When Claire Rhyneer was in middle school, she was going through what she now describes as a depressive episode — “self-harming, not knowing what to do.”
Rhyneer, who is 19 now, said in a recent interview that in the absence of other resources, she remembers searching Google to self-diagnose and try to find help. She ended up finding “horrible, unhelpful information and never really knowing what to do. And most nights wondering, like, is something wrong with me?”
Providers in Alaska who work with teens say resources in Alaska are limited — that mental health education in schools is lacking, that there aren’t enough in-state inpatient beds for those needing high-level care, and that teens still don’t always know where to turn when they need help.
Alaska has long had one of the highest adolescent suicide rates in the nation. While the pandemic may have exacerbated some of the challenges surrounding youth mental health in Alaska, these issues have persisted for years, providers say.
Rhyneer graduated in the spring from West High School and is currently taking a break before attending Middlebury College in Vermont in the fall.
She’s spending her gap year working with the National Alliance on Mental Illness, or NAMI, in Anchorage to help facilitate a storytelling workshop focused on talking about mental health and decreasing stigma. She’s also trying to gather support for two bills in the Alaska Legislature that she says would create guidelines schools around the state could use to develop mental health education.
This work is important, Rhyneer said, because she knows how much she would have benefited in middle and high school from having additional guidance and more opportunities for conversations about mental health. She thinks less stigma and more resources are still needed in Alaska for youths struggling with mental health issues.
“When I talk to other youth, there’s this chorus of nods when I say I turned to Google because I didn’t know what else to do,” she said. “In health classes, they were talking about nutrition and diet and getting outside and dental care and cancer prevention, but they were not talking about mental health,” she said.
“I was like, this really needs to be talked about in schools because you can’t expect that everybody has parents who are willing and able or even around to talk about mental health with their kids,” she said.
At a public event Rhyneer helped facilitate in December, a group of teens stood on the stage of the Wilda Marston Theatre in Anchorage and told personal stories related to mental health. They described harmful relationships, the struggle to fit in, how they would compare themselves to others.
Some talked about how the pandemic affected their lives, but most described struggles that had existed for years.
Rhyneer said she thinks many Alaska youths have been battling mental health issues since long before the pandemic — and that the pandemic just shed light on the existing problem.
Data from 2019, the last year the state’s annual Youth Behavior Risk Survey was conducted, painted a troubling picture of youth mental health in Alaska.
The school-based survey of Alaska high school students — which has been postponed for the past two years due to pandemic-related obstacles, according to the state — showed that out of 1,875 respondents in 39 schools, about a quarter had seriously considered suicide and 19% had attempted suicide.
“I kind of calculated how many people in every one of my classes who I could assume that, like, either seriously thought about suicide or had attempted already,” she said. “It’s really sad.”
The survey indicated that since 2007, there’d been a significant increase in students feeling sad or helpless: 38% had felt that way for two weeks or more in 2019 compared to about 27% in 2007.
The survey also found that the percentage of students attempting suicide had nearly doubled, from 10.7% in 2007 to 19.7% in 2019. In 2017, that percentage was about 12%.
Alaska’s suicide rate has long been among the highest in the country. Alaska’s average annual adolescent suicide rate from 2016 to 2019 was about three times higher than the national average.
During 2019, suicide was the leading overall cause of death for Alaska youths and young adults ages 15 to 24 — the only age group where that was the case, Leah Van Kirk, the suicide prevention coordinator with the Alaska Department of Health and Social Services, said recently. Rates were also highest among Alaska Native people, men and people ages 20-24, state data showed.
“Alaska is in pretty rough shape as far as our continuum of care,” said Jason Lessard, executive director of the National Alliance on Mental Illness’ Anchorage chapter, where Rhyneer works.
The problems are wide-ranging. They include limited options for Alaskans seeking treatment for eating disorders, fewer beds for psychiatric care and not enough support for young people dealing with mental health issues, Lessard said.
He said that while it may be too soon to tell the role the pandemic has had on youth mental health, he doesn’t think it made it better.
“We were already trending in the wrong direction on a lot of metrics,” he said. “So certainly, this issue predates pandemic.”
Lessard said he thinks the switch to all-online learning and socializing may have contributed to some of these issues as well.
“I have a son in high school now — he did almost the entirety of his middle school online,” Lessard said. His son went from in-person grade school to now high school, “which is a big, big jump.”
He said he thinks in some ways, virtual communication has been “a saving grace” because without it, people would have felt even more isolated through the pandemic. But he’s concerned about young people relying so heavily on social media and screen time for most of their social outlets.
Karen Zeman, executive director of the Anchorage youth nonprofit Spirit of Youth, said she also thinks teens rely on face-to-face interactions even more than adults do.
“I mean, that’s just how you make your friend groups. That’s how you get crushes. That’s how their society is formed,” she said.
“There’s a skill set that adults have for socializing that young people don’t have, where they need the construct of being in an organized space,” she said. That’s harder online, she said.
Alaska’s struggles are part of a broader national problem.
In December, U.S. Surgeon General Vivek Murthy issued a rare advisory highlighting the urgent need to address youth mental health, describing a growing problem that he believes was exacerbated by the pandemic.
In a 53-page report, Murthy cited data showing that symptoms of depression and anxiety have doubled during the pandemic, with 25% of youths experiencing depressive symptoms and 20% experiencing anxiety symptoms.
That research also found that during the first few months of 2021, emergency department visits in the United States for suspected suicide attempts were about 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same time period in early 2019, according to the advisory.
“What I like about this (advisory) is it lays out pretty clearly in one place, what various individuals or organizations can do at all sorts of different levels,” Lessard said. “It really kind of goes into, OK, well what can an individual do, and then zooms out from there: what can the family do, what can the school district do, what can the government do.”
Rhyneer said that one thing she would tell parents and friends of someone who seems to be struggling with their mental health is to not be afraid to reach out and start a conversation.
“It’s really important to remember that as scary as it is for you to ask, ‘Hey, is there something going on?’ ... It’s so much scarier for the actual person who’s hurting to reach out,” she said.
“If I talked to parents, I would say, ‘Hey, don’t ignore the signs that your kids are giving you,’ ” she said.
Lessard said that part of the struggles youths are facing recently are connected to what the adults in their lives are experiencing too.
“It’s affecting the society as a whole, and a lot of that trickles down to the youth. So there might be stresses at home just because of the stress it’s put on the family and really having nothing to do with being in school or not being in school,” he said.
“Maybe home is the place that caused your depression or anxiety or your stressors, and school was that escape and outlet. So it’s not just the social isolation that could come with it, but all of a sudden, you know, maybe the home is not the best place,” he added.
The latest state data showed that Alaska is seeing an increase in the number of youths ages 11 to 14 who have attempted suicide.
But in 2020, Alaska actually experienced a 50% decrease in the number of youths ages 10 through 19 who took their own lives, according to Van Kirk, the suicide prevention coordinator with the state. That’s an encouraging sign, she said.
Lessard said an important thing to take into consideration when looking at Alaska data is to know that the figures are partially a sign of increased comfort regarding talking about mental health, and acknowledging that it’s a problem.
“Maybe not fully as a society, but generationally, they’re more comfortable talking about this stuff,” he said.
“We’ve always had mental illness,” Lessard said. “It just wasn’t OK to talk about it when I was in high school.”
If you or someone you know are dealing with a mental crisis or suicidal thoughts, you can call the Alaska Careline at 1-877-266-HELP or the National Suicide Prevention line at 1-800-273-8255. You can also text NAMI to 741741 to access the Crisis Text Line anytime. For more information on the Alaska Suicide Prevention Council and suicide in Alaska, visit dhss.alaska.gov/suicideprevention and namialaska.org/crisis-resources.