Presented by Franciscan Children's

Adolescent Mental Illness in Boston: One Family’s Story

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In an affluent suburb of Boston, Beth, the mother of a teenage girl, started to notice changes in her daughter’s behavior. Abby, 17, an ordinarily outgoing girl, seemed to sleep away the summer leading into her senior year of high school. Beth chalked up the changes to a typical teenage phase.

However, as summer turned to fall, Abby’s changes in behavior persisted. One evening after school, Beth heard glass shattering in Abby’s room. She ran upstairs and saw the framed picture of her daughter and some friends in pieces on the floor. Abby said, “I hate my life, and I want to die.” Beth thought, “What teenage girl hasn’t had a fight with her friends?” The next morning, Abby didn’t want to go to school, but Beth made her go. At 10 a.m., Beth received a call from the school’s guidance counselor, who said Abby wasn’t doing well, and that Beth needed to get there right away. When Beth arrived, Abby spoke about how the idea of suicide had dominated her thoughts for three months. Mother and daughter went directly to the ER. That’s when Beth realized Abby’s issue was more than teenage angst – it was a true mental health crisis.

Beth felt scared and helpless. She wasn’t sure where to turn for additional care and treatment. Who should she call? A psychiatrist? Abby’s pediatrician? A family therapist? Beth was lost. The staff at the ER referred Abby to Franciscan Children’s in Boston – a place Beth had never heard of despite her years working in health care in the area. Beth was instantly thrust into the unfamiliar world of caring for a child experiencing a mental health crisis. She and Abby went from the ER to Franciscan Children’s feeling scared and not knowing what to expect.

Upon Beth and Abby’s arrival, staff members compassionately welcomed both mother and daughter, explaining what Abby’s stay at Franciscan Children’s would look like. Beth sensed the staff’s confidence and felt relieved that Abby was under the care of experts. The doctors and clinicians developed a treatment plan for Abby, and Beth knew her daughter was in the right place.

Abby’s struggle is, unfortunately, common; mental illness doesn’t discriminate and occurs in families from every socioeconomic group. “Families feel isolated when their child is battling depression. But some of that isolation is self-imposed, and it’s important for families to share their struggles because [depression is] so much more common than most people realize,” says Brian Duffy, RN, nurse manager of Franciscan Children’s Inpatient Mental Health Program. Statistics indicate that every two hours and seven minutes, a person under the age of 25 completes suicide in the United States. For every completed suicide, estimates show that 100 to 200 young people have made an attempt to end their life. Astonishingly, suicide is the second-leading cause of death in children ages 10-19; and for teens ages 15-19, the number of deaths from suicide is three times greater than deaths from cancer.* Here in Boston we’re seeing it firsthand, as too many kids go without care because there aren’t enough beds in high-quality mental health programs to meet the need. Between 2010 and 2014, half of the adolescents in Massachusetts who experienced a major depressive episode did not receive treatment.**

When Abby was admitted to the Inpatient Mental Health Program at Franciscan Children’s, Beth remembers giving her a long hug. It all seemed surreal. Why would her beautiful baby girl – who seemed to have everything going for her – want to take her own life? The answer came two days later. With the close support of her treatment team, Abby finally shared the trauma that led to her suicidal feelings. Abby had been raped in her home by a boy she had known since kindergarten. “I hadn’t even adjusted to the fact that she was suicidal,” Beth says, “and then to find she had been raped … I couldn’t comprehend it.”

Looking back over this terrible period in her family’s life, Beth said she wishes she had known the warning signs of teen depression, a precursor to suicide. Abby’s behavior had sharply changed. She was avoiding her friends, was sleeping a lot, and seemed detached from and disinterested in the things that used to make her happy. Still, Beth was unable to string all of these warning signs together and make sense of it all. In retrospect, the warning signs were there. “In a typical high school classroom, it’s likely that two or three students have made a suicide attempt in the past year,” says Dr. Ralph Buonopane, Director of the Inpatient Mental Health Program at Franciscan Children’s. “When parents recognize warning signs, they can potentially catch the problem before suicidal behaviors develop.” Albeit through an alarming and frightening situation, Beth was grateful to have discovered Abby’s condition before the suicidal thoughts turned into action.

Knowing Abby was suffering and wasn’t the carefree child she had once been weighed heavily on the entire family. Beth felt like a horrible mom for not knowing what had been going on with Abby. She blamed herself for not being able to protect and take care of her child. She was afraid to reach out to her family and friends for fear of how they might judge her and Abby. “We never told her grandparents what happened,” Beth says. “It would have killed them.” With friends and family not in the know, the support offered by the staff of Franciscan Children’s became a critical source of strength for Beth and her immediate family. Beth bonded with the care team, and their support became the family’s rock through the ups and downs of Abby’s condition and treatment.

With all that had happened, Beth was worried that a mental health diagnosis would mean Abby might never be able to live a “normal” life. The care team at Franciscan comforted Beth and assured her that with treatment, adolescents can go on to live healthy, productive lives. Beth grew to understand that this reassurance came from a wealth of experience. Franciscan Children’s is the most comprehensive pediatric mental health provider in Massachusetts, providing extensive inpatient, outpatient and school-based mental health services. Its team of child psychiatrists, psychologists, nurses, physicians and social workers marry science with sensitivity to connect with their young patients. Last year alone, they provided mental health care to more than 1,300 children and adolescents in need. “One of the things we know about preventing suicide is that building up a sense of belonging is one of the most powerful, protective factors,” says Buonopane.

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The biggest gift Abby and her family received at Franciscan Children’s was hope. After the trauma Abby had been through, Beth thought she might never get her little girl back. But the staff surrounded her family with a virtual scaffolding of expertise and support. With equal parts skill and compassion, the team worked side by side with Beth and Abby to help mend her unique emotional wounds. Abby began to recover from what once felt like an insurmountable and hopeless situation.

The Inpatient Mental Health Program at Franciscan Children’s operates in partnership with McLean Hospital and has long been recognized for its family-centered care. By offering a strengths-based environment, the program helps build resilience in patients like Abby and their families, while providing them with state-of-the-art psychiatric care.

It’s been eight years since Abby was a patient, but the nine days she spent at Franciscan has had a lasting impact on her life. Abby’s experience inspired her to become a nurse. “I plan to spend my whole life providing care for people the way the team at Franciscan Children’s provided care for me.”

“While every patient’s story is unique, we know that 90 percent of teen suicides are associated with an underlying mental health condition – most commonly depression or anxiety. These conditions are treatable,” Buonopane says. However, a condition that isn’t recognized cannot be treated. The first critical step toward mental health treatment is awareness, and that is followed by discussing the issue with your child. You may not have the perfect words or the perfect approach; it’s natural to struggle to find the right way to deal with your child’s mental health issues. Adolescent mental illness is a complicated and scary issue for any parent to face.

But you don’t have to struggle alone; help is here for you across all levels of mental health care. At Franciscan Children’s, you have an ally to support you and your child. With this support, your family can thrive and your child can get back to the healthy life he or she deserves.

If you think your child might be displaying signs of a mental health problem, please call 617-779-1566 to be connected with the Franciscan Children’s Mental Health Resource Line.

For more information or to learn more about the programs Franciscan Children’s has to offer, please call 617-254-3800 or visit FranciscanChildrens.org

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*National Vital Statistics Report Vol. 65, No. 5, June 30, 2016 (CDC/HHS)

**Substance Abuse and Mental Health Services 2015 Massachusetts Behavioral Health Barometer Report

***Some names and identifying details have been changed to protect the privacy of individuals in this story