SERIES: Understanding the Youth Mental Health Crisis

Following the opening preview of a psychiatric residential youth facility in East Bethel, managed by Nexus Family Healing, we talked with CEO Dr. Michelle Murray about the youth mental health crisis. This is the first in a series of stories we are developing about public health, both physical and mental, with more to come based on available funding for the reporting.

 

This content is underwritten by Valvoline Instant Oil Change across Northern Minnesota, a woman-owned business supporting women and families across the region.


Q: There is a lot of news about schools and the criminal legal system struggling with whether kids can be rehabilitated, whether force and punishment is required for behavior changes, and what the gaps in help for families are. Can you walk through the concerns about how to correct aggressive behavior from your perspective?

Michelle K. Murray has been CEO and President of Nexus Family Healing since 2018.

Children and adolescents have a higher success rate than adults in turning problematic behavior around. Particularly in the field of sexually acting out behavior, if you can reach a child in their teen years and reverse that, they don’t repeat the bad behavior. We put communities at risk when we don’t work with youth before they reach adulthood. As an adult, it’s harder to reverse. 

Brain development is a huge piece of that. Children and adolescents brains aren’t developed yet. That’s why it’s harder as an adult to change — because you have more hard wiring. Science shows that our brains can still change as adults, but it takes a lot more work to do that than when brains are developing.

Why kids act out aggressively, and have high-level intense behavior, is going to be different for every child. We assess their trauma history — emotional, psychological, sexual, physical, neglect, lack of attachment to parental figures. It really does change the brain and puts somebody into a fight-or-flight mode. They start to learn that they have to survive by acting in certain ways.

You compound trauma with a mental health issue, or cognitive delays, or fetal alcohol syndrome, and you’re going to have a child who’s going to be much more likely to act out physically when they’re feeling emotionally threatened. The back of their limbic system brain has no stopping mechanism. It’s more like very rudimentary behavior. It’s from a place of needing to protect oneself psychologically and emotionally for survival. That’s why you have the aggression. 

You are rarely going to find a child who is just a bad seed. People sometimes think that if a child is punished enough, they’ll “get it” — but that doesn’t change behavior. You have to teach new skill sets, how to rewire their brains. You do that through interventions. You help them understand their behavior so they can choose how to think or behave differently when they’re encountering situations that are setting them off emotionally.

You have to teach them how to recognize the cycles, interrupt the cycles, and then keep practicing. Practicing is what rewires our brains, especially for a child. It’s so much easier to learn French or Spanish when you’re three than for an adult. There’s a reason for that. Same with learning an instrument. The early you is such a different world.



There is a stereotypical fallback that boys tend to be aggressive. Girls might be self destructive, with anxiety, depression, and suicidal tendencies. Is there a gender relationship to how people act out? Or is aggression part of a fight or flight, and anxiety and depression is something else?

What we tend to see is, yes, some of those gender stereotypes are shown in the research. Boys will tend to be more external, girls will be more internal. However, with developmental delays, or cognitive disabilities — when the brain is damaged in certain areas — your thinking and calming ability are impacted. You are not going to have as much control. 

What we find is that even for the female population, if you start having lots of trauma, developmental delays, cognitive delays, and mental health issues all wrapped up into one, a girl can be just as aggressive as a boy, because it’s the way the brain is working for survival. The emotions are high and not controllable. 

 


Can you speak to the level of anxiety and depression that are hitting kids today, and whether there’s any known reason for it?

This is the conversation that everybody’s having right now, without research. What our field is discussing is the isolation factor that’s creating the anxiety and the depression. We’re all anecdotally theorizing this based on human behavior knowledge. Human beings have to have contact with others. We are animals that have to attach.If we don’t do that, it will start a cycle of not being as resilient.

What we see with the pandemic is as people started to be isolated, and not have that contact, it can be a trigger factor. It may not cause it, but it can certainly be a factor for bringing an onset of depression or anxiety. It’s again about child development, right? They’ve lost a year or two of growing and developing their brains around interacting with people in certain ways. Plus, you have more social media attacks on kids, online bullying which hits self esteem. 

When they’ve lost a couple of years of learning how to be in relationship with people, I think that’s where we have to be the most concerned. They’ve lost a couple years of interacting with people across a restaurant table versus across the screen. I’m not saying it’s a bad thing — I think we’ve gained a lot of knowledge coming out of the pandemic with how we can still function — but you and me knew what it was like to live years of meeting in a restaurant and having a cup of coffee. Kids who miss two years of experiencing that can be triggered with depression and anxiety if they are isolating themselves.


What do you say to people who might think that kids are “too soft, that everybody’s had bullying and peer pressure in their lives, and awkward self esteem, and you just have to push through and develop resilience. How do you speak to that? 

Kids getting bullied has always been there. What’s different is the amount of opportunities that people have to be bullied. Maybe in the past bullying happened six hours at school and 20 minutes on the bus. Now they can experience bullying 24/7, through a computer, or cell phone. We’ve exponentially opened up every minute of a child’s life to have the opportunity for someone to do something hurtful. I don’t think that the answer is to cut kids off from technology; then they’re not going to be equipped to deal with the world. We need to educate more about bullying. 


What do you say to people who think bad behavior in kids is the product of bad parenting?

A child’s behavior is based on the way their brain is functioning cognitively. We can’t just punish a child out of that. It’s not a bad parent that creates it. But what you want to do is teach parents coping skills to deal with a child who is aggressive. They have to learn skills on how to parent that child differently to get a different outcome. There’s a saying that sometimes difficult behavior in a child is what creates bad parenting, right? That’s why the parents have to be a part of the journey that the child is on, because they have to learn the same skills that the kids are learning.

We’re always going to have people who can’t parent well, and do horrible things to children because they don’t have better skills. They didn’t get the treatment and interventions earlier to know how to be different. But it is a really bad stereotype that kids that need this level of care is because of bad parenting.

SERIES: Understanding the Youth Mental Health Crisis