Hey everyone!
I think I have "teen-issue" health down. I am a certified family planning counselor, so I am constantly asked about sexual health issues, I have many friends who have had issues with self-harm, I've read up on steroids, too many of my friends are current smokers, and I know a lot about the drug and alcohol issues my friends have dealt with. I also am very experienced at being a teenager in this millennium: I turn 20 in a little less than six months, so I'm on my "home stretch" of being a teen: I am still in it, but I'm on the "older, more mature" side of it all. I'm legally still an adult, but my allies lie with the teens, and I'll continue to advocate for them as long as I remember what it's like to be this age, I really really hope.
I personally think there should be set protocols for seeing teenagers in health clinics. It is crucial that doctors know things like sexual activity, medications, drug/alcohol use, and thoughts/actions of self-harm so they can receive the best medical care possible, without exposing them to treatments that could be dangerous or not protecting them to the best of their ability. I think doctors would get better answers and teens would be more protected and comfortable if some quick, basic, age-appropriate actions were taken.
1.
Never ask a teen about things like smoking, drugs, sexual activity, self-harm, and steroid use in front of their parents- ever, even if they're older. Even though I tell the truth when they ask in front of my mom, at the age of 19, I know many of my friends would not if put in that situation, and for younger teens, the risk and fear of getting "in trouble" for telling the truth are high. I think, by the age of 12, parents should be "kicked out" for part of the physical. If it were a mandated protocol, that would even further protect the teen.
2.
"you won't ask any leading questions, right?" A leading question is a question that has an expected answer, usually with a statement and a "right?" or another sentence that implies an assumption. I know kids who have smoked cigarettes at nine, others who have gotten pregnant at 12. When you're young and you think you might get in trouble or "lectured", you're less likely to tell the truth. Instead, ask, "are you sexually active?", "have you ever tried any tobacco products, like cigarettes?", instead of "you aren't sexually active, right?" or "I'm assuming you don't smoke?" It's hard when you're actually doing a session with someone, but trust me: the answers will be much more honest.
3.
Use a non-judgmental tone. Though there are certain behaviors we all know are dangerous for teens to engage in, and doctors can certainly do what they can to correct those behaviors, most teens won't talk about it if they feel threatened or looked down upon.
4.
Educate, don't lecture. If a teen admits to smoking cigarettes at sixteen, and you reply with, "you shouldn't smoke cigarettes, it's really bad for you", they may not tell you about the marijuana they've been smoking at seventeen. Try, "have you considered quitting? Smoking can cause lung cancer, problems in pregnancy, and other risks, and the sooner you quit, the lower your risks later in life." Plus, us teens like being treated like you grown-ups, and this is one way that we feel trusted.
5.
Start asking young. I know, nobody wants to think about a twelve-year-old having unprotected sex and it's not very common, but if it has happened, it could happen again and you never know. Plus, if you've been asking since 12, a 16 year old might feel more comfortable saying "yes" when they get to that point.
6.
Ask about sexual assault, regardless of gender and stated sexual activity. Even if it's as simple as "has anyone ever touched you in a way that made you feel uncomfortable?", it gives teens an opportunity to tell a story they may not have told so far. Though this is certainly not "lie-proof" and not everyone who has been will say "yes", it reminds the teen that there is support out there, so they may go home and call the rape crisis hotlines and get what they need.
7.
Ask if they are taking birth control- even if they aren't sexually active. It's scary how easy it is for teens to get a hold of the good ol' BCPs, and even if it's "just in case" or "for my acne", it's important to note for drug interactions, and if it's much safer for a doctor to write an Rx than the teen to be acquiring them on the streets.
8.
Prescription drug abuse may not qualify to teens as "drug abuse", so ask about it separately. I know a lot of people who buy adderall, vicodin, or klonopin from friends or on the street, but far too many don't consider it a "drug" in the same way as heroin or cocaine because it's not illicit, yet it still can be as (or sometimes more) dangerous.
9.
Ask about witnessing/experiencing violence- in the home, and out. It is a doctor's legal priority to keep their patients out of abusive situations- especially at home- but beyond that, psychological damage can cause major health issues later on. It's important for the teen to be able to talk about the gang fight they saw in their psychology appointments and to tell their doctors that their parent has been beating them up.
10.
Ask them if they want to mention "anything else" when you're finished with the health intake. Sometimes, that's when the crown jewels of information come out, from the weird abdominal pain that could be serious to the incessant bullying that could cause suicidal thoughts and should be referred to a psychologist, even if they may have been overlooked or confusing when they were asked originally. If the patient thought to bring it up, it's a real issue for them.
These guidelines are far from "lie proof", and it may take longer to do an intake session, but doctor-patient communication is key, and letting people know they can talk, even if they don't, is crucial for trust. Not trusting a doctor is scary for a patient and may cause the patient to discontinue a medication improperly (been there) or blatantly not listen to medical advice. Trust is a crucial key to better, personalized, medical care, and proper medical care is a right of teenagers.
<3 Althea
PS-
Speaking of violating teen's rights....