Guidance on Mental Health and Youth from the National Alliance on Mental Illness of New York City


In the United States, approximately 20% of children aged 13–18 experience a mental health condition, and suicide is the third leading cause of death in adolescents and young adults. The COVID-19 pandemic has created additional stressors for teens who are already challenged by a variety of internal and external pressures.


We recently sat down with Jessica Feldman, Director of Programs and Services for National Alliance on Mental Illness - New York City (NAMI-NYC), to talk about the main signs that parents, teachers and tutors can identify in their teens, and what the best ways are to help them get through their struggles. Jessica is a licensed Mental Health Counselor, a Certified Psychiatric Rehabilitation Practitioner and holds a Master’s Degree in Education with a focus on Community Counseling.


Every month, NAMI-NYC presents Ending the Silence for Families program via Zoom and other public education events, and you can watch their videos at


 “The most important thing a parent 

or caregiver can do is listen, listen, listen.”

Jessica Feldman, Director of Programs and Services for NAMI

NAMI-NYC is creating space to talk about mental health during the youth. Why is it so important to have these conversations? What are the main statistics about mental health and teenagers that we should keep in mind?

Teenage years aren’t an easy time for young people or for their family members and caregivers.  As young people move through the incredibly difficult and tumultuous transitions that accompany adolescence — physical, emotional, hormonal, sexual, social, intellectual — the pressures and problems they encounter can all too easily seem overwhelming. For many teenagers, these and other pressures can lead to one or more of a variety of mental health conditions. 


The statistics in regard to teenagers and mental illness are alarming and continue to grow, According to the National Center for Children in Poverty, are:

  • Approximately 20% of adolescents have a diagnosable mental health disorder. 
  • Many mental health disorders first present during adolescence, many by the age of 11. 
  • Between 20% and 30% of adolescents have one major depressive episode before they reach adulthood. 
  • Between 50% and 75% of adolescents with anxiety disorders and impulse control disorders (such as conduct disorder or attention-deficit/hyperactivity disorder) develop these during adolescence. 
  • 37% of students with a mental health condition age 14 and older dropout of school—the highest dropout rate of any disability group.
  • Suicide is the third leading cause of death in adolescents and young adults. 
  • Suicide affects young people from all ages, races, genders, and socioeconomic groups, although some groups seem to have higher rates than others. 
  • Older adolescents (aged 15-19) are at an increased risk for suicide.
  • Between 500,000 and one million young people aged 15 to 24 attempt suicide each year.
  • An estimated 67% to 70% of youth in the juvenile justice system have a diagnosable mental health disorder.

What are some of NAMI's campaigns and programs about teen mental health?

Delivering the NAMI National signature program, Ending the Silence, NAMI-NYC is proud of the work we’ve done to educate junior and highschool students throughout NYC.  This unique presentation helps young people learn about the warning signs of mental health conditions and what steps to take if you or a loved one are showing symptoms of a mental health condition.


During the past year, NAMI-NYC has adopted two more NAMI Nationally recognized programs - Ending the Silence for Families and Ending the Silence for School Staff, which utilizes current information on youth and mental illness to inform adults who care for youth on issues related to mental health conditions and how to approach a student or family member who may be displaying warning signs of a mental illness or when a young person is thinking about suicide.


All three presentations pair an adult family member of a youth living with mental illness and a young adult who shares his/her story of their mental health challenges and journey through early recovery. As a young adult presenter stated so succinctly, "'Ending the Silence' succeeds where so many other forms of outreach fail because of the genuine validity of our experience. Unlike many health teachers who work out of a book and have no personal context to draw on, we have lived expertise acquired through years of struggle."

What are the most common mental health issues amongst people aged 13 and 18?

Each year in America, 1 in 5 teens aged 13–18 experience a mental health condition, most common, depression and anxiety disorders. The COVID-19 pandemic has created additional stressors for teens who are already challenged by a variety of internal and external pressures. Young people are likely to be experiencing worry, anxiety and fear, and this can include the types of fears that are very similar to those experienced by adults, such as a fear of dying, a fear of their relatives dying, and the experience of isolation from friends and family, which  is antithetical to our instinct and desire for community and socialization.


Jessica Feldman has dedicated her 25+ year career to serving people living with mental illness and their families, helping them live meaningful lives as contributing members in the community of their choosing. She has extensive experience working across a wide spectrum of behavioral healthcare services and settings, including for profit and not-for-profit companies and organizations. As the Director of Programs and Services for The National Alliance on Mental Illness New York City (NAMI-NYC), Jessica oversees all programs and services including the NAMI Helpline, public education programming, NAMI signature classes, and over 30 support groups and programs for adults living with mental illness, family members, and parents and caregivers of children 18 years of age and under. Jessica presents on issues related to mental health conditions, suicide prevention, NAMI-NYC programs and services, Workplace Mental Health, and anti-stigma campaigns to nonprofits, community groups, corporations, and houses of worship throughout NYC.


What are some of the signs that parents, teachers, and mentors could identify to recognize when a teenager is dealing with mental illness?  

It can be difficult to tell whether or not your teen has a mental health condition, but there are certain nonverbal cues and signs you can watch out for. Experts agree that it is very important for parents, caregivers and teachers pay to pay particular attention to the possible warning signs that a teenager is struggling with a mental illness and/or are considering suicide.  


It’s important to note that warning signs that a young person is spiraling into a mental health condition are physical, emotional as well as behavioral.  


Warning signs include but are not limited to: losing interest in things that they used to enjoy, having low energy or seeming lethargic, sleeping too much or too little or being exceptionally sleepy throughout the day, spending more and more time alone and avoiding social activities with friends or family, fear gaining weight or diet or exercise excessively, engaging in self-harm behaviors (e.g., cutting or burning their skin), smoking, drinking or drug use, engaging in risky or destructive behavios or having thoughts of suicide.


In addition to paying attention to these warning signs, it’s important to be aware of signs that a young person may be considering suicide. Below are a few things to watch for:


If a young person displays any of the behaviors below, it’s time to seek professional guidance:

  • Threatening to hurt or kill himself/herself.
  • Seeking access to pills, weapons or other means.
  • Talking or writing about death, dying or suicide.
  • Expressing hopelessness, no reason for living or having no sense of purpose in life.
  • Displaying high levels of  rage, anger or seeking revenge.
  • Acting recklessly or engaging in risky activities, seemingly without thinking.
  • Feeling trapped.

What should people do or avoid doing when considering a conversation with a young person to try to help them?

It can be scary to talk to a young person about mental illness, especially given that when a youth is experiencing or demonstrating some of the warning signs, they tend to isolate and have difficulty expressing their feelings and thoughts. The most important thing a parent or caregiver can do is listen, listen, listen.

  • Family members should ensure that their child knows they will always be heard and will respond without judgment. Be an attentive listener, sit in a relaxed position, and use appropriate eye contact.
  • Ask open-ended questions to try and get them talking rather than asking questions with yes/no answers that won’t really tell you how they’re feeling or what they’re thinking
  • Acknowledge their feelings. Try not to minimize or down-play how a young person may be feeling by saying things like, “You’ll feel better tomorrow” or, “It could be worse…”
  • Avoid giving advice. Always respond with empathy such as, “I’m so sorry you’re feeling this way” or, “This is really hard for you, I can tell.” and, “I so appreciate you sharing your feelings with me.  It means so much to me for us to talk like this.”
  • Don’t jump in immediately. Some silence is ok. Be calm and let them do the talking. Ask questions, gently and slowly and with affection in your tone.
  • Try to keep your reactions in check. If your child gets a judgmental, critical, shocked or angry response from you, they’ll be much less likely to come to you with issues in the future. A judgemental response may also lead to shame and embarrassment.
  • Remind your children that they’re not alone. Let them know that you’re there to support and help in any and every way that you can.
  • If your child doesn’t feel like talking, try being creative by writing a note or sending a supportive text or Facebook private message.
  • Help your child improve their confidence by acknowledging and building on the things they do well. Regardless of behavior that may be concerning, you can always find something they’ve done to recognize and/or celebrate.
  • Be respectful of your child’s privacy, but avoid promising absolute confidentiality.  

The National Council for Behavioral Health has developed a free training called, “Mental Health First Aid for Youth”. This 8-hour coruse is designed to teach parents, family members, caregivers, teachers, school staff, peers, neighbors, health and human services workers, and other caring citizens how to help an adolescent (age 12-18) who is experiencing a mental health or addictions challenge or is in crisis. Youth Mental Health First Aid is primarily designed for adults who regularly interact with young people. The course introduces common mental health challenges for youth, reviews typical adolescent development, and teaches a 5-step action plan for how to help young people in both crisis and non-crisis situations. For more information and instructions on where to find this free course in your area, please visit

Are there any other organizations that NAMI-NYC is working with or institutions that you would like to highlight?

We work closely with WellNYC, a crisis line under the auspices of Vibrant Emotional Health that provides emergency clinical support to individuals experiencing depression, high levels of anxiety and who may be considering suicide. This 24/7 service can assist parents and caregivers in their emergency response to a young person who may be experiencing a crisis, the onset of a  mental health condition or potential acts of suicide.  

Is NAMI-NYC planning any other events about this topic or other topics of interest?

Every month, we present the Ending the Silence for Families program via Zoom as a public education event. We invite all family members, caregivers and friends of young people to join us for this free , engaging and informative presentation. To learn more about the NAMI-NYC Ending the Silence Programs, please visit NAMI-NYC Ending The Silence.




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