- [Michelle] Tonight, Rhode Island's young people are in a mental health crisis.

Why some are faring worse than others.

- Feel really tense all the time.

And you feel like everything is gonna, like, happen, like, everything wrong is gonna happen to you.

- [Pamela] Then, the troubling number of Americans who feel alone.

- Loneliness is just as deadly as smoking an entire pack of cigarettes a day.

- [Michelle] And teens, social media, and tragedy.

- It's like, still I can't believe it.

I feel like it's not real.

(bright music) (bright music continues) - Good evening, and welcome to "Rhode Island PBS Weekly."

I'm Michelle San Miguel.

- And I'm Pamela Watts.

Tonight, a special edition.

We're reporting on youth and mental health issues.

- During the month of May, Rhode Island PBS and The Public's Radio will have coverage across our programming.

Our aim, to make critical information more accessible and raise awareness among our audience.

All of our segments tonight were generously underwritten by a grant from Blue Cross Blue Shield of Rhode Island.

We begin with a story about why many youth around the country and here in Rhode Island are feeling lost.

Students are opening up about their mental health struggles, and we're also hearing from area professionals about what needs to be done to help those who are in the midst of a crisis.

- The whole pandemic kind of made my academic skills go down, and I felt, like, really lost in a sense.

I didn't really know how to socialize again.

- [Michelle] 17-year-old Arianna Bouzi is a high school senior in Providence.

She says her mental health was in a dark place last year.

- When I went to the school, I had, like, really bad anxiety.

I did open up to people in sophomore year, but then it went down again during junior year.

I started not going to school.

- You would skip school because you were feeling anxious?

- Yeah, I would skip school, it was like a whole, like, cycle.

So, like, I would not go to school, then feel bad for not going to school.

- Bouzi says she missed about half of her junior year because of her mental health.

She believes most of it had to do with struggling to socialize after learning remotely during the pandemic.

On the worst of days, what was that anxiety feeling like in your body?

- It's like your body is, like, all, like, tense.

Like, you feel really tense all the time.

And you feel like everything is gonna, like, happen, like, everything wrong is gonna happen to you, so you don't wanna step outside.

- [Michelle] Bouzi's experience is shared by many others.

A report by Rhode Island KIDS COUNT found young people are in a mental health crisis both nationally and in Rhode Island.

- We had seen increased rates of anxiety and depression prior to the pandemic, but then when the pandemic hit and young people were at home or away from their peers, were not able to be learning in school, it got worse.

- [Michelle] Stephanie Geller is the deputy director at Rhode Island KIDS COUNT.

She wrote the report, which describes how mental health issues are at higher rates among Black, Indigenous, and other people of color and lesbian, gay, bisexual, transgender, and queer youth.

- One of the things that they talk about is racism that they experience in their community, racism they experience online.

Members of the LGBTQ+ community talk about lack of acceptance and isolation in their own families when their parents don't accept them as well as how they feel in their schools and community and the way that they're received or what they see online in terms of negative comments about their identities.

- [Michelle] Geller analyzed data collected from the Youth Risk Behavior Survey, which is distributed to high school students nationwide every two years.

It found that in 2023, 9% of Rhode Island high school students reported attempting suicide one or more times during the past year.

Black and Hispanic or Latino teens consistently have higher rates of suicide attempts than White teens.

- I think that it really shows the struggles that young people are facing, the lack of confidence in themselves, the lack of acceptance they're feeling, the lack of support they're feeling.

And this anxiety and depression that we are seeing is translating, unfortunately, to action.

- It's terrifying to, like, think about the average experience of young people.

- Marco Lima is a sophomore at Brown University.

He helped lead focus groups with high school students from two youth development organizations, Young Voices and Youth Pride Inc. Those experiences were included in the Rhode Island KIDS COUNT report to help understand the issues facing young people in the state.

What was the most difficult thing that you heard a student share?

- Having those feelings that you know something's wrong, and then you can't really go to anyone about them, or at least not a professional about them.

And I think another one was just the not accepting, or their family didn't accept them fully for their queer identity.

- [Michelle] Lima describes himself as a gay man who's Latino and Indigenous.

He remembers how difficult it was to watch the news during the pandemic.

- Seeing how much police violence was out there and, like, the negative comments around queer people but then also people of color.

And at this point, I wasn't really out to my family, so it was all, like, an internal battle where I'm just, like, fighting these causes and, like, explaining to my family why it's important.

- [Michelle] Lima recalls feeling anxious and depressed during the pandemic but says he did not seek professional help.

- I didn't mostly because I didn't know where to go.

At this time, like, our insurance wasn't the best either.

So it was really a challenge, 'cause when I would talk to my mom about it, she would just say the truth, of like, "We don't have the money for that."

And then in my school, I just didn't know where to get that help.

And once again, we're on Zoom, so there's no office to go to.

- [Michelle] Julio Sabater is a licensed clinical psychologist in Pawtucket.

He's not surprised that young people in marginalized communities are reporting higher rates of mental health issues.

- You already have PTSD, you have trauma, and then you have your networks are maybe small, right?

You don't have a lot of connections.

And then when the pandemic hit, again, that intensified it, - [Michelle] But Sabater and Geller say the situation is not hopeless.

One of the solutions Geller writes about in the report is the need for funding to increase the number of mental health professionals in schools.

- When we talk to young people about any policy they want to see passed, this is their number one ask.

They've been working, a number of the organizations have been involved in a campaign called Counselors Not Cops, which is around trying to get school resource officer out of school and use that funding to replace them with mental health providers.

- Another recommendation, recruit and retain more diverse mental health providers.

Do you hear from people who seek you out specifically because you are a Latino man and they want someone who speaks their language, who looks like them, reminds them of a relative they have?

- Yes, absolutely, all the time.

It's about connection.

But particularly for our people, the Latinos and the BIPOC community, it's been proven that that's what helps in therapy.

One of the top indicators that therapy works and is successful is because you have someone in front of you that you could tell them, it's like you don't have to explain two or three times, you know, 'cause we get it.

- [Michelle] Arianna Bouzi, who identifies as bisexual and Haitian, says she once tried to get help at school when she was having a panic attack.

When she went looking for a guidance counselor, she was told there was no counselor available and felt dismissed by an administrator who told her to go back to class.

- Once I'm 18, I am gonna go get a therapist, talk to a therapist, like, routinely, but right now I can't 'cause obviously my parents have to do it.

- [Michelle] She says her mother is not supportive of her going to therapy.

- She thinks I have to talk to her.

When I talk to her, she just, like, blows up on me and she doesn't really get, like, how I'm feeling.

So that's why I really wanna talk to a therapist, but she doesn't really support that.

- [Michelle] As for Lima, he says his mental health has improved and he's better able to manage his emotions.

- If I'm having a bad week and everything's going wrong, I'll sit with myself and, like, really kind of go through each problem I'm having and try to unpack it a little bit and just, like, really work through why I'm feeling the ways I do with that problem.

- [Michelle] Both Lima and Bouzi credit afterschool programs like Young Voices with having a positive effect on their emotional wellbeing.

- I've surrounded myself with, like, people like me.

I have way more, like, support.

Like, I could go to anybody, talk about anything, and I just really love it here.

- [Michelle] Lima says it's important that young people ask for help when they need it, even if that help comes from outside of their family.

- Once again, like, you're not alone in this.

So many youth are going through this, and we're just all not willing to share, but we should be.

- And now a story about the ever-growing sense of loneliness that many young people in Rhode Island and around the country are experiencing.

It's a feeling we all have from time to time, but new research has found it's more widespread than many previously realized.

And an October Gallup poll found one in five Americans said they experience loneliness for much of their day.

Producer Isabella Jibilian explores how this problem and potential solutions are taking shape here in the Ocean State.

- I was, like, so nervous to go.

- [Isabella] At 17, Tabitha Grandolfo moved from Hong Kong to Providence, Rhode Island, to study at Brown University.

- It was 2021, and the COVID restrictions meant that if I wanted to go home, I would have to spend three weeks in a hotel in quarantine before I was able to, like, go back and see my family.

- [Isabella] Living far from home, she began feeling depressed and lonely, and she was having trouble making friends.

- I was in a play.

And I was really excited, it was my first, like, play that I did on campus.

A roommate and a friend came to see it, and I came back after the show and, like, they didn't talk about it at all.

And then the two of them went to some, like, party or after party and left me in the dorm alone.

I was just sitting there in my room alone, folding laundry.

- [Isabella] By the time she returned to Hong Kong at the end of freshman year, her depression had become overwhelming.

- I remember, like, not being able to get out of bed, and my mom was like, "Do you think you can go back?"

- [Isabella] Stories like Grandolfo's are all too familiar to psychologist and Harvard lecturer Richard Weissbourd.

- When people think of loneliness, they often think of senior citizens.

But in our data, the people who have the highest rates of loneliness are young adults.

They're people in their 20s and they're people in their 30s.

- Weissbourd conducted a national survey on loneliness during the pandemic and found that one in three Americans felt miserable levels of loneliness.

For young adults, the numbers were even higher.

About 60% felt that way.

Those statistics have improved since that time but remain a worry.

What particular challenges do young adults face that you feel contributes to this high rate of loneliness?

- People don't feel a sense of community at work, they don't feel identity or purpose in work that they once did.

There's much less participation in religion among young people.

And religious communities are places where you're asked to think about your responsibility for people in your community.

We're much less likely to reach out to people who are lonely or to create the kinds of communities where everyone feels a sense of belonging.

- [Isabella] In 2023, the U.S. surgeon general warned that there was an epidemic of loneliness.

- And social disconnection is associated with an increased risk of not only depression, anxiety, and suicide, but also heart disease, dementia, stroke, and premature death.

- Loneliness is just as deadly as smoking an entire pack of cigarettes a day.

- [Isabella] Ashley Kirsner has spent much of her career studying the psychology of loneliness.

- One of the trickiest things about loneliness is that the lonelier you are, the more negatively you see social situations and therefore the less likely you are to put yourself in social situations.

- [Isabella] Kirsner saw firsthand how damaging this mindset can be.

For two years, she volunteered at a suicide hotline in Boston, where she began to notice a pattern among the people who called in.

- No matter who I was talking to, they generally had someone who cared about them in their life.

But when I asked them, "Oh, have you talked about how you're feeling to that person?"

almost across the board, people would say, "Oh, no, we just don't talk about that sort of thing," or, "No, I don't wanna be a burden."

It just seemed like the determining factor of whether you were lonely or not was whether you felt comfortable opening up to those people.

I started asking, "Well, if the roles were reversed, would you want them to tell you about it?"

And the answer was, without exception, "Oh, of course I would want them to tell me about it."

So I realized there was this weird gap between how vulnerable people were comfortable being and how vulnerable people wanted others to be with them.

- [Isabella] It gave her an idea.

She created an event she called Skip the Small Talk, where people could get together and practice being vulnerable.

- Before I knew it, we sold out at 50 tickets weeks in advance.

It was supposed to be a three-hour-long event.

I had to kick people out after seven hours 'cause they wouldn't stop talking to each other.

(people chattering) - [Isabella] Skip the Small Talk has since spread to more than 20 cities across the country.

- All right, you got about 30 seconds left.

30 seconds.

- I remember one thing people expressed at the event were, "Oh, I thought I was the only one who wanted to talk about this more vulnerable, deep stuff."

And people were surprised to see that other people wanted to talk about it too.

- [Isabella] Talking about it was also important for Brown student Tabitha Grandolfo.

She worked with a therapist, took medication for her depression, and opened up to a friend.

- I told her, I was like, "I don't know how I'm feeling, I'm feeling really nervous."

And I was telling her, like, all the reasons why, and she was like, "We can create a routine together."

- [Isabella] Each morning, she and her friend would eat breakfast and then walk to class together.

And each evening, they came together to do homework.

- Thanks for coming.

- [Isabella] She also got involved with a mental health advocacy group called Active Minds.

- The first day I joined, they're like, "We're looking for someone to do our graphic design," and I was like, "I'll do it."

- [Isabella] The group has a tradition of making friendship bracelets.

- Everyone, have their eyes closed.

- [Isabella] Each bead that's shared represents a positive quality the giver sees in the recipient.

- Oh my God!

- [Isabella] Grandolfo has kept her bracelets from years past.

- I have some others too, but this one, I feel like, is special 'cause it's the first one that I did.

- [Isabella] They're a reminder of the community she's found.

- No matter what happens, I can go on a Wednesday evening and be able to see these people who are willing to, like, listen to me.

- [Isabella] Grandolfo is now a senior and plans to graduate this spring with degrees in psychology and theater.

- Finally, young people and social media.

Teenagers often spend more than five hours a day online.

For many it can be habit forming, which may just be what the creators of these platforms are looking for.

Tonight, producer Isabella Jibilian reports on how technology that's designed to be addictive can have tragic consequences for kids and teens.

And a word of warning, the issues discussed in this story may be disturbing to some viewers.

- So big.

(chuckles) Owen and his grandfather, he got to wear a Super Bowl ring.

- [Isabella] Owen Zimmer grew up in Warwick and East Greenwich.

He was a shy kid with a passion for football and technology.

- He was great at gaming.

He and my dad built his gaming computer together.

- [Isabella] His mother, Amanda Zimmer, said technology helped him to connect socially.

But in 2021, his computer skills got him into trouble.

- We got a call from the school principal, his father and I did, and saying that we needed to come down to the school right away, that there was an issue.

- [Isabella] Zimmer says Owen and his friends had shut down his school's server.

Owen alone took the blame and was charged with 14 felonies.

- He became very depressed and just anxious.

He didn't want to be seen.

You know, he thought that everyone at school, between teachers and administration and other kids, like, hated him.

- [Isabella] He quit the football team and instead spent hours a day playing video games and using social media.

- He pretty much the next year in his room.

- [Isabella] Zimmer worried about her son isolating and the number of hours he was online.

It's a concern for many parents today.

- You have platforms that have been constructed to maximize how much time young people spend on them.

- In his 2023 advisory, then surgeon general Vivek Murthy warned that the way social media is designed to engage could come at the cost of kids' mental health.

- And almost every conversation we have with young people about mental health, they bring up social media.

- This activity is called, what's going on in this photo?

- [Isabella] So we went to Woonsocket to see what high school students think.

Do you think social media is helpful or harmful to kids' mental health?

- I feel like social media is helpful if you're going through depression and you don't like to talk about it.

I feel like going on social media and listening to music or watching inspirational videos can help you overcome it.

- I can be with my friends and they'll just be staring at their phone on social media.

And then I'm just sitting there like, "I want to talk.

We barely see each other, like, get off the phone."

- On the positive side, you're able to connect with family, friends, and other people.

But on the negative side of it is that it can really affect your mental health.

I experience cyberbullying a lot, but now, like, I don't really care about it, to be honest, 'cause I am who I am, and people just think what they wanna think.

- [Isabella] Different kids, different experiences.

It's the subject of study for clinical psychologist Jacqueline Nesi.

- Social media encompasses a lot of different platforms.

It encompasses, within a given platform, a lot of different behaviors and experiences.

And of course some of those things are gonna be helpful and some of those things are gonna be harmful.

- What design elements do you find have a particular impact on the way kids use them?

- One thing that's important to understand about social media platforms is that everything that occurs on a social media platform is by design, right?

Like, every button, the defaults when we first open it up, the first thing we see, nothing's really happening by accident.

- [Isabella] Nesi's collaborator, clinical psychologist Anastacia Kudinova, says that kids already feeling down offline can face a domino effect online.

- They might be then more likely to spend more time paying attention to content that is consistent with their current emotional state.

And then unfortunately, many platforms use the algorithms that tends to feed similar content based on what you have just viewed.

So in that scenario, they might be stuck in a loop of unhelpful thoughts, kind of on a downward spiral.

- [Isabella] Amanda Zimmer saw her son struggle emotionally for about a year after getting in trouble.

But when started him at a new school, things seemed to get better.

- And it was just like, oh my gosh, like, you know, I see, like, you know, this brightness and this shine and this enthusiasm in my child again, - [Isabella] She planned a trip to Boston for the two of them so that she could introduce him to a favorite band.

- We had the best time before he went to bed.

He said, "Mom," he's like, "Do you think we could get tickets for the summer?"

He's like, "I know that they'll be expensive and stuff."

I'm like, "Don't worry about it.

We'll figure it out, we'll definitely go."

And I brought him to his dad's house the next afternoon.

He went to school Friday.

- [Isabella] And that evening, he took his own life.

He was 17 years old.

- It's like, still I can't believe it.

I feel like it's not real.

Like, I just can't imagine not seeing him again.

Like, we just went to the concert.

How's he gone?

- [Isabella] After his death, Zimmer began searching his social media accounts, looking for an explanation.

She found that he had entered a dark world online.

He followed influencers with anti-Semitic, racist, and pro-suicide content.

And on Discord, he had been messaging with two strangers for months, who encouraged suicide.

- I never, it's like, my kid's, like, smart, my kid's not gonna talk to some stranger online, like, that would never be my kid, like.

And it was.

- In the years since Owen's death, reports have found that rings of predators regularly use platforms like Roblox, Minecraft, and Discord to groom and exploit children, often soliciting sexual content and urging them to harm themselves or others.

How many other cases of suicides have you seen among families you've talked to and represented?

- Hundreds.

I feel like I know each one of those kids.

- [Isabella] Matthew Bergman is the founder of the Social Media Victims Law Center.

- We represent now over 4,000 parents around the country and are at the forefront of the battle to hold social media companies accountable.

- [Isabella] They are representing the Zimmers in a class action suit against multiple social media companies.

Bergman started the firm after Facebook whistleblower Frances Haugen testified to Congress.

- Facebook knows that its amplification algorithms, things like engagement-based ranking on Instagram, can lead children from very innocuous topics, all the way from just something innocent like healthy recipes to anorexia-promoting content over a very short period of time.

- Kids don't go online seeking maligned content.

They go online seeking material that is interesting to them.

But based on the design of these algorithms that are steering kids toward material not that they wanna see but what they can't look away from.

- Have you ever seen something on social media that you wish you hadn't seen?

- I have Twitter, but I don't go on it as much.

But, like, the thing is, like, when I first opened the app, it's just gore.

- When you say gore, you mean, like, violent and, like, bloody images?

Is that what you mean?

- Yeah.

Mm-hmm.

- Some guy, you know, himself, and it was, like, very publicly out there and then- - Like, sexual images?

- No, like- - Or, like, harming himself?

- Harming himself.

- Lately, I mean, on Instagram Reels, you can just, I can see people harming themself or somebody getting harmed.

I wouldn't want my own siblings seeing that.

- A lot of that content has been pretty, you know, readily accessible on these platforms.

I know some platforms have taken steps to try to limit that, but it really hasn't always been effective.

- [Isabella] But does viewing this content translate to real-life risks?

Suicide is complex and caused by many factors.

Nesi researched what social media behaviors were associated with suicide risk in real life.

She found that the amount of time kids spent on platforms didn't have a strong link, but for vulnerable kids, certain experiences did.

- That included viewing suicide-related content.

Being the victim of cyber bullying was also a factor that increased risk for suicide.

- [Isabella] In light of these concerns about safety, social media CEOs were asked to testify before the Senate Judiciary Committee last year.

- Safety is built into everything we do.

It's essential to our mission and our business.

- We have around 40,000 people overall working on safety and security, and we've invested more than $20 billion in this since 2016, including around $5 billion in the last year alone.

- In Rhode Island, the state, City of Providence, and multiple school districts have filed suits against social media companies for harming kids.

And across the country, a flurry of new bills and laws have aimed at regulating kids' social media use.

And at home, families are looking to protect their kids online.

What recommendations do you have for parents?

- Parents need to carefully monitor what their kids are doing online.

At the same time, you have to also encourage kids to be open about what they're doing online.

- [Isabella] Nesi writes a popular parenting newsletter called "Techno Sapiens" with advice.

- The first thing I would say is, I think it's really important for parents to look at, outside of these technologies, what is going on in a child's life.

And then, I mean, the other thing I would say to parents, talk about it often (chuckles) with their kids.

It sounds like very simple advice, but come in, ask a lot of questions, and really listen.

And trying to kind of flip this from it's me the parent against you the child, and more like me the parent and you the child together against the draw of some of these technologies.

- Now, if you or someone you love is feeling suicidal, please reach out for help.

You're not alone.

You can call or text 9-8-8.

The Suicide and Crisis Lifeline is available 24/7.

And that's our broadcast this evening.

Thank you for joining us.

I'm Pamela Watts.

- And I'm Michelle San Miguel.

We'll be back next week with another edition of "Rhode Island PBS Weekly."

Goodnight.

(bright music)