Frustration over a fight with a parent. Getting bullied by peers. Struggles with body image. Thousands of teenagers contact mental health hotlines about a range of struggles, from failing a school exam to more high-acuity calls; as recently as 2023, teen-specific hotlines like YouthLine reported receiving around 25,000 contacts per year.

I’ve been working for over a year at a similar hotline, Teen Link, a Washington-based national peer-to-peer phone line that provides emotional support and crisis intervention to teens. It became more and more apparent through my time on the phone line that there was a pattern to what these teens were feeling, no matter the situation. Teens who called echoed similar sentiments of loneliness, isolation, and hopelessness, and all felt like there was no one there to support them. 

I wanted to see if this was something only I had noticed or if it was a common observation. I reached out to several long-time Teen Link adult supervisors and phone line workers for their opinion on the current teen mental health landscape. Collectively, we have nearly 10 years of experience at Teen Link, or close to 1,000 hours listening to hundreds of teens across the nation. Additionally, I reached out to a few high school students to get their opinions as well.

When asked what it is that teens want regarding mental health support, we all came to the same three conclusions. 

Validation of Emotions and Reassurance of “You’re Not Alone”

Among those I interviewed, isolation was the most prevalent emotion that got brought up, frequently paired with a lack of trust in adults.

In early childhood, parents and guardians are usually a child’s first line of defense when it comes to finding emotional support. In the teen years, generational and cultural differences can cause teens to distance themselves as they seek independence. Now on their own, many teens feel like they’re thrust into a wider, open world without the tools required to navigate through it. 

Additionally, hormonal and neurological changes in teens make teens more reactive to external stressors, such as a parents’ stray comment. The prefrontal cortex of teenagers isn’t fully developed either, making them more prone to reckless behavior and emotional outbursts. All these factors combined explain slip more easily into these feelings of isolation, even with a perceived strong support system.

Because of these higher risk factors, teens need more emotional support than we might think. As Kayanne, a Teen Link phone worker puts it, “The thing to be learned from the fact that teenagers’ brains haven't fully developed yet is more that you should approach it with empathy and less of ‘this is silly’ and ‘they'll learn it better later.’”

It might sound cliche, but the words “you’re not alone” can be extremely powerful to a teen who’s struggling. Long-time Teen Link volunteer coordinator Zanny explains that it’s important for teens to hear this: “It probably feels like you have the weight of the whole world on your shoulders right now, but you don't have to face that alone. It doesn't have to be like this all the time. There are people out there who care about you and want to help.”

Takeaway: As the first line of defense, it is crucial for parents and guardians to listen to their teens and not be afraid to have judgment- free conversations. Active listening skills and reassurances are a few ways parents can go about this; phrases like “I hear you say…” or parts of Zanny’s comments are a few examples.

Anonymous, peer-to-peer affordable services

Traditionally, the second line of defense for teens’ emotional challenges would fall to a school counselor or an outside therapist. 

It’s well known that accessibility to school counselors is a widespread issue exacerbated by a lack of funding. The Washington Post reported that schools need around 140,000 total more mental health professionals to achieve recommended levels of help nationwide.

Dennis, a student representative on his school district’s board of directors, spoke extensively about this issue. Oftentimes, Dennis says, schools will have a severe lack of trained mental health professionals or will have to rely on existing, untrained staff to be mental health counselors instead. Lack of funding also mainly affects low-income student districts, which typically comprise of majority students of color — students who are statistically at a higher risk for mental health struggles to begin with.

On the other hand, finding a good therapist that matches is difficult. Therapists are costly, especially if long-term therapy is needed. Most importantly, when it comes to the time when a teen needs to talk to a therapist, the issue of long wait lines often arises, which can be problematic for high-acuity cases. 

The difficulty not only lies in accessibility, but also that it’s not easy for teens to open up to their parents to ask for a therapist. Lingering stigma around mental health further makes it harder for teens to admit they need help. For teens to first open up, it’s often more comfortable for them to reach out anonymously.

The teens and adult supervisors I spoke to all agreed that Teen Link’s success lies in the fact that it’s an affordable, anonymous service that allows teens to talk to other teens. Chloe, a Teen Link phone worker, explains that Teen Link offers a safe space to open up without the fear of judgment. Teen Link also lets teens get support from other teens, who better understand the emotions chatters/callers are going through. 

Takeaway: Following the success model of Teen Link, a website or app that provides a similar anonymous, peer-to-peer youth mental health support system is what’s needed to break the perceived barrier of seeking help. 

Preventative, research-based education 

Many widely-accepted mental health measures are reactive and late-stage focused as opposed to preventative. Especially on the school end--educators are worried about addressing the symptoms and implementing crisis intervention rather than creating a broad mental health curriculum that addresses root causes. 

Beyond the first and second line of defense, there’s been an overlooked ground zero: educating teens themselves. 

Takeaway: If teens can learn world history and calculus, they can learn basic cognitive science and well-being knowledge such as active listening skills, cognitive distortions, basic brain development, how to better manage their emotions, how to regulate their parasympathetic system for better stress response, and so on. The knowledge is out there in psychology textbooks, but it hasn’t been spread to teens in a teen-friendly format yet. 

What teens NEED

As Zanny puts it, “loneliness and isolation can exacerbate so many other mental health issues and even just everyday stresses.” 

Calling on all mental health professionals, parents, entrepreneurs, educators, legislators, and fellow teens: 

We need to give teens better education on cognitive science and psychology and find some sort of anonymous, accessible service to validate the loneliness that hundreds of teens are facing today. 

Whether it’s through a curriculum, website, app, club at school, or program -- We can’t stop teenagers from going through tough experiences, but we can prepare and support them better. Teens don’t have to face this alone.