Children Running

Addressing Teen Mental Health Challenges

A Mental Health Toolkit for Parents and Guardians of Teens

What To Do in a Crisis

Before you read about more about a mental health crisis, we want to remind you of how important you are in your teen’s life and to their well being. Never stop believing in your ability to keep your teen safe. You might feel scared, worried, overwhelmed, and unsure of how to help, but remember, you know them best and should trust your instincts.

What is a crisis?

A mental health crisis is when someone is at risk of causing harm to themselves or others, usually paired with extreme emotions and behaviors that are out of control.

What are signs of a crisis?

Warning signs may include:

  • Expressing suicidal thoughts and statements such as “I want to die” or even possible vague statements such as “I don’t want to be here anymore.”
  • Making threats to harm others or themselves
  • Exhibiting self-injurious behavior, for example cutting or burning themselves on purpose
  • Exhibiting severe aggression and agitation (for example, physical aggression, destroying property, hostility)
  • Experiencing hallucinations or delusions
  • Isolating themselves from friends and family, not coming out of their room.
What can I do to help my teen in crisis?

The first thing to do is ask yourself if your teen or someone else is in danger. If so, this is an emergency, and you should take all needed measures to keep everyone safe. If not, then try some techniques to bring your teen to a calmer state.

If Immediate Danger is Present

If you are worried your teen will harm themselves or others now or in the immediate future, this is considered an emergency and you should take immediate actions. Please take all the necessary measures to keep yourself and everyone safe. You have two choices. You can drive them to the nearest emergency room or you can call 911. It’s important to know that in this difficult situation, each option has challenges. If you choose to drive your teen to the hospital, only do so if you think they will remain safe and under control in the car. By bringing your teen to the emergency room (ER), they will be “voluntarily” admitted which allows you to see them while they are there and you remain the ultimate decision maker in the length of your teen’s stay. However, the ER you go to may or may not be equipped to help youth in a mental health crisis and there may be long wait times.

When you call 911, police will come to your home and help you and your teen stabilize. You should not be surprised if they handcuff your teen. This is done for your teen’s safety and the safety of those around, but it can be difficult as a parent to watch this. The police will then call a Crisis Intervention Officer who will either meet your teen at your home or at the police station. Your teen will be taken with the Crisis Intervention Officer and admitted into the hospital. It can be helpful to have the police and Crisis Intervention Officer helping you to navigate this very difficult moment. However, you are giving up any power in the admission and discharge process when you involve the police. You may not be able to see your teen for the next 48-72 hours and you will have to rely on the psychiatrist at the hospital to decide when your teen will be discharged.

There is no “wrong” way to help your teen when they are in a mental health crisis. As parents and guardians, we want our teens healthy and well, and we have to be able to make the best decision we can in the moment. Whether you take your teen to the ER or call the police, you are doing what you need to in order to keep them safe.

Calling 911, or one of the local crisis lines listed below.
  1. Inform the 911 operators that your teen is experiencing a mental health crisis: This will help them connect you with trained responders for youth mental health crises
  2. Request a Crisis Intervention Trained Officer: These youth crisis teams are specialists and are trained to intervene in a situation like this
  3. Provide your name and relationship to the teen
  4. Provide your location/address
  5. Provide as much detail about the situation as you can: Are they suicidal, aggressive, threatening someone, off their medication?
  6. Stay on the phone until the dispatcher asks you to hang up
Crisis Lines & Resources
  • Los Angeles County Department of Mental Health Help Line: 800-854-7771
    • This is the entry point for mental health services with Department of Mental Health
    • Access line (option 1) is available 24 hours a day/7 days a week (24/7), and includes the following services:
      • Mental health screening and assessment
      • Referral to service provider
      • Crisis counseling
      • Mobilizing field response teams
      • Linkages to other services and resources
    • Emotional Support Warm Line (option 2) is available 10:30am-9pm daily
    • Veteran Line (option 3) is available 9am-8pm daily
  • 988 Suicide & Crisis Lifeline
    • This is the national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress
    • 24/7 throughout the U.S., via phone (dial 988), text (text 988), or online chat
  • Crisis Text Line
    • Connect with trained counselors or receive free crisis support via text message
    • Text “LA” to 741741
  • California Coalition for Youth
    • California statewide emergency response system for youth (ages 12 to 24) and families in crisis. Professionally trained staff and volunteers provide counseling and resource referrals to service providers in the caller’s local community.
    • 24/7
    • Call 1-800-843-5200
    • Text 1-800-843-5200
    • Email them
  • Disaster Distress Helpline
    • The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Disaster Distress Helpline provides crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters.
    • Call 1-800-985-5990
  • Trevor Project Lifeline
    • The Trevor Project Lifeline provides support to LGBTQ+ youth and allies in crisis or in need of a safe and judgement-free place to talk.
    • Call 1-866-488-7386
  • 211 LA County
    • 211 LA County is the hub for all types of health, human and social services in Los Angeles County, providing callers with information and referrals to the services that best meet their needs.
    • Dial 211
  • Family Urgent Response System (FURS)
    • FURS is a free hotline for current or former foster youth up to age 21 and their caregivers to receive phone, text, chat and/or in-person support when needed for any issues, big or small.
    • 24/7
    • Call or text 1-833-939-3877
    • Dial 211
    • Visit CAL-FURS.org
What happens if my teen is hospitalized for a mental health crisis?

Once your teen is admitted to the hospital, consulting regularly with the hospital medical staff is recommended. Please expect to discuss treatment options, which may include a combination of individual therapy, group therapy, and/or medications. Depending on the medical needs of your teen, and your health insurance coverage, a residential or partial hospitalization program, called a PHP, may also be recommended. A residential program is a place where your teen would go and live for several weeks to get intensive therapy and support. A PHP allows for your teen to attend the program during the day and return home at night. Each treatment recommendation will be made according to your teen’s individualized needs.

As you can imagine, this is an incredibly difficult time for everyone in the family. As you will read this more than once in this toolkit— remember to take care of yourself and get help when you need it as you navigate this. Call your friends and family for your support, talk to your teen’s pediatrician, and try your best to care for your immediate needs as much as you can.

If Immediate Danger is Not Present

During a mental health crisis, your teen is not thinking logically. The best thing you can do for your teen in this moment is to make them feel safe, make sure their physical needs are met, and help them to remain calm.

Remember that the words you choose to communicate with matter during these challenging times and can impact how the conversation is received. Learn more about this by reading Your Language Matters.

Caring for the Whole Family

A mental health crisis affects the whole family dynamic. It can be physically, mentally, emotionally, and even financially taxing. It is important to check in with and support all members of the family on a regular basis. This includes yourself, your partner, other children, and relatives living in the same household.

Other children in the family need to know and feel that they are just as important and deserving of your love, time, and compassion. They also have needs to be met, such as quality time and conversations with you. They will want to know why their sibling behaves the way they do. Remember to have open and honest communication with your children and use words that don’t put your child down or negatively talk about or dismisses a mental health illness. Keep in mind that your child(ren) is/are also affected by the outbursts of your teen. Talk to them about how they feel.

Finally, a reminder: don’t feel like you need to deal with this alone or that you are expected to have all the answers. Connect with your support networks – family, friends, other parents, and community groups. Call upon local resources found throughout this toolkit and don’t be afraid to seek professional support.

If you or someone you know is experiencing a mental health crisis and needs immediate assistance, please call "911" and explain the nature of your problem to the operator.

Getting the mental health support your teen needs is critical to their wellbeing and successful life outcomes. Both Federal and State laws require that health plans provide treatment for mental health and substance use disorder conditions. Most recently amended in 2020, California’s Mental Health Parity Act requires commercial health plans and insurers to provide full coverage for treatment of all mental health conditions and substance use disorders. However, many plans don’t cover certain mental health services. It’s important to understand the difference in your employer’s coverage of mental health services and general health services. It’s also important to keep in mind which plans cover mental health services “in network,” versus “out of network” because that will have a large impact on the overall cost. It can be draining to spend time figuring out insurance coverage while also supporting your teen and family through a mental health crisis. The good news is that many of the mental health providers you work with are equipped to help you. Some programs even have staff whose sole purpose is to work with families and insurance companies to support getting medically necessary care for your teen.

Don’t have health insurance? Find it hard to navigate? In Los Angeles County, the Community Health Outreach Initiatives (CHOI) program works to reduce the number of uninsured residents through coordinated outreach efforts for children and families across Los Angeles County. Multiple agencies are available in every Service Planning Area (SPA) to support clients seeking assistance with enrollment into health insurance or with troubleshooting using existing coverage. See Get Help Applying for Free or Low-Cost Health Coverage and call one of the listed agencies that corresponds to your neighborhood. The agencies have bilingual staff that can assist you with enrolling in a private or public health insurance plsn, ensuring utilization of services, and with renewing existing coverage.

Once you’re enrolled in a health plan, you will need a referral from your primary care doctor, your behavioral care provider, or your health plan. If your plan allows it, you may be able to make an appointment directly with a behavioral care provider. Otherwise, you will need to get authorization first. You can always call the number on your Health Plan Membership Card to ask about seeing a behavioral health care provider.

If you have Medi-Cal, services include outpatient mental health services such as individual or group counseling, outpatient specialty mental health services, inpatient mental health services, outpatient substance use disorder services, residential treatment services, and voluntary inpatient detoxification. Contact your Medi-Cal managed care plan or call the Medi-Cal Mental Health Care Ombudsman at 1-800-896-4042 and ask for an assessment or needed services.

Navigating health insurance can feel like you’re jumping through hoops. Don’t let that discourage you from seeking the care you need. Always advocate for yourself and your family. Use the various tools and resources found throughout this toolkit to access services that will provide the level of mental health support that is right for your teen. For a comprehensive list of resources, please visit the Resources section of this toolkit.

Teens With Special Healthcare Needs

If your teen is a person with a developmental disability, they can receive mental health care through a regional center.

  1. To be eligible for regional center services, you must have a substantial disability that began before the 18th birthday and is expected to continue indefinitely. Persons interested in regional center services must first obtain a diagnosis and assessment of their disability from a regional center.
  2. There are 7 Regional Centers in Los Angeles County. The Los Angeles County Department of Mental Health provides more information on their Regional Centers webpage.
  3. For more information about regional center services, supports and eligibility, visit the Depatment of Developmental Services – Regional Centers.
Foster Youth

Being in foster care can be difficult and feel lonely at times, but they are not alone.

  1. The Foster Youth Rights Handbook can help foster youth learn about available rights and services available here in Los Angeles and across the state of California.
  2. Whether in need of assistance with mental health services, school, employment, living independently, or looking for other resources, the Los Angeles County Department of Children and Family Services (DCFS) is a great starting point. Learn about health insurance, mental health, substance abuse, sexual and reproductive health and expectant youth services available by visiting DCFS’ Health and Mental Health page.
  3. The Department of Mental Health, DCFS and other community providers have come together to form the Multidisciplinary Assessment Team (MAT) to ensure the immediate and comprehensive assessment of children and youth entering out-of-home placement. Learn about the MAT program here.
  4. If you need immediate help, you can call the Family Urgent Response System (FURS), which includes a free 24/7/365 hotline for current of former foster youth (up to age 21) and caregivers to call and get immediate help and in-person support when needed for any issues, big or small. Call or text FURS at 1-833-939-3877.
LGBTQIA+ Teens

When it comes to mental health support, it is important to connect with someone who understands your teen’s daily challenges. Los Angeles County is home to organizations that provide safe spaces, affirm who they are, help teens love themselves, provide counseling and mental health services.

  1. Bienestar serves Greater Los Angeles, focusing on identifying and addressing emerging health issues faced by Latinx and LGBTQ+ populations. Their Youth Empowerment Program encourages the development of thought leaders and change-makers. They provide an affirming environment to foster relationships, build personal and professional skills, and nurture the evolution of identity. The program is open to young queer people between 18 and 25.
  2. Children’s Hospital Los Angeles: Center for Transyouth Health and Development (CTYHD) provides affirming care for transgender and gender diverse children, adolescents, young adults and their families. The Center partners with youth and their families to advance the field through innovative practice, training and research.
  3. Kaleidoscope supports LGBTQIA+/Questioning neurodivergent and neurotypical youth, young adults and their families in building healthy relationships, strong social connections and critically needed life skills. They provide affirming mental health services, social support and life skills coaching to help each person realize their unique potential and thrive!
  4. Los Angeles LGBT Center is one of the largest and most experienced providers of LGBT health and mental healthcare, supported by a research team working to advance the care and treatment of lesbian, gay, bisexual, and transgender people. They accept Medi-Cal, Medicare, most major insurance plans, and some HMOs. If you are uninsured, we can help you get insurance through Covered California
  5. Penny Lane Center’s LGBTQ+ Programs are designed to help LGBTQ+ youth and their families find the support they need, while helping to create safe and welcoming spaces.
  6. Rainbow Pride Youth Alliance is for LGBTQ+ youth and allies in the Inland Empire. They provide a safe space for youth to meet, make friends and participate in their weekly events and activities. They offer support and resources for gender affirmation and community building. They also have a parent/caregiver program!
Males & Teens of Color

Mental health care is just as important as our annual physical. However, the stigmas related to mental health care services continue to affect and limit the access to services for those who identify as a male or male of color. The following are resources for them.

  1. Los Angeles County Department of Mental Health’s iPrevail Program provides 24/7 online support where LA students have an opportunity to chat with a peer coach to discuss personal challenges, enroll in a program, or interact in a virtual community to learn healthy habits, ways to manage stress, or lessen anxiety.
  2. Mental Health America of California provides mental health resources, support and services to live a full and productive life.
  3. My Brother’s Keeper (MBK) was launched by former President Obama in February 2014. The President called upon cities, counties, and tribal governments to make a commitment to improving outcomes for boys and young men of color. The MBK Challenge outlines six goal areas to increase education, employment, and safety.
  4. If you need immediate help, you can call the National Alliance on Mental Illness (NAMI) is the nation's largest grassroots mental health organization dedicated to educating, advocating, supporting, and building better lives for the millions of individuals & families affected by mental illness.
  5. TherapyForBlackMen.org provides proactive, multiculturally competent care to men of color through partnership with licensed mental health professionals and coaches in private practice.
Infographic 1
9Centers for Disease Control and Prevention. (n.d.). CDC WONDER Online Database About Underlying Cause of Death, 1999-2020. Retrieved from https://wonder.cdc.gov/ucd-icd10.html
Suicide was the third leading cause of death among LA County youth ages 10–24 between 2016 and 20209. Suicide attempts among this same age group were even more common (16 youth were treated for suicide attempts for every youth suicide)10, 11. People who experience violence and/or feel isolated, depressed, or anxious are more likely to attempt suicide. Social support from family, peers, teachers, coaches, and other forms of community plays a positive, vital role supporting teen mental health for years to come25.

Although it can feel uncomfortable, prevention starts with being comfortable having conversations about suicide, self-harm, and other suicidal behaviors. Learning about suicide warning signs and having a plan for what to do in moments of crisis is important for you and your teen. Having an open discussion with your teen who may be experiencing thoughts of suicide or self-harm is critical to supporting their welfare.

What are signs that my teen might be having suicidal thoughts?
  • They talk about it (using both specific language and context clues)
  • They look for ways to end their lives (planning or seeking access to lethal means)
  • Teens with suicidal thoughts may give away prized possessions
  • They may visit, text, or call people to say “goodbye”
  • Signs and symptoms of depression and anxiety may be present
  • Expressing relief or other sudden improvement in difficult circumstance is a questionable behavior for a teen having suicidal thoughts

What are some strategies I can adopt to help my teen?

  • Provide opportunities for connection with peers, mentors, and other loved ones
  • Try to have frequent, consistent conversations about managing emotions, coping skills, and conflict resolution
  • Encourage the practice of spiritual and cultural traditions and rituals
  • Find trusted and competent mental health care providers that reflect your family’s culture, beliefs, and/or values
  • Remove access to lethal means (firearms, stockpiled medications, other weapons)
  • Speak up for your teen and ask for safe spaces for LGBTQ+ youth, disabled youth, youth of color, and other underrepresented groups at school and other shared community locations
Image credit: American Foundation for Suicide Prevention (afsp.org)
Learn more: Risk factors, protective factors, and warning signs
If I suspect that my teen is at risk for harming themselves, what can I do to prevent it?
  • Watch How to Help Someone in Crisis
  • Follow these 5 action steps:
    • Ask: “Are you thinking about suicide?”
    • Be there: try to be physically present for your teen when they let you know they are having suicidal thoughts or help them make a plan to identify who they may talk with that can best support them.
    • Help keep them safe: reduce their access to highly lethal items, or items that they have expressed that they may use in a suicide attempt.
    • Help them connect:help your teen develop a safety plan that includes establishing a safety net to ongoing supports like suicide crisis hotlines or friends/relatives that they may be able to call. Assist them with finding and meeting with a mental health provider as soon as possible.
    • Follow up: check-in on your teen even when you have a safety plan in place. Regularly talking with your teen about how they are feeling will help you know if there is more that they may need help with.
Where can my teen and I get more information and support?

National Suicide Prevention Lifeline (24/7 hotline for those in distress or suicidal crisis)




Los Angeles County Department of Mental Health (24/7 entry point for mental health services in LA County)




Teen Line (Free hotline for teens run by trained teen counselors)



California Youth Crisis Line (24/7 Crisis counseling and resource sharing for youth and families)




The Trevor Project (Crisis support for LGBTQ+ young people)



Los Angeles County Youth Suicide Prevention Project




There are 5 common mental health challenges impacting teens nationwide and in Los Angeles County.

  1. Abuse and unhealthy relationships
  2. Alcohol and substance abuse
  3. Stress, anxiety, depression
  4. Suicide
  5. Trauma
In the following sections you will learn about each of the above mental health challenges and be able to recognize the warning signs and how best to support your teen if you suspect they are experiencing any of these challenges. There are several local, state, and national resources listed throughout this toolkit, all of which provide information to help you guide your teen as they navigate mental health challenges. For the entire list of resources and information, please refer to the Resources section of this toolkit. You are always encouraged to contact a professional mental health provider if you are concerned about your teen’s behaviors.

Stress, Anxiety and Depression

We all face daily stressors. Teens are also stressed about their relationships with their peers, social media posts, and their academic achievement. Whatever the reason for the stress, teaching your teen to cope with stress in a healthy way will help their mental health and their relationship with those around them.

What is stress?

Stress is a state of worry or mental tension caused by a difficult situation12. Stress is a natural human response that can allow us to address challenges and threats in our lives. We all experience stress, but how we deal with it can make a big difference to our health and well-being13.

What are the signs that my teen is experiencing stress?

Some signs include:

  • Feeling anger, sadness, worry,
    numbness
  • Changes in interests, appetite, desires, energy
  • Nightmares or trouble sleeping
  • Trouble concentrating or making decisions
  • Physical signs: body pains, skin rashes,
    nauseous, headaches
Image credit: Edweek.org
What is anxiety?

Anxiety is an internal reaction to stress. It involves a recurring feeling of uneasiness or dread that interferes with how you live your life10. It is a natural and important emotion because it signals that danger or sudden, threating change is near. However, prolonged anxiety over time is unhealthy.

What are signs that my teen is experiencing anxiety?

Some signs include:

  • Excessive fear and worry
  • Inner restlessness
  • Excessively cautious and vigilant
  • Continuous nervousness
  • Physical signs: muscle tension, cramps, headaches, stomach aches, fatigue
What is depression?

Depression is a common and serious mood disorder that can present in many ways. Depression can cause symptoms that affect how a person feels, thinks, and handles daily activities.

Types of depression14:

  • Major depression
  • Persistent depressive disorder
  • Perinatal depression
  • Seasonal affective disorder
  • Depression with symptoms of psychosis
What are signs that my teen is experiencing depression?

Some signs include:

  • Feelings of sadness, emptiness, loneliness, hopelessness
  • Little to no interest in activities
  • Changes in appetite, sleep patterns, weight, hygiene
  • Thoughts about death or suicide
What can I do if I think that my teen is experiencing stress, anxiety, or depression?
  1. Talk to your teen and ask them about what they are experiencing. Let them know you are on their side and want to support them
  2. Help your teen understand their feelings are part of a normal reaction
  3. If your teen has trouble identifying what is making them feel stressed/anxious, suggest offering to help your teen make a list of their current priorities, obligations, and/or challenges and then set aside time to talk through each one
  4. Remind your teen that a healthy body supports a healthy mind. Talk with your teen about eating nutritious meals, getting quality sleep, and exercising regularly
  5. The news and social media can trigger stress and anxiety. Be sure that your teen takes regular breaks from screen time; this may include limiting your own screen time to model the advantages to taking breaks
  6. Unwinding is important particularly after a stressful day. Join your teen in deep breathing exercises, stretching or yoga, and/or mindfulness practices.
  7. Make time to join your teen in an activity that bring them joy
  8. Connect with others: family, friends, and other parents are often great support systems for both you and your teen. Encourage your teen to get involved with school or community groups that support their interests

Seek professional support if:

  • Stress/anxiety begins to take over your teen’s life
  • Stress/anxiety limits their activities
  • Anxiety has been persistent for over 6 months
  • Depression has been present for over 2 weeks
Learn more: Tools for Youth and Teens
Where can my teen and I get more information and support?
  • 24/7 Help Line 800-854-7771
  • Get Help Now!
  • Social media: @LACDMH

Los Angeles County Department of Mental Health




CalHOPE



Mental Health Resources for Youth



  • Dial 988 to call, text or chat with a trained counselor

National Suicide Prevention Lifeline



What are some activities that I can I do with my teen to support them?
  1. Create a stress catcher
  2. Watch these videos together to develop coping skills: Deep breathing, Increasing favorite activities calming your mind, catch, check and change your thoughts (part 1) (part 2)
  3. Review Tips for Talking With a Mental Health Care Provider About Your Mental Health
  4. Watch this video together: Guided visualization- Dealing with stress
  5. Download the free Headspace app and try one activity from its categories: meditation, sleep, stress, mindfulness

Schedule time for at least one of the many activities in the Guided Self-Management Tools for Depression, including:

  • Mood Tracking
  • Thinking Traps
  • Relaxation Skills
  • Problem Solving
Teen Behavior Changes

Regardless of the strength of your relationship with your child, you will face challenges during their adolescent years as they transition into adulthood. Paying attention to your teen’s behavior can allow you to determine whether they are behaving typically for their age or if their behavior may be concerning.

Teens Will Be Teens
  1. Sleep pattern changes: staying up late & sleeping in (changing circadian rhythm)
  2. Moodiness
  3. Irritable
  4. Stress about grades, exams, and their impact on their future
  5. Pushing boundaries, like not wanting to do chores
  6. Impulsive
  7. Disagreeing
  8. Giving some attitude
  9. Curiosity about alcohol and drugs
  10. Secretive
  11. Sensitive about body image
  12. Sensitive about sexual development
  13. Feel misunderstood
  14. Greater interest in social causes
  15. Greater interest in justice-related issues
Pay Closer Attention
These could be warning signs of a more serious problems or mental illness.

  1. Sleep pattern changes: Sleeps all day, misses important routines like waking for school
  2. Escalating moodiness
  3. Irritability turning into outbursts of anger and/or violence
  4. Physical or verbal aggression
  5. Anxiety towards schoolwork: Hard time sleeping due to thinking about schoolwork, Unable to regulate emotions about school, Difficulty focusing to study
  6. Disobedience, breaking laws/rules, frequent detention, school suspensions
  7. Dangerous and thrill-seeking behavior
  8. Frequent use of drugs and alcohol, binging, self-treating anxiety and/or depression
  9. Pathological lying
  10. Doesn’t enjoy spending time with friends and family as much as before
  11. Increased absences from school
  12. Problems with memory, attention, or concentration
  13. Increased physical complaints like stomach aches, headaches, or backaches
  14. Frequent feelings of hopelessness, sadness, anxiety
  15. Frequent crying
  16. Neglecting personal appearance or hygiene
  17. Unwarranted suspicion of others
  18. Seeing and hearing things that others do not

Adolescents learn to form safe and healthy relationships with friends, parents, caregivers, mentors, and romantic partners. Through these relationships, they explore different identities and roles, all of which contribute to the development of their identity.

What makes a relationship healthy?

In a healthy relationship, your teen should feel safe and comfortable expressing respect for themselves and others. Common characteristics:

  1. Mutual respect – Each person values the other and understands their boundaries
  2. Honesty – Each person is truthful and trusts the other
  3. Compromise – Each acknowledges different points of view and is willing give and take
  4. Individuality – No one must compromise who they are; their identity is not based on their partner’s; they continue to see their friends and do the things they love
  5. Healthy sexual relationship (if applicable) – Partners feel comfortable, they consent, they don’t feel pressured or forced to engage in a sexual relationship
Image credit: LoveIsRespect.org
What makes a relationship unhealthy?

One of the biggest signs of an unhealthy relationship is a power imbalance. Typically, at least one of the people in the relationship has trouble communicating and controlling their anger. It can lead to physical, emotional, or sexual violence.

Some common characteristics:
  1. Control – One person makes all the decisions (what to wear, what friends to see, who to spent time with, etc.); they are unreasonably jealous and/or try to isolate the partner from friends and family
  2. Intimidation – One person tries to control the other by making the other feel fear or timid and may try to keep the partner from their friends and family, threaten violence or a break-up
  3. Dependence – One person feels that they “cannot live without” the other. They threaten to do something drastic if the relationship ends
  4. Violence – This can be physical, verbal, emotional, psychological, or sexual
  5. Unhealthy sexual relationship (if applicable) - Pressuring sexual acts, lack of consent, controlling contraceptive usage (not allowing or demanding it)
What are common types of abuse?

Knowing about the most common types of abuse will help you recognize the signs that your teen may be involved in an abusive relationship:

  • Physical
  • Emotional and verbal
  • Sexual
  • Financial
  • Digital
  • Stalking
What are signs of abuse?

Often at the beginning of a relationship, abusive people seem to lack flaws. As time passes, the abusive person tries to gain power and control. Warning signs come to light and become more intense as the relationship develops over time.

Some Common Signs of Abuse:

  • Extreme jealousy of friends or time spent away from them
  • Preventing or discouraging time with friends, family, or peers
  • Insulting, demeaning, or shaming, especially in front of others
  • Preventing you from making your own decisions, even about work or school
  • Pressuring sexual acts, controlling contraceptive usage (not allowing or demanding it)
  • Intimidating
  • Making threats
  • Destroying your belongings
If I suspect my teen is in an unhealthy relationship, what can I do to help them?

Anyone can experience abuse, regardless of gender identity and sexual orientation. If your teen is involved in an abusive relationship, they may not even understand that it is happening to them and may not know how to handle it. This is where your help is crucial.

  1. Prioritize their health and safety – contact police if you think they are in immediate danger. Take them to a licensed medical provider for treatment if you have suspicions of physical and/or sexual abusey
  2. Have open communication about healthy relationships (including sex)
  3. Balance being protective with respecting their decisions
  4. Address issues of self-blame
  5. Do not dismiss the relationship; talk about the behaviors, not the person
  6. Model healthy behaviors
  7. Empower your teen to set boundaries when dealing with love and control issues
  8. Friends often are a great source of support
  9. Decide next steps together
  10. Consider involving a school counselor. They can help to create a safety plan with your teen which may include suggestions like: Buddy-walking between classes, Using a code word between friends to indicate when help is needed
  11. Share resources
Where can my teen and I get more information and support?
What activities can I do with my teen to help?
  1. Is my teen in a healthy relationship? Take the quiz now
  2. Create a My Safety Plan
  3. Learn about Title IX services provided by their school Title IX FAQs

As a parent, we know that our teen’s social life is crucial to their happiness and well-being. Social media platforms like Instagram, YouTube, TikTok, and Snapchat have provided opportunities for social interaction that are a normal part of development. But social media is tricky—on the one hand it’s a great way for our teens to socialize and build networks, but on the other hand, there is a dark side to social media that we have to keep our eyes open to.

The U.S. Surgeon General recently published Social Media and Youth Mental Health, an advisory on social media, and there are a number of important messages for parents and guardians. First and foremost, we don’t yet know if social media is safe for your teens. There is growing evidence that there are some positive benefits to social media, however, the negative impacts may outweigh the positive. Another important message from this advisory is that parents and guardian, need to stay involved when it comes to keeping your teens safe on social media. No one else is paying attention to this the way that parents and guardians can. With this in mind, Dr. Murthy, the United States Surgeon General, has the following recommendations:

Image credit: Stopbullying.gov
  1. Have the conversation. “Start the conversation with your child about social media so you can learn how they use it, how they feel when they use it. And you can also help them understand what’s a safe and unsafe interaction or engagement on social media. We want our kids to know if they’re being harassed or bullied, especially by strangers, that they should reach out for help,” Murthy said.
  2. Establish tech-free zones. “We know that for our kids, especially in adolescence, that sleep is critical for them, physical activity is essential, and in-person interaction is vital. So creating tech-free zones around those activities – for example, having an hour before sleep and throughout the night when your kids can’t use their devices, making dinner time or mealtimes tech-free zones – that can also help those kinds of boundaries,” he said.
  3. Partner with other parents. “That can actually make it a bit easier to make some of these changes and to also troubleshoot when we’re having a hard time. It can also help our kids too, because if we are putting certain limitations or boundaries in place and we’re doing that collectively, with other parents, then our kids know that they’re not the only kids out there who are being limited in their use of social media,” he said.
Safety Threats

This resource guide wouldn’t be complete without a warning about severe safety issues related to social media: cyberbullying, sexting and online predators. All of these safety threats also pose very real threats to your teen’s mental health.

Infographic 1
16Protecting Youth Mental Health. Surgeon General’s Advisory Report 2021. Page 25. https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf
Cyberbullying is bullying that takes place over digital devices like cell phones, computers, and tablets. Cyberbullying can occur through SMS, Text, and apps, or online in social media, forums, or gaming where people can view, participate in, or share content. Cyberbullying includes sending, posting, or sharing negative, harmful, false, or mean content about someone else. It can include sharing personal or private information about someone else causing embarrassment or humiliation. Some cyberbullying crosses the line into unlawful or criminal behavior15. In a review of 36 studies, a consistent relationship was found between cyberbullying via social media and depression among children and adolescents, with adolescent females and sexual minority youth (LGBTQIA+) more likely to report experiencing incidents of cyberbullying.
Nearly 75% of adolescents say social media sites are only doing a fair to poor job of addressing online harassment and cyberbullying. (Social Media and Youth Mental Health)16.
Infographic 1
16Protecting Youth Mental Health. Surgeon General’s Advisory Report 2021. Page 25. https://wonder.cdc.gov/ucd-icd10.html
Image credit: Stopbullying.gov

To interrupt cyberbullying, be sure to talk with your teen about what is going on on-line. The “Prevent Cyberbullying” website can help with identifying when bullying is happening, tips on how to help if you’ve discovered this problem and a resource guide ready to download17.

Sexting is a complicated subject to talk about but let’s start with something simple: For minors, sexting is illegal. Sending or receiving explicit photos of people under 18 is child pornography under federal law — even if the exchange is between minors and the exchange was consensual. Spend time talking with your teen about sexting. Here is a list of places to start from Common Sense Media:

  1. Don't wait for an incident to happen to your child or your child's friend before you talk about the consequences of sexting. Sure, talking about sex or dating with teens can be uncomfortable, but it's better to have the talk before something happens.
  2. Remind your kids that once an image is sent, it can never be retrieved -- and they will lose control of it. Ask teens how they would feel if their teachers, parents, or the entire school saw the picture.
  3. Talk about pressures to send revealing photos. Let teens know that you understand how they can be pushed or dared into sending something. Tell them that no matter how big the social pressure is, the potential social humiliation can be hundreds of times worse.
  4. Teach your children that the buck stops with them. Teach your children that it is their responsibility to delete and/or not pass on revealing photos to others. It's better to be part of the solution than the problem. Besides, if they do send it on, there could be legal implications.
  5. Check out ThatsNotCool.com. It's a teen-friendly website that gives kids the language and support to take texting and cell phone power back into their own hands. It's also a great resource for parents who are uncomfortable dealing directly with this issue.

From: How do I talk to my teens about sexting? | Common Sense Media

Online Predators

“The Internet is much more anonymous than the real world. People can hide their identities or even pretend to be someone they're not. This can sometimes present a real danger to children and teens who are online. Online predators may try to lure kids and teens into sexual conversations or even face-to-face meetings. Predators will sometimes send obscene material or request that kids send pictures of themselves. Therefore, it's important to teach your kids to be on their guard whenever they're online. Teens are generally more at risk from predators. Because they are curious and want to be accepted, they may talk to a predator willingly, even if they know it's dangerous. Sometimes teens may believe they are in love with someone online, making them more likely to agree to a face-to-face meeting.”18.

Image credit: GCFGlobal.gov

Take the time to talk with your teen about online predators. There are a number of guides that can help you through this conversation. Here are a few that we think are good places to start:

GFC Global: Internet Safety for Kids: Staying Safe from Online Predators (gcfglobal.org)
NetSmartz: online enticement (missingkids.org)
CommonSenseMedia:How to Talk to Teens About Dealing with Online Predators | Common Sense Media

You may be feeling scared or a little overwhelmed but take a step back and remember that the internet isn’t all bad and it’s definitely a part of our day to day, hour to hour existence. Social media safety for your teen is about making sure they have the tools to navigate it safely.

Below is a list of suggestions19 to consider as you help your teen foster a healthy relationship with technology and keep them safe when on social media.

How much time is my teen spending online?

  • Is it taking away from healthy offline activities, such as exercising, seeing friends, reading, and sleeping?”
  • Are there healthy limits I can set on my teen’s use of technology, such as limiting screen time to specific times of the day or week, or limiting access to certain websites, apps, or games? Many devices have parental controls built in. Look into the specific ways you can limit screen time and app access for your teen’s device.

Content

  • Do you know which devices and apps your teen has access to? Check out the Parents’ Ultimate Guide to Parental Controls for advice and options to ensure that your teen’s hardware and software device settings are safe for scrolling.
  • Make sure you and your teen talk about how they can stay safe online. It may feel awkward or scary but talk with your teen about online predators and how to avoid being a target. Remember, you are a trusted adult in their life.
  • Is your teen getting something meaningful and constructive out of the content they are looking at, creating, or sharing? Ask your teen about what they enjoy accessing on their smart devices and ask them to show you.
  • Determine your teen’s online risk factor. Using social media is not inherently good or bad for young people. But you know your teen best. If they are more vulnerable because of their personality or even a pre-existing mental health condition, talk with them about limiting their time on social media20. Come up with a plan together that makes sense for your teen and their needs.

Impact

  • Ask your teen how they feel about time spent online. Do they engage with social media, for example, because they enjoy it or because they feel like they must because their friends are?
  • Is your teen experiencing any form of cyber bullying? If needed, step in and help your teen put a stop to it.
  • Check in with yourself – how do you feel about your own use of technology? Do you understand the social media apps your teen frequently uses? Parents’ Ultimate Guides to Social Media has helpful links to everything you need to know about safe teen access of popular social media apps.
Alcohol and Drug Use

You may be worried about your child’s access to alcohol and drugs. You are not alone. Many parents worry that their teen might encounter situations where pressure and access to alcohol and drugs will be present. Talking to your teen about the risks of alcohol and drug use—particularly the current, high risk of fentanyl being found in various types of substances and counterfeit pills—is important. Try your best to have an open dialogue about substance use that avoids blaming, judging, and labeling and that seeks to understand your teen and their experiences related to drugs and alcohol. These conversations are hard. It’s important that your teen hears from you about the risks of alcohol and drugs and understands how to stay safe if they encounter drugs or alcohol in a social setting. You play a vital role in helping your teen navigate these situations.

What can I do to lower the risks of alcohol and substance use for my teen?
Talk to your teen about alcohol and other drugs
  1. Parents can positively influence their teen’s decisions about using alcohol and drugs, through having necessary conversations and through demonstrating healthy decisions and actions
  2. Some teens try alcohol or other drugs at a young age - it is far better to talk with your teen before they start using alcohol and/or other drugs
  3. But remember, it’s never too late to sit down and talk with your teen.
  4. Set clear rules and expectations to send a consistent message to your teen
Reduce the accessibility of alcohol and other drugs for teens in your household
  1. Secure any controlled substances in the household to avoid unapproved access by youth
  2. Limit youth access to substances that they are not prescribed
  3. But remember, it’s never too late to sit down and talk with your teen.
  4. Avoid the use of alcohol and other drugs in the presence of youth. Parents/guardians who have problems with alcohol and/or other drugs should obtain treatment; see below for treatment information and related support
Learn more: Talking to Kids About Alcohol and Other Drugs – 5 Conversation Goals
What signs can indicate that my teen may be using alcohol or drugs?

While some of the signs that teens are using drugs or alcohol are like typical teen behavior, it doesn’t hurt to be extra cautious.

Some signs to look for include:

Shift in mood and personality

  • Inability to focus
  • Hyperactivity
  • Hostility

Changes in behavior

  • Avoiding eye contact
  • Missing school
  • Using over-the-counter medications to reduce eye reddening or nasal irritation
  • Periods of sleeplessness or high energy, followed by long periods of “catch up” sleep

Changes in hygiene and appearance

  • Smelling of smoke or other unusual smells on breath or clothes
  • Burns or soot on fingers or lips
  • Track marks on arms or legs – or long sleeves in warm weather to hide marks

Physical health

  • Unusually tired or lethargic
  • Slurred speed or rapid-fire speech
  • Seizures or vomiting
  • Sudden or dramatic weight loss
Learn more: Signs of Drug Use in Teens

If I suspect my teen is vaping/smoking, using alcohol and/or drugs, what can I do to help them?
Before having a conversation with your teen about their substance use, be sure to take a few minutes to prepare in advance of the conversation. Ensure that you are calm and have a clear plan about what specifically you would like to address with your teen. Identify resources that you would like to share with your teen during your discussion and remember to keep an open mind. Start conversations with your teen by asking how they are taking care of themselves, coping with stress, and what activities they enjoy doing with friends. Try to use “I” sentences to describe your thoughts and feelings rather than being accusatory. Ask direct questions of your teen like, “Have you been drinking, vaping, or using drugs?” If your teen shares that they have been using drugs or alcohol, try your best to respond without blaming, judging, or labeling. Emphasize your concern about their health and well-being and focus on sharing the best information and tools that may help them. If you or another adult in your home actively use drugs and/or alcohol be prepared for this come up in your conversation. Your teen may need you to change your substance use behavior to better support the changes they want to make.

Set Conversation Goals:

Establish clear expectations

  • Don’t assume your child already knows your expectations. For example, say “I expect you not to use alcohol or drugs with your friends” is clearer than “make good choices.”
  • Detail what you’d like to achieve by the end of the discussion.

Show that you care

  • Tell your child that you care about them, are on their side, and want them to get the most out of their middle and high school experience, including being happy and safe.

Establish yourself as a reliable, trustworthy source

  • Ensure your child knows that they can come to you with questions.
  • Tell them if you don’t know something, you will speak with a credible source, like their doctor, to find out accurate information.

Run through scenarios

  • Be realistic about situations they may face.
  • Talk about their options and help them come up with a plan to refuse if they are offered alcohol or drugs. Some examples may be:
    Directly refusing: Feeling comfortable to say “No” to peers

    Exiting the situation: Having their caregiver or friends pick them up

    Relying on help: Having a peer who supports their decision not to use with them

Address family history

  • Talk with them about mental health, anger, or substance abuse issues that may exist in your family
  • Make sure your child feels ready to make informed decisions while reminding them that it is ok seek help

Share resources

  • Provide specific resources to your teen and let them know it is okay to access at any time
If my youth has begun vaping/smoking, using alcohol and/or drugs, what do I do next?

There may still be times when your teen uses drugs or alcohol or when their friends do, and parents / guardians can take key steps to reduce the safety risks for youth.

These questions can save lives:

  • Do they have a designated driver?
  • Do they have a buddy system set up and know never to use alone? (see “signs of an overdose” below)
  • Do they know they can call you for help if they are in a dangerous situation?
  • Do they have naloxone on hand?
  • Do they know how to test drugs using fentanyl test strips?
    See fentanyl section below for more information on naloxone and fentanyl test strips.
Where can my teen and I get more information and support?
What activities can I do with my teen help them avoid using alcohol and other drugs?

Set your teen up for success by building a drug and alcohol refusal plan and practice using real-life scenarios together.

  1. Direct refusal – Teach your teen to know their “no” and be direct
  2. Give a reason – Help your teen to identify a reason they can use to say “no” to their peers if they are offered drugs or alcohol. Remember to keep the reason short and simple
  3. Make an excuse – Practice a couple of scenarios with your teen where they use an excuse (e.g., “I have to get home to meet my little brother at the bus stop”) to say “no”. Avoid long explanations
  4. Exit the situation – Have your teen think of which friends may be best able to offer immediate help to get them out of an uncomfortable peer pressure situation
  5. Make a joke – Offer the alternative of encouraging your teen to keeping the situation light, offer a “no” in a humorous way
  6. Ask them to share their thoughts on a strategy – Ask your teen, “What other ways might help you feel more comfortable refusing drugs and/or alcohol?”
Learn more: Learn more: “Talk. They Hear You.” Discussion Starter (VIDEO)
Fentanyl
Image credit: United States Drug Enforcement Administration (DEA.gov)
Fentanyl is all over the news. What is it?

Fentanyl is a synthetic opioid. Opioids are a broad group of pain-relieving drugs that work by interacting with opioid receptors in your brain, spinal cord, and gut. Opioids can be made from the poppy plant, like morphine, or synthesized in a laboratory. Pharmaceutical fentanyl is used in specific, supervised medical situations—such as during surgery, labor and delivery, and for end-of-life pain management. Because of its powerful properties that trigger the release of “feel-good” endorphins, fentanyl is highly addictive, posing risks of misuse and addiction. Fentanyl most often associated with recent overdoses is made in laboratories. This synthetic fentanyl is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that look like other prescription opioids.

Opioid-related overdoses among California’s 15- to 19-year-olds nearly tripled between 2019 and 2020, according to a CalMatters analysis of state data21.
Infographic 6
18California confronts youth mental health crisis. Cal Matters. March 17, 2022. Available from: https://calmatters.org/newsletters/whatmatters/2022/03/california-youth-mental-health-crisis/
Why are teens using Fentanyl?
Infographic 7
19Prescription Medication Misuse and Public Perceptions in Los Angeles County: Finding from the 2017 Community Needs Assessment. Los Angeles County Department of Public Health. March 2019. Available from: http://ph.lacounty.gov/sapc/MDU/SpecialReport/Opioid/PrescriptionMisusePublicPerception.pdf
Why is Fentanyl causing so many deaths in teens?
Infographic 6
20Fentanyl. California Department of Public Health. February 16, 2023. Available from: https://www.cdph.ca.gov/Programs/CCDPHP/sapb/Pages/Fentanyl.aspx
Fentanyl is a synthetic opioid that is 50 times more potent than the opiate morphine and 100 times more potent than heroin23. In addition to its potency, some drug dealers mix fentanyl with other drugs, such as heroin, cocaine, methamphetamine, Xanax, and MDMA (Ecstasy). This is because it takes very little to produce a high with fentanyl, making it a cheaper option. It is especially risky when people taking drugs might not realize that they may be taking stronger opioids than their bodies are used to and can be more likely to overdose.
Drug Enforcement Administration (DEA) officials reported a dramatic rise in the number of counterfeit pills containing at least 2 milligrams of fentanyl, which is considered a deadly dose. Lab testing found that at least 6 out of every 10 pills confiscated contained dosages of fentanyl that were potentially deadly dose24.
Infographic 6
21FOne Pill Can Kill. Department of Justice Drug Enforcement Administration. December 2022. Available from: https://www.dea.gov/sites/default/files/2022-12/DEA-OPCK_FactSheet_December_2022.pdf
Figure 1. Los Angeles County Fentanyl-Related Overdose Deaths. California Overdose Surveillance Dashboard25
Reducing the Risk of Overdose
What can parents do to reduce the risks caused by opioids such as fentanyl?

Establish clear expectations about abstaining from using drugs and alcohol in a non-judgmental way and consider the key conversations in the preceding recommendations for steps parents and guardians can use for youth who have begun vaping/smoking, using alcohol and/or drugs. Let your child know that the safest thing they can do is avoid taking any medication that has not been prescribed to them by a licensed medical professional. If you think there is still a risk that your teen or their friends might use drugs containing fentanyl or other opioids, the next most important step is to ensure that your household has naloxone (Narcan) on-hand. Naloxone (Narcan) can be obtained from a pharmacy or through community-based access points. Narcan reverses opioid overdoses, including overdoses involving fentanyl.

Image credit: California Department of Public Health (CDPH.gov)

For youth who may continue to use drugs despite parent interventions, it is safer to test the drugs that they are using for fentanyl directly with fentanyl test strips that may be purchased over the counter. Reminding a known user of drugs or alcohol to be sure to never use drugs alone is extremely important in preventing death due to overdose and having Narcan on hand whenever possible is advised.

Learn more: Harm Reduction and Overdose Prevention Resources

How can someone know if the drugs they have contain fentanyl?

Fentanyl test strips (FTS) are a form of low-cost drug testing technology effective at detecting the presence of fentanyl and fentanyl-like substances in drug samples prior to ingestion. However, an FTS does not tell you how much fentanyl is in a substance or how strong the fentanyl in the substance may be.

Image credit: Centers for Disease Control and Prevention (CDC.gov)
How do you use a fentanyl test strip (FTS)?

To use fentanyl test strips, you must first crush the substance into a very fine powder to ensure that the fentanyl is completely mixed into the substance. Then, dissolve a small amount of substance in water, and dip the test strip into the liquid for 15 seconds. Because the test strips are highly sensitive, only a small amount of drug residue is needed to get an accurate result. The test strip is then set on a flat surface until results appear, typically within 5 minutes. One line indicates fentanyl is present in the sample; two lines indicate a negative result.

Where can I purchase fentanyl test strips?
  1. The AIDS Project Los Angeles sites
  2. The Engagement and Overdose Prevention (EOP) Hubs
  3. Team Awareness Combating Overdose (TACO)
  4. BTNX: Harm Reduction
  5. Wide Batch: Harm Reduction
  6. DoseTest: Fentanyl Test Strips
What are the signs of an opioid overdose?

Recognizing the signs of an opioid overdose can save a life. These are some of the signs to look for:

  1. Small, constricted “pinpoint pupils”
  2. Falling asleep or losing consciousness
  3. Slow, weak, or no breathing
  4. Choking or gurgling sounds
  5. Limp body
  6. Cold and/or clammy skin
  7. Discolored skin (especially lips and nails)
Is medication available to reverse an overdose?

Naloxone, or Narcan, is a lifesaving medication that can reverse the effects of opioid overdoses, like those from fentanyl, or other opioids including norco, Percocet, Vicodin, oxycodone, oxycontin, morphine, or heroin. If used properly, it may save lives. Naloxone is available as a prescription from your healthcare provider and the cost is often covered by many health insurance plans however it was approved to be sold as an over-the-counter medication in the fall of 2023. Los Angeles County, through the Departments of Public Health and Health Services are also distributing no cost naloxone to various settings and populations.

Learn more: Accessing Naloxone, Drug Testing and Test Strips

Learn more: Naloxone Access Points

What should I do if I think someone is having an opioid overdose?
  1. Call 9-1-1 immediately
  2. Give Naloxone/Narcan, if it’s available
  3. Try to keep the person awake and breathing
  4. Lay the person on their side to prevent choking
  5. Stay with the person until emergency assistance arrives

Trauma refers to a survivor’s biological response to events (an experience, a sensation, an occurrence) that they find distressing, disturbing, or life-threatening. Each person experiences trauma differently and what may cause a trauma response in one person may not cause the same response in someone else.

Examples of Trauma Include

  • Difficult life experiences such as neglect, loss, violence
  • Victimization such as that associated with sexual abuse, physical abuse, emotional abuse, intimate partner violence, rape, and/or human trafficking
  • Witnessing violent events such as terrorism or natural disasters

Reactions and responses are different for every person and can be both immediate and delayed. Sometimes, a sound, smell, or feeling can trick our body into thinking we are back in a moment of danger, even if that moment happened many years ago. We call these “triggers” or “stressors”.

Stressors are a sensory experience that remind us of a traumatic event and can activate our survival responses26 even if we aren’t currently in danger. This is why, even after a traumatic event is over, it may still negatively impact our mental health, relationships, and behaviors. Teens might have a hard time studying, being social, or sleeping which might affect their grades and/or attendance at school. Understanding the signs of trauma, validating the traumatic experience, and connecting teens with resources to better understand and resolve trauma is essential to lessen the impact of stressors in their daily lives.

What are signs that my teen might be experiencing trauma?

Behavioral

  • Clinginess
  • Hyperactivity
  • Emotional and
    psychological regression
  • Difficulty socializing

Cognitive

  • Difficulty concentrating
  • Feeling confused
  • Recurring nightmares
  • Hopelessness

Physical

  • Easily startled
  • Physical weakness
  • Changes in sleep, appetite
  • Stomach pains, headache
Gun Violence & School Shootings

242016-2019 mortality data from California Department of Public Health Vital Statistics, provided by Office of Health Assessment and Epidemiology. Linked mortality datafile 2020 (provisional), LA County Dept. of Public Health. Office of Health Assessment and Epidemiology. Population data for rates from Hedderson Demographic Services for LA County ISD. ICD-10 codes used to identify firearm homicides: X93-X95, U01.4. Available from: https://www.cdph.ca.gov/Programs/CHSI/Pages/Data-and-Statistics-.aspx

School shootings contribute to trauma in youth. Trauma may occur whether a school shooting is experienced in-person, through participation in mock school shooter drills, or heard through news outlets. Any one of these can lead to a teen’s heightened fear of going to school or thinking about the possibility that they may experience a school shooting at their school and in their community. It is important to address the effects of gun violence as it relates to your teen’s mental health.

If I suspect my teen is experiencing trauma, how can I help them?
  1. Take a social media and news break: revisiting the event can contribute to their trauma
  2. Avoid making major life decisions
  3. Maintain physical health: eat nutritious meals, get quality sleep, get regular physical activity
  4. Unwind: try deeps breaths, stretches, mindfulness practices, journal
  5. Encourage your teen to do activities they enjoy
  6. Connect with others: family, friends, and other support systems
  7. Seek professional support if: it begins to take over your teen’s life, it limits their activities
Image credit: Los Angeles County Department of Public Health, Office of Violence Prevention
Where can my teen and I get more information and support?

Los Angeles County Department of Mental Health




Los Angeles County Office of Violence Prevention



Teen Line



What activities can I do with my teen to help?

Image credit: Los Angeles County Department of Public Health, Office of Violence Prevention

The World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity28”. There are 3 main components to maintaining your and your teen’s health: physical health, mental health, and environmental health.

Image credit: World Health Organization (WHO.org)

In this section you will learn about each of the areas and what you can do to support your teen reaching optimal well-being with a focus on mental health. Bear in mind that these are suggestions; no one is perfect, and time is a limited resource. Do not put pressure on your teen for not being able to do all the recommendations every single day. Remember that little wins add up to big victories!

Use the checklist on pages 6-7 from the Surgeon General’s Playbook for Stress to stick to your wellness goals.

Image credit: The California Surgeon General’s Playbook for Stress

Physical Health
Physical Activity

Regular physical activity can provide multiple physical and mental health benefits. Physical activity improves happiness and keeps the heart healthy as well as lead to better sleep and focus at school or work.

Infographic 1
Physical activity is any type of movement like brisk walking, jumping rope, playing soccer, or lifting weights. Even daily activities like walking to the store instead of driving there, riding a bicycle, taking the stairs, or doing chores are considered physical activity and can contribute to good health. Recent studies suggest that any activity resulting in about 10,000 steps, if not more, can reduce the risk of chronic conditions and early death from any cause (also call ‘all-cause mortality’) later in life.
Physical MentalHealthToolkit

Physical MentalHealthToolkit (PE) is an academic subject, just like math and is important for all school age children, especially for teens, as it helps them grow, avoid obesity, and maintain physical fitness. It has other benefits as well. In some research, PE is associated with better academic performance – for example in various subjects like math, reading and writing. For many teens, academic achievement is an important part of their future, and their journey after high school, whether it be college, trade school, or gaining work experience; PE can help with this. People often think that PE is the same as physical activity. But it is not. PE teaches physical skills like catching and throwing a ball. It provides knowledge such as game rules and how exercise improves health. Studies show that teens who are overweight often become overweight adults. Ideally each student will find an activity they can participate in and enjoy throughout their life. This can help them get to and stay at a healthy weight. PE can help students enjoy and have a good attitude about being active. This is a starting point for creating healthy, life-long physical activity habits. By law, all public-school students have a right to be taught physical education.

Physical Activity Recommendations:

  • Preschool-Aged Children (3-5 years) should be physically active throughout the day doing active play and a variety of fun activities.
  • Children and adolescents (6-17 years) should get 60 minutes or more of moderate to vigorous intensity physical activity per day
  • Adults (18-64 years) should do at least two hours and thirty minutes of moderate aerobic activity per week (30 minutes a day, 5 days a week) OR 1 hours and 15 minutes of vigorous aerobic activity per week

What is moderate aerobic activity?

Aerobic activity is also known as cardio. It includes physical activity that gets you breathing harder and makes your heartbeat faster. Moderate aerobic activity raises the heartrate and is enough to cause a sweat. At this level of activity, you can still carry a conversation but not sing a song comfortably.

What is vigorous aerobic activity?

Vigorous intensity aerobic activity means that breathing is hard and fast with an increased heart rate. At this level of activity, you will be unable to say more than a few words before having to pause to catch your breath.

How can I improve my teen’s physical activity?

Fortunately, you can do several things to help your teens be more physically active at school and at home.

As a teen, it is important to stay regularly active and avoid sedentary lifestyle habits. As a parent…
  1. You can talk with your school principal to make sure your teen is getting the required PE minutes they are entitled to by law.
  2. You can also talk with your school principal to make sure that PE is taught by appropriately qualified teachers, and that teachers are following California’s recommended guidelines (PE standards).
  3. You can advocate and help organize with your teen’s school to open up their facilities and space to the community for physical activity programming and sports through an arrangement called ‘shared use agreement’ (see https://www.changelabsolutions.org/product/what-joint-use-agreement). Many of the afterschool or weekend programs that are available through shared use agreement can benefit your teen, their friends, your family, and your community.
  4. Set a positive example for your teen and the rest of the family by leading an active lifestyle yourself.
  5. Take your teen to places where they can be active, such as public parks and pools, community baseball fields or basketball courts. Encourage them to join play school-organized sports or join extramural teams after school (tennis, basketball, baseball/softball, soccer, track & field, others based on their interest).
  6. Be positive about the physical activities in which your teen participates in and encourage them to try new things.
  7. Make physical activity fun! Fun activities can be anything your teen enjoys, structured or non-structured. These can range from team sports or individual sports to recreational activities such as walking, hiking, running, skating, bicycling, and swimming.
  8. Instead of watching television, playing video games, or spending time on the internet via their cell/smart phone after dinner, encourage your teen to find fun activities to do on their own or with friends and family, such as walking, swimming, or riding bikes. Setting reasonable limits on sedentary activities (e.g., internet, video game and cellular phone use) can help encourage your teen to seek alternative activities that not only increase physical activity but the potential for improved social connectedness with family and peers.
  9. Be safe! Make sure that your child has appropriate protective equipment such as helmets, wrist pads, and knee pads and ensure that physical activity is age appropriate.

Need creative ways to get moving? Move Your Way fact sheets help you understand your teen’s physical activity needs and provide fun ways to keep moving.

Nutrition

Regularly eating a well-balanced diet is the best way to provide your teen with the nutrients their body needs to grow, think, and perform at their best. Fueling up with healthy foods is just as important for your teen’s brain and mental health as it is to their other organs to prevent illness and chronic diseases.

Healthy eating is important at all ages. Being a positive role model and involving the whole family in taking small steps to a healthier diet is key to success. Check out this Healthy Eating for Families tip sheet for simple steps to get started. Remember, the benefits of healthy eating add up over time, bite by bite!

Where to start?

One of the most helpful tools that outline daily nutritional recommendations is the U.S. Department of Agriculture’s MyPlate. Make choices from all food groups – fruits, vegetables, grains, protein foods, and dairy and fortified soy alternatives – every day. Each group provides you with different nutrients and you need all of them. Looking for information about Type 2 Diabetes? The Type 2 Diabetes and Prediabetes Prevention toolkit for Schools is a great place to start.

MyPlate Nutrition Recommendations
  1. Fruits and Vegetables – make sure that your teen is filling half of their plate with fruits and vegetables; focus on whole fruits and vary your veggies
  2. Grains – Make sure that half of the grains are “whole grains” on your teen’s plate
  3. Protein – Help your teen choose from a variety of proteins regularly
  4. Dairy – Low-fat or fat-free dairy milk or yogurt (or lactose-free dairy or fortified soy versions) are good options
How much of each food group is appropriate each day?

Everyone’s needs are different. However, based age, sex, height, weight, and physical activity levels, the MyPlate Plan can be used to create personalized food plans for all members of your household. Learn more about key differences with these quick fact sheets for Healthy Eating for Teens and Healthy Eating for Adults.

Eating healthy can fit your family’s busy lifestyle and budget

Get active in the kitchen as a whole family with MyPlate approved recipes at MyPlate Kitchen.

Short on time? MyPlate Kitchen features several meals that take less than 30 minutes. Make the most of this resource by selecting “Browse Categories” in the “I’m Looking For” dropdown menu to search by supplemental assistance programs, food groups, cooking equipment, cuisine, and total cost.

Budget Savvy? The Shop Simple with MyPlate computer, tablet, and smart phone app helps you find cost-saving opportunities in your local area and discover new ways to prepare budget-friendly foods.

Keep in mind that healthy eating is also a wonderful way to stay socially connected and learn about different cultures that may be of interest to your teen. The CalFresh Healthy Living program in California has a number of recipes that offer diversity in food and food preparation.

More Helpful Resources
  1. 211 LA: Food Resources: Find food near you using the new map tool and discover food resources for children/ youth, food benefits programs, and more.
  2. BenefitsCal: Apply for CalFresh food benefits. With this one stop click, you can also apply for other assistance programs like Medi-Cal health coverage and CalWORKs cash aid.
  3. CalFresh Healthy Living: Tips and resources for healthy eating and staying active. Find 100’s of quick, budget-friendly recipes too!
  4. eatFresh.org: CalFresh Healthy Living and EatFresh offer more than 500 tasty and healthy recipes to choose from based on meal type, cuisine, and more.
Additional Food Resource Fact Sheets (Spanish)
  1. School Meals Program (SPN)
  2. Summer Meals Program (SPN)
  3. Market Match(SPN)
  4. CalFresh Food (SPN)
Eating Disorders
An eating disorder (or disordered eating) is when a person is experiencing severe disturbances in their eating behavior and related thoughts and emotions around food and their body weight. Eating disorders affect at least 9% of the U.S. population and between 35-57% of teenage girls engage in crash dieting, fasting, self-induced vomiting, diet pills, or laxatives29. However, eating disorders do not only impact girls and women. People of every age, race, size, and gender identity can be affected by eating disorders. The exact cause of eating disorders is not fully understood, but research suggests a combination of genetic, biological, behavioral, psychological, and social factors can raise a person’s risk. Eating disorders are serious and have both mental and physical health implications. If you suspect your teen has an eating disorder, there are resources that can help. There are several types of eating disorders and symptoms vary. Check out Eating Disorders: About More than Food for specific information on various eating disorders.
Infographic 1
29Eating Disorder Statistics. National Association of Anorexia Nervosa and Associated Disorders. Available from: https://anad.org/eating-disorders-statistics/
Sleep

Sleep is important for mental and physical health. In adolescence, sleep supports growth and development. It can impact how a person thinks, learns, reacts, and gets along with others. Getting the correct amount of good sleep is an important preventive measure to reduce your risk for long-term health concerns related to your heart, circulatory system, metabolism, hormones, immune system, respiratory system, and memory.

How much sleep does my teen need?
  1. Teens 13 to 18 years old should sleep 8 to 10 hours per day
  2. Adults should sleep between 7 to 9 hours a night

It is recommended that you speak to your doctor or your teen’s doctor if you are concerned about too little or too much sleep.

How can I improve the quality of my teen’s sleep?

Good sleep habits can help you achieve a better night’s rest. Try adding these tips to your teen’s sleep regimen:

  1. Keep a routine. Have your teen go to bed at the same time each night and wake up at the same time each morning. If they want to sleep in on weekends, have them stay within 2 hours of their regular sleep schedule.
  2. Ideally none of us would have electronics in our bedrooms, but sometimes this just isn’t realistic. If you don’t feel that removing electronics (this includes TVs, smartphones, computers and tablets) from the bedroom is possible, discuss electronic “downtime” with your teen. Agree to the hours each day when electronics will be turned off.
  3. Make sure their room is comfortable – including desired levels of darkness, noise, and temperature.
  4. Try to encourage your teen not to have large meals or caffeine before bedtime.
  5. Regular daily exercise will help teens fall asleep easier.
Mental Health

Mental health refers to how your teen is feeling, thinking, and acting. It is influenced by physiological, social, and emotional wellness factors. Good mental health is important because it can help us respond thoughtfully to daily stressors, influence how we relate to others, and help us deal with conflicts to live healthier and happier lives.

Spiritual Health

Spirituality is a sense of connection to something bigger than us. Spirituality can have a positive impact on mental health, as it helps people look inward and helps them understand themselves in relation to how they fit into the rest of the world.

Your teen’s spirituality may look different than yours and this is ok. Some people express spirituality through religious beliefs, while others immerse themselves in nature and solitude. No matter how spirituality is practiced, rest assured that the benefits are the same and do your best to encourage your teen to share ways in which they prefer to practice spiritual health.

How can spiritual health support my teen’s mental health?

Through spiritual practices, the mind and body will be better connected, positively influencing mental health and emotional wellbeing.

Spirituality improves:

  1. Individuality
  2. Mindfulness
  3. Unity to surroundings

Emotional Health

Emotional health may be thought of as an extension of mental health. Emotional intelligence translates to one’s awareness of their emotions and the ability to manage and express feelings in an age-appropriate way. There are 6 strategies that the National Institutes of Health recommends to best support your teen’s emotional health30.

Strategies for Improving Your Teen’s Emotional Health
  1. Build resilience
  2. Reduce stress
  3. Get quality sleep
  4. Be mindful
  5. Cope with loss
  6. Strengthen social connections
Social Health
During adolescence, your teen will build relationships and bonds with adults and friends in their community. This is important because it helps them feel a sense of connectedness, which is supports mental health and well-being.

How can I support my teen’s social health?
  1. Practice regular, open, and honest communication
  2. Listen and let them lead the conversation
  3. Learn what they value, what is important to them and why
  4. Spend time doing activities they love
  5. Communicate regularly with their teachers and coaches
  6. Encourage safe social media use
  7. Facilitate healthy decision-making in their relationships with new and old friends
  8. Be present
Learn more: 11 Tips for Communicating with Your Teen

This section outlines four science-based exercises that you can do with your teen that focus on numerous strengths with the single purpose of answering one of life’s biggest questions, “How can one be truly happy?”

Positive Psychology Focuses On:
  1. Positive experiences – encouraging optimism (like happiness, joy, love, and inspiration) - by finding fulfillment in creativity and productivity as their own rewards not just a means to an end
  2. Positive states and traits - fostering gratitude and developing strengths (like gratitude, resilience, and compassion) – helping teens make the most of rising to life’s challenges and using adversity and setbacks as opportunities to learn and grow from
  3. Positive institutions (applying positive principles within entire organizations and institutions) – looking beyond oneself and helping others to find lasting meaning, satisfaction, and wisdom
Gratitude Journal

Grab a notebook and something to write with. Locate a quiet space.

There are many things that we can be grateful for. Take some time to identify what you are grateful for in your life. Some things can be big, but some may also be very small. These things also differ from person to person.

Try this with your teen: each of you list five things from the past week that you are grateful for and take 15 minutes or so to share with each other.

Learn More: The Gratitude Journal - Prompts, PDFs, and Worksheets.
Random Acts of Kindness

Make it a goal to encourage your teen to practice acts of kindness regularly.

Try this: set a goal with your teen to each perform five acts of kindness this week. Each of you should write down what you did and how it made you feel. Set some time aside at the end of the week to share with one another. Learn more: Random Acts of Kindness

Learn more: Random Acts of Kindness
Strengths List

Identifying strengths increases self-awareness and can help with self-worth and appreciation.

Try this activity with your teen:

  1. Each of you identify one of your personal strengths (like creativity, compassion, or perseverance).
  2. Now, think of the many ways that you can use that strength as you have never used it before; write that down.
  3. Next, focus on using your strength frequently, setting a goal of how often you’d like to exercise it (e.g., once per week).
  4. Write about your experiences using your personal strength, describe how you used it, how you felt, and what you learned.
Learn more: Use Your Strengths

S.M.A.R.T. Goals

Setting specific, measurable, achievable, relevant, and time-based goals provides individuals with clarity and focus, helping to identify priorities, clarify ideas, and focus energy and efforts.

Try goal setting with your teen: ask your teen to share a specific goal that they would like to achieve this week, this month, or this year. Make sure you guide them to set a goal that is specific, measurable, achievable, relevant, and time bound. Remember: the goal should be important to your teen, something they really value. Talk them through visualizing how they will achieve this goal and have them write out the steps that will allow them to reach it. Lastly, support your teen in the pursuit of their goal and encourage them consistently to follow through.

Learn more: SMART Goal Setting Worksheet
Learn more: Goal Visualization

Additional Mental Health Helplines and Resources 211 LA County 211 LA County
Dial: 211
988 Suicide & Crisis Lifeline6 988 Suicide & Crisis Lifeline
Call: 988
Text: 988
Chat
California Coalition for Youth California Coalition for Youth
24/7 response system
Call 1-800-843-5200
Text 1-800-843-5200
Email them cycl@calyouth.org
Crisis Text Line Crisis Text Line
Text: “LA” to 741741
Disaster Distress Helpline Disaster Distress Helpline
Call: 800-985-5990
Family Urgent Response System (FURS) FURS
Hazel Health Hazel Health

Free, 24/7 hotline for current or former foster youth up to age 21 and their caregivers to receive phone, text, chat and/or in-person support when needed for any issues, big or small.

Call or text 1-833-939-3877
Los Angeles County Department of Mental Health Hazel Health – ask your school if they are participating in this program
Los Angeles County Department of Public Health Substance Abuse Service Helpline
Call: 844-804-7500
Teen Line Teen Line Call 800-852-8336 nationwide, from 9-10pm PST Text TEEN to 839863, from 6-9pm PST Email them
Trevor Project Lifeline Trevor Project Lifeline
Call: 800-788-7386
Accessing Mental Health Services California Department of Managed Health Care Behavioral Health Care
Los Angeles County Department of Public Health Community Outreach Initiatives (CHOI)

Get Help Applying for Free or Low-Cost Health Coverage
National Alliance on Mental Illness (NAMI) How to Seek Help

Understanding Health Insurance
Accessing Mental Health Services – Teens with Special Healthcare Needs Department of Developmental Services Regional Centers
Los Angeles County Department of Mental Health Regional Centers for the Developmentally Disabled
Accessing Mental Health Services – Foster Youth Family Urgent Response System (FURS) Family Urgent Response System (FURS)
Los Angeles County Department of Children and Family Services (DCFS) Los Angeles County Department of Children and Family Services (DCFS)

Foster Youth Rights Handbook

DCFS’ Health and Mental Health

Multidisciplinary Assessment Team (MAT)
Accessing Mental Health Services – LGBTQIA+ Teens AIDS Project LA AIDS Project LA
Airport Marina Counseling Services Airport Marina Counseling Services
Antioch University Counseling Center Antioch University Counseling Center
Bienestar Bienestar
BlackLine BlackLine
Colors LGBTQ Youth Counseling and Community Center Colors LGBTQ Youth Counseling Services
Children’s Hospital Los Angeles Center for Tansyouth Health and Development
Kaleidoscope Kaleidoscope
Los Angeles County Department of Mental Health Get Help Now!
Los Angeles LGBT Center Los Angeles LGBT Center
National Queer and Trans Therapists of Color Network National Queer & Trans Therapists of Color Network
Penny Lane Center Penny Lane Center’s LGBTQ+ Programs
Rainbow Pride Youth Alliance Rainbow Pride Youth Alliance
The Alexis Project LGBTQ+ Clinic – The Alexis Project
The Center for Professional Counseling Center The Center for Professional Counseling
The Trevor Project The Trevor Project
Trans Wellness Center Trans Wellness Center
UCLA EMPWR Program EMPWR Program
ViaCare ViaCare
Accessing Mental Health Services – Male Teens and Males of Color Black Infants & Families Fatherhoood
Los Angeles County Department of Mental Health iPrevail
National Alliance on Mental Illness (NAMI) NAMI
Mental Health America of California Mental Health America of California
My Brother’s Keeper My Brother’s Keeper (MBK)
TherapyForBlackMen.org TherapyForBlackMen.org
Alcohol and Substance Abuse California Department of Public Health California Overdose Surveillance Dashboard, Los Angeles County Dashboard
Centers for Disease Control and Prevention Fentanyl Facts
Los Angeles County Department of Public Health, Substance Abuse Prevention and Control Substance Use and Prevention Resources
Overdose Prevention
Accessing Naloxone, Drug Testing and Test Strips
Harm Reduction and Overdose Prevention Resources
Partnership to End Addiction Partnership to End Addiction
Why Teens Drink and Experiment with Drugs
Substance Abuse and Mental Health Services Administration “Talk. They Hear You.” Family Agreement Form
"Talk. They Hear You.” Campaign Videos
COVID-19 Substance Abuse and Mental Health Services Administration “Talk. They Hear You.” Family Agreement Form
"Talk. They Hear You.” Campaign Videos
Healthy Relationships Domestic Violence Resources
24-hour Support Services
1-800-978-3600
ENDTAB (End Technology Enabled Abuse) ENDTAB
Futures Without Violence Futures Without Violence
Jeneration J by Jenesse Center Jeneration J by Jenesse Center
Know You IX Know Your IX
Los Angeles County Department of Public Health, Office of Women’s Health Gender Based Violence – Resources for Victims of Violence
Los Angeles County Department of Public Health, Office of Violence Prevention Email: OVP@ph.lacounty.gov
Los Angeles County Department of Public Health, Office of the Domestic Violence Council Email: DVC@ph.lacounty.gov
Love is Respect Love is Respect
Text: “LOVEIS” to 22522
Call: 1-866-331-9474
National Domestic Violence Hotline National Domestic Violence Hotline
Call: 1-800-799-7233
TTY 1-800-787-3224
Text: “START” to 88788 Chat
Peace Over Violence Peace Over Violence
That’s Not Cool That’s Not Cool
Youth.Gov Characteristics of Healthy & Unhealthy Relationships
Stress, Anxiety and Depression American Academy of Child and Adolescent Psychiatry Stress Management and Teens
California Surgeon General The California Surgeon General’s Playbook for Stress Stress Relief for Caregivers and Kids
Centers for Disease Control and Prevention Stress Management and Teens
Child Mind Institute Anxiety: The Basics, Parenting Anxious Kids, Anxiety and School, Videos, Treatment
National Institute of Mental Health Getting to Know Your Brain: Dealing with Stress (VIDEO)
I’m So Stressed Out!
Teen Depression: More Than Just Moodiness
Society for Adolescent Health and Medicine Mental Health Resources for Adolescent and Young Adults: Apps and Tech, Guides, Helplines
Suicide: Thoughts, Behaviors and Attempts American Foundation for Suicide Prevention Risk factors, protective factors and warning signs
Substance Abuse and Mental Health Services Administration Preventing Suicide
Maintaining Wellness: Mental Health National Institute of Mental Health Mental Health Benefits of Religion and Spirituality
National Institutes of Health Emotional Wellness Toolkit
Emotional Wellness Toolkit – More Resources
Maintaining Wellness: Nutrition Benefits Cal BenefitsCal
CalFresh Budget friendly recipes
CalFresh Healthy Living
EatFresh EatFresh
Los Angeles County Department of Public Health BCalFresh Food
Market Match
School Meals Program
Summer Meals Program
211LA 211 LA: Food Resources
Maintaining Wellness: Physical Activity/MentalHealthToolkit Centers for Disease Control and Prevention Getting started with physical activity
How much physical activity do adults need?
How much physical activity do children need?
Physical Activity Recommendations for Different Age Groups
Los Angeles County Department of Public Health What is the difference between physical activity and physical education?
Youth Resource Guide
Maintaining Wellness: Sleep Centers for Disease Control and Prevention Basics About Sleep
Healthy Sleep Habits
How Much Sleep Do I Need?
Happiness Exercises 17 Benefits of Positive Psychology
What is Positive Psychology and How Can It Help?
Gratitude Journal Gratitude Journal
Random Acts of Kindness Random Acts of Kindness
S.M.A.R.T. Goals Goal Visualization
SMART Goal Setting Worksheet
Strengths List Use Your Strengths

1National Alliance on Mental Illness. (n.d.). Mental Health Conditions. Retrieved from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions

2Centers for Disease Control and Prevention. (2021, June 28). About Mental Health. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/mentalhealth/learn/index.htm

3Centers for Disease Control and Prevention. (2023, February 13). Mental Health. Retrieved from https://www.cdc.gov/healthyyouth/mental-health/index.htm

4Children and Youth Behavioral Health Initiative. (n.d.). Youth At the Center. Retrieved from https://www.chhs.ca.gov/wp-content/uploads/2023/01/CYBHI-Youth-at-the-Center-Report.FINAL_.pdf

5American College of Obstetrictians and Gynecologists. (2017, July). Mental Health Disorders in Adolescents. Retrieved from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/07/mental-health-disorders-in-adolescents#:~:text=The%20most%20common%20mental%20illnesses,people%20aged%2015%E2%80%9324%20years

6Centers for Disease Control. (2023, March 8). Mental Health Symptoms in School-Aged Children in Four Communities. Retrieved from https://www.cdc.gov/childrensmentalhealth/features/school-aged-mental-health-in-communities.html

7Office of Populations Affairs HHS. (n.d.). Mental Health For Adolescents. Retrieved from https://opa.hhs.gov/adolescent-health/mental-health-adolescents

8Centers for Disease Control and Prevention. (2023, March 8). Data & Statistics. Retrieved from https://www.cdc.gov/childrensmentalhealth/data.html

9Centers for Disease Control and Prevention. (n.d.). CDC WONDER Online Database About Underlying Cause of Death, 1999-2020. Retrieved from https://wonder.cdc.gov/ucd-icd10.html

10California Department of Public Health. (n.d.). 2016-2019 Mortality Data from CDPH Vital Statistics, Provided by Los Angeles County Department of Public Health Office of Health Assessment and Epidemiology. Retrieved from https://www.cdph.ca.gov/Programs/CHSI/Pages/Data-and-Statistics-.aspx

11California Department of Public Health. (n.d.). 2020 Provisional Mortality Data from California Department of Public Health Vital Statistics. Retrieved from https://www.cdph.ca.gov/Programs/CHSI/Pages/Data-and-Statistics-.aspx

12National Institute of Mental Health. (n.d.). I'm So Stressed Out! Fact Sheet. Retrieved from https://www.nimh.nih.gov/health/publications/so-stressed-out-fact-sheet

13World Health Organization. (2023, February 21). Stress. Retrieved from https://www.who.int/news-room/questions-and-answers/item/stress#:~:text=What%20is%20stress%3F,experiences%20stress%20to%20some%20degree

14National Institute of Mental Health. (2023, April). Depression. Retrieved from: https://www.nimh.nih.gov/health/topics/depression

15GCFGlobal. (n.d.). Staying Safe from Online Predators. Retrieved June 8, 2023, from GCFGlobal: https://edu.gcfglobal.org/en/internetsafetyforkids/staying-safe-from-online-predators/1/

16Protecting Youth Mental Health. Surgeon General’s Advisory Report 2021. Page 25. https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf

17Health Advisory on Social Media Use in Adolescence. American Psychological Association. May 2023. https://www.apa.org/topics/social-media-internet/health-advisory-adolescent-social-media-use

18California confronts youth mental health crisis. Cal Matters. March 17, 2022. Available from: https://calmatters.org/newsletters/whatmatters/2022/03/california-youth-mental-health-crisis/

19Prescription Medication Misuse and Public Perceptions in Los Angeles County: Finding from the 2017 Community Needs Assessment. Los Angeles County Department of Public Health. March 2019. Available from: http://ph.lacounty.gov/sapc/MDU/SpecialReport/Opioid/PrescriptionMisusePublicPerception.pdf

20Fentanyl. California Department of Public Health. February 16, 2023. Available from: https://www.cdph.ca.gov/Programs/CCDPHP/sapb/Pages/Fentanyl.aspx

21One Pill Can Kill. Department of Justice Drug Enforcement Administration. December 2022. Available from: https://www.dea.gov/sites/default/files/2022-12/DEA-OPCK_FactSheet_December_2022.pdf

22Los Angeles County Fentanyl-Related Overdose Deaths. California Overdose Surveillance Dashboard. Available from: https://skylab.cdph.ca.gov/ODdash/?tab=CTY

23Understanding the Stress Response. Harvard Health Publishing. Harvard Medical School. July 2020. https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

242016-2019 mortality data from California Department of Public Health Vital Statistics, provided by Office of Health Assessment and Epidemiology. Linked mortality datafile 2020 (provisional), LA County Dept. of Public Health. Office of Health Assessment and Epidemiology. Population data for rates from Hedderson Demographic Services for LA County ISD. ICD-10 codes used to identify firearm homicides: X93-X95, U01.4. Available from: https://www.cdph.ca.gov/Programs/CHSI/Pages/Data-and-Statistics-.aspx

25CDC WONDER Online Database About Underlying Cause of Death, 1999-2020. Centers for Disease Control and Prevention. Available from: https://wonder.cdc.gov/ucd-icd10.html

262016-2019 Mortality data from California Department of Public Health Vital Statistics, Provided by Los Angeles County Department of Public Health Office of Health Assessment and Epidemiology. Available from: https://www.cdph.ca.gov/Programs/CHSI/Pages/Data-and-Statistics-.aspx

272020 provisional Mortality data from California Department of Public Health Vital Statistics, Provided by Los Angeles County Department of Public Health Office of Health Assessment and Epidemiology. Available from: https://www.cdph.ca.gov/Programs/CHSI/Pages/Data-and-Statistics-.aspx

28Health and Well-Being. World Health Organization. Available from: https://www.who.int/data/gho/data/major-themes/health-and-well-being#:~:text=The%20WHO%20constitution%20states%3A%20%22Health,of%20mental%20disorders%20or%20disabilities

29Eating Disorder Statistics. National Association of Anorexia Nervosa and Associated Disorders. Available from: https://anad.org/eating-disorders-statistics/

30Emotional Wellness Toolkit. National Institutes of Health. August 8, 2022. Available from: https://www.nih.gov/health-information/emotional-wellness-toolkit