Mental Health

My unusual advice to one family with a teen in crisis

Delaney Ruston, MD
September 6, 2022
Teen boy head in his hands

Many of you are aware of the recent New York Times report entitled Inside the Adolescent Mental Health Crisis.

The reporter, Matt Richtel, covers a lot in the article, including the fact that getting mental health care (also referred to as behavioral health care)  for teens is often excruciatingly difficult. This has been a long-standing problem, and it is heartbreaking. I have experienced it in my own family and with many friends, and I see it time again with the patients and families I see in my clinic. 

Since 2004, I have been doing mental health advocacy, and believe me, I could easily take this opportunity to expand upon Richtel’s reporting.

But rather than doing that,  I want to share a story that offers a strategy that anyone can choose to do to help any youth or family who might be struggling, including your own. 

Recently, after an especially busy day in the clinic, while biking home, I decided to stop by my old neighborhood to see if my former neighbors were home. Happily, they were, and they invited me in, and we started chatting about life.

They were expecting a couple for dinner, and not long after I arrived, the couple showed up. (I will call their friends Jason and Sarah).

While we were talking, the topic of kids came up, and Jason mentioned that their son was in college. That was all he said. 

Later, when I was talking about mental health advocacy, I noticed that Sarah’s expression had changed. She looked more serious and said, “Our son is not doing well. At the end of this past year in college, he had a real mental health crisis. He even became delusional for a short time.” 

Their son, they explained, was living with them this summer, and they were doing all they could to get him appropriate care. They were getting services at our main hospital in Seattle, but things were extremely fragmented, and they weren’t getting sufficient help. 

Sarah explained that her son was really withdrawn, with lots of symptoms of depression. 

Jason said, “We try to get him to do things with us, but he just refuses all the time. We try to get him to be active, but he only takes a walk now and then.” 

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Sarah said something I hear all too often, “We feel so isolated and alone.”

We discussed the resources they had found, and I shared others they had not heard about.

Eventually, I leaned forward and offered the following advice:

“It is so common that our efforts to help our own kids don’t work, and what we need is a brigade of other people to show up unannounced at our door and offer support. This could be one of their friends showing up with a basketball. It could be a family friend showing up and saying, ‘Hi, I am making this new dish I never made. I thought of you, so I am here to pick you up, and let’s go do it.’”

At this point, my old neighbor Steven (not his real name) chimed in and said, “He loves this international food store, and I could take him there, and then we could cook together!  I could see if he wants to do that.”

I responded, “Yes, and the whole point is not to talk with him before, not to call and see if he wants to do it. The key is just showing up. It turns out that this primal social behavior kicks into gear when people we know show up at the door. It is part manners, part curiosity, part being flattered – plus other things. The point is that it often works. The person can be persuaded to come and talk with the visitor. Once they are at the door, the goal is to say, let’s go do this quick little thing. Or, I would love your help with such and such. I call these ‘ambushes of love.’”

At this point, I could see that both parents were leaning forward, their eyes were big, and I could tell they wanted to hear more.

I leaned in and chose my next words carefully. “Here is the thing, this takes vulnerability. It means sharing with different people what is happening in your family — that Cole (not his real name)  is going through a hard time, and you need a team of caring folks to help you.  

This could look like talking to some of Cole’s and some of your own friends, like Steven, who has a good rapport with Cole. If possible, the idea is to create a schedule of people agreeing to come by and do this.”

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At this point, Jason, Cole’s father, looked at Sarah and said, “You know, if Cole had cancer, it would not be strange to do this. But wow, with this, it’s different… but… it makes sense. I can see doing this.”

Sarah, the mother, agreed, and we all started brainstorming people they could reach out to and different activities people could invite him to do.

I said, “Look, the truth is there will be times where he still says no, but the occasional wins are huge. And you will be building a team that not only helps him but you both as well. And heck, you are giving people the opportunity to help-people love feeling needed. And speaking of which, I would love to help in any way.”

How does this story relate to all of us?

Each one of us can offer to do a “love ambush.” Think right now, do you know a family in which a person is struggling? If it is a teen, talk to the parents and offer to stop by (without notice) and get them to go see a sunset with you or to play 20 minutes of frisbee. 

This is not about making sure the person struggling has a fabulous time. Instead, it is the tiny positive moments and the sheer act of going out with someone. And even if they say no, the fact that someone came to the door wanting to spend time with them is something they will take away. 

Finally, in doing this, we help counter a family’s feeling of isolation. That’s huge. 

Questions to get the conversation started:

  1. Is there anyone we know at school who is having a really hard time? Could you see just stopping by their house one day?
  2. As a parent (or teacher if you share this story with your students), can you talk about any time you may have done some version of a love ambush for someone who was emotionally struggling? 
  3. In terms of low resources, what are students doing to raise awareness and find solutions? For example, in Screenagers Next Chapter, one of the stories is about a high school where students have organized a mental health club focused on suicide prevention. Does your school have anything like that?
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Mental Health

My unusual advice to one family with a teen in crisis

Delaney Ruston, MD
September 6, 2022
Teen boy head in his hands

Many of you are aware of the recent New York Times report entitled Inside the Adolescent Mental Health Crisis.

The reporter, Matt Richtel, covers a lot in the article, including the fact that getting mental health care (also referred to as behavioral health care)  for teens is often excruciatingly difficult. This has been a long-standing problem, and it is heartbreaking. I have experienced it in my own family and with many friends, and I see it time again with the patients and families I see in my clinic. 

Since 2004, I have been doing mental health advocacy, and believe me, I could easily take this opportunity to expand upon Richtel’s reporting.

But rather than doing that,  I want to share a story that offers a strategy that anyone can choose to do to help any youth or family who might be struggling, including your own. 

Recently, after an especially busy day in the clinic, while biking home, I decided to stop by my old neighborhood to see if my former neighbors were home. Happily, they were, and they invited me in, and we started chatting about life.

They were expecting a couple for dinner, and not long after I arrived, the couple showed up. (I will call their friends Jason and Sarah).

While we were talking, the topic of kids came up, and Jason mentioned that their son was in college. That was all he said. 

Later, when I was talking about mental health advocacy, I noticed that Sarah’s expression had changed. She looked more serious and said, “Our son is not doing well. At the end of this past year in college, he had a real mental health crisis. He even became delusional for a short time.” 

Their son, they explained, was living with them this summer, and they were doing all they could to get him appropriate care. They were getting services at our main hospital in Seattle, but things were extremely fragmented, and they weren’t getting sufficient help. 

Sarah explained that her son was really withdrawn, with lots of symptoms of depression. 

Jason said, “We try to get him to do things with us, but he just refuses all the time. We try to get him to be active, but he only takes a walk now and then.” 

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