How We Can Help Kids with Mental Health, A Step Before The Suicide Hotline

Mercedes Oromendia, our Chief Clinical Officer &  Nuzi Barkatally, our Director of Product elaborate.

Self-care feature

Not surprisingly, in 2020, we saw a sharp rise in mental health related visits to the emergency room for kids and teens. In fact, mental health emergency room visits were 44% higher in 2020 than 2019! Experts point to the pandemic, social isolation, racial inequity, and political turbulence as likely contributing factors to this increase (let’s be honest, 2020 was hard for all of us, not just kids!).

It’s clear that our kids are hurting, but on top of that, we’re having a harder time identifying who actually needs help. The shift to ‘virtual everything’, has left many kids without an extra pair of eyes to monitor their wellbeing (source). It’s much harder for parents and teachers to catch those mental health warning signs, like, being more withdrawn, self-injury marks, limited social interaction etc. With suicide rates on the rise, it’s no surprise that tech companies are being pushed to alleviate risk.

The most common way tech companies or apps support kids who have suicidal thoughts, is by showing them crisis or suicide hotlines. You’ve probably seen them pop-up too. Though they are a necessary source of support for kids in immediate risk, it’s rarely what most kids who struggle need.

Example of connection tab within the self-care feature

So, at Manatee we started thinking, what can be done to help our kids before things escalate? What about those times when kids need something, but a crisis hotline feels too drastic? How can we help them snap out of a funk and into a healthy coping tool? Like calling a friend or writing down their thoughts. That’s when we decided to develop our ‘self-care feature’.

This feature prompts kids to use self-care tools to help them, right from their pocket. For many of us, when we are experiencing strong feelings, our emotions hijack the thinking part of our brain (the prefrontal cortex) and it becomes much more difficult to think logically and remember what may be helpful. This feature guides kids through healthy coping skills that are right for them in the heat of the moment. Our self-care feature does 3 crucial things:

1. Promotes self-care, a cornerstone of resilience, which will help them throughout their life.

2. Normalizes asking for help or guidance when they’re feeling down.

3. Helps kids recognize what is helpful (or not) when they need something to lift them up.

Kids choose an option of what they want to try first — to connect with someone? To get their feelings out? Or perhaps to laugh and be silly for a bit? Then, they swipe through funny gifs to show them examples of what healthy coping skills look like and what they can try to help them next time they are feeling this way.

We still give the option to connect kids with crisis hotlines, but most importantly, we support them before they are in immediate crisis.

But that’s not all. We also actively check when kids need more help, or may be at risk by routinely administering standardized depression and anxiety questionnaires such as the PHQ-9 and GAD-7. These measures check for the severity of symptoms and explicitly ask about suicide or self-harm thoughts. If suicide ideation is reported, we follow our escalation plan to ensure that parents are notified and the child has the support they need. We also monitor our journal features to identify and escalate when a child writes something that makes us worried about their safety.

Example on anxiety or depression questionnaires

Journal Feature


Given the current mental health crisis, we wanted to make these features available to kids as soon as possible. We plan to expand on this feature to further help kids understand and learn from their own experience which coping tools they find most helpful. We also want them to strengthen their relationships by sharing with their parents what tools were helpful or unhelpful, and allow kids to suggest their own coping tools that other kids may want to try. Stay tuned!

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