Speaker 1: That is the issue of mental health screening for teenagers.
Speaker 1: We're speaking to doctor Lizza Street, who's a pediatrician and
Speaker 1: co founder of a Judah. But just you know, for
Speaker 1: a bit of background, there's lots happening. I mean, I've
Speaker 1: been saying that it's such an important conversation to have
Speaker 1: in light of the youth that we have right now
Speaker 1: and the circumstances that they live under Number one, there's
Speaker 1: so much that's different from what the youth of twenty
Speaker 1: twenty five are experiencing compared to the youth twenty thirty,
Speaker 1: forty years ago. The screen time that they spend, the
Speaker 1: content that they're exposed to, all are found to be
Speaker 1: contributors or potential contributors to their mental health challenges. In fact,
Speaker 1: according to a UNISE study from twenty twenty one, thirty
Speaker 1: two percent of South African teens showed symptoms of anxiety depression.
Speaker 1: If you told parents ten fifteen, twenty years ago that
Speaker 1: their children could be suffering from depression they're thirteen, fourteen
Speaker 1: year old, I think they would be shocked, they would know,
Speaker 1: they'd wonder, what do you mean. But now the reality
Speaker 1: is just it's right there and so many parents are
Speaker 1: aware of the potential and the risks. So we had
Speaker 1: a conversation this evening around why every teenager needs mental
Speaker 1: health screening, and our guest, Liza's Street, a pediatrician and
Speaker 1: co founder of a Juda, joins us now Live. Liza,
Speaker 1: thank you so much for joining us and welcome to
Speaker 1: seven oh two.
Speaker 2: Good evening, Kmoso, thank you for having me on your
Speaker 2: show this evening.
Speaker 1: Doctor I don't want to is it Lizard Eliza, It's Lisa, Lisa, okay, cool,
Speaker 1: Thank you so much for that. Maybe let's just start
Speaker 1: a doctor Street with I mean, what mental health screening
Speaker 1: actually is and if it's something that just teen should
Speaker 1: be doing or if we should all be getting screened
Speaker 1: for mental health issues.
Speaker 2: So any screening is it's very important to differentiate between
Speaker 2: what a screening is and what a diagnostic test is.
Speaker 2: So a diagnostic test is something we're actually going to
Speaker 2: find out the root of the problem. It's a blood
Speaker 2: test that will tell you that you have a low
Speaker 2: blood a low sugar, or a urinee make et cetera.
Speaker 2: But when it comes to screening, a screening is a
Speaker 2: suggestive test that is quick, quick, it's cost effective, it
Speaker 2: can be done at scale. It can be done in
Speaker 2: a community like for example, schools, and we can assess
Speaker 2: large groups to see who is at risk of developing
Speaker 2: the condition and therefore been needing to be diagnosed. So
Speaker 2: screening isn't the diagnosis. It is really just a way
Speaker 2: to find out who is a high risk person or
Speaker 2: child that needs further evaluation, and that by doing that
Speaker 2: then they can be directed to the professionals that can
Speaker 2: then do that that proper further evaluation and diagnosis.
Speaker 1: Right, And I mean I'm always speaking about teens here
Speaker 1: in particular, but the screening is this something that we
Speaker 1: should all.
Speaker 2: Be considering doing one percent? You know already now we
Speaker 2: find that with corporate wellness, it is already brought into
Speaker 2: the programs. In corporate wellness when they're checking blood pressures
Speaker 2: and sugars and cholesterol levels, they often do do what
Speaker 2: we call a PHQ nine. It's a very well known
Speaker 2: validated screening tool with nine questions that adults are asked
Speaker 2: and to find out how they're doing, you know, in
Speaker 2: terms of the depression. Fans and some medical aids also
Speaker 2: have it on the for their members to be able
Speaker 2: to do so. It has already been spoken about within
Speaker 2: the within amongst adults. However, amongst teenagers, we're not finding
Speaker 2: that it's been spoken about. It's not being done. And
Speaker 2: it's extremely important because we're dealing with a crisis in
Speaker 2: our hands with our teens. As you mentioned earlier, it's
Speaker 2: on the rise mental health issues and we need to
Speaker 2: start acting now and making a change otherwise things that
Speaker 2: can just get worse.
Speaker 1: And I mean, in terms of teens, what are some
Speaker 1: of the reasons why we should consider prioritizing screening for them.
Speaker 1: I mean I mentioned screen time, which I know is
Speaker 1: a is a big part about social media, the influences
Speaker 1: of social media. Those are all reasons to consider screening
Speaker 1: for them.
Speaker 2: Right absolutely. And you know why it's so important because
Speaker 2: I always say, don't screen for something unless you can
Speaker 2: do something about it. So the reason we screen is
Speaker 2: because they're an adolescent period. It is vitally important for
Speaker 2: us to detect if there is if a child is
Speaker 2: showing funds of depression or suicidal thoughts or anxiety, we
Speaker 2: can actually give them the coping mechanism, the tools to
Speaker 2: support so that they can learn to cope with it
Speaker 2: and not either commit suicide, which is the worst case
Speaker 2: scenario or for them not to for them to learn
Speaker 2: the current mechanisms that don't become adults with these chronic
Speaker 2: conditions and prevent them from having mental health problems with adults.
Speaker 2: You know, the brain is very plastic in a teenagers,
Speaker 2: they can it's maliable. We can change the trajectory of
Speaker 2: these kids' loves. So for me, the importance of the
Speaker 2: screening is because we can intervene and we can change
Speaker 2: how the synapses are growing and all the you know,
Speaker 2: I don't want to get into medical jargon, but you
Speaker 2: know we can change they rewire their brain so to speak,
Speaker 2: to put it simply, and therefore they will have a
Speaker 2: coping mechanisms so they're not land up with medication as
Speaker 2: an adult or with a diagnosis as an adult. So
Speaker 2: for screening for teenagers is so important. For one, you
Speaker 2: want to risk identify any high rist child and be
Speaker 2: able to intervene and get them the help and support
Speaker 2: immediately that they need. Number two is to say those
Speaker 2: that are showing sounds that they need support, getting them
Speaker 2: in the correct care pathway so that we can support
Speaker 2: them and then at least as adults, then we're not
Speaker 2: going to have a crisis that already we're seeing more
Speaker 2: and more adults presenting the signs of anxiety and depression
Speaker 2: as well.
Speaker 1: What are some of the science to look out for.
Speaker 1: As a parent, who might you know, have a teen
Speaker 1: to think maybe I should take much child for screening.
Speaker 2: You know, it's very, very difficult for parents. It's actually,
Speaker 2: you know, adolescents are moody and emotional and you just
Speaker 2: don't know as a parent. I think, you know, it's
Speaker 2: hard for parents to put it on themselves and expect
Speaker 2: to identify the science and the symptoms. You know. However,
Speaker 2: having said that, we need to be like you mentioned earlier,
Speaker 2: social media is a huge problem in today's teenagers. They
Speaker 2: are worried about how many likes they have and who
Speaker 2: they're following, and even when they're not looking for certain things,
Speaker 2: it will find them on social media and they will
Speaker 2: be influencing ways that really we need to be protecting
Speaker 2: our teams. In many countries they ban social media from
Speaker 2: the end of the age of sixteen, but even when
Speaker 2: as a sixteen seventeen year old, the infant of social
Speaker 2: media and the effects of depression and diety is huge,
Speaker 2: and it's well known, and so as parents, We need
Speaker 2: to be responsible in the social media usage and what
Speaker 2: we allow our kids to do at home. And then
Speaker 2: you know, asking them if your child not eating well
Speaker 2: and not a behavior has changed more than what you
Speaker 2: would imagine a normal teenager would behave speak to them,
Speaker 2: Talk to them, make sure you're communicating because it's going
Speaker 2: to be hard for you to know just from a
Speaker 2: few sympsons and science, So it's important to you have
Speaker 2: good communication as a family. You know, the traditional round
Speaker 2: the table is vitally important to know what's going on
Speaker 2: in their list, what's happening at school? Are they being bullied?
Speaker 2: Are they having relationship difficulties that are they just need
Speaker 2: help and support to cope through. There's so much that
Speaker 2: can be addressed from communicating with your kids that we
Speaker 2: now don't spend enough time doing so. I think that
Speaker 2: is vitally important and often the teenagers will come forward
Speaker 2: and tell you a lot if you just spend time
Speaker 2: asking them. The screening we've done is for those teenagers.
Speaker 2: You know that they're not comfortable we're talking to parents.
Speaker 2: They haven't got the opportunity and really for them to
Speaker 2: have a chance to be heard, because they do want
Speaker 2: to be heard. We've done this test on many children
Speaker 2: and they really do tell the truth and they want
Speaker 2: to be heard and they want support, they just don't
Speaker 2: know where to find it. Unfortunately.
Speaker 1: We're talking at screening mental health screening for teens. My
Speaker 1: guess this evening is doctor Lisa Street and she's a
Speaker 1: pediatrician and co founder of Judah Zree double one double
Speaker 1: A three seven two. We want to hear from you
Speaker 1: if you have teens that you think might require some screening,
Speaker 1: and actually says it's a difficult one, right because teenagers
Speaker 1: are so difficult to figure out and just decipher. You know,
Speaker 1: they are emotional, they can be moody, So get in
Speaker 1: touch with us. She's here to take some of your
Speaker 1: questions around the screening of what it looks like and
Speaker 1: we're and how you can go about getting screening for
Speaker 1: your teens. Doctor, maybe let's just start with what the
Speaker 1: typical mental health screening involves.
Speaker 2: So what we've decided to do is we try to
Speaker 2: create an environment within the school environment to do the
Speaker 2: screenings and therefore we can do it in a large
Speaker 2: scale and when the kids are all at school and
Speaker 2: comfortable in a normal lesson where we give them it's
Speaker 2: a test. It's paper based. We didn't want to use
Speaker 2: a digital format, even though we'd be much easier for
Speaker 2: data capturing and forgetting results. We decided for the anonymity
Speaker 2: of it and for the comfort of what children are
Speaker 2: used to with writing tests. We do a pepper based
Speaker 2: screening test, and we've used tools that are validated that
Speaker 2: are well known. The tools that we've used are specifically
Speaker 2: in teenage language, so to speak. It's not an adult
Speaker 2: test that we're now giving to teenagers. It's specifically from
Speaker 2: the ages of twelve to eighteen, and in that test
Speaker 2: that are answer a number of questions. The first tool,
Speaker 2: there are about twenty five questions, and in that we
Speaker 2: can determine whether their signs of anxiety or depression. They
Speaker 2: can't score that themselves in the test. We need to
Speaker 2: take that test into our offices and we get it
Speaker 2: professionally scored, and then based on those scores, we can
Speaker 2: get feedback back to the school to give them an
Speaker 2: overview of what's going on in their school. The screen
Speaker 2: really the goal of it wasn't so much to diagnose,
Speaker 2: like I say, your child has anxiety or your child
Speaker 2: has depression, and to make them feel they've been singled
Speaker 2: out and identified amongst a group of peers. It was
Speaker 2: rather for us to go back to the schools and
Speaker 2: to say, this is what's going on in your school.
Speaker 2: We've got a school of a thousand kids from grade
Speaker 2: eight to twelve. Your grade eights are struggling with this,
Speaker 2: or your grade twelves are striving with depression, whatever it
Speaker 2: may be. So that they can within the school and
Speaker 2: target strategies specifically to that year or that class to
Speaker 2: facilitate the conversation and to make sure that they are
Speaker 2: helping these students to get help and to know where
Speaker 2: they can get help. So we're facilitating this at scale
Speaker 2: within the school's environment. We're not doing screenings one on
Speaker 2: one in the doctor's rooms. When you're going into the
Speaker 2: doctor's room or the psychologist psychiatrists, that will be more
Speaker 2: of a diagnostic test because that's one on one personalized attention.
Speaker 2: The screening we're doing is really to say, to give
Speaker 2: the school an opportunity to really understand what is happening
Speaker 2: in the mental health of the students attending their school.
Speaker 2: The second part of it is we have a high
Speaker 2: risk identification. So, like I said, it's anonymous. However, there
Speaker 2: is an opportunity for kids who are suicidal and our
Speaker 2: higher risk to identify themselves and say I need help,
Speaker 2: help me. This is my name, this is my number,
Speaker 2: this is my mom's name. Because then what we have done,
Speaker 2: we're working with SADAC, which is a South African anxiety
Speaker 2: and depression group, and we will then be able to
Speaker 2: call those children and give them the countany and the
Speaker 2: support that they need. And then if they are hirisk
Speaker 2: and need to be admitted into a facility, we can
Speaker 2: then facilitate that happening so that they are not left
Speaker 2: on their own and something bad can happen. And then
Speaker 2: the final part of the assessment is social media, and
Speaker 2: we've touched it. What's notice about the social media assessment
Speaker 2: is that they can self school, so they can do
Speaker 2: the test of social media and they can then see
Speaker 2: what is their social media doing to them? How is
Speaker 2: it affecting? Do you have healthy habits or are your
Speaker 2: habits actually unhealthy intoxic? And you need to slow down
Speaker 2: a little bit. And that's a great tool for them
Speaker 2: to be able to self engage and reflect on.
Speaker 1: Yeah, so what happens after the screening.
Speaker 2: Then, so after the screening, we collect everything, we collect
Speaker 2: all the tests. We immediately check new high risk. We
Speaker 2: identify those students and we individually, individually go in and
Speaker 2: tell the school who these kids are so that they're
Speaker 2: not exposed. It's very private and confidential. We then get
Speaker 2: those children that are high risk help the rest of
Speaker 2: the kids. Then we will then intervene from a group
Speaker 2: counseling and we work with the psychologists or the social
Speaker 2: workers based in the school to facilitate strategies to help
Speaker 2: these kids cope.
Speaker 1: And I mean, you know, we spoke about how kids
Speaker 1: are just so difficult to figure out, but what are
Speaker 1: some of the primary causes of mental health challenges among teens?
Speaker 2: So you know, there's different causes, you know, a lot
Speaker 2: of the lot. Unfortunately, I'm saying it over and over.
Speaker 2: The social media has become a big red flag in
Speaker 2: our teens. But there can be disruptions at home, they
Speaker 2: can be you know, problems within the family unit at home,
Speaker 2: and bullying is another very big cause. Unfortunately, the bullying
Speaker 2: is often linked to social media. So that's why we
Speaker 2: flag the social media because the bullying doesn't just stay
Speaker 2: at school, it follows them on the devices. When they
Speaker 2: go home and they never seem to be able to
Speaker 2: escape it. So and then obviously if there is any
Speaker 2: substance abuse or thing like that that can trigger some
Speaker 2: sort of mental health issue like depression or a psychosis,
Speaker 2: et cetera. So they multiple causes, but it depends on
Speaker 2: the children. And like we say, the big bad one
Speaker 2: at the moment is social media and bullying and.
Speaker 1: A lot of some of the symptoms that parents should
Speaker 1: absolutely not ignore among their children because you know, with
Speaker 1: the moodiness and sometimes the emotion, you know, you can say,
Speaker 1: are they being teens?
Speaker 2: But what should you not ignore? You know, if they
Speaker 2: are not able to eat and they're refusing to eat,
Speaker 2: and they are not able to sleep, and if they
Speaker 2: are completely withdrawn and noncommunicative at all and more so
Speaker 2: than normal, you know, your parents really feel that they've
Speaker 2: been shut out of their lives. They must start really
Speaker 2: intervening and getting someone to help communicate with their child,
Speaker 2: to say, what is going on? Why you so distance?
Speaker 2: What is why are you're not eating? You know, those
Speaker 2: are simple funds that show you, okay, these there's there's
Speaker 2: lack of will. These kids don't have no will to
Speaker 2: do anything. They don't want to go to school, they
Speaker 2: don't want to do their work, they don't want to
Speaker 2: be with their friends. They withdraw quite a lot to
Speaker 2: be with themselves. And because they feelings are sad and
Speaker 2: so lonely, those parents, let's just keep an out. They're
Speaker 2: not interested in interacting with their friends as per normal.
Speaker 2: There's a red flag to get some help.
Speaker 1: And I mean just for a bit of a step
Speaker 1: by step guide for parents. So if they if they
Speaker 1: see these symptoms, where do they go? What's what do
Speaker 1: they do?
Speaker 2: So what is great is that you can actually contact
Speaker 2: SATAK there's South African anxidity depression group that do have
Speaker 2: a helpline and the parents can counterct them and say
Speaker 2: where they what the area that they live in is
Speaker 2: and they can then direct you to your closest facility
Speaker 2: based on what the symptoms are. So SADAK will follow.
Speaker 2: They have trained comes within the services that will determine
Speaker 2: what is the risk. Here are we dealing with a
Speaker 2: child that is at high risk that needs intervention immediately
Speaker 2: and needs an ambulance to go and fetch them and
Speaker 2: bring them into a hospital. They can arrange exactly that.
Speaker 2: They have very strict protocol. They know how to do that.
Speaker 2: If it is a parent that just needs counseling and
Speaker 2: support to be able to facilitate their child, they will
Speaker 2: then be able to give in that ongoing they do
Speaker 2: two or three sessions, they can do then telephonically, they
Speaker 2: can do them on zoom and they can then decide, okay,
Speaker 2: well we've done a couple of sessions, but now we
Speaker 2: actually need to go and see a psychologist or psychiatrist
Speaker 2: and get the further diagnosis and treatment. So the actual
Speaker 2: councilors in Sadak are incredible and they're doing an amazing
Speaker 2: job and their work in South Africa is really being
Speaker 2: it's fantastic, and so they are the best people to
Speaker 2: call for parents that are worried and they think something's
Speaker 2: going on, and they can really they'll go through all
Speaker 2: the step by step question and then their protocol and
Speaker 2: decide what kind of interventions are needed or counseling and
Speaker 2: direct the parents accordingly.
Speaker 1: And you know, I know you spoke about doing the
Speaker 1: screening at schools, but you know, unfortunately we live in
Speaker 1: South Africa and inequality is the reality. I mean, how
Speaker 1: how widespread or how how how how yeah, I mean,
Speaker 1: is it available at most schools. Is this the reality
Speaker 1: that most schools have.
Speaker 2: So what's so interesting is we did the first screening
Speaker 2: when we did it last year. Initially we were working
Speaker 2: at a in a in a township that was getting
Speaker 2: free screenings for ours is and dental and because the
Speaker 2: children we were screening we're an older age group, we thought,
Speaker 2: let's slip in a mental health assessment as well, and
Speaker 2: so we got consent for doing all the different types
Speaker 2: of screening and we did this mental health assessment and
Speaker 2: we were it was opening to see the results and
Speaker 2: we thought, Okay, now we've got a clear problem. Yeah,
Speaker 2: what are we going to do? And so we made
Speaker 2: sure we created a full, clear pathway for all those
Speaker 2: teenagers to get help. The school where we did it
Speaker 2: was incredible. They've now got ongoing counseling. These kids are
Speaker 2: all getting support and surina can be done. There are
Speaker 2: facilities available for these kids to get help. So, as
Speaker 2: we've now obviously grown and we've realized this needs to
Speaker 2: be a more widespread intervention, we're targeting both the private
Speaker 2: and the public schools. It's not one not the other.
Speaker 2: And what is impressive is that our public schools the
Speaker 2: principles are extremely involved and are caring and they know
Speaker 2: that there is a problem. They see it with their
Speaker 2: social workers are inundated with children. It's going into their
Speaker 2: office and requiring help. And so they have really they
Speaker 2: have found budget within their school to make sure that
Speaker 2: they can cover the minimum costs. You know, it's really
Speaker 2: not a big cost, but it's just to be able
Speaker 2: to make sure that these kids have all the helpline
Speaker 2: available to them. The ongoing counseling and think and the
Speaker 2: schools that have been quite incredible with coming on board
Speaker 2: and intervening for these kids.
Speaker 1: And I suppose this is something that's you know, many
Speaker 1: might be wondering what exactly are the questions that are
Speaker 1: asked as you do the screening.
Speaker 2: So I'm not there. Like I said, the first test
Speaker 2: is quite comprehensive. It's twenty five different types of questions,
Speaker 2: and it will be things like that you're feeling It's
Speaker 2: been spoken in very much inappropriate teenage language, and it'll
Speaker 2: be like, are you feeling sad or empty inside? Are
Speaker 2: you worrying when you think that you've got something poorly?
Speaker 2: Do you feel afraid when you've been at home on
Speaker 2: your own? Things like that. So there's very specific questions
Speaker 2: that they can answer and they can say it's never,
Speaker 2: it's sometimes, it's often always, and it's a validated tool
Speaker 2: that then we can score at the end of the
Speaker 2: twenty five questions and it will point to what we're
Speaker 2: dealing with with these kids.
Speaker 1: Doctor Eliza, maybe just tell us where we can find you.
Speaker 1: If parents are looking for you, how can they get in.
Speaker 2: Touch perfect they can email us at schools at a
Speaker 2: judo dot dotza. We can bring the mental health screen
Speaker 2: to their school and make sure that it's been implemented
Speaker 2: and all the supports, you know. Just to note it's
Speaker 2: not only about the day of the screening, it's more
Speaker 2: the support thereafter that is so important with these children.
Speaker 2: It's one thing to say there's a problem, but it's
Speaker 2: really the most critical thing is to intervene thereafter. So yes,
Speaker 2: So if you just