Our teens are struggling. Evidence shows rates of depression, anxiety, suicidal ideation, substance use, and self-harming behavior have increased, with teens and young adults reporting escalating levels of adverse mental health symptoms.
In light of this evidence, we’ve prepared some tips on preparing your adolescent for the transition back to school after the summer, including signs that may indicate your teen needs professional support before they return. These tips can help you understand what to watch for during this adjustment period—especially in the first three weeks, when issues are most likely to become apparent.
The State of Mental Health Post-COVID
According to the Centers for Disease Control, the mental health crisis in teens is on the rise.
“In 2021, more than a third (37%) of high school students reported they experienced poor mental health during the COVID-19 pandemic, and 44% reported they persistently felt sad or hopeless during the past year. The new analyses also describe some of the severe challenges youth encountered during the pandemic…More than a quarter (29%) reported a parent or other adult in their home lost a job.”
While living amid such uncertainty and possessing fewer coping skills than an adult, teens are taking on some of the emotional burden—and it’s making a big impact on their mental health.
Step 1: Re-establishing Routines
The summer months tend to relax many families’ schedules. Curfews may have loosened. Structured meal times may have been replaced by more flexible eating habits. And, despite your best intentions, screen time limits may have been thrown out of the window altogether.
Now, it’s time to bring those rules back. It takes time to settle back into a routine, and you don’t want your teen to start school sleep-deprived and bleary-eyed from watching Tik Tok videos till 4 AM. Explain why you’re re-tightening the rules so they’ll understand the rationale behind the changes and be more willing to comply.
What to watch for:
If teens can’t return to their previous sleeping, eating, and activity routines, there may be a problem. Teens struggling with mental health issues may find it difficult to get out of bed, attend to their hygiene, and function as they used to. If their appetite and sleep patterns have changed and they’ve lost interest in activities they used to enjoy, consider making an appointment with a licensed mental health counselor for an evaluation. Teens showing those signs may be experiencing depression, anxiety, or another mental health disorder, and may benefit from treatment before they return to in-person classes.
Step 2: Review the schedule
Take time to sit down with your teen to review the upcoming schedule. What will the week look like, day by day? How much time do they need in the morning to shower, eat breakfast, get dressed, and get to school on time?
Teens transitioning to middle school or high school will also probably have new teachers, new classmates, new classrooms, and in many cases, school buildings that are entirely new to them. Creating a set schedule together, along with thinking through and estimating how long the morning routine, travel, and other things will take, will help your teen prepare emotionally and mentally for the upcoming changes.
What to watch for:
If your teen is consistently neglecting their class and homework assignments, then you may need to have a different conversation altogether. Adolescents who are unable to keep up due to mental health, addiction, or behavioral issues are unlikely to instantly transform once class resumes. Their schedule and academic demands will get more difficult over time. Teens having problems now may need treatment to get to the source of the issues that hamper their ability to participate fully in their education.
Step 3: Validate their feelings
Your teen may have conflicting feelings about returning to school, and that’s okay.
They may be thrilled about certain aspects of school, such as seeing their friends, but worried about other things, such as bullying or academic challenges. Listen to their feelings, take time to explore their concerns, acknowledge whatever they share with you, and help them work through emotions when you can.
What to watch for:
If your teen is terrified of or unwilling to go back to school, that may be a sign of a larger problem. While some hesitancy toward returning to school is normal, elevated fear that prevents teens from participating fully in school is not. Teens with excessive fear or extreme resistance might be struggling with mental health issues, such as social anxiety, depression, obsessive-compulsive disorder (OCD), agoraphobia, attention deficit hyperactivity disorder (ADHD), or other emotional/behavioral disorders.
Step 4: Check in regularly
Even if your adolescent is excited to go back to school to see friends and return to normal life, problems can arise over time. Teens may have a good couple of weeks, but then begin to flounder as the excitement wears off and pressure starts to mount.
What to watch for:
Be on the lookout for emotional, social, and academic issues not only when school resumes, but also in the weeks and months that follow. Monitor your kids daily and check in regularly to see how things are going. Also be sure to use the school portal to track their academic progress. Missing assignments and poor grades can be early warning signs that your teen is struggling.
Step 5: Partner with the school
If your child has special needs, you may already be familiar with the term “IEP” or Individualized Education Program. An IEP is essentially a plan that lays out the support your child will receive in school, whether that means different instruction, services, or test-taking experiences. Similarly, a 504 plan outlines how a child with special needs gets access to the learning they need to thrive.
If your child has an IEP or 504 plan, contact the school to confirm how their needs will be addressed. Will they be able to get up and walk around during a test, or get support if needed? If your child has fallen behind, how will the school help them catch up? It may be helpful to set up a meeting to talk through these questions.
What to watch for:
If you notice attitude changes, difficulty sleeping or eating, or low grades, or you hear concerning reports from your teen or their teachers, your child may need more support than they’re receiving at school. Even if teachers and school administrators are doing all they can to meet students’ needs, teens who struggle with anxiety, depression, or other mental health disorders may fall behind. Addressing the underlying issues with a mental health professional can put your child in the best position to succeed at school.
Tips for Talking With Your Teen
Many parents want to help their kids during this back-to-school transition period, but communicating with teenagers can be a challenge. When they try to talk, they receive blank stares, shrugs, or mumbled, one-word non-responses.
So what do you do when you try to open up and your teen doesn’t want to engage?
The first step is to set up a time to talk. Before you talk, make sure they’re not otherwise distracted. Your teen most likely won’t be excited about a heart-to-heart when they’re in the middle of a Snapchat streak with their best friend or focused on an epic game of Minecraft.
Try saying this to your reluctant-to-talk teen:
“I’d really like to talk with you about the transition back to school at a time that’s good for you. Are you available at 8 o’clock tonight?”
Phrasing it in this way does two things: (1) it sends the message that the conversation is important and necessary, and (2) it gives your teen the respect they deserve.
Once you have their attention, ask them how they feel about going back to school. Most teens will be happy about going back to school if they feel isolated and miss their friends.
If you sense, though, that your teen is unhappy about going back, take the time to dig a little deeper. Ask gently, “What’s your hesitancy? How are you feeling about this?”
If they don’t answer right away, just wait. Be patient. Stay quiet. Give them the space they need to gather their thoughts and reply. If they have complex emotions around returning to school, they may not know how to articulate them.
When they start talking, make sure to listen actively. Don’t interrupt. Don’t answer too quickly. Refrain from rattling off a list of reasons they shouldn’t worry. Do not dismiss their comments and concerns. If they share something with you, that means it’s really an issue for them.
Additionally, keep your own feelings about school out of the conversation. You yourself might be stressed, anxious, excited, or apprehensive – or all of the above – about your teen going back to school. Whatever the case may be, try your best not to pass negative emotions on to your child. Teens absorb much more than we think – and they pick up on your emotions whether you want them to or not. Your job during this conversation is to listen.
Warning Signs: Mental and Behavioral Issues
If your teen is unusually distressed about going back to school, or refuses to go back altogether, there could be a problem.
A teen who is unusually apprehensive about going back to school may have social anxiety. Teens with social anxiety might be worried about being called on in class by the teacher, facing their peers again in person, or being left out of social cliques.
Or a teen might be anxious about a specific bully. Statistics show bullying-related anxiety keeps students home far more often than most people realize. A study published in 2017 found that in California, about 300,000 students missed at least one day of school in the month they answered survey questions about bullying at school.
Other teens – especially those with learning differences or social anxiety – might be apprehensive about the pressure that will return once classes start.
Whether they have a history of social anxiety or developed symptoms recently, these teens may require professional support to facilitate their re-entry to school.
One way to determine if your teen has anxiety is to listen to them. Do they share fears and concerns with you that disproportionately occupy their attention? Do they talk about specific concerns they have about school?
If they don’t talk about their anxiety or fear, but you think they are anxious, here are signs to watch for:
- Being fidgety and restless
- Shaking or trembling
- Headaches or other aches
- Being jumpy or on edge
- Being highly self-critical
- Panic attacks
- Sense of dread
- Difficulty tolerating uncertainty
- Difficulty making decisions
- Inability to let go of worry
- Asking unanswerable “What ifs” and allowing the absence of answers to cause additional anxiety
- Focusing only on possible negative outcomes
- Bringing up the same issues over and over, needing your reassurance about them each time
If you notice any of these signs in your teen – and they disrupt their life or cause excessive discomfort – we recommend contacting a licensed mental health counselor. For some teens, anxiety may be short-term, and their fears and worries may ease with gradual efforts. If your teen continues to struggle or has an anxiety disorder, request a free clinical assessment from an adolescent behavioral health treatment center.
Studies show that some teens are experiencing new or exacerbated symptoms of depression. These adolescents may not be motivated at all to go back to school.
If your teen stays in bed most of the day, has lost interest in most regular activities, or cannot function or participate in typical day-to-day activities, they may have developed clinical depression and might not be ready to return to school.
Here are some additional signs of depression to watch for in teens:
- Low energy
- Decreased physical movement
- Frequent crying
- Persistent sadness or moodiness
- Changes in weight and/or appetite
- Changes in sleep habits (sleeping more or less)
- Decline in personal hygiene
- Less interaction with friends
- Slowed or disorganized thought and speech
- Persistent fatigue
- Alcohol or drug use
- Low self-esteem
- Feelings of worthlessness
- Excessive guilt
- Inability to think clearly, concentrate, or make decisions
- Psychosomatic complaints (physical symptoms like aches or pains that stem from emotions)
- Self-harming behavior
- Thoughts of death or suicide*
*DO NOT IGNORE SUICIDAL THOUGHTS OR BEHAVIOR*
If your teen talks about suicide, have them evaluated by a mental health professional at a teen treatment center ASAP. If you think your child is in immediate danger, call 911 or go to the nearest emergency room. If there’s a psychiatric hospital nearby, go there.
If you notice any of these signs of depression, contact a licensed mental health counselor or teen mental health treatment center.
Teens who don’t want to go back to school may remember their negative past experiences in school. If your teen has a behavioral issue such as oppositional defiant disorder (ODD), disruptive mood dysregulation disorder (DMDD), or conduct disorder (CD), they’ve likely had trouble with teachers and school administration in the past. Perhaps they’ve been suspended or expelled and you both fear a repeat of those experiences once school restarts. That’s why now may be the time to get treatment: before the school calls you to pick up your child for a behavioral issue or crisis related to their behavioral disorder.
If you’re not sure whether your teen has a behavioral issue or a clinically diagnosable behavioral disorder, consider whether they demonstrate any of the following signs:
- Frequent irritability
- Angry outbursts
- Frequent defiance of rules
- Making hurtful, spiteful remarks
- Constant negative attitude
- Frequent, excessive arguing with authority figures, including you
- Frequent non-compliance with requests of parents, teachers, and other adults
- Short-tempered/easily angered
- Low tolerance for frustration of any type
- Deliberately tries to upset others
- Intentionally causes chaos
Often, behavioral issues go hand in hand with mental health issues. If your teen shows any of the symptoms/ behaviors listed above, we recommend contacting a licensed mental health counselor for an evaluation. They can determine whether your teen has a behavioral disorder or identify another source of their symptoms and behavior.
Attention Deficit Hyperactivity Disorder (ADHD)
Teens with attention deficit hyperactivity disorder (ADHD) might struggle with going back to school after an extended period of time at home. For some teens with ADHD, summer was a welcome break. They could grab a snack, go outside to get some fresh air, or stand up and stretch – all things that do not typically happen at-will during school. Once they go back to classes, they’ll have tests and lessons, and they won’t have the option to access things that may have given them a little bit of extra help.
For other adolescents with ADHD, missing the structure that school provided may have negatively impacted their ability to cope and function effectively. Returning to school may be harder than ever. It may require extensive support and treatment beforehand to build the skills they’ve lost over the past year.
If your teen displays the following symptoms, consider having them assessed for ADHD:
- Difficulty following instructions
- Difficulty concentrating or staying focused
- Frequent daydreaming
- Easily distracted
- Frequently loses possessions
- Difficulty getting and staying organized
- Dislikes/avoids doing tasks (like homework) that require focus
- Lack of attention to detail
- Difficulty finishing tasks
- Frequent procrastination
If your teen has a mental or behavioral disorder such as depression, anxiety, conduct disorder, or oppositional defiant disorder, there’s an increased chance they also have ADHD, compared to teens without a mental or behavioral disorder.
If your teen has social or academic problems, we recommend contacting a licensed mental health professional for an ADHD evaluation. It’s important to get treatment as soon as possible if your teen receives a diagnosis of ADHD. Studies show that early intervention offers the best possible chance of treatment success for teens with ADHD – or any other mental health, substance use, or behavioral health disorder.
Other Problematic Behaviors and Issues
Stress exacerbates drug use and other high-risk behaviors worldwide for people of all ages. Studies show rates of suicidal ideation, substance use, and self-injurious behavior have increased, with teens and younger adults experiencing particularly alarming increases in adverse mental health symptoms.
If your teen engages in any of the behaviors below, we recommend seeking professional support as soon as possible:
- Drug use (including alcohol, marijuana, and vaping)
- Self-harming behavior (such as cutting)
- Suicidal ideation, which includes thinking about suicide or talking about suicide
Teens struggling with depression or anxiety often use these behaviors as coping mechanisms to handle internal pain and/or uncomfortable thoughts or emotions. While a guide like this cannot diagnose your teenager or recommend a treatment plan, it’s likely that adolescents who display the behaviors listed above need mental health, substance abuse, or co-occurring disorder treatment provided by qualified professionals. During treatment at an adolescent behavioral health treatment center, teens can learn how to manage their overwhelming emotions in productive ways – without turning to alcohol, drugs, or other life-interrupting behaviors.
Don’t Delay Treatment: Get Help Before Returning to School
Most adolescents in the U.S. will be back in class soon. But what if your teen isn’t ready to go back to school? What do you do if they need 24/7 care and supervision due to mental health, substance use, or behavioral issues?
They may need residential treatment – not school.
Sometimes parents wait too long to seek treatment and support for their teen. Parents may think “it’s just a phase” or “things will get better once they’re back in school.” Things might get better, but evidence shows they often get worse.
While mild symptoms may fade once teens are back in school, acute mental health and addiction issues are more likely to intensify upon return. Studies show that early intervention gives teens the best chance of treatment success. That’s why it’s important to get mental health or addiction treatment as soon as possible.
Don’t ignore these issues and hope they’ll disappear once school restarts.
If you observe signs of a mental health, substance use, or behavioral disorder in your teen, we recommend contacting an adolescent treatment provider to schedule an evaluation. If a mental health professional recommends treatment, then your teen can receive high-quality, evidence-based treatment before heading back to school.
If their symptoms allow them to function at home and participate in their typical daily activities, they may benefit from intensive outpatient or partial hospitalization treatment. If their symptoms prevent them from functioning at home as they used to, or if their behavior threatens the health and safety of themselves and/or others, residential treatment may be necessary.
Find out how we can help your child. Contact us at 855-904-4340 today to discuss your teen’s symptoms. Our admissions counselors can help you determine which level of care is appropriate.
Treatment for Teens: Evaluating Your Options
Finding the treatment option that best meets the needs of your child and your family can be challenging. The following information aims to reduce confusion about the common types of treatment and levels of care available.
In outpatient treatment, parents take teens to an office visit once or twice a week. This is a typical entry level of treatment for a teen who needs help with psychological or emotional issues, but whose issues do not significantly disrupt their ability to function in school and do not significantly impair their family or peer relationships.
In Intensive Outpatient Programs (IOP), adolescents attend treatment for a half-day, three to five days a week. This level of mental health treatment is appropriate for teens with mental health and/or substance use issues that are significant enough to disrupt day-to-day living but who can still live at home and/or go to school.
In Partial Hospitalization Programs (PHP), adolescents attend treatment for a full day, five days a week. This level of treatment is appropriate for teens with mental health issues that are significant enough to disrupt day-to-day living. Teens in PHP programs typically do not go to school while receiving this level of care although most PHP programs have an academic component. Participants in PHP programs live at home, and do not live on-site.
These programs occur at Residential Treatment Centers (RTCs). This level of treatment is appropriate for teens with mental health or substance use issues that are so severe they need 24/7 support and monitoring. Teens who attend an adolescent residential treatment center do not live at home and need an immersive level of care to manage their mental health or substance use issues.
In a residential program, teens receive more intensive therapy and psychiatric care than in Intensive Outpatient or Partial Hospitalization programs. These teens need time away from their current environment to concentrate on recovery and healing. Residential treatment allows for more time for one-on-one therapy, family therapy, group therapy and peer support. Teens learn and practice coping skills, distress tolerance techniques, and relapse prevention strategies. They have time to practice what they learn and hone their skills with feedback from therapists, counselors, and peers. This prepares them for success when they finish treatment or step down to a less immersive level of care.
The length of stay in a residential treatment program – typically 30-60 days – is often covered by insurance plans that include behavioral health benefits. Insurance plans that include behavioral health benefits often do not cover programs of greater length than residential treatment programs, such as long-term treatment programs, wilderness programs, and boarding schools.
Our Guide to Finding Treatment
If your teen shows signs or symptoms of a mental health, behavioral, or substance use disorder, they may benefit from treatment. Rest assured that you can get them the treatment they need to manage their symptoms and rediscover their mental, emotional, and spiritual balance.
At Evolve, we’re committed to helping restore harmony to your family and home. We created a treatment guide to help you navigate the process of finding the best possible treatment option for your adolescent.
To download our Finding Treatment Guide, please visit:
About Evolve Treatment Centers
Evolve offers a full continuum of care, including Intensive Outpatient (IOP), Partial Hospitalization (PHP), and Residential Treatment Centers (RTC). Our locations in Northern and Southern California provide the highest caliber of evidence-based treatment for teens 12 to 17 years old, who struggle with mental health, substance abuse, and/or behavioral issues.
Evolve programs include:
- Psychiatric Support
- Individual Therapy
- Family Therapy
- Group Therapy
- Experiential Therapy
- Academic Support
Evolve Treatment Centers maintains the highest level of safety protocols for teens. We utilize strict line-of-sight policies, state-of-the-art monitoring technology, and maintain a 3:1 client-staff ratio. At each residential location, treatment is offered in comfortable, well-appointed homes with a maximum of six clients at any given time. We create a home-like atmosphere of inclusion and acceptance, ideal for healing, learning, and growth. Evolve’s team of highly trained mental health and addiction experts includes psychiatrists, nurses, licensed clinicians, and residential counselors who bring a diverse and eclectic background to the treatment experience. Teens receive individual therapy three times a week and group therapy several times daily. Families participate in programming with therapy sessions twice a week and weekly parent support groups. We cultivate an authentic, compassionate, and caring environment where real change happens daily.
To learn more about mental health programs at Evolve, please call (800) 665-GROW.