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Stress and anxiety don't come with a power-off button for teenagers; it seeps in through peer pressure, and lingers on social media. It's exacerbated by an overwhelming sense that one needs to have their entire life mapped out at Tu wanted more focus on helping her peers battle mental health problems, and she figured that if the adults in the room weren't going to make it a priority, the students would have to take things into their own hands.

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So in , she founded StAMINA Student Alliance for Mental Health Innovation and Action , which she calls "a network of really passionate students who are dedicated to improving mental health through a bottom-up approach. In the two years since the group's founding, its leadership team has grown to include a dozen students across the state. They connect weekly via video calls and discuss ways to raise the conversation. And the group isn't messing around: It has partnered with a handful of organizations, including Kentucky Education Television, the Kentucky Partnership for Families and Children, and the Kentucky Attorney General's office to raise awareness locally.

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It also recently hosted a Youth Mental Health Ideathon where community stakeholders gathered to brainstorm ideas for new policies and programs addressing challenges in youth mental health services. One of those challenges, Tu says, has been helping teens overcome the huge stigma that attaches itself to conversations about mental illness. There are a lot of reasons why stigma exists so strongly in Kentucky, but psychologists say a lack of access to mental health care in rural communities, plus a general "suck it up" attitude toward feelings of stress and anxiety are some of the biggest contributing factors.

But the stigma keeps teenagers from talking to anyone about how they're feeling — even their parents.

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StAMINA partnered with O'Connor recently on a research study to identify sources of stigma and found that peer and family attitudes, religion, and a misrepresentation of mental health in the media all play a role. But the study also found, optimistically, that young people were actively interested in improved education about symptoms, resources, and coping mechanisms.

O'Connor says it's not just students who need support; parents and teachers need help, too.

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I think there's a lot of social and emotional type of coaching and skill-building that could be done that could really help people prevent maybe using drugs and alcohol as ways to cope, or making other less effective decisions in adolescence. Physical symptoms. Service teams and settings. Preventing crises.

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David Kingdon has worked as a psychiatrist with mental health teams for over twenty years. He has also been involved in policy, research and teaching about mental health services and particularly cognitive therapy, latterly, as Professor at the University of Southampton. He has published many papers, chapters and three books, including Cognitive Therapy of Schizophrenia. Marie Finn is an approved mental health social worker in Hampshire who has also worked extensively in the voluntary sector.

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