courtesy Jeremy Folmer
“Use your head!
What in the world were you thinking?!
How many times have you shouted something like this at your adolescent child? Teens and young adults get into a lot of mischief, and in an effort to keep our kids safe, we parents certainly have our work cut out for us. (Helpful hint: Here are the things your teen wishes you knew.) Adolescents are surrounded by risk every day, and if you’re a parent, or a child and adolescent psychiatrist like me, you’ve got to ask yourself—what are the real hazards to our children’s health and safety?
More than 15,000 teenagers die each year in the United States, and far more than one million die annually worldwide. When our teens are injured or die, it’s rarely due to the sorts of ailments we know to be killers, like heart disease and cancer. Rather, teens in both the U.S. and abroad die largely because of accidental injury, suicide, and homicide, all of which occur because of the emotions they feel, the behaviors they engage in, and the thoughts they have. Discover these apps for keeping your kids safe online.
Teen risks by the numbers
For example, nearly 90 percent of high school students rarely or never wear a bicycle helmet, and nearly one-third rarely or never wear a motorcycle helmet. Almost half of teens text or e-mail while driving, while 1 in 10 high school students drives under the influence of alcohol each month, and more than 1 in 5 rides with a friend who has been drinking. An unfathomable 1 in 10 female high school students has been forced to have sexual intercourse, and 1 in 4 adolescent girls becomes infected with a sexually transmitted disease every year—and STDs are on the rise. Meanwhile, 3 in 10 teen girls becomes pregnant, including a whopping 51 percent of Latina teens.
Almost half a million people die each year in the United States because of tobacco, making it our nation’s greatest cause of preventable death, far deadlier than obesity, alcohol, or motor vehicle accidents. Almost half a million—are you kidding me?! Given that nicotine is the most habit-forming substance available to kids and that over 30 percent of people who try tobacco will become addicted, you would think we’d be more effective at stopping teens from getting started with tobacco. Yet nearly 1 in 6 high school students is a regular smoker. Billions of dollars are spent each year on health care and lost work time due to tobacco, and yet regular tobacco use virtually always starts during the teen years. (This may be the best way to quit smoking.)
Given all of these home-grown threats and risks that our adolescents face daily, it’s no wonder that one-third of high school students feel sad or hopeless each year, nearly 1 in 5 seriously considers suicide, 1 in 7 has made a suicide plan, and 1 in 12 has attempted suicide. Chronic mental illness too skyrockets during the adolescent years with half of all lifetime mental illness setting on by age 14 and three-quarters by age 24.
How the teen brain sees risk differently
These numbers spell trouble, and parents, teachers, clinicians, and policymakers know it. Frightened that our kids may be exposed to dangerous drugs, unlimited sexual opportunities, and hazardous situations, we try to convince them that they are at great risk. We mistakenly believe that if they could only think logically like we do, they would see the dangers looming and change their behavior. But the reality is that entirely different mechanisms are at work in the adult and adolescent brain when it comes to assessing risk. In other words, no matter how much we scare adolescents with our statistics and pleading, it won’t stop them from taking risks. Most of our best-known risk reduction programs, in fact, like D.A.R.E., Scared Straight, and zero tolerance policies in schools, generally don’t work and often make things worse because they focus on telling kids over and over again that they are at risk. But our kids already know that driving drunk and having unprotected sex is dangerous—just ask them.
Counterintuitively, adults make decisions involving risk with the least amount of information possible. Mature decision-makers use intuition and experience, not large amounts of objective data. They don’t weigh pros and cons when staring down a risk because they know that the benefits of jumping off of a bridge into a river or driving 100 miles an hour on the freeway are minimal at best. In the mind of a grown-up, there’s no discussion or debate to be had when it comes to these kinds of risks. Our brains are built to allow conscious cognitive control over our emotions. (Here are some tips to making better decisions.)
But to a teenager or young adult, reward trumps all. Peak levels of dopamine drive adolescents to seek out new experiences and feelings. Eons of evolution have honed their brains into risk-taking machines designed to make them the most attractive and successful mates. Hormones tune them into the social zeitgeist, leading them to strive for a prominent place in the social hierarchy. Peer admiration is paramount, and the pain of being left out is both emotional and physical, and nearly intolerable. Emotional pain due to things like not being invited to a party or having your photo tagged on Facebook is so real to our teens that it can even be relieved with Tylenol. Because we’ve misunderstood the adolescent brain and how young people make decisions, we’ve been going about addressing risk all wrong. But with all that we now know, there’s so much we can do right.
How parents can manage teen risk-taking
We must start by doing a better job of supporting parents by teaching them to parent authoritatively and giving them the evidence-based skills of behavioral parent management (which include things like how to give effective commands, use positive reinforcement, and selectively ignore unwanted behaviors). Parents who learn these skills when their children are young raise kids who perform better on every academic and psychological health metric studied. These teens earn better grades, experience less anxiety and depression, have higher self-esteem, are more socially competent, and are less likely to engage in antisocial behaviors like fighting, lying, stealing, damaging property, and using drugs and alcohol. (Here’s how to raise emotionally intelligent children.)
We must also remember to focus on reward, not punishment when trying to motivate our kids. Because of the high amounts of dopamine circulating in our kids’ brains, novelty really rocks their world. So, we want to make the rewards our adolescents want (like driving and dating) contingent upon them doing the things that will improve their future, like getting their school work and chores done.
I’m sure you’ve asked yourself, probably countless times, why in the world you gave your child a smartphone at the tender age of way too young to have a super-computer in his pocket. All told, our teens now spend an average of between 9 and 11 hours each day on media. This is why I advise parents to put the phones and all portable screens into the fruit bowl or some other convenient place until homework is done. Unlimited screen access contributes to the epidemic of childhood obesity (more than one-third of U.S. children and adolescents are now overweight or obese) and impacts our kids’ emotions, behavior, and brains. We parents need to remember that we own those devices and that using them is a privilege, not a right for our kids.
How schools can manage teen risk-taking
In school, we would do well to teach our kids neuroscience, where they will discover that their brains are malleable and that they can enhance their resilience and willpower. And in addition to teaching them about the importance of exercise, proper nutrition, and sleep, we can actually help them get better at doing these things by providing more exercise opportunities, healthier school meals, and later school start times. Starting high school at 9 a.m. and extending the day to 5 p.m. will allow for enhanced tutoring for the kids who need it, mentoring, and expanded extracurricular activities in both sports and arts. It will also allow us to supervise our teens for more hours of the day, as they learn important life skills, instead of spending more time hanging out at the mall. Furthermore, we can teach our kids media literacy so that they don’t fall under the spell of a corporate America only too willing to sell them down the river by making them into nicotine or alcohol addicts.
We also have a big job to do by identifying and intervening early with those kids who are at the greatest risk for behavioral, emotional, and learning disabilities. Today, well over 20 percent of children meet criteria for a major psychiatric disorder by the time they reach 18 years of age. School is where our kids work, and it’s there that we should be providing mental health care. But fewer than 10 percent of the nation’s 80,000 public schools provide comprehensive mental health services.
There are many other interventions that will also help us cut down on the risks our kids face and make the world a safer place for our children. Graduated drivers licensing reduces motor vehicle accidents, injuries, and deaths. More stringent controls on tobacco and alcohol advertising, along with raising the legal age of tobacco use to at least 21, will also help.
Adolescent risk-taking scares the bejesus out of us and with good reason—it feels unpredictable and threatens those we love. The fallout all too often injures or kills our kids, deprives them of a college education, satisfying relationships, and a good job. But the strategies above, plus many others, will help our teens and young adults to make better, safer decisions and lead happier, more productive lives. We have the technology. We know all we need to know. We can and must make this happen.
Jess P. Shatkin, MD, MPH, is a professor of Child and Adolescent Psychiatry and Pediatrics at the NYU School of Medicine, and author of “Born to Be Wild – Why Teens Take Risks, and How We Can Help Keep Them Safe.”