Helping Resistant Teens into Mental Health Treatment

Teens are often reluctant to pursue crucial mental health treatment for conditions like anxiety and depression, but there’s plenty parents can do to help.

More than 40% of high school students in 2021 reported feeling so sad or hopeless they could not engage in regular activities for at least two weeks during the previous year, according to the U.S. Centers for Disease Control and Prevention, and one-third experienced poor mental health.

Parents may struggle to convince their teens to participate in treatment services that could dramatically improve their quality of life. If a teenager isn’t on board with therapy or other treatment, they’re less likely to take it seriously and fully benefit from it, says Justin Schreiber, DO, MPH, a pediatrician and child psychiatrist at UPMC Children’s Hospital of Pittsburgh.

Teens may fear the confidential information they share with a therapist will be then shared with family, or feel embarrassed due to the enduring stigma associated with seeking mental health care.

“Stigma is one of the biggest, if not the biggest, barrier,” says Dr. Schreiber. “If I ask someone about their family history, they will tell me about everyone’s headaches, but they can’t tell me about diagnoses for depression and anxiety. It’s gotten a little better with more normalization and conversations that adolescents are having with each other, but there’s still a fear that some of the conversations they have will not be kept confidential.”

Teens may resist mental health treatment, including therapy, if:

  • They fear their therapist will share their feelings or secrets with their family.
  • They’re embarrassed or fear social rejection.
  • They believe treatment will not help.
  • They don’t think they need help or feel they can help themselves.
  • They feel defensive, hopeless, or exhausted in dealing with their mental health struggles.

“We know that mental health diagnoses in teens are extremely high,” says Dr. Schreiber. “As we think about the pandemic and continued stressors that come up financially for families, we know that’s continuing to rise. It’s important to help them get the help they need, but also to help them identify the symptoms of these conditions so — as they get older — they know how to get help and continue to get support.”

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Helping Resistant Teens into Mental Health Treatment

Whether it’s talking to a skilled therapist, participating in cognitive behavioral therapy, or considering medication, mental health treatment can help teens — and people of all ages — better navigate the world.

Dr. Schreiber suggests including teens in the conversation from the get-go. Share why you believe they would benefit from treatment, and ask for their opinion.

“What I’ve found is teens are least likely to do it when it’s the parents’ idea and it feels forced,” he says. “As adolescents, they want to have that independence. So, work collaboratively with them. Help them understand how they could benefit from it and ask them to identify what they want to get out of it — whether that’s improving their relationship with friends, better managing school, or sleeping better.”

Parents should consider participating in therapy or counseling themselves to further encourage their teens. Ask them to consider just a few sessions at first, rather than a long-term commitment; it’s possible they’ll become more comfortable during this time and decide to stick with it.

“I think it’s beneficial if parents say, ‘Hey, you’re going to have confidential time by yourself and I’m OK with that — I want you to have that one-on-one time with them,'” says Dr. Schreiber.

If they’re still unwilling to listen to your recommendations, they may listen to a trusted family doctor, or another family member they’re comfortable with.

“There’s a benefit of working with your primary care practice,” says Dr. Schreiber. “If it’s someone they trust, it’s super helpful to have that long-term connection to encourage them to feel more comfortable.”

“It’s really about coming to them in a place of support,” Dr. Schreiber continues. “Saying, ‘This is not because of an argument but because you deserve to feel better. I care about you so much as a parent and I really want you to get the care you deserve.'”

Click here for a full list of behavioral and mental health services at UPMC.

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is the hub of UPMC Behavioral Health, a network of community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors. Our mission is to provide comprehensive, compassionate care to people of all ages with mental health conditions. UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. We are here to help at every stage of your care and recovery.