Nurse Practitioners Discussing the Changing Landscape of Adolescent Health
Two nurse practitioner experts invite you into their conversation about holistically understanding and treating young patients.
This Mental Health Awareness Month, join NPs Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP, FAAN, and Ashley Hodges, PhD, CRNP, WHNP-BC, PMHNP-BC, FAANP, FAAN, on NP Pulse: The Voice of the Nurse Practitioner®, where they take no shortcuts in plotting out the many challenges that young people are experiencing today — both mentally and physically. The first episode in the four-part podcast series was released on Feb. 5, the latest on May 7, and two more in the series on suicide and “the sexualization of a generation” are scheduled for release on Aug. 6 and Nov. 5, respectively.
On the podcast, Peck and Hodges speak about subjects that can be difficult for adolescents to broach with their families, and even with health care providers. Both NPs stress understanding and communication when it comes to tough topics, giving listeners an evidence-based tour of adolescent development and providing advice for caregivers of all kinds to help them understand and relate to a generation coming of age.
Tough Topics and Hard Conversations
Any NP or caregiver working with teens — or who remembers what it was like to be one — knows that being taken seriously and feeling heard is extremely important to young people. While it is important to validate the experiences of adolescents, it is also true that they have not finished developing physically or mentally in ways that will soon change as they reach adulthood. Teens often engage in risk-taking behaviors “because of their brain,” states Peck. “We have to remember the basics of brain development. Their amygdala develops first. It matures first, and those are their emotionally driven responses. They’re more sensitive to emotional stimuli, it makes them impulsive — all of those stereotypical behaviors that we see in teenagers […] the prefrontal cortex comes second, and that’s where their decision-making comes in — their impulse control — and that is not usually until later in the teen years. Sometimes we are just expecting them to do something that they may be physiologically limited in what they’re able to do.”
Parents and caregivers are encouraged to discuss these facts with teens in a supportive way. While teens may misinterpret these conversations as questioning their intelligence, the intent is to differentiate between intellectual maturity (which teens often have) and the still-developing areas of executive functioning. One result of this continued development is that in early stages, adolescents are more prone to act impulsively than adults. As such, it’s more important than ever during these crucial years to talk to young people about making healthy and safe decisions around issues important to them, especially regarding subjects that tend to make everyone a little uncomfortable.
After Hodges speaks about teen sexuality, Peck notes that “as you’re talking, I’m hearing you use words that I know make parents squirm. There is nothing that makes parents more uncomfortable than when we start talking about their child’s sexuality, which is just a biological fact of life. And I think that’s a strength that NPs can come in and just kind of normalize those conversations.” Peck stresses the need to normalize these talks, noting that many teens are already exposed to mature content via technology. It's better for them to receive accurate, age-appropriate information from trusted adults rather than misleading or harmful content elsewhere.
The Current Adolescent Mental Health Crisis
Why is it so important for adolescents to have a trusted adult to speak with about their greatest concerns and fears? The truth is that young people are experiencing a mental health crisis in the U.S. On the second episode in their series, Peck is blunt about the state of mental health for adolescents. “Everywhere I go, people ask me: ‘Is it really as bad as people say it is? Is it really a crisis?’ And you know, Ashley, as a nurse — as the most trusted profession — it’s important to me to be trustworthy and honest in my answer. And I tell them, ‘No, it’s not as bad as people are saying it is, it’s worse. It is infinitely worse.’”
Hodges agrees, and notes that in addition to the assorted troubles that adolescents have always experienced, today they also have to deal with “social media, mass violence, political polarization. And to the young person, this can seem insurmountable.” Add in the pandemic, and you have adolescents experiencing a combined and completely unique set of stressors that can lead to anxiety and depression.
Parents often struggle to tell the difference between typical teen behavior and more serious mental health issues. Hodges advises against parents trying to handle these concerns alone. Instead, they should involve health care professionals early, whether it’s for basic screening or more advanced care. Peck also believes that it’s important for parents to know that if their child is experiencing symptoms of depression, it is necessary to act as soon as possible. “Depression is actually the fourth leading cause of disability among adolescents. It is severely crippling when you have symptoms that are untreated,” she says. Both NPs suggest early screening, and in particular, Hodges recommends utilizing a PHQ-9, which is particularly useful as it identifies symptoms of depression and assesses suicide risk. Finally, dealing with the adolescent health care crisis can feel overwhelming, but NPs have resources. The most important one may be one another: “Make sure you network, because that is how you're going to really learn the best,” says Hodges.
Resources for NPs Working in Pediatrics and Mental Health
AANP offers many resources related to psych and mental health, and communities dedicated to both that specialty and pediatrics. For more educational opportunities, NPs who attend the 2025 AANP National Conference in San Diego, California, have the option of attending many sessions and workshops concerned with adolescent health, including “Adolescent Anxiety: How and When to Treat,” “Adolescent High Risk Sexual Behaviors” and “Sleep Hygiene for Treating Adolescent Depression.”