A certain amount of confusion and worry is expected from adolescents as they grapple with the growing demands of their academic and social lives while trying to find their place in the world. Youth advocates on the Vineyard, however, have begun to notice a concerning upward trend in anxiety and depression among Island youth. In some cases, this has led to self injury and suicidal intentions.

Visits to the guidance office at the high school are up, and guidance counselors at the middle schools say anxiety and depression is affecting kids younger than previously observed.

“We are seeing an increase in the numbers of students who are anxious, and they are more anxious than they have been in the past,” said Judith Boykin-McCarthy, a guidance counselor in West Tisbury.

In some cases, kids have turned to maladaptive behaviors such as substance abuse and cutting.

“Self injury has definitely become an epidemic here, as it has become nationwide,” said Amy Lilavois, school adjustment counselor at the regional high school. “Kids are using self injury as a coping mechanism.”

From July 1 to Jan. 31, Martha’s Vineyard Community Services documented 36 total mental health hospitalizations for adolescents between the ages of 9 and 20. During the entire previous fiscal year, there were 23 hospitalizations in that age range.

“There has been a definite increase and the acuity is higher, which is a major concern,” explained Tom Bennett, associate director of Community Services. “We need more services here on the Island for young people, especially adolescents, to help prevent hospitalizations.”

The most common reasons for being seen were suicidal intention and drug overdose, according to community services staff. Teens and preteens are driven to the point of a mental health crisis for many reasons, Mr. Bennett said.

“It’s family, it’s peers, it’s some with major mental illness, some with the stresses and pressures of daily living,” Mr. Bennett said. “Sometimes kids are very influenced by the social media, and cyber-bullying.”

The high school has seen a corresponding increase in mental health concerns overall among their students, said guidance director Michael McCarthy.

“This year especially has been more amplified than it has been in the past,” Mr. McCarthy said. Counselors did say that it is hard to judge whether this is the result of growing stressors in adolescents’ lives such as academic pressure and online bullying, or due to more awareness and less stigma about getting help. “Is it that we are doing a better job becoming more accessible to students?” Mr. McCarthy said.

Self injury is not necessarily new, counselors said. These behaviors appear periodically from year to year. However, the use of social media may compound the contagion effect of cutting, Ms. Lilavois said.

“It could be triggering and it could be normalizing,” she said.

Maladaptive behaviors have also been observed in Island kids of a younger age. Ms. Boykin-McCarthy said there are a few girls in the upper grades and at other middle schools who have tried cutting or talked about it. She said it was difficult to know if the behavior is trickling down from the high school.

Several girls told her that they learned about cutting mainly through social media, whether it was from girls who go to this high school or girls from other schools.
To try and address these concerns, and bring all the agencies together as a unified front, the Youth Task Force hired Dr. Lisa Machoian, a national expert on adolescent mental health, to spend last week on the Island. Ms. Machoian gave several presentations during her week here, speaking to public and charter school staff, community clinicians and hospital employees about how to identify and address anxiety and depression in adolescents. She also met with the student peer outreach group at the high school.

At an event mid-week, Ms. Machoian spoke to a crowd of about 250 parents and other community members, a showing that far exceeded organizers’ expectations.

“We feel we struck a chord with a resource people are really wanting,” said Theresa Manning, coordinator of the Youth Task Force.

In Ms. Machoian’s talk, which was titled Stress, Anxiety and Coping in Teens, she encouraged parents to listen to their children carefully, and to help them find healthy ways to deal with the stressors in their lives.

“We can’t shield kids from stress but what we can do is help them learn how to manage it and how to cope with it,” she said to those assembled. She suggested limiting the time spent on electronic devices, breathing deeply in moments of acute stress and seeking outside help.

She said by age 15, there are twice as many girls diagnosed with depression than boys, but this may be the result of a cultural stigma that discourages boys from showing emotion.

“Males tend to have higher rates of alcoholism, so we can also raise the question, is male depression manifesting differently?”

Ms. Machoian also addressed cutting, saying it can become an addiction because the behavior releases opioids which can make kids feel better temporarily. Others cut because others are doing it, or for attention, she said.

“I have had girls say they cut because nobody was listening any other way,” she added.

Parents have since asked for further programming, Ms. Manning said, and she hopes to comply with that request.

The visit was a collaborative effort between multiple Island agencies, including the Youth Task Force, YMCA, the schools, Community Services and the hospital. These groups are also involved in the Island Wide Youth Collaborative, which has been meeting for six months to fill gaps in adolescent mental health services.

“I think we have struggled for a long time on the Island with trying to provide enough therapeutic resources for children and adolescents,” Ms. Boykin-McCarthy said.

Mr. Bennett said the diagnoses seem to be more severe, which require more intensive outpatient services.

“The capacity in our community isn’t accommodating the increase in need,” Ms. Manning said.

Community Services is currently writing a grant to the Tower Foundation for help in enhancing the care continuum. Ms. Lilavois started a group for kids who have been hospitalized, which has now moved across the street to Community Services.

But more groups are required to meet a growing need, Mr. Bennett said.

“We need more groups for youth, for parents and for family members,” he said.

Reached the week after her visit, Lisa Machoian said she was impressed by the high level of collaboration between Island groups.

“It’s not every community where people step up to work together,” she said.

The organizers hope that Ms. Machoian’s visit will bring the issue to the forefront.

“We have been dialoguing about it for a while and we’ve dialogued with individual parents, but I think it’s time that the community realizes that our kids are in crisis, and we need to step up to the plate,” Ms. Lilavois said. “We all have things to bring to the table that can help.”