Youth Mental Wellness: Thoughts

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In February, West Michigan Woman hosted the Wine Down panel discussion Youth Mental Wellness: Emotions Matter.

On the panel were Valencia Agnew, Ph.D., DBTC, Adolescent & Family Behavioral Health Services; Gregory V. Mallis, Psy.D., Pine Rest Christian Mental Health Services; and Jennifer Shalhoup, Psych R.N., Forest View Hospital.

Dr. Valencia Agnew, a well-known therapist who offers hope to many of the more difficult cases in the Grand Rapids area, is recognized by the school, legal and healthcare communities as a leading provider of group and counseling services. She holds a master's degree in Counseling Psychology from Western Michigan University, a doctorate from Walden University and certification as a Dialectical Behavior Therapy therapist (DBTC). She is trained to work with individuals, children and families on anxiety, depression, addictions, trauma, abuse and domestic violence, multicultural issues and blended families, among other areas. Her true passion for helping others has led to development of a diverse set of skills to help adolescents make powerful, positive changes in their lives.

Here, Dr. Agnew provides further responses to some of the audience questions that arose during the panel discussion.

What has been your experience with kids and sports?
What is the good, the bad and the ugly?
When is too much, too much?

All my children have played sports. My son played football in the NFL. Needless to say, we are a sports family. A rule of thumb I share with parents: one sport per season in high school. More than one sport per season may be feasible in elementary and middle school, because the level of intensity and demands on time are less than in high school. Things become ugly when kids are forced to be in sports they do not like. This should not be confused with having kids try a sport and stick with it for the season. Being forced is when there is a clear dislike, but the child is made to continue with the sport. A way to tell it is too much is when grades drop because there is not enough time to manage the sport and education. Sometimes, just paying attention to the child can let parents know what is best. One child may love a sport and gladly work hard to achieve; another may like the sport—versus love it—and not be willing to invest the same level of energy and time into the sport. And that is OK. The good part about sports is that it can build resilience and create a sense of belonging and accomplishment. In addition, endorphins are released during sports.

When you refer to treatment options, what percentage of treatment involves medication versus other interventions?

I cannot say what percentage of treatment includes medication versus other options. It is difficult to respond to this question without more content, because it depends on the reason the client has entered treatment. For example: If someone is diagnosed with bipolar disorder, then treatment includes medication. If a client is diagnosed with borderline personality disorder, medication is not generally recommended for that diagnosis. However, there may be other things at play—such as depression, in which case medication may or may not be needed depending on severity of depression. If a client is diagnosed with ADHD, medication may or may not be used as there are other options if parents do not want to use medication. The treating therapist would make a decision based on client's needs and possible results of not taking medication. Those are just a few examples; as you can see, it depends.

When and how do you get involved when you see issues with your child's friend?

It depends on the issue. If it is an issue that can result in you feeling regret and guilt because you said nothing, then err on the side of caution. For example: If you believe a friend is depressed, consider the option of having noticed, saying nothing and the child commits suicide; a life is lost. Error on the side of caution. If you know illegal activity is involved or drug use, consider the guilt of legal troubles, addiction or overdose. A life could be ruined when help could have been made available.

Not every parent is receptive to hearing something is going on with their child and it can be tricky trying to figure out when it is or is not your place to say something. If it bothers you—if you would want to know—then say something. It is not your role to make a parent hear you; only to give them a fighting chance to help and support their child.

I believe it takes a village to raise a child. This does not mean a parent has to be called every time their child does something. One of the best things a parent can do is be involved. Know your child's friends. If you know their friends, you may have an opportunity to influence them and speak words of encouragement. You may notice a change in mood or relationship struggles and be able to say something that lifts their spirit or point them in the right direction.

How do you recommend we manage the balance of supporting and protecting children—particularly teens—in toxic, abusive friendships that appear to be unhealthy to us, as parents, but that our kids seem committed to?

First, let me preface with this: If there is a point in which a parent feels their child is in danger, then it is important to take steps to get the child out of the relationship/friendship. Prior to that, parents can take other steps. For example: Parents can talk with their kids about their friendships—not just the toxic one. The idea is to find out what draws your children to certain relationships and interactions. If you know your child is in a toxic relationship because he or she is loyal to a fault, or is a rescuer, the intervention or help will look different than if he or she has low self-esteem, low self-confidence, low self-worth.

Basically, I am saying it is important to understand why there is a problem or the nature of the problem, before rushing in to fix it. It can seem you lose all influence as a parent at certain ages but be encouraged; you do not. Role model healthy relationships, share how your friendships are give and take, and share what you dream of for your children in relationships.

A nonthreatening way to strike up a conversation with children is by looking for natural life moments; perhaps while watching a movie, strike up a conversation about the healthy or unhealthy nature of the relationships. I do have to laugh, because my kids caught on and asked if I needed to have a meaningful conversation about every movie we saw. However, they started telling me to watch movies because they were sure I would want to have a talk with them about scenes. Of course, having a conversation with a therapist can help parents determine a best course of action based on the specifics and level of severity.

We have seen shocking stories of youth turning to suicide—kids as young as 8! What warning signs should we look for and actions can we take to avoid this unexpected and tragic choice?

There are risk factors and warning signs.

Risk factors are characteristics or conditions that increase the chance that a person may try to take their life and endure over a period of time.

Environmental factors.

  • Stressful life events, which may include a death, breakups, loss of any nature.
  • Prolonged stress factors, which may include harassment, bullying, relationship problems.
  • Access to lethal means including firearms and drugs.
  • Exposure to another person's suicide, or to graphic or sensationalized accounts of suicide.

Health factors.

  • Serious or chronic health condition and/or pain.

Historical factors.

  • Previous suicide attempts.
  • Family history of suicide attempts.

Suicide risk in teens is clearly linked to seven disorders.

  • Depressive
  • Anxiety
  • Conduct Disorder
  • Schizophrenia
  • Bipolar Disorder
  • Eating Disorders
  • Substance Use Disorders


  • Youth who report both being bullied and bullying others have the highest rates of negative mental health outcomes, including depression, anxiety and thinking about suicide.
  • Youth who report being frequently bullied by others are at increased risk of suicide-related behaviors and negative physical and mental health outcomes.
  • Youth who report frequently bullying others are at high, long-term risk for suicide-related behavior.
  • In youth, bullying behavior and suicide-related behavior are closely related.

Warning signs are the expression of the suicidal risk and signal an imminent suicide risk.

Changes in behavior or the presence of entirely new behaviors: When the typical range of behaviors changes and lasts for a few weeks, be concerned. This is of sharpest concern if the new or changed behavior is related to a painful event, loss or change. Most people who take their lives exhibit one or more warning signs, either through what they say or what they do.

Talk can be a warning sign. People will oftentimes say certain things that will tip you off. Although they may even try to make it sound like a joke, when any of the subjects listed below are mentioned take notice:

  • Killing themselves.
  • Having no reason to live.
  • Being a burden to others.
  • Feeling trapped.
  • Unbearable pain.

Behavior can be a warning sign.

  • Increased use of alcohol or drugs.
  • Looking for a way to end their life, such as searching online for materials or means.
  • Acting recklessly.
  • Withdrawing from activities.
  • Isolating from friends and family.
  • Sleeping too much or too little.
  • Visiting or calling people to say goodbye.
  • Giving away prized possessions.
  • Increasing violent behavior.

Mood can be a warning sign.

  • Depression
  • Loss of interest
  • Rage
  • Irritability
  • Humiliation
  • Anxiety

Understand that when people display these behavioral changes it may often look like they want to be left alone, rather than a cry for help.

There are also protective factors that can help.

  • Effective treatment for mental, physical and substance use/abuse disorders.
  • Easy access to clinical treatment, interventions and support.
  • Family and community support.
  • Support from ongoing medical and mental health relationships.
  • Developing of coping skills, problem-solving skills, conflict resolution as a nonviolent way of handling disputes.
  • Cultural and religious support systems.
  • Cultural and religious beliefs that discourage suicide.
  • Pets.

You could also call or text the National Suicide Prevention Lifeline, to talk or text with a trained crisis counselor. Not only can they help someone contemplating suicide, but they can assist those trying to help someone contemplating suicide. Both are free, 24/7.

  • Call 800.273.TALK (8255)
  • Text TALK to 741741

Talking to someone about suicide will not make them suicidal. ASK if they have felt like hurting themselves or taking their life.

Visit Adolescent & Family Behavioral Health Services to learn more about Dr. Valencia Agnew and the services she and her group practice provide.


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