NEW YORK, N.Y. - Chiara de Blasio helped get her dad elected mayor, flaunting quirky head gear and joking from the podium on primary night. But on Christmas Eve, the 19-year-old did something else: She bared her soul on YouTube about her history of depression and substance abuse.
The idea, she said, was to urge others to get help. Fiercely protective of her privacy while allowing her front and centre on the campaign trail, her parents released a statement of support when the surprise video dropped.
While the timing was questioned — the four-minute video from her father's transition team was released when many were distracted by the holidays — advocates for Chiara's generation of digital natives lauded her speaking out publicly as the act of a brave young woman.
Brave, yes, but foolhardy, perhaps, for other teens who don't have access to slick political handlers and, unlike Chiara, still face the perilous and competitive college admissions process. She already attends in California.
Handled or not, today's teens are notorious over-sharers on social media, but does Chiara's revelation symbolize something else as mental health advocates work to destigmatize the shame and silent suffering of those afflicted? What of other young people so inspired to publicly disclose their depression, drinking and drugging, eating disorders or struggles against suicidal thoughts?
"I think in general that it's healing for people to be honest. I also think in the admissions context that it's very challenging and problematic. I would advise a child to go very, very gingerly," said Carol Barash, founder and CEO of Story to College, a Manhattan-based non-profit that has worked with thousands of students from diverse backgrounds on how to shape personal narratives for college essays and scholarships.
"There's a difference between telling your friends and the whole world," she added. "Most kids don't have a PR team to help them through what could happen, all the fallout from doing that brave, courageous thing."
From 13 to 20 per cent of young people in the U.S. age 3 to 17 experience a broad range of mental disorders in a given year, and prevalence appears to be increasing, according to a recent report from the Centers for Disease Control and Prevention, which looked at data over multiple years from multiple sources.
Suicide, for youth ages 12 to 17, was the second leading cause of death in 2010, the report said.
"We are seeing more public disclosure," said Cheryl Rode, senior clinical director for the non-profit San Diego Center for Children, which is under contract to provide services through San Diego County.
"Some of it is because of the movement of social media but some of it is also within the field of mental health. There's a large focus on stigma reduction," she said. "Many teens feel like they're the only ones experiencing whatever it is they're going through, and so when others are speaking up, it makes it a little bit safer. Talking about mental health is really important."
But talking to whom? That, she said, is a "very individual and person decision" that should definitely include parents.
"Most kids, when they're sharing, are sharing more impulsively," Rode said. "I would not say parents should encourage publicizing to a mass audience their youth's mental health status. You lose control of it. Disclosing in a more limited personal way is a better way of building support."
More young people suffering both mental health and serious physical health conditions are enthusiastic in recovery and treatment about sharing their stories to help others, she said.
"I think adolescents often see themselves as very altruistic, whether it's giving advice to another kid in a group kind of setting or being the example, the role model. That's often a very healing process for kids," Rode said.
But they still require adult guidance on exactly how to get that done. It could be a therapist, guidance counsellor or parent, or all three.
"They're still adolescents. They don't think about the future," Rode said. "They're very in the present. It's what sounds good now, and social media sounds good right now, but once you've put it out there and if you have a change of heart, it's hard to take it back."
While trying to lessen stigma over mental health diagnoses and substance abuse, Los Angeles child and adolescent psychiatrist Anandhi Narasimhan cautions that public disclosure remains risky for young people, especially when "coming out" at school or in the college admissions process.
"It depends on the admissions committee and who reads the essay. You just don't know," she said.
Family therapist Rick Meeves in Salt Lake City oversees a network of teen treatment centres for CRC Health Group and has worked with adolescents for 20 years. While he, too, considers Chiara's disclosure a positive, he also thinks other teens should tread lightly.
"It's heroic, it's pioneering and it's laudable, but I don't think we're quite there yet as a society of being able to say, 'Hey look, I suffer from depression and I manage it. I would like to think that we're almost there but I'm not sure we are."
In Chiara's case, rumours that she had battled drug issues were rampant during the mayoral campaign, but she and her brother were off-limits to reporters and the campaign refused the media's questions on the subject. In the video, she said outpatient treatment got her through, but no media outlet published a story before the video surfaced at a traditionally dead period in the news cycle.
Psychiatrist Joseph Shrand in Brockton, Mass., works with children and adolescents on issues relating to addiction, bullying and at-risk behaviours. He believes timing is everything when it comes to disclosure.
"General, public disclosure should only happen when the patient is ready," he said. "Premature disclosure can make a person more depressed, or result in increased substance use due to shame and embarrassment."
The problem could boil down to a young person feeling ready when he or she really isn't.
The comment function below Chiara's YouTube was disabled, so routinely vicious, anonymous feedback on the site was limited. The video received nearly 100,000 views in about two weeks. Tim Jordan, a St. Louis developmental and behavioural pediatrician specializing in teen girls, was among those who took a look.
"My guess is that being of service to others in need is a critical part of her healing and recovery," he said. "Instead of being stuck in shame, regret and blame, she is focusing her intention and energies on being valuable to others. A younger person would probably not have the maturity and sense of security to be able to handle the backlash from such an admission."
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