Risk behaviors in adolescents

Michigan has approved new guidelines to help health care providers address risk behaviors in adolescents.

Experts say the problem is more prevalent that most people realize.

According to the Center for Disease Control and Prevention (CDC), in nearly three out of every four teens that were seriously injured or killed, high risk behaviors were the primary cause.

In many instances, it’s likely that those risk behaviors could have been noticed and addressed with better screening for physical, emotional, and social health risk factors, Michigan Department of Community Health officials say.

Data from the national Rapid Assessment for Adolescent Preventive Services (RAAPS) survey completed by 20,000 youth in school-based health centers across Michigan indicates a significant and rising new set of risks facing teens today that reinforces the need for behavioral health risk screening as part of assessing total health risk factors.

“We have done a great job in Michigan teaching parents, teachers, and youth role models to look for the usual risk factors of drugs, alcohol, pregnancy and STD prevention, but we need to begin paying closer attention to these much more common risks,” said James K. Haveman, Director of the Michigan Department of Community Health.

“Preventing the deaths of children and youth due to violence has become a national priority, and here in Michigan, we have taken notice,” Haveman said in a statement.

The Michigan Rapid Assessment for Adolescent Preventive Services data shows:

– More than one quarter of teens surveyed 28 percent say they have trouble managing anger and admit to doing things that get them “in trouble” when they are angry.

– Twenty-four percent of teens reported depression, responding that they have feelings of sadness or that they have nothing to look forward to.

– Bullying continues to rise in prevalence, with more than 16 percent of teens surveyed reporting they have been threatened, teased or made to feel afraid.

All of these mental health issues affected a higher percentage of middle and high school youth than the risks more commonly associated with teen populations.

Illicit drug and alcohol use was reported by 13 percent of total respondents, with 19 percent reported by high school-aged youth.

“The real value of a standardized approach to risk assessment with teens is the ability to uncover these hidden dangers that they aren’t likely to bring up – and we, as adults, might not even think to ask, and to provide the counseling and resources necessary to make a positive change to prevent future tragedies,” said Dr. Jennifer Salerno, Adolescent & School Health Consultant at the Michigan Department of Community Health.

The Michigan Department of Community Health and Michigan Quality Improvement Consortium worked collaboratively with a group of practitioners and adolescent health experts to develop recommendations for assessing risk behaviors which most impact adolescent health.

These recommendations have been compiled into the Adolescent Health Risk Behavior Assessment Clinical Practice Guideline, for health care providers to identify the riskiest behaviors, along with counseling strategies shown to be most effective in helping teens change their behavior.

This guideline recommends that adolescents should have an assessment of health risk behaviors at least once annually, and in any health care setting they present for care using a validated screening tool.

This ensures the questions being asked include all behaviors, especially those that could cause the most harm to teens, and provides consistency among health professionals.

Research has shown that teens are more honest in disclosing risky behaviors when answering a survey, preferably electronic, versus being asked verbally about their behaviors.

Parents, family members, schools, community organizations, and health care providers can play a key role as supportive adults who encourage teens in making better choices, identifying future goals and creating positive connections to the school and community.