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The Changing Landscape of Teen Mental Health Treatment

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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Teen Mental Health Treatment: Meet Them Where They Are, Treat the Whole Person

Mental health treatment has come a long, long way.

Just a hundred years ago, we hid people with mental health problems away in places with names like insane asylums or sanitoriums. We treated them with techniques that now appear barbaric. Ice baths, restraints, and isolation were common. They were better, however than what came before that. During the middle ages, mental illness was thought to be the result of demonic possession. People with mental health disorders were often labeled as witches or the victim of witchcraft. The techniques used to treat them – if that word applies – were virtually indistinguishable from torture.

The 19th and early 20th centuries brought a scientific approach to mental illness. Unfortunately, many of the techniques lacked nuance and a basic understanding of mental illness. Treatments like electroshock therapy and lobotomy were common. However, the mid-20th century also marked the beginning of the modern era of mental health treatment. Freudian talk therapy emerged as the first psychoanalytic treatment. Also, physicians prescribed the first generation of antipsychotic drugs and other types of psychiatric medication.

Then, the middle and end of the 20th century changed everything.

During the 60s and 70s, psychiatrists, therapists, and counselors refined psychoanalysis and began practicing empathy and compassion during treatment. Although the stigma and general ignorance about mental illness dominated the popular landscape until the beginning of the 21st century, the 80s and 90s introduced techniques and perspectives that would change the landscape of mental health treatment forever.

To learn more about stigma, mental illness, and how we can work to finally eliminate stigma for good, please read our article Topics in Recovery: Obstacles to Treatment.

The first scientific endorsements of approaches like community support, harm-reduction, and compassionate, integrated, holistic treatment gained traction. But the most important change for mental health treatment was the advent of the medical model of mental illness.

That may not seem so revolutionary now, we admit. However, the idea to treat mental illness as an illness – rather than a moral failing or personal weakness – was the first step toward reducing stigma. This approach brought many people with mental illness out of the shadows and into the light.

What About Teen Mental Health Treatment?

The American Academy of Child & Adolescent Psychiatry (AACAP) began life as the American Academy of Child Psychiatry in 1953. It was not until 1986 that the academy voted to include adolescent in its name, partially in response to the publication of “Child Psychiatry: A Plan for the Coming Decades” as part of an initiative called “Project Future.”

The goal of the project was to “…to develop an assessment of the profession of child psychiatry and recommendation for the future…” One simple question served as the driving force behind Project Future:

“How can child psychiatry do a better job for the children of this country in need of psychiatric care?”

The Project Future report concluded with a rosy spin:

“Today, child psychiatry, as a discipline and as a profession, is multifaceted and lively. Its commitment to children, adolescents, and their families and to providing psychiatric care within a humane and ethical framework creates a collegial ambiance and opportunities for varying and, at times, controversial perspectives.”

This was a big step for teen mental health treatment in the U.S. and around the world. By that time, mental health researchers determined that many common mental health disorders first appeared during adolescence. Understanding the age of onset – the clinical term for when a medical condition begins – for many mental health problems was earlier in life than many professionals previously realized foregrounded the need for advances in teen mental health treatment.

Teen Mental Health Treatment in the 21st Century

In many ways, we can say that Project Future accomplished its goals. While stigma still exists, mental health support for children and adolescents has been normalized in the U.S. While resistance remains, most parents understand that there’s nothing wrong – and everything right – with getting a child or an adolescent in need of psychiatric support the treatment they need. That’s significant progress, but there’s still a long way to go in teen mental health treatment.

That’s why the AACAP reconvened in 2013, twenty years after the initial publication of The Future Project, to spearhead a new initiative: Back to Project Future: A Plan for the Coming Decade. They went through a similar process as with the first project. But this time, they identified specific goals for the advancement of child and adolescent psychiatry and teen mental health treatment. These goals help us do two things. First, they gauge the progress made since 2013. Second, they ensure that the treatment community heads in the right direction in the years to come.

We’ll share those goals now. We’ll explain how each of them contributes to the expansion, improvement, and effectiveness of teen mental health treatment.

Back to Project Future: Ten Goals for Adolescent Mental Health Treatment

1. Knowledge and Skill Building

The AACAP encourages mental health treatment providers to develop and maintain competence and engage in lifelong skill-building. This will help them offer the latest, evidence-based treat the child and adolescent population.

This goal helps ensure the providers of teen mental health treatment stay current on best practices and continue to provide the highest level of care, no matter when they received their initial training.

2. Advocacy and Awareness

The AACAP reminds mental health treatment providers it’s their duty to promote and preserve their unique role, skills, and expertise in healthcare and advocate for the mental health rights and needs of children.

This goal helps ensure the providers of teen mental health treatment understand the critical function they play. On one level, their job is to reaffirm that mental health care for children and adolescents is a vital component in the overall health and wellbeing of our society.

3. Embrace New Modes

The AACAP encourages all mental health treatment providers to become leaders on the question of how to provide necessary and appropriate psychiatric care to children and adolescents. As modes of healthcare delivery and healthcare delivery systems change, their input will be essential.

This goal places providers of teen mental health treatment at the forefront of our changing systems of healthcare. We can’t predict exactly how things will change. One thing we do know is that child and adolescent mental health providers need to raise their voices and conserve the presence and importance of their work as healthcare transforms throughout the 21st century.

4. Expand Access

The AACAP advises mental health treatment providers to support the development of innovative approaches to mental health support that improve access to quality mental health support for all children, adolescents, and their families.

This goal encourages providers of teen mental health treatment to promote new, evidence-based approaches to teen mental health treatment whenever possible. Important new approaches to teen mental health treatment include: integrated treatment, treatment for co-occurring disorders, and trauma-informed care.

5. Educate and Collaborate

The AACAP recommends that mental health treatment providers receive the necessary training and support to engage with, educate, and collaborate with all systems of care that serve children and adolescents.

This goal encourages providers of teen mental health treatment to fully integrate with all environments and contexts within which children and adolescents receive care. These include schools, the child welfare system, and the juvenile justice system.

6. Research

The AACAP promotes any and all relevant research that improves the prevention and treatment of mental illness and/or psychiatric disorders during childhood, adolescence, and early adulthood.

This goal advises providers of teen mental health treatment to not only participate in but also keep abreast of the latest developments in child and adolescent mental health treatment. New research and developments appear every day in areas like mindfulness, experiential therapies, expressive therapies, and medication for psychiatric disorders.

7. Recruitment

The AACAP promotes recruitment into child and adolescent psychiatry and seeks to find new ways to address shortages and uneven distribution of child and adolescent mental health providers.

This goal helps the cause of teen mental health treatment in the big picture for one simple reason. We need talented and dedicated providers to address the ever-increasing demand for high-quality mental health care for children and adolescents.

8. Leverage Technology

The AACAP recognizes that mental health treatment providers must include all relevant technological advances into training, teaching, and clinical practice.

This goal also helps the cause of teen mental health treatment in the big picture. The rise of remote care, telehealth, and virtual therapy – especially relevant in light of the coronavirus pandemic – can help mental health providers meet teens and children where they are. Whether that means individual therapy via teleconference, group therapy via the internet for rural children and teens, or mental health-oriented computer/phone apps and games, providers of teen mental health treatment need to learn to use any method they can to serve and support children and teens in need.

9. A Global, Connected Perspective

The AACAP realizes our teens and children live in a connected global community. Therefore, mental health treatment providers need to connect to that same global community. Expanding awareness of trends in treatment and support around the world will enhance and improve the quality of treatment for children and teens here at home.

This goal moves teen mental health treatment forward by encouraging providers to open their minds to new and innovative techniques and perspectives from mental health professionals developed by their international peers. This, in turn, will ensure our teens receive care that has a broad knowledge base, unconstrained by our specific cultural biases.

10. Diversity, Culture, and Awareness

The AACAP recommends that mental health treatment providers enhance their cultural competency and awareness to meet the needs of the entire child and adolescent population.

This goal moves teen mental health treatment forward by prioritizing inclusion. Through knowledge and the understanding of differing and different perspectives, viewpoints, and lifestyles, mental health professionals can better serve each child and teen according to their specific needs. Whether those needs are related to their cultural background, country of origin, religion, gender, or sexuality, a culturally competent provider will be ready to meet them where they are with what they need to heal.

When seeking mental health treatment for a teenager, you’ll see all ten of these components in the highest quality teen treatment centers. A modern, up-to-date treatment center that uses the latest evidence-based approaches will offer integrated programs that incorporate the ten goals outlined by Back to Project Future.

The New Paradigm in Practice

This contemporary, comprehensive, holistic approach – approved by SAMHSA and in use in treatment centers worldwide – includes a mix of individual therapy, group therapy, family therapy, medication, lifestyle modifications, and complementary supports such as mindfulness, expressive therapies, experiential activities, and community support. Here are the different types of therapies and treatment common to each of these categories:

Please understand that, although this approach – and the integrated concept – is relatively new, it is not at all rare. We’ll reiterate that the best teen mental health treatment centers will offer most, if not all, of the therapies, treatments, and approaches listed above. Parents seeking mental health treatment for their teenagers do not have to settle. Integrated treatment is the new standard. Although the landscape of teen mental health treatment continuously changes, we can expect integrated treatment to be the dominant paradigm for years to come. And for good reason: it works.

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.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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