Building Resiliency – Addressing Youth Mental Health Crisis

Early detection and treatment of diseases such as diabetes, heart disease, and cancer are critical in keeping patients healthy and increasing their quality of life. The same idea holds true for mental health crisis such as depression, anxiety, and psychosis, when early detection and treatment can be advantageous. Mental health crisis remains a serious public health concern in the United States, particularly among adolescents and young adults.

According to the National Institute of Mental Health, roughly one out of every ten kids in the United States aged six to seventeen years have had a significant depressive episode in the previous year. Suicide is the second highest cause of death in those aged 10 to 34.

 Dr. Daphne Holt, the director of the Resilience and Prevention Program and the Emotion and Social Neuroscience Laboratory at Massachusetts General Hospital, an MGH Research Scholar from 2018 to 2023, and an associate professor of Psychiatry at Harvard Medical School were interviewed. Holt and her team are working on ways to identify the early signs of psychiatric disorders in youth and provide them with tools to manage their mental health. 

“I came to a realization about a decade ago that little progress had been made in developing preventive approaches in psychiatry, unlike most other areas of medicine, such as infectious disease, oncology and cardiology,” Holt states. 

One of the difficulties in detecting depression and anxiety symptoms early is the lack of observable biological indications for these conditions, such as those detected through a blood test or an MRI.

Holt adds that in modern medicine, diagnosis for psychiatric diseases are based on self-reported symptoms. Clinicians may ask, “Do you have little interest or pleasure in doing things?” Alternatively, “Are you feeling down, depressed, or hopeless?”

“One could argue that we need these types of biomarkers in psychiatry more than in other fields of medicine since ‘self-report’ of subjective symptoms is a particularly unreliable source of information at times, especially in people who have illnesses that may affect their judgment and their ability to perceive themselves accurately,” Holt says. 

This self-report method may also overlook persons who do not fulfill the criteria for a diagnosable illness but still experience a variety of symptoms and are at risk of developing more serious mental illness in the future. Many young people fall into this category because, while symptoms of mental diseases can appear as early as childhood, the peak time of onset for many mental illnesses is late adolescence and early adulthood.

Holt developed and presently directs the MGH Resilience and Prevention Program, which focuses on detecting children with early indicators of mental illness and teaching them resilience training to enhance their mental health.

Training people in resilience-building practices while they are at risk of developing a mental illness gives them the skills they need to better “bounce back” in the face of hardship. This approach has been studied and found to be effective in lowering or eliminating the early indicators of mental illness in college students, adolescents, and healthcare workers.

Researchers said “We conducted a randomized control trial that showed our program for at-risk young adults works. It significantly decreased early symptoms of mental illness long-term more so than a control condition. Since then, we have started training clinicians in this approach to hopefully implement it on a broader scale.” 

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