(people chatter) - [Woman] I've been on meds since I was 14.

- [Woman] Mostly what I rely on for any form of happiness is like drugs.

- [Narrator] They're called a generation on the edge, caught in the throws of a mental health crisis.

- [Man] Whenever I looked at someone, I saw an evil shadow right next to them, but it would always talk with me in my moments of like isolation, telling me like, oh, this person is out to get you.

- [Woman] Before I went off to school, I took like a handful of pills.

- [Narrator] Society says today's youth are spoiled, fragile, broken, but they're not.

- [Woman] I do not want to be in that place ever again in my life.

(slow gentle music) - [Announcer] This program was made possible by the David and Lura Lovell Foundation in support of Arizona Public Media's efforts to educate people on the spectrum of mental health challenges and resources.

- If we want to understand society, all we have to do is look at our teenagers.

They're sort of our canaries in the coalmine.

We blame them for the things that we see them do, the excesses, the indulgences, the compulsions, that kind of thing, and yet we forget that they reflect us.

They reflect the people who came before them.

They reflect our inventions.

They reflect our consciousness.

They totally reflect our priorities.

- [Narrator] If teens reflect our society and its priorities, what they're revealing is an epidemic of pain.

Nearly one out of three teens reports feeling sad or hopeless everyday.

One of five has a seriously debilitating mental illness like depression, bipolar disorder, or schizophrenia.

On school buses and playgrounds, in locker rooms and living rooms, in rural communities and urban ones all over the US, young people are suffering in unprecedented numbers.

- I was a pretty happy child throughout elementary school and stuff.

But yeah, I mean yeah, as soon as I started getting into middle school, that's when I kind of noticed things becoming harder, like there's some obviously mean girls in middle school.

And I started getting very self-conscious about the way I looked, and I just felt awful about myself.

And so, in seventh grade was actually the first time I self-harmed.

I took out all the self-hatred that I had on me and then like I needed to be control of something, and when I was self-harming I was in control of at least one thing.

I was in control of how I hurt myself.

- [Narrator] It's been said that this generation of youth is more sheltered and less resilient than the ones who came before, but the reality is more complex.

Young people who are struggling today come from a range of different backgrounds and experiences.

They're the most racially and ethnically diverse generation yet.

And the first to grow up in the era of smart phones, social media, and cyberbullying, in the midst of the war on terror, and in the wake of the Great Recession.

- I grew up with mental illness in my house, and so it was surprising to me because me looking at her, on the outside you see someone who seems to be, you know, successfully navigating what I was aware of was a tough time.

- So I didn't really talk much, kept to myself, and the cuts and stuff weren't very like noticeable anyway, so they didn't really get noticed at all.

- [Beth] How's that going?

- [Brynn] It's good.

It started getting worse in high school.

- If you ask people who injure regularly as a way of coping, what they will most often tell you is that they use it to feel better.

Part of what's happening is that they are having usually very big emotions or no emotion, and the physiological and neurological response to inflicting damage on the body helps them to come back into a state of stasis or calm.

This isn't an attempt to end life, this is an attempt to come back into stasis.

You can assume that in most secondary schools in the United States and a lot of other places that probably at minimum of 25% of the student body has ever self-injured.

- I told my mom finally that I need to get help probably the end of freshman year, beginning of sophomore year.

- And the first therapist she saw had to call me and she wasn't comfortable working with Brynn.

- I was like I can't be helped.

That was my first conclusion.

I had one meeting with this lady and she's like, I can't help you.

(slow tranquil music) - Hi, Matty, Matty, go say hi.

Ready?

- [Bree] Yeah.

- [Narrator] For many families, finding treatment can be tough.

Less than 1/2 of kids who need mental health treatment actually receive it.

There are lots of reasons why, the stigma or shame of admitting you need help, the lack of available services, and the cost of getting care.

And then, finding the right treatment can be a challenge too.

It's a journey that usually starts with a diagnosis.

- I actually started seeing a psychiatrist too, and that's when I officially got diagnosed with major depressive disorder, major anxiety disorder.

- 100% of adolescents at one point or another probably meet the diagnostic criteria of mental illness.

When you're an adolescent, you know, your entire world changes internally, and especially externally the way you perceive it, the way you perceive yourself, the way you relate to your peers, to your parents, to other authority figures in your environment.

And the adjustment to that can be very difficult when it gets so bad that problems occur, like say, running away or suicidal behavior, then we see that as an indication to help such a kid actively.

- [Narrator] To know how to help, experts have to tackle the question of why so many suffer so much?

And that's still a hard question to answer.

Although decades of research suggests family history or genetics play a part, that's just one of many factors in the mix.

- We've got a huge challenge in trying to find the causes of an illness that is poorly defined, that probably encompasses multiple illnesses that changes over time, and that is also to this point, not diagnosable with any test.

We still have no biological test that's definitively proven to diagnose any mental illness.

We still don't have a single psychiatric illness for which we know definitively a cause, a genetic cause.

And part of the problem that's made it so hard for us to make those advances in psychiatry is because psychiatric illnesses are not caused by genetics alone, they're caused by genes and environmental factors.

- [Narrator] Those environmental factors are the things we're exposed to.

The things that happen to us that can change us forever.

- I was a really big tomboy, so I liked, man, playing outside, digging holes, playing in the desert.

But then on the other side, I also loved Barbies.

That was a really good time in my life, my childhood.

I started getting bullied in third, fourth grade, and it was just really hard to go to school.

As a Latina, obviously your hair is darker and thicker, and so one of their favorite things to call me was like a monkey or a gorilla.

It's even hard for me to say that now 'cause it's like so intense.

Food is definitely like a major important part of Latino culture.

Because it's so central, when you don't eat, I mean in my family, like for my grandma, it's almost an insult.

When I went into high school is when I first started to develop the anorexia.

For me it was more about control.

It's the only thing I had control of in my life.

And, you know, the smaller you get it is like disappearing.

Like one day I'm just not gonna be here, and I'll just be gone.

(slow serious music) - Expressions of distress, symptoms of distress are very culturally related.

And so, for example, in African American cultures it's not seen as a strength to have mental illness or to deal with problems of sadness and depression.

And you gotta pick yourself up and you gotta be okay, and you gotta be strong.

It's often seen as a sign of weakness.

And many other cultural groups kind of view mental illness with that sense of stigma, that sense of brokenness, incompleteness.

- [Narrator] Andrea's need for control led her to start cutting herself too.

And then it got worse when she experienced sexual abuse at age 17.

- I didn't tell anybody about it.

And then 2008, that is when I attempted suicide for the first time.

I had actually stabbed myself and I was like 80 pounds.

And at that point I realized if I don't get help now, I really am gonna die.

- As the number of traumatic experiences that you've had increases, your likelihood of developing a mental illness is also increased.

- [Narrator] You can't talk about mental illness without talking about psychological trauma.

Multiple studies have found that trauma puts young people at greater risk of depression and other mental health issues.

Trauma can include physical, sexual, and emotional abuse, but also witnessing violence, experiencing a serious illness, or being bullied.

Treating childhood trauma early on is so important that hundreds of centers across the country, like North Carolina's Center for Child and Family Health have focused their efforts on helping families to understand and address it.

- Trauma that's been experienced in both childhood and adulthood, but particularly when it's been in childhood, it's very common for people to have in addition to posttraumatic stress symptoms to have co-occurring depression, to have co-occurring anxiety, to have substance abuse.

They just have trouble controlling their behaviors and their emotions.

And so that can lead to what looks like a picture of multiple psychiatric conditions and other functional impairment that may be directly tied to the experiences of trauma.

- My dad was a very special person.

Like my dad was one of those days he was happy this one day, and then all of a sudden he was mad.

I've witnessed him hit my mother for the first time, actually beat my mother, and that's the first time that I really was tested on my thoughts because even at an early age I was taught to never put my hands on a woman, especially if she's your significant other, or the mother of your kids.

And like I actually grabbed soda bottles and started beating him with it.

I mean I probably know now that I didn't make any damage, but I just wanted to stand up for my mother.

It wasn't 'til I was nine or in middle school where he just up and one day told my mom that he was gonna go fix the car, and then I mean I never heard from him then, no phone call, no goodby letter, no man-to-man talk, he was just, he was gone the next day.

And my mom explained to us, I mean.

Yeah, that was it.

He was gone from the picture.

And it was three days before my birthday, so I kind of felt guilty about it, I thought that was my fault, I mean I didn't do.

11 years into life, I started hearing like voices.

I started seeing things.

I started having visions.

I couldn't go to sleep.

I don't know if it was insomnia or just the voices keeping me awake.

I mean I got anxious.

I would always shake.

I would always feel depressed.

I didn't want to leave my room.

I mean it was like I was changing.

One day I left like I actually ditched school when I was in sixth grade, and jumped the fence.

I ran away 'cause I was hearing voices.

I was having trouble controlling my angers, and I just left and I was gone for about a day, I think.

And it wasn't until the next day when my teacher found me.

He actually took me back to school, and that's where I got reevaluated by the school counselor.

And that's where she said that I needed to go seek outside help to heal my quote unquote, damaged mind.

I don't think anybody likes having anything about them being called damaged.

Being diagnosed with schizophrenia, bipolar disorder, anxiety, and depression, I thought that was a death sentence.

It's exactly what we're gonna have.

We're gonna have resume building.

We're gonna have people doing mock interviews.

(slow serious music) - He was very artistic, creative.

He was always musically inclined.

- Hey, so I'm gonna play this second part of the Pathetique Sonata that's-- - [Christina] He made great grades and he was a, he was a really, I thought, perfect child.

- He was just always content, happy.

He didn't really ever throw tantrums, ("Pathetique Sonata" by Beethoven) but always engaging a very kind of a mild personality.

A lot running beneath the surface, maybe, but really sharp, clear perspective on things.

- [Narrator] After excelling in music during high school, Michael went off to college.

During his sophomore year, Dave and Christina got a call from his college roommates who'd known him since childhood.

They were worried about him.

He hadn't slept for days and was suddenly delusional, paranoid, and frightened.

Paramedics took him to the hospital where his condition deteriorated quickly.

(sirens blare) - Oh, it was the worst thing in my whole life.

All the other things I've gone through, to deal with that, worse thing of my whole life.

- [Narrator] Michael was diagnosed with serotonin syndrome, a rare life-threatening condition most often caused by combining certain medications.

Serotonin syndrome causes a dangerous build up of serotonin, a chemical that affects mood, sleep, and other functions.

It almost killed him.

But eventually his caregivers were able to bring him back from the brink of death.

- He came back and you know, but his mental wasn't there.

Um, he, that's where it started.

- I kept hearing like slams and stuff like that outside.

I almost thought that people were like jumping from the windows at the, 'cause it's like a really tall hospital.

I thought people were like jumping off and you know falling down because like just these loud bangs I kept hearing.

But I was still having the psychosis kind of symptoms where I thought all this crazy stuff was happening around me.

And you know, it's just a normal hospital environment, but still thought like you know, there was like destruction and all this stuff going on around me.

- It was almost like a switch had been pulled, and that's when Michael didn't seem like the Michael that we earlier talked about.

- I'm 1/2 black and 1/2 white.

I came out like a lot more ambiguous than a lot of other people.

A lot of me growing up was I was never a girl, like much of a girl.

I consider myself agender, I just very strongly feel like I'm not a boy or a girl.

So when I was a kid, I went to Catholic and a Lutheran school, and like all of my mom's friends are gay, like all of them are lesbians.

So like fourth or fifth grade where they tell you that all gays are evil and they're all going to hell.

I'm sorry, like being told that the person you look up to the most is going to hell?

When you're like 12-years old, it's like a really big deal, like really big deal, really took me out.

- [Narrator] Brenda faced racism and violence while growing up, and was sexually abused by an older child starting at an early age.

- I didn't know what to do.

I didn't want to tell anyone anything.

I didn't want to tell anyone anything, and like I knew it wrong in my head.

I knew what he was doing was wrong, and I knew what I was doing was wrong too, but I couldn't really put it all together.

I was eight, you're not supposed to be sexually anything at that age, and so I couldn't ever piece it all together.

He was like my older brother.

He was like a part of my family, so like I wanted to anything I could to make him happy, like anything at all, and he just took advantage of me for years, for years.

He told me that if I ever told anyone he'd kill me.

(Brenda hums) Going to therapy, love you.

- [Man] Bye, see you later, bye.

- Thanks, see you later.

- Our culture just says, fit in.

And then if you're a person of color or you have a different language, or you have an accent, or you're from a different nation, or you're LGBTQI or whatever the situation is, you get get further marginalized, and have an inability to really express what's going on.

(slow serious music) Just because someone identifies in the LGBTQIA community doesn't necessarily automatically mean that there's a metal illness.

However, there's a lot of stress, a lot of bullying, a lot of social norming, a lot of conversion therapies, a lot of trying to correct the sexuality or gender identity as the illness, and in doing that, it really wipes people's ability to have a mental and physical wellness out of their life.

(slow stirring music) - I thought my depression couldn't get any worse.

When I left high school and then I went to college, and then it got worse.

Like I'd get so low where I'd just sit there for days inside my head thinking about dying, thinking about dying, thinking about dying, thinking about tearing my skin off, like ripping organs out of myself.

I thought I was gonna die before I was 18, so it's kinda hard being 20, thinking that I already should have been dead two years ago 'cause like I don't know how to move forward.

Most of the time I just get so freaked out and so scared and so stuck.

- I think there was 102 in my graduating class.

I was the student body president.

I played three sports.

I played soccer, basketball, and softball, ended up as captain on soccer and softball my junior year of high school.

I really enjoyed my high school experience.

Looking back I can so see how the bipolar was already manifesting, having suicidal ideations at age 12, and then feeling like I was going to kill myself or run away to do fabulous saving the world type of things by the time I was 16.

(slow serious music) - [Narrator] By the time she found her outlet at school, Angel had been sexually molested for years by someone outside her immediate family.

- The first time it happened was the night before my fifth birthday.

So my mom's doing all these amazing things for me, and part of me wants to tell her, but then there's this very typical textbook trust that is like the five-year old doesn't want to tell on the 14-year old, so I never said anything, and then I just never said anything.

And it really damaged my relationship with my mom and then going forward I mean I refused to hug my brother.

- [Narrator] Angel cycles from periods of depression that leave her feeling hopeless to manic episodes where she's energized and willing to take dangerous risks.

- Tinder has been a fantastic creation for someone with bipolar disorder because it's a way for me when I am in that elated state, I can make plans here, here, here, here, with 15 different types of guys.

And then complete them all, and then crash into my blanket fort.

And so there's definitely that feeling of invincibility, but wild, unrestrained recklessness.

And like a big middle finger to the world of just being like I can go as hard and as fast and flame out as much as I want because then I'll just be back in my blanket fort.

But the past two episodes I've had have been mixed.

And the mixed state is absolutely the worst, and pretty much everyone who has bipolar disorder will agree because it's exploding in slow motion, it's feeling like you're being torn apart from the outside.

You're excited enough to, you know, that you can't sleep but too tired to create.

Like it's just constant warring and you know, the feeling like you have enough energy to kill yourself but you're too depressed to even try.

Like it's this bizarre kind of combination.

And yeah, so, these episodes can be really traumatic, honestly.

- I have, I think, six brothers and sisters, three brothers and three sisters.

I come from a pretty decent size family.

I've always been the black sheep, the different one.

The one that thinks differently from, you know, the rest of the flock, as it were.

My stepfather, stepfathers, would abuse me physically, would abuse my brothers and sisters physically.

My biological father abused me emotionally, sexually, physically, verbally.

But he's the only one to ever do that whole cocktail of bull.

For the majority, it was just emotional and physical.

So I would come to school with a black eye or a busted nose, and the teachers would naturally ask questions.

They'd be like, who did this to you?

And at first, I was very hesitant to respond because I didn't want to get my mom in trouble.

You know, I thought it was, I did something wrong and I deserved it.

I broke into someone's house with two other kids, and I stole a firearm which I later, accidentally, I didn't know there was a bullet in the chamber.

I'd forgotten that I put a bullet in the chamber, and the gun went off, and it shot my little brother.

He didn't die, but he's to this day, I think it's the main cause of his spiral into his unfortunate lifestyle.

I was taken away by the cops.

Everyone else was broken up by CPS.

They went to various places, have ended up in various places.

CPS had every reason to do what they did.

I'm surprised they didn't do it sooner.

Maybe if they had done it sooner, things wouldn't have turned out the way they did, hmm.

The what ifs (chuckles).

(slow serious music) - [Narrator] Rickey's brothers and sisters wound up with different foster families.

Rickey was confined to juvenile mental health and detention facilities from age 13 until he released at 18.

- When I first got there I was scared.

I was a kid.

I didn't know what was gonna happen to me.

I thought was gonna be locked up for the rest of my life.

And they would prescribe you these medications that would make you like a drooling zombie.

Like all I would do there is just like rock back and forth.

I was oblivious to all of my surroundings around me.

And when I wasn't, I was very angry, I was very violent because I wasn't able to deal with those feelings, the feelings that were killed with the medication.

You know, if I wasn't on that medication I could have gone to some of the groups and dealt with the difficult feelings I had.

If they would have taken the time to you know talk it out on deeper level, and get to understand the situation things would have turned out a lot differently, for the better.

- [Narrator] Kids who walk into a doctor's office today are more than twice as likely to get a prescription for a psychiatric medication than they were 20 years ago.

Although the drugs can be helpful, and even life changing for some, there's often a gap between what people expect of them, and what they can actually deliver.

- It's pretty rare that something as simple as prescribing a medication truly takes away all the problems and then you never see the child again.

In our modern society, there's that tendency or sort of wishful thinking that there can be a quick solution to most problems, and child and youth mental health unfortunately gets a part of that.

- I think that's the myth or that's the wish that parents have, that maybe there'll be a pill that makes this better for us, so that we don't have to talk about it.

Sometimes community physicians believe that it worked for one child, and it seems like it should for another.

But I think it's becoming increasingly complex to determine what the right combination of medicines are for kids.

What we know works for kids when it comes to the combination of medication and talk therapy is that really those two together do a better job instead of medications only.

- [Narrator] There's a kind of talk therapy called cognitive behavioral therapy that can be especially effective whether it's on its own or combined with medication.

It teaches people to notice their negative thought patterns and change them.

- It works with a therapist having a really good sense of wanting to work with the individual to understand from their perspective what's happening in the world, in their world.

And then sharing with the individual some other options, and working together towards change.

I admire the young people, and the 20-somethings, and the adolescents, and the children, who get into therapy to try to alleviate some of their suffering because it's very brave to start going inward and start looking at stuff on the inside.

But it also means that we challenge the systems on the outside too.

- [Narrator] Sometimes, youth who suffer self-medicate instead.

Those who live with severe mental illnesses are about twice as likely to have a problem with drugs or alcohol as those who don't.

- I actually just got out of a detox center for personal you know, like opiate use, stuff like that.

So I got clean for like five days from that.

I've been doing it for about five or six months.

I just haven't really been honest with like anybody it, my parents, or anybody, you know my case worker, or nurse, or doctor.

And I just started being honest about it, and made the choice for myself 'cause I'm ready to change.

I wasn't IV-ing it or anything.

I was just smoking the dope, smoking black tar.

So yeah, I mean it's just as bad, it's still heroin.

(slow piano music) (students chatter) - Nice move, good stuff, man.

- Good stuff.

- You guys, could we line up back here in this hallway, please?

- Congratulations Brynn.

(audience cheers and applauds) - Even though all this stuff is going on right now, it hasn't hit me yet.

Just all the stress has hit me, but the fact that I'm going to be moving out and taking this huge step.

- One tip they had in the list is you don't wanna get caught in fire drill in your underwear in the middle of the night (laughs).

- [Brynn] Well, I'll always have sweatpants on.

- [Narrator] With or without a mental illness, kids grow up.

Life goes in new directions with new challenges.

Brynn is going away to college, 200 miles from her home and her family.

- A lot that I'm excited about, a lot I'm worried about.

I'm worried that I might isolate myself.

That's something that I tend to do if I am stressed out or like anxious.

If those things do happen, I can ask for help, or I can reach out to somebody, and I do have that support up there, as well as back home.

- Recently I moved out of my mom's and my sister's house, and I'm staying with friends.

I think it's time for her that I stop depending on her.

That was my main concern is that I have to stop depending on her.

When I moved away, I mean she took it the hardest way I think, and she cut off communications with me.

I haven't talked to her since I've moved out.

Hey, Paul.

- What up, brother, how you doing?

- [Gabriel] Doing good man.

- What's going on today?

- Nothing.

I've been learning how to take more responsibility of myself and setting up my appointments.

I have yet to miss one appointmnet after moving out, I have yet, so.

I thought that was gonna be the hardest thing I had to do, but it's actually getting pretty easier everyday.

(slow gentle music) ♪ Eight doobies to the face ♪ 12 bottles in the case ♪ Two pills and a half weight - Do you feel like you have the courage in you or even the words in you to explain to her how much progress you've made with your metal health?

- So right now me and Chad are just working together um, just talking everything out.

And like I don't know, the older that I get the more that I wanna stay around.

I keep meeting people that I really like, and I'm like really, really into my partner.

My god (laughs), oh my god.

So I've been trying to like focus on that, and like what it would look like to accept myself as a 20-year old who like lived past my death date, and then keep living past my, like not just like existing and like waking up every morning and going to bed every night, but actually living for a future.

That's really what I've been thinking about.

(dog barks and growls) I called my mom, I talked to her a lot, and she really, really loves me, so I think what's gonna happen is that I'm gonna end up working the same place my mom works, and living with her again.

And like I'm not ready to go through the whole job hunt process again and my self esteem's like ruined, like I'm, I feel wrecked.

I feel like everyone knows that I'm mentally ill, and that they can like see it, and they try to like get rid of me before it's a big problem.

- Stigma is an interesting word.

The original meaning of that word is that it's kind of a mark, like a physical mark on someone, a stigmata, like a birthmark or a physical deformity that people find sort of disturbing.

And there's a kind of a label put on that person that they're different, and they're kind of to be feared.

- [Narrator] Stigma is a key reason why people don't seek help.

One source of stigma perpetuated over decades in the media is the idea that there's a link between mental illness and violence, especially mass shootings.

(sirens blare) - [Reporter] Three hours of terror overnight.

- Took the stairs and all I hear is just gunshot after gunshot.

- Now we are learning of possible warning signs.

He had been seeing a psychiatrist and had mailed her a package.

- [Narrator] Stories about the perpetrators often speculate about their mental health, and that feeds an unfounded fear.

- The majority of adults in this country believe that people with schizophrenia are likely, or very likely to commit violent acts which doesn't square with the science.

The vast majority of people who suffer from serious mental health conditions are not violent towards other people, never will be.

The other thing about the mass shootings, I mean people very looked at what are the commonalities across these cases.

If you describe all these common characteristics of the mass shooters, you're gonna get this picture of a young, alienated, isolated, troubled, young man.

And that also matches the description of tens of thousands of other young, isolated, alienated, young men.

And we can't just round them all up.

That's actually the problem with a lot of the risk factors for violence is that they're non-specific.

I mean one of the main ones is being male.

If we could do something about being male we could really reduce violence in society.

We have very good research that shows that people with serious mental illnesses are far more likely to be victims of violent crime than they are to be perpetrators.

- [Narrator] But there is a very real link between mental illness and violence against oneself.

- If we talk about suicide, there is a strong correlation between gun suicide and mental illness.

Most of the people who are gonna use a firearm to end their own life have some kind of a mental health problem.

(slow serious music) If we could cure mental illness magically tomorrow, schizophrenia, and bipolar disorder, and depression, which would be wonderful, our violence problem would go down by about 4%, and 96% of it would still be there.

Mental illness is one problem.

Violent behavior is another one.

They are both complicated.

They're both challenging.

They're not the same.

- [Narrator] Although violence is rare, mental health issues can lead to trouble with the law.

More than two million people living with mental illness are booked into jails every year.

In fact, young people in crisis are more likely to encounter police than medical help.

Facing that challenge can be isolating and scary for families.

- We've enrolled in support groups.

We've tried to do different things to kind of understand because I'll tell you the truth, it felt like I was the only person in the world that this was going through.

I honestly did not think there was one other person that was going through this, and that it couldn't get any worse, but it did.

September 10, in the early morning, he was raging at his father and I.

He pounded a hole in the wall and he started coming after me.

And I feared for my life, so I called 911.

Every other Wednesday he goes to court, the mental health court.

- Let's talk about your medications.

- [Woman] Okay.

- You were off your medications when this happened?

- [Woman] Yes.

- Okay, and so what's happening now with your medications?

One of the things that we try to do is to address the underlying problems that cause the person to commit the crime and cause them to come into our criminal justice system.

- [Narrator] Since the 1990s a handful of communities across the country have set up mental health courts that steer people towards treatment instead of incarcerating them.

Studies have shown that people who go through mental health courts are less likely to be arrested or jailed again.

- Well, that's one of the reasons that we have this court is to help you develop some skills.

We both encourage them to stay on their medications.

We have reviews.

Sometimes I see them as much as once a week.

We encourage them to engage in therapeutic groups, and we try to match those groups to the needs of the client, the defendant, and also to the charges.

You know, mental illness is just like any other chronic illness, it can be managed.

We are a problem solving court.

What is the barrier to treatment?

What is the barrier to success?

And I'm glad you're doing well.

- [Woman] Thank you.

(slow gripping music) - I've just been working, kind of getting used to not having Brynn at the house, trying to be a little more hands off, trying to not check in with her everyday.

She's very short with texts and she's very in the moment.

- We text everyday, and then we'll call every once in a while.

She obviously worries a lot about me.

She definitely always let's me know that she's proud of me for doing this on my own.

It's really actually interesting because people up here are really like friendly.

They wanna get to know you better.

I think that's awesome.

Like I've been able to do that without this previous reputation that I had at high school 'cause they don't have any idea about me before they met me, so I think that's cool.

(slow piano music) - I guess that one thing that I have struggled with frequently is people liking me better one way or another.

Like friends who say, well, I'll only hang out with depressive Angel because the up Angel is just too much, like too much excitement, I don't wanna go follow through all these things.

Or you know, I only wanna hang out with excited Angel who wants to do the party kind of scene.

Oh, you know when they say, oh, you're not being like yourself.

It's like actually, I'm just being anther part of myself.

I have bipolar disorder.

All of these things have happened to me, but I can still live on four continents, learn four languages, written 11 novels.

All of these things I've done but that's only during 50% of my life, so it's like 50% I'm dysfunctional, 50% I'm flying colors.

So you need to you know, you as in people who have stay stigma, you need to recognize that mental illness does not automatically mean violent, slothful, you know like apathetic waste.

- You're not bipolar.

You are not cancer, right?

You have that condition.

And that condition may make you struggle.

That condition may have you suffer in some way, but it is not, it is not who you are, it is what you have.

(mellow electric guitar music) - [Narrator] Three months after Michael's first try at detox, he's still struggling with his addiction and having trouble holding a job.

- He went into residency voluntarily, and then found out that he was a little outclassed by some of the other residents of the facility.

They ultimately said after about a week eh, he's not really ready.

- The thing that worked the best for me was actually detox.

You're in a locked facility, so there's no way you can really use or anything like that.

Like I haven't had to go to the hospital at all, like to a mental hospital.

I've been stable with my moods and not having psychosis, you know, like any psychotic breaks or anything in like over a year now.

But yeah, I'm just taking it one day at a time, and trying to just find activities to stay clean, and live a clean lifestyle, yeah.

- There's very few experiences in our life as humans and as families that bring us really to our edge.

And it's really when we're on our edge I thing that the most opportunity for growth happens.

And the other thing especially for parents to know is that time is on your side.

I mean just neurologically speaking, physiologically speaking, part of what's happening as someone is moving for say 12 to 25, it's a long time, but is that our brain is becoming better integrated in a lot of ways that make it much easier to manage emotion.

So it can feel like a long time, but time is your friend.

(mid-tempo riveting music) - It's like kind of back and forth living with my mom 'cause sometimes she really stresses me out and she nags on me and I don't know.

She fails to see me like as a, like as a person, like as an adult other than her child.

And then also like a depressed adult, specifically 'cause I have like no motivation to like succeed right now, or like nothing to do, and I just like sleep a lot.

She gets upset about that.

- She makes comments, she's depressed.

She sleeps a lot.

You know, she's not working, which I have a problem with.

I want her to work.

I want her to be able to take care of herself.

If something happens to me, she has to be able to support herself, and she can't right now, and the scares me.

- Every time I try to sit down and talk to her about like something that's really affecting me or the sadness I can't get to go away, she's always like, well, "Go see a therapist.

"Go get on meds."

And I'm like I just kind of wanna talk to you though, you know, like you're my mom.

I just wanna talk to you a little bit.

- And I can tell her to go, but if she doesn't make the steps to do it, then that's her choice.

And I have to let her make those choices, but it scares me because I don't wanna find her dead, and sometimes I think that's what's gonna happen.

And it's scary and she's tried before.

- I think my mother is a very, very sweet and like caring person.

And like she's like the one family member that I can like completely rely on.

I just always feel like I'm disappointing someone, or like I'm not holding up to this ideal of like a brilliant, like beautiful sunshiny Brenda 'cause like I just keep ending up on the wrong track or messing up somewhere.

I don't know, I'm trying again.

I'm trying to get somewhere, maybe, hmm.

- We're leaving okay, we're leaving, bye.

- [Narrator] Joronda Montano is the program director for a nonprofit that comes up with strategies for preventing substance abuse, self-harm, and suicide.

- 50% of all mental illness occurs by the age of 14, but it's not typically diagnosed until 10 years later.

So that's a lot of years for someone to deal with that struggle, that internal struggle, and it's not diagnosed.

And in my case, you know for sure, by 14 I had been dealing with it and it never got diagnosed.

- [Narrator] Joronda grew up amid gang violence in South Central Los Angeles where she watched her other get caught up in the crack epidemic.

For years, she battled depression that sometimes gave way to explosive anger.

She speaks from experience when she tells young people and their families that there's hope.

- The first thing is there's nothing wrong with you, absolutely nothing wrong with you.

Things do get tough, and it's tough to go through those things.

It doesn't mean that you did anything wrong or there's anything wrong with you.

All right Munira, what was the thing that you didn't like about today?

- I'm trying to get a work done and everyone's bothering me and stuff.

I do not like about my day.

- On the flip side though, that you were able to get a lot of work done today, right?

You know, having someone who you can at the least talk to even if it's just for a short time to relieve some of that pain, I think is important.

Trusting yourself that if you give yourself a chance to deal with it and deal in it, if you just give yourself a chance to see how much you can do, that you'll see that you can accomplish a lot more than you initially believed when you were struggling and in that crisis, but you gotta give yourself a chance.

Help adults to understand you.

- [Man] Hands up, fight stance.

- What I always encourage parents to do is pay attention to your gut.

You know your child better than anyone else.

They don't wake up with a mental health crisis, it takes some time.

Sometimes parents will say, well, you know my kids don't want me in their business.

You wanna be in their business.

You want to be relatable to them.

You want to have that communication.

You don't want to allow your kid to feel like they're growing up on their own.

- [Children] 20 step, 21 step, 22 step, 23.

- [Narrator] Months pass and life is better for Michael.

He's working as a cook at a local restaurant and has his addiction in check.

- It's been a couple of months now.

Like I had a little bit of slip-ups after rehab, and I've been off of the quarter treatment for a few months now, and almost like six months now, but it's been going all right.

You know, I haven't had any episodes, I haven't had to go to the hospital.

I'm trying to just be like the best person I can be, and so that always helps my parents when they see me like you know, working on myself the best I can.

Even if I do have like bipolar disorder, or I've been a heroin addict, and I had problems with cocaine stuff like that.

You know, I don't have to let that define who I am, you know because I'm just Michael, and you know I play music.

I can keep a job.

Like I'm a good person, you know.

(lively piano music) - [Narrator] Defining yourself is part of growing up, and that's harder in a society where young people confront new and constant pressures from social media, from each other, from themselves, and from a world the seems evermore uncertain and unsafe.

- We're creating environments that are almost toxic for healthy develop, and we're seeing it.

We're seeing the effects of that through higher rates of anxiety and depression and a lot of other kinds of mental illnesses that are basically communicating, too much, I need things to stop.

And we're not doing a very good job of responding to that, other than to put Band-Aids on it.

(slow dramatic music) - [Narrator] For youth who suffer, finding wellness means finding a way through a broken system.

Most of those who need help aren't getting it.

Where they live and how much money they have can determine their chances for survival and success.

Finding the right treatment and support can be a long-term struggle, and there's so much researchers and providers don't yet know about why people hurt and how to help them heal.

But young people living with mental illness are not broken.

Treatments do work.

Lives do get better, even within a broken system there is hope that they can have the lives they image and be the people they want to be.

- Well, young people are us.

I mean they're humans and they're profoundly resilient.

There's nothing wrong with them.

It's just that they need to find the place inside themselves where the will to live, and not just to live but to flourish and do well, exists.

And they have to find that place inside them where they know that they're okay.

They're not broken and life can be good.

(Brynn laughs) - A lot of us feel broken at times, or broken down, or less whole than other people, or like we're missing something.

But like all you can ever be is yourself, so thinking of it as not broken, just different, just you, just unique is like really nice.

I like that.

(slow gentle music) - I define myself as Gabriel.

I'm not my mental illness.

I'm not my experiences.

I'm a product of my environment.

You know, I'm a product of my choices.

I am a product of the people I choose to involve myself with.

And maybe I can help some small kid that's actually in the same position I was when I was 12, and he doesn't have to go in scared of it.

And he could go in seeing that there's a future for him.

That there is actually happiness in the end.

(delicate piano music) (mellow electric guitar music) - [Announcer] This program was made possible by The David and Lura Lovell Foundation in support of Arizona Public Media's efforts to educate people on the spectrum of mental health challenges and resources.

(mid-tempo lively music)