Talking teenage mental health with the U of M

Every year, statewide data show that depression and suicidality are increasing among Minnesota’s youth. 

In a recently published study, University of Minnesota Medical School researchers found that, for public school students overall in Minnesota and for the majority of specific racial and ethnic subgroups, teenagers who get more sleep and have strong parent relationships have reduced rates of depressive symptoms, suicide ideation and suicide attempts. 

To explain the effect that sleep and parent relationships can have on teenage mental health, senior author Andrew Barnes, MD, MPH, an associate professor of pediatrics at the U of M Medical School and a developmental and behavioral pediatrician with M Health Fairview, and lead author Marvin So, MPH, a third-year medical student at the U of M Medical School, answer questions and offer ways to promote better mental health. 

Q: How does sleep and having strong parent relationships affect the mental health of teenagers?
Answer: Teenagers who get 8-10 hours of sleep every night and have at least one parent (or other caregiver) with whom they feel they can talk to about their problems have better mental health than their peers without these. We have an internal clock that regulates not only our sleep but also our mood, hormones, immune system and thinking abilities. If we are chronically sleep-deprived, these fine-tuned systems get unbalanced. 

Strong parent relationships are just as essential as sleep for teens’ health. Teens are at their best when they can count on their parents to listen, and they really do look to their parents for guidance and boundaries — including healthy routines like a regular bedtime — and, of course, for encouragement in dealing with life’s ups and downs. That’s why sleep and parent relationships are among the factors that protect teens from the wear and tear of stress from problems not of their own making, like bullying, discrimination or family substance use disorders.

Q: How do the effects of sleep and parent relationships differ between racial and ethnic groups and why is it important for these differences to be addressed? 
Answer: Most U.S. teens get less than 8-10 hours of sleep per night, and BIPOC youth often get less than white peers. In our study of approximately 100 thousand teens across Minnesota, sleep and positive parent relationships each independently reduced the probability of depression and suicide for teens — regardless of race and ethnicity — and for the “average” teen in Minnesota, this was even better among teens with both good sleep and positive parent relationships. 

When we looked deeper, this combined effect was only significant for the white and Asian teens in our sample. Social conditions are key — for example, Black teens who experience intrusive police stops or live in neighborhoods with fewer resources get worse sleep than white youth  a ZIP code away. These stressors are over-represented in communities of color as a result of historical policies rooted in institutional racism. While helping teens improve their sleep and parent relationships does improve their health regardless of race, true healing will only come through changing the structural and social forces that wound communities of color.

Q: What are some ways parents can help their teenagers sleep better? 
Answer: Parents play a key role in shaping their teenager’s sleep habits. Although adolescence is a time when young people are trying out their own daily rhythms regarding schoolwork, extracurriculars and free time — parents still matter. Parents can set consistent expectations around routines like meals, chores, homework, bedtime and screens to help guide healthy practices. They can encourage their teen to reflect with them on their sleep and its relationship with how they deal with stress and emotions. Parents also help to ensure that their teens have a quiet, cool, dark, comfortable place to sleep. Discussing these practices with trusted friends, family or health care professionals can help parents figure out what might work best for their teenager and household. Approaching these topics collaboratively and with curiosity helps a lot — especially when parents are honest with their teens about things they are working to improve about their own sleep habits, too.

Q: What are some ways parents can strengthen relationships with their teenagers?
Answer: Parents often know their child better than anyone, so they already have the tools to build strong relationships. Things like taking an interest in teenagers’ activities and friends, respecting their developing opinions and autonomy and being a listening ear can all be helpful. Before offering unsolicited advice, try asking something like, “can I give you a suggestion?” Parents are surprised that the answer is usually, “sure!” Putting these ideas into practice may be easier said than done; things like losing a job or dealing with their own health can soak up parents’ time and energy. Enlisting the support of counselors or other trusted adults can help families create stronger relationships and dynamics as they shoulder life’s challenges. 

One important finding from our study was that good parent-youth relationships were important for mental health regardless of one’s race or ethnicity. We know that caregivers practice many ways of raising children, drawing on diverse cultural values and their own experiences being parented. Although there is no one size-fits-all approach, our results agree with many decades of previous research: teenagers are healthier when they can talk with a parent about the things that matter to them.

Q: What are some resources if you are struggling with or know of someone struggling with mental health?
Answer: Mental health conditions such as depression, anxiety and suicide are common, affecting one in five people in the U.S. People of all ages, ethnicities, cultural backgrounds and financial situations experience them. While these can present considerable challenges, there are countless stories of people who have gone on to achieve stability, healing and recovery. The support of one’s friends, family, health care teams and community can make a big difference in managing mental health issues and cultivating resilience.

If you or someone you know are struggling, we encourage you to look for support. There are professionals that can help in your community in a manner sensitive to various cultures and languages. 

• National Suicide Prevention Lifeline is available 24/7: 1-800-273-TALK (8255)
• Crisis Text Line is available 24/7: Text MN to 741741
• Minnesota Farm & Rural Helpline: 1-833-600-2670
• National Alliance on Mental Illness, Minnesota Chapter which includes suicide warning signs and resources for multicultural communities
• Minnesota Teen Mental Health Directory

Andrew Barnes, MD, MPH, is an associate professor of pediatrics at the University of Minnesota Medical School, where he directs the fellowship program in developmental-behavioral  pediatrics. He is also a developmental and behavioral pediatrician with M Health Fairview. His clinical work with children and families focuses on helping children gain mastery of their own mind-body interactions, and his research focuses on promoting resilience in children under stress and on the interplay between behavior and biology. 

Marvin So, MPH, is a third-year medical student at the U of M Medical School who plans to practice strengths-based primary care grounded in the power of relationships. His background is in the delivery and evaluation of programs to foster healthy development for children of color and those facing adversity.

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