Challenges to mental health treatment have existed across the board throughout age groups, populations, and socioeconomic classes, but the COVID-19 pandemic has brought many of these issues to the surface. Although some face greater challenges than others, mental health remains a difficult subject for many to broach. Receiving therapy can even be harder for those teens in survival mode, coping with tremendous pressures as they transition into adulthood.

What many people don't realize is that mental health disorders begin to develop during adolescence. About 75 percent of adults with a mental health disorder experienced an onset of symptoms before the age of 24. Additionally, suicide is the third leading cause of death among those aged 10-24 years old. For this reason, the assessment, diagnosis, and treatment of mental health disorders in young people are more important than ever.

Treatment Challenges

Some of the challenges for this vulnerable group involve a lack of access to services; others are related to the stigma associated with receiving treatment for mental health diagnosis. Some specific challenges include:

• Financial concerns
• Confidentiality
• The stigma associated with seeking mental health treatment

Need for trained adolescent treatment professionals 

Lack of access to a clinician is a big problem. There are not enough professionals in the field who are trained to treat mental health disorders. There are fewer who specialize in adolescents. Many schools must share mental health professionals with other schools in their district. This means that therapists are unavailable to focus on a set caseload or provide continuity of care to struggling teenagers. An adolescent having to speak to several different counselors, on an irregular schedule, is an immense obstacle.

Need for greater resources 

Lack of access may also be due to finances. Some insurance companies limit the amount of inpatient and outpatient treatment that adolescents can have. This leaves the client, or their family, responsible to pay for services privately. For a group aged 10-24, or a family on a tight budget, this presents a huge challenge. Many young people in our country lack health insurance or reliable transportation, and may even face homelessness. Circumstances like these make services nearly impossible to provide effectively.

Need for greater clarity on ethical and legal matters

In adolescent treatment, there remains the age-old problem of lack of confidentiality in treatment for adolescents. This means that when a minor is involved in treatment, there are countless legal and ethical ramifications, especially with confidentiality. Some states may not allow a minor to explicitly consent to their own outpatient medical treatment. If an adolescent is not able to confide in a parent or guardian, this can create a challenge. Many teens who need treatment for depression or suicidal ideations, do not feel comfortable talking about it with their parents.

Other challenges arise if the adolescent confides in their therapist something of a serious nature, and there is debate regarding whether to inform the parent or guardian. Caregivers not only need to decide what information to share but also how to make sure that a child's family remains updated and informed about their progress, particularly those in residential treatment facilities.

Need to balance treatment for the adolescent and the family

While we may consider the adolescent to be the identified patient, we cannot forget about the role that the entire family plays in the adolescent’s therapy trajectory. When the adolescent functions better, the family functions better and vice versa. Communication processes, attachment styles, and parenting styles all have an impact on the adolescent’s functioning. It is vital to have families work on their dysfunctional patterns in order to truly impact the adolescent’s maladaptive thoughts or behaviors. 

There are several forms of family therapy, and they are typically used in conjunction to provide the best treatment.

• Psychodynamic -- highlighting the idea that no behavior is random due to our inner conscious and its processes.
• Structural Family Therapy -- focusing on the overall structure of the family.
• Strategic Family Therapy -- remaining solution-focused to strategize and solve problems.
• Cognitive-Behavioral Family Therapy -- focusing on the idea that no behavior is random due to external social forces.

Although we know that family therapy is an enormous factor in the mental health of adolescents, we cannot guarantee that the family is able or willing to take part in therapy. Challenges to families receiving therapy include time constraints, cost, and biases toward receiving treatment. It is also important to consider that if the adolescent is showing maladaptive behaviors and the family believes the adolescent may need treatment, the family may need a lot of psychoeducation before agreeing to complete sessions as a family. 

The stigma around mental health 

Stigma is a word that we have heard much about, as the importance of mental health has taken over our morning TV programs, social media, and the news. What this generally refers to is the idea that many people avoid seeking treatment for fear that others may see them as weak or unable to solve their own problems. In our individualistic culture, the idea of solving one’s own problems is seen as equivalent to strength, thus therapy is not always considered a valuable resource. 

However, in recent years in the younger community, it appears that this stigma is lessening, as we may now consider it acceptable to have a therapist. That being said, there still exists a role discrepancy because many people view having a therapist as a status symbol. 

Overall, it is important to remember that challenges facing adolescents in terms of treatment come from both internal and external forces. It is the lack of appropriate resources, and the feelings of shame that may come along with the need for professional help. Compounding the problem is the current state of our healthcare system and the coronavirus restrictions in place. Child and adolescent treatment providers must ensure continuity of care during all phases of the pandemic. We can work together to remove the stigma associated with getting help and mitigate these treatment challenges so that our young people get the mental and emotional support they need.

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Whether you work with adolescents in an outpatient or residential treatment environment, or are considering adding an adolescent wing to your inpatient treatment program, Alleva has solutions for you.  Keeping track of clients and tasks, staying in touch with family members, and using our scheduling platform has never been easier. With the friendliest EMR around, your to-do list just got a whole lot easier.