It is no surprise that youth and young adults have faced new challenges to their mental health during the COVID-19 pandemic. Findings from the 2021 Youth Risk Behavior Survey showed that, in the past year, nearly half of 10th and 12th grade students in the Roanoke Valley felt so sad or hopeless that they stopped doing some usual activities¹. Recent research has identified childhood depression as a key risk factor for opioid use in young adulthood (Shanahan et al., 2021)². This means we all need to be able to recognize warning signs and strengthen factors that protect youth mental health in our community.

If you are concerned about a loved one’s mental health or drug use, it is important to recognize warning signs of a developing problem. More importantly, it is essential to know that help is available and where you can find it! Here are some common signs and symptoms of drug misuse and mental health problems:

        • Risky behavior (such as driving while intoxicated or having unprotected sex)
        • Sudden changes in appetite, sleep habits, personality, or mood
        • Acting secretive or suspicious
        • Withdrawal from friends, family, and favorite activities
        • Neglecting school or work responsibilities
        • Bloodshot eyes and unusual smells on body or clothes
        • Talking or thinking about suicide – If you or someone you know needs immediate help, call one of these emergency resources:
            • National Suicide Prevention Lifeline: 1-800-273-8255
            • Crisis Text Line: Text the word HOME to 741-741
            • Call 9-1-1
            • You can also visit to locate nearby treatment services for substance use, addiction, or mental health problems.
        • Warning signs in younger children may involve behaviors. Some examples are:
            • Changes in school performance
            • Frequent nightmares
            • Frequent disobedience or tantrums
            • Hyperactive behavior
            • Fighting to avoid bedtime or school (due to excessive worry)

These are just some of the common signs that someone might be suffering from a mental health or substance misuse problem. Keep in mind that sometimes, warning signs might be hidden, or they may be caused by something other than a mental health or drug use problem. This list is NOT meant to diagnose a disease; it should only be used to help you decide if professional help is needed.

While it is important to recognize signs of a problem and know when to get help, preventing problems from occurring in the first place is just as important. Many factors can increase or reduce a person’s risk for drug misuse. These are sometimes called risk factors and protective factors. Communities like ours can reduce the prevalence and impact of substance misuse by reducing risk factors and strengthening protective factors. And because many of these underlying factors influence multiple parts of society, we can all benefit from building up protective factors in our area.

Protective factors can be found (and built up!) in any part of a community. They can be found in families, neighborhoods, communities, faith-based groups, schools, sports teams, clubs, friend groups and even an individual’s personal characteristics. There are too many opportunities for strengthening protective factors to list them all here, but some examples are:

    • Parents who tell their kids that they do not approve of drug misuse
    • School or workplace anti-drug policies
    • Neighborhoods and communities that support positive connections
    • Parents who are involved in their kids’ lives
    • Students who have positive goals and hopes for the future
    • Friends who encourage each other to do well at school and in life

Boosting a teen’s mental health can be as simple as regularly asking them about school and their group of friends. We all need help from others sometimes, so let’s all show that we care about youth by investing in their mental well-being.



1. 2021 Youth Risk Behavior Survey implemented in the counties of Botetourt and Craig and the cities of Roanoke and Salem in grades 10 and 12. 47.3% of respondents said that, during the past 12 months, they felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities.

2. Shanahan, L., Hill, S. N., Bechtiger, L., Steinhoff, A., Godwin, J., Gaydosh, L. M., Harris, K. M., Dodge, K. A., & Copeland, W. E. (2021). Prevalence and Childhood Precursors of Opioid Use in the Early Decades of Life. JAMA pediatrics175(3), 276–285.

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