hope, and a hopeful teen can make the kind of breakthroughs a teen without hope may struggle to find.

Christine Frey Shares Her Experiences With Psychiatric Treatment in San Diego

Another industrious San Diego teen has firsthand experience with serious mental health issues, as documented in this article in the San Diego Tribune. Christine Frey began experiencing symptoms of psychosis at age 12 in the form of hallucinations she could both see and hear. To help her classmates and teachers understand her mental health issues, she made a youtube video explaining her diagnosis and symptoms. Now age 19, Frey has since published a book about her experiences and now dedicates her life to “…coaching, speaking and singing to fellow teens and their parents about ways to cope with, understand and change the conversation on mental health.”

What the students at High Tech and Christine understand is that getting the subject of mental health and mental health treatment out in the open is a critical step in safeguarding the future mental health of San Diego teens.

They understand that treatment works and support matters.

In San Diego, families and teens can find the following types of mental health programs for adolescents:

1. Outpatient Programs

This is an entry level of care for San Diego teens with mental health challenges. Outpatient treatment typically happens in an office setting, once or twice a week, with each session lasting about an hour.

2. Intensive Outpatient Programs (IOP)

These programs are a step up from outpatient treatment. The IOP level of care is for teens with mental health or addiction issues that are disruptive, but do not prevent them from going to school, living at home, and participating in most typical daily activities. IOP care typically happens at an adolescent mental health treatment center 3-5 days a week, for 2-3 hours per day.

3. Partial Hospitalization Programs (PHP)

These programs are a step up from the IOP level of care. Teens in PHP programs have mental health or addiction issues that are very disruptive and prevent them from going to school, but do not prevent them from living safely at home. PHP care typically happens at an adolescent mental health treatment center 5 days a week for 5-6 hours per day.

4. Residential Programs (RTC)

Short of emergency inpatient psychiatric hospitalization, this is the most immersive level of care for teens in the San Diego area. Teens in RTC programs have mental health or addiction issue that are so severe they prevent them from going to school and living at home. Teens engage in this level of care at specialized adolescent mental health treatment centers. They receive immersive, intensive support and care 24/7, supervised by doctors, nurses, therapists, and counselors.

Those are the types of programs available to teens and families in San Diego. Now we’ll talk about the types of mental health or addiction issues programs like those can help teens learn to manage and overcome.

Mental Health Treatment for San Diego Teens: What Kind of Issues Can My Teen Get Help For?

All three of the levels of care we describe above can support teens with clinical diagnoses for mental health disorders such as:

• Mood disorders:
  • Depressive disorders
  • Bipolar disorder
  • Co-occurring disorders:
    • Mood/behavioral disorder + substance use disorder
  • Anxiety disorders:
    • Generalized anxiety disorder (GAD)
    • Social anxiety disorder (social phobia)
    • Panic disorder (PD)
    • Post-traumatic stress disorder (PTSD)
  • Alcohol use disorder (AUD)
  • Substance use disorder (SUD)
  • Behavioral disorders:
    • Oppositional defiant disorder (ODD)
    • Disruptive mood dysregulation disorder (DMSS)
  • Non-suicidal self-injury
    • Self-harming behaviors such as cutting
  • Suicidal ideation*
    • Thinking or talking about suicide

* Note: Never ignore talk of suicide. If you think your teen is in immediate danger or poses an imminent threat to themselves or someone else, call 911 immediately or take them to an emergency room at a regular hospital or a psychiatric hospital.

The level of care your teen needs depends on the severity of their mental health or addiction disorder. If you think your teen has a mental health issue, the best thing to do is arrange for a full evaluation performed by a licensed mental health professional experienced in working with teens. They can confirm or rule out the presence of a mental health or addiction disorder. If your teen does receive a clinical diagnosis, they can recommend and appropriate level of care. High-quality treatment centers design treatment programs that follow the integrated model.  The integrated model includes a combination of individual therapy, group therapy, family therapy, lifestyle changes, experiential/complementary support, community support, and medication if needed.

Before we close this article, we’ll answer summarize the content by answering the question we pose at the end of the first section:

Are there sufficient psychiatric treatment programs in San Diego for teens who are troubled and need mental health support?

The answer is yes.

There are enough high-quality treatment programs in San Diego to meet the psychiatric needs virtually any family or teen may have. Please take the time to follow the links, read the articles, and learn more about adolescent mental health and treatment for adolescent mental health disorders. The time you take now can help you and your teen get a head start on the road to balance, positive mental health, and overall wellbeing.

Finding Help: Resources

If you’re seeking treatment for your teen, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.

In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting for you right now.