November 20, 2017

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Tackling Mental Health Through YA Lit

1511_Empathy-MentalHealthBks

For years at the public library where I work, we have tried to cope with the behaviors of a young woman, whom I will call Jane. She used to come in every day and was clearly struggling with mental health issues. Such challenges are not new for those of us who work in public libraries. I have often found that young people take refuge in our sacred walls and that stacks of books can be a fortress of solitude for those who need a place to rest. Jane was unique in that she interacted with the staff in very specific and sometimes troubling ways. For instance, she would ask for the same information over and over again and would accuse the staff of committing horrific crimes against her.

Trying to understand and best accommodate Jane caused us to look at the problem harder, and ultimately to implement a lot of specific policies and procedures. We had representatives from various organizations, including the police and a local mental health agency, come in to train the staff. We changed the desk schedule, making it a rule that no staff member was ever to be alone at the desk, in order to protect the staff’s safety and to prevent any liability issues for the library. We created folders on our desktop with the information we knew Jane asked for repeatedly so we could get to it quickly.

Although Jane was in her 20s, her mental health struggles began in her teenage years. Those years are, in fact, when many of these issues will present. According to the National Center for Children in Poverty (NCCP), about 20 percent of adolescents have a diagnosed mental health problem. Many more go undiagnosed and untreated. According to the National Alliance on Mental Illness (NAMI), 50 percent of teens with mental health issues will drop out of school. Suicide is the third leading cause of death among teenagers, and mental health is a significant predictor.

This got me thinking about how we can help earlier. As the response to last year’s article “Bibliotherapy and Teens” illustrates, guidance for the profession is needed and welcome, and the conversation is ongoing.

What do we mean when we say “mental illness”?

Although there are more than 200 mental health disorders listed in the Physicians’ Desk Reference, mental health issues are generally and broadly divided into major categories. Some sources list as few as five, while others list as many as 10. The organization Triad Mental Health provides a thorough discussion of the different categories. Professional organizations, including NAMI, the American Psychological Association, the American School Counselors Association, the National Association of Social Workers, and the World Health Organization, to name a few, also provide related information, resources, and training. WebMD organizes mental health challenges into eight categories: anxiety disorders, mood disorders, psychotic disorders, eating disorders, impulse control and addiction, personality disorders, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).

A 2010 NIMH report, focusing on mental health and youth, found that:

  • 11 percent reported being severely impaired by a mood disorder
    (e.g., depression or bipolar disorder);
  • 10 percent reported being severely impaired by a behavior disorder,
    such as attention deficit hyperactivity or conduct disorder;
  • 8 percent reported being severely impaired by at least one type of anxiety disorder;
  • and about 40 percent of those who reported having a disorder also met criteria
    for having at least one more.

Educate staff and advocate for teens

Those who work with youth in libraries must be aware of the prevalence of and types of mental health issues facing teens. We need to educate our staff members, particularly our frontline staff, who interact with our teens on a daily basis. This knowledge, coupled with an understanding of normal adolescent development, can help create a culture of empathy and better customer service. Understanding what teens may be struggling with can help us better respond to and meet their needs.

This awareness should also inform our approach to programming in one-on-one and group interactions with teens. We need to make sure that teens know they can opt out of a situation if it becomes too stressful or triggers negative reactions or behavior. Opening announcements can remind teens that they can participate, or not, based on their own comfort levels. As librarians get to know the teens they serve, they will learn more about how to accommodate them. For example, having a quiet corner set up in a program room can help a variety of teens, including those with anxiety or on the autism spectrum, know that they have a safe place where they can catch their breath and minimize stimuli.

We also need to make sure that information on mental health is represented in our collection development. The big push toward diversity should include more and appropriate representations of these hurdles in the lives of young adults. When evaluating books for collections, librarians also need to look for titles that present the issues authentically and without judgment or stigma. It’s important when adding titles on mental health to read a wide variety of reviews to evaluate whether the authors handle the issues in a way that is helpful or harmful to teen readers. Librarians should avoid selecting titles that perpetuate stereotypes, ones that may make teen readers feel ashamed—thus possibly preventing them from seeking appropriate treatments—or others that suggest mental illness is anything other than a medical condition that can be treated. According to the Ontario Human Rights Commission, some stereotypes to look for include:

• Mental illness is a sign of weakness, a sin, or
some other personal choice on the part of the teen;
• A person can think positively or make lifestyle
choices that will completely erase their mental illness;
• Mentally ill people are dangerous.

Helping teens find the information they need

Many teens will not want to ask an adult for help finding information on sensitive topics like mental health, so librarians should make it easy for them to find what they need without having to engage with staff. Librarians can create book lists and displays and topical web pages to help teens navigate the collection, including fiction and nonfiction. A simple sign can help them ask for information about sensitive topics. Broad Dewey classifications (Depression 616.85, Grief 155, Suicide 362) can also help teens find and browse nonfiction collections. Libraries with a strong online or social media presence can also use those outlets to share resources.

One way to erase the stigma associated with the various mental health challenges—and help young people get help—is through early intervention. According to NAMI, research shows that “early detection, assessment, and linkage with treatment and supports can prevent mental health problems from compounding and poor life outcomes from accumulating.” It can lead to the development of good coping strategies.

A teen book discussion group, for example, can include titles that deal with mental illness and provide some background on the topic. Local mental health professionals can be invited to visit the group and talk with teens. No one should be asked to share their personal struggles, but some basic information and education can happen through the sharing of books.

Hosting staff book discussions using YA literature is another strategy for enlightening and sensitizing staff to these challenges. An alternative approach is to create a system for reviewing and sharing book reviews with staff to help keep them updated on YA literature.

Throughout 2016, “Teen Librarian Toolbox,” the blog I founded, will focus on mental health in YA literature as part of our #MHYALit discussion. A variety of authors, librarians, and teens will share their personal stories, discuss their books, and contribute to a better understanding of the impact that mental health issues can have on the lives of teens.

For five years, we wrestled with how to best serve Jane while maintaining boundaries and balancing the needs of our staff and other patrons. Over time, Jane’s safety became a concern, and she was moved out of town to a facility that could better provide care.

Not all mental illness is like Jane’s; in fact, most isn’t. The majority of our young people living with mental illness do so in much more silent, unseen ways. Just because we can’t see it doesn’t mean it isn’t there.

Sometimes they share their struggles with me in unguarded moments—during a craft program, or while asking for a book about a young person grappling with…depression, cutting, an eating disorder, or something else. Jane helped me understand the struggles of people with mental illness. I encounter some of them every day, and I do my best to make a difference in their lives.

Jensen-Karen_Contrib_WebKaren Jensen is YA services coordinator at the Public Library of Mount Vernon and Knox County (OH) and founder of the blog “Teen Librarian Toolbox”.

Recommended Titles

Addiction

Crank by Ellen Hopkins. (S. & S., 2010)

Zoo Station by Christiane F. (a memoir). (Soho, 2013)

The Fix by Natasha Sinel. (Sky Pony Pr., 2015)

Tiny Pretty Things by Sonia Charaipotra & Dhonielle Clayton. (HarperTeen, 2015) [also deals with eating disorders]

Other Broken Things by Christa Desir. (Simon Pulse, Jan. 2016)

Anxiety disorders

The Nature of Jade by Deb Caletti. (Simon Pulse, 2008)

The “Ruby Oliver” series by E. Lockhart. (Delacorte)

Cracked Up to Be by Courtney Summers. (St. Martin’s Griffin, 2008)

Freaking Out: Real-Life Stories About Anxiety, edited by Polly Wells. (Annick, 2013)

Finding Audrey by Sophie Kinsella. (Delacorte, 2015)

Bipolar disorders

All the Bright Places by Jennifer Niven. (Knopf, 2015)

When We Collided by Emery Lord. (Bloomsbury, Apr. 2016)

Bleeding Violet by Dia Reeves. (Simon Pulse, 2010)

Impulse by Ellen Hopkins. (S. & S., 2007)

Every You, Every Me by David Levithan. (Knopf, 2012)

Eating disorders

Perfect by Natasha Friend. (Milkweed, 2004)

A Trick of the Light by Lois Metzger. (HarperCollins, 2013)

Wintergirls by Laurie Halse Anderson. (Viking, 2009)

Purge by Sarah Darer Littman. (Scholastic, 2009)

Elena Vanishing: A Memoir by Elena and Clare B. Dunkle. (Chronicle, 2015)

Mood disorders (depression)

It’s Kind of a Funny Story by Ned Vizzini. (Miramax, 2007)

Crazy by Amy Reed. (Simon Pulse, 2012)

Hold Still by Nina Lacour. (Dutton, 2009)

Will Grayson, Will Grayson by David Levithan & John Green. (Dutton, 2010)

Dr. Bird’s Advice for Sad Poets by Evan Roskos. (HMH, 2013)

Obsessive compulsive disorder

OCD Love Story by Corey Ann Haydu. (Simon Pulse, 2013)

The Unlikely Hero of Room 13B by Teresa Toten. (Delacorte, 2015)

Every Last Word by Tamara Ireland Stone. (Disney-Hyperion, 2015)

Fig by Sarah Elizabeth Schwartz. (S. & S., 2015)

Perfect Escape by Jennifer Brown. (Little, Brown, 2012)

Psychotic disorders/schizophrenia

Freaks Like Us by Susan Vaught. (Bloomsbury, 2012)

Challenger Deep by Neal Shusterman. (HarperTeen, 2015)

Calvin by Martine Leavitt. (Farrar, 2015)

Schizo by Nic Sheff. (Philomel, 2014)

17 & Gone by Nova Ren Suma. (Dutton, 2013)

PTSD

Something Like Normal by Trish Doller. (Bloomsbury, 2012)

The Impossible Knife of Memory by Laurie Halse Anderson. (Viking, 2014)

Things a Brother Knows by Dana Reinhardt. (Random, 2010)

This Is Not a Drill by Rebecca McDowell. (Penguin, 2012)

The Unbecoming of Mara Dyer by Michelle Hodkin. (S. & S. 2011)

Self-harm and cutting

Cut by Patricia McCormick. (Scholastic, 2000)

Scars by Cheryl Rainfield. (Westside Bks, 2010)

Willow by Julia Hoban. (Dial, 2009)

Crosses by Shelley Stoehr. (Delacorte, 1991, 2003)

Break by Hannah Moskowitz. (Simon Pulse, 2009)

Suicide

13 Reasons Why by Jay Asher. (Penguin, 2007)

Hold Still by Nina LaCour. (Dutton, 2009)

Falling into Place by Amy Zhang. (Greenwillow, 2014)

My Heart & Other Black Holes by Jasmine Warga. (HarperCollins, 2015)

Waiting by Carol Lynch Williams. (S. & S., 2012)

Teens with parents dealing with mental health issues

Making Pretty by Corey Ann Haydu. (HarperCollins, 2015)

The Chance You Won’t Return by Annie Cardi. (Candlewick, 2014)

A Blue So Dark by Holly Schindler. (Flux, 2010)

This Is How I Find Her by Sara Polsky. (Albert Whitman, 2010)

The Impossible Knife of Memory by Laurie Halse Anderson. (Viking, 2014)

This article was published in School Library Journal's November 2015 issue. Subscribe today and save up to 35% off the regular subscription rate.

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Comments

  1. We host programming for Mental Health Awareness Month every May, but I am always at a loss for how to encourage teen participation and attendance. What kind of programs would you recommend for that month that appeal to teens?