What to do if a young person doesn't get out of bed by noon and is also otherwise listless, if he neglects friendships or even thinks about suicide?

Does that happen during puberty, is it already an adolescent crisis, or is it a sign of depression that needs treatment?

Parents, but also friends, are often overwhelmed with such questions.

The fact is that mental illnesses are not uncommon among schoolchildren: according to the World Health Organization, one in seven people between the ages of ten and 19 suffer from it.

Three-fourths of all mental problems diagnosed in adults have already appeared during their school years.

Matthew Trautsch

Coordination report Rhein-Main.

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When Alix and Oliver Puhl talk about mental health, they also do so from their own family experience.

Emil, one of her four children, suffered from Asperger's Syndrome, which went undetected for a long time, and the resulting depression.

For him, the diagnosis and help came too late: at the age of 16, he ended his life in 2020.

The case received a great deal of publicity in Frankfurt, where the family lives and Emil went to school, through the search for the boy who had been missing for more than a week.

"When a child can't cope with life"

The fact that Alix Puhl had been chairwoman of the city parents' advisory board in previous years also contributed to the fact that a number of parents contacted her.

They expressed their condolences, but some also reported mental illness and suicide in their own families.

Often with the addition that they have never talked about it.

"An oh under every roof - that's true too often," says Alix Puhl.

"It seemed that Emil pointed out a task for us: we should help keep young people alive." Two years later, Alix and Oliver Puhl founded the non-profit company Tomoni Mental Health.

There are also other foundations, self-help groups or scientific projects that deal with the topic of mental illnesses in adolescence.

These work partly locally, temporarily or limited to a certain group of illnesses or people.

Tomoni's approach is digital and cross-disease for prevention.

It is already expressed in the name: Tomoni means "together" in Japanese and wants to include everyone who has to do with young people who may be affected and who can recognize and help with a mental illness: relatives and friends, teachers and the school community, but also the broader social community environment such as the sports club.

The work is supported by a network consisting of a scientific advisory board headed by Andreas Reif, the director of the psychiatric clinic at Frankfurt University Hospital, an educational advisory board made up of teachers and social workers from all school types, and the "game.changers", a group of adolescents and young adults, some of whom are themselves affected.

Birgit Vollrath is a member of the educational advisory board.

She was a teacher at Frankfurt's Heinrich-von-Gagern-Gymnasium for 40 years and was nominated by her students to receive the German Teachers' Prize.

Self-destructive behavior, such as injuries or eating disorders, is increasing – across all school types.

The cause is not necessarily in school, but that is the place where children spend more time than with their families.

Therefore, the teachers should be made aware of warning signs.

And they needed help to respond appropriately, Vollrath says.

"Everyone gets a stomach ache before a math test, but it's different when a child constantly injures themselves because they can't cope with life."

knowledge about mental illness

One of the "game changers" is Kayra Karakaya, a high school graduate from the Otto Hahn School in Nieder-Eschbach.

Many students don't dare to talk about mental health problems, she says.

"We live in a meritocracy in which everyone has to function - and if you think you can't do it, it triggers shame and fear." Sometimes calls for help are also expressed in secret.

Adults must learn to listen to young people.

"It's better to ask again than give good advice right away," Karakaya recommends.

Tomoni is about more than suicide prevention, namely mental health, says Oliver Puhl.

The sooner a disorder is recognized, diagnosed and treated, the better the prospect of living happily and according to one's own possibilities.

Because of their experience with a large number of young people, teachers have a good chance of recognizing whether a crisis goes beyond the usual level.

At Tomoni, they can learn how to react correctly in digital training courses, by imparting knowledge about mental illnesses and possibilities for external support, as well as through exercises on how to have a conversation with an affected young person or their parents.

The aim is that there are several forces in each college that can be addressed in questions of mental health.

In the medium term, Tomoni also wants to create an online platform where young people can get information directly and "at eye level", as Alix Puhl says.

Because if you enter search terms like “tired of life” on the Internet, you sometimes end up on dubious pages that, in the worst case, even lead to suicide.

Tomoni wants to do something to counter this: a digital contact point that young people can trust – whether it is about themselves or a friend.

Questions should be answered online, such as how depression develops, how you can distinguish it from mood swings, how you can talk about sadness and what help is available.