When teenagers are going through a rough time, parents may struggle with how to best approach them.

Adolescence is a period of development when teens often push parents away as part of growing their independence. So it makes sense that many young people are reluctant to discuss their troubles with their parents.

Dr. Ken Ginsburg, pediatrician and founder for the Center for Parent and Teen Communication in Philadelphia, says asking if your teen feels sad or anxious will not make them that way. Instead, “it makes them feel seen and heard.”

“Kids feel safer when the adults in their lives check in on them,” he said.

So, what is the best way to talk to teens if you are worried about their mental health or changes in mood or behavior?

Ginsburg writes that caregivers should focus on communicating three main points: 1. Professional guidance, such as counseling and/or medical treatment, can make a difference. 2. Emotional discomfort is treatable. 3. There are people who specialize in supporting teens and helping them feel better.

Katie Heiden-Rootes, an associate professor of family and community medicine at the St. Louis University School of Medicine, is also a licensed marital and family therapist. She says that a caregiver engaging with a struggling teen is profoundly important.

When she asks young people who are struggling what prevents them from telling their parents, friends or another trusted adult how they are feeling, she frequently hears, “They won’t believe me,” or “They’ll tell me it’s not a big deal -- to get over it.”

When a young person’s concerns are minimized, they stop talking to us. One of the goals of Heiden-Rootes’ work is to increase adults’ empathy, as well as their capacity to listen to their children without judgment.

“It’s harder than it sounds,” she said.

It can be helpful for parents to recall difficult moments from their own childhood. Remember what the turbulence of adolescence was like: how they felt and what they wished they had from their parents. She asks parents to imagine giving their own children what they had needed.

When adults approach young people with a barrage of questions, it can feel like an interrogation -- one in which teens fear getting in trouble if they say how they are really feeling, she explained.

She suggested a more thoughtful and gentle way to broach a conversation: “It seems like you’ve got a lot going on. How are you doing?” Or start by sharing your own experiences, such as, “When I was younger, I had a lot of anxiety.”

It is helpful to normalize feeling stressed or anxious, even if things appear to be going well.

Ginsburg suggests framing a conversation about seeking professional help as an act of strength: Strong people know they are capable of feeling better, deserve to feel better and will take action to do so.

“A first step is to use the right language -- it is not what they ‘need,’ but what they ‘deserve,’” he writes. “It is genuinely brave to be able to clearly state, ‘I don’t feel right, and I deserve to feel better.’”

In some cases, families are not highly functioning. In these cases, other professionals who serve youth -- coaches, teachers, mentors -- become incredibly important.

Changing the way our teens and young adults think about their mental health often means changing our own notions, as well.

With all of the media coverage and talk surrounding young people’s mental health, it’s reassuring for parents to hear how influential they remain in their teen’s lives -- even when it doesn’t feel that way.

“The most important thing is to notice your children,” Ginsburg said. “Show up for them. Ask them how they are doing. Talk to them.”

Some people form mental pictures -- "brain movies" -- when we read.

I never watch television footage of heinous crimes. It’s too gruesome for me to bear. But I do read news reports obsessively, and the stories from America’s school shootings have imprinted indelible brain movies in my mind.

The events 11-year-old Miah Cerrillo described to CNN last week should be seared in our collective memory.

Miah was one of the fourth graders trapped in a classroom at Robb Elementary when a gunman rained gunfire on her peers and teachers, killing 21 of them. In order to survive, she placed her hands in the blood of her dead classmate, who was lying next to her. She smeared her friend’s blood on herself and played dead.

She managed to escape death at the hands of a teenager armed with an AR-15 rifle and hundreds of rounds of ammunition -- an 18-year-old too young to legally buy a beer, but able to purchase military-style assault weapons.

It hurts to think about what Miah must have experienced in those moments. Her class had been watching the Disney movie "Lilo and Stitch" before the nightmare began. Then, suddenly, she was watching her teachers and classmates murdered in front of her.

Spend a minute thinking about what this little girl endured just to survive. Think about the lifelong trauma she will carry inside her.

This kind of terror has unfolded in American schools over and over and over: More than 311,000 children in America have experienced gun violence in school since Columbine, according to a Washington Post database.

That’s more than the population of St. Louis.

Imagine how the worst moments of Miah’s young life were made even worse by feeling abandoned by those she thought would protect her.

She and a friend managed to get their slain teacher’s cellphone and dialed 911 -- exactly what we teach our children to do in an emergency.

“Please come ... we’re in trouble,” she told a dispatcher.

No one came.

Armed officers stood outside that door for more than 40 minutes while children were trapped inside with a madman wielding an AR-15.

A child called again, begging for help: “Please send the police.”

Miah started crying when she remembered hearing officers outside, saying to CNN she just didn’t understand why they didn’t come inside and rescue them.

I can hear the voice of a terrified child calling 911 again and again.

“Please send the police.”

We need to sit with that and hear those words in our children’s voices. What would we do to protect them?

The Uvalde Police Department and the Uvalde Independent School District police force are no longer cooperating with the Texas Department of Public Safety’s investigation into their delayed response during the massacre. The officers waited for around an hour outside the adjoining classrooms because a commander on the scene wrongly believed the suspect was "barricaded" and that no lives were at risk.

Police outside Robb Elementary even threatened to arrest parents trying to rush in to save their children. The Uvalde police department's version of events has changed several times.

But this wasn’t the first time we saw armed “good guys” waiting it out while children were murdered inside a school. The school resource officer in Parkland, Florida, stood outside Marjory Stoneman Douglas High School while 17 people were murdered inside by another teenager wielding an AR-15.

Do the chaos and terror of a mass shooting paralyze some "good guys" with guns? Does a survival instinct override the oath to serve and protect? Is it fear? Is it cowardice? Is it knowing that their weapon is no match for a semi-automatic rifle? And why do we expect teachers to be even braver and more heroic than these "good guys"?

The Texas Tribune reported that FBI analysis of 277 gun massacres between 2000 and 2018 found that “so-called 'good guys with guns' interrupted mass shootings 3.9% of the time.” By comparison, unarmed civilians interrupted them almost three times more often (11.9%).

Unarmed civilians like teachers, principals and children, who have all sacrificed themselves during school shootings to save other children.

As for the myth of the "good guy with a gun" stopping the bad guy?

Bury that for good.

I don’t feel numb to the massacre of children in American schools.

I feel a growing anguished disgust.

Last week, an 18-year-old man fatally shot at least 21 people at Robb Elementary School in Uvalde, Texas. It’s just the latest in a long series of uniquely American horror stories.

The reason each school shooting feels worse than the one preceding it is precisely because it keeps happening. We know how to make them less likely, but GOP politicians hold our children hostage.

The Republicans are now wholly owned by the National Rifle Association, which is owned by the gun manufacturers. They continue to deny evidence and common sense that improving gun safety laws would mean fewer such tragedies.

Their denial is deadly for America’s children.

Why should a disturbed 18-year-old be able to buy two AR-15 rifles and 375 rounds of ammunition -- enough to wipe out an entire school? Why is America the only country where this keeps happening? Why do we allow our children to be traumatized by intruder drills, never feeling safe at school, fearing classmates and teachers being gunned down?

Guns are now the leading cause of death for children and adolescents in America.

We are a sick country.

As I followed the reports of the events in Uvalde, I was struck by these observations and how the “debate” following these mass gun crimes often goes in the same circles.

Think about how gruesome this is: “The parents had to provide DNA samples because their children’s bodies had been mutilated beyond recognition,” wrote historian Kevin M. Kruse on Twitter.

What if Americans had to face the images of the brutalized victims of these mass shootings? How much longer would we tolerate the status quo?

Current and former teachers described the terror and trauma of intruder drills and the unthinkable scenarios they are forced to act out with the smallest children.

“What they don’t tell you is teachers are told in training that they have to lock out any of their students who are out of the classroom,” tweeted author and teacher Erin Hahn. “Even if they beg and bang on the door. Because there could be a shooter using them to access your classroom.”

That means if a kindergartner uses the bathroom and gets stuck in a hallway during an intruder drill -- or, the worst possible nightmare, an actual attack -- that 5-year-old would be crying and banging on his teacher’s door to be let inside, only to be left in the hall. Potentially with a killer.

Others pointed out how quickly the government is able to take action on behalf of powerful adults, but not vulnerable children.

“Ten days ago it took the Senate about twenty minutes to unanimously pass a bill extending security protection to the family members of Supreme Court justices when it looked like a house might be picketed,” noted Kieran Healy, a sociology professor at Duke.

Texas Republican Gov. Greg Abbott, who has signed dozens of bills making it easier to buy guns in Texas, was asked at a press conference about gun safety reforms. He pivoted, pointing fingers at the gun violence in Chicago.

Journalist Kelly Bauer tweeted in response: “(about) 60% of ‘crime guns’ taken in by Chi police are bought in other states where laws are more lenient” -- a point echoed by Illinois Gov. J.B. Pritzker.

So, what is the Republican response to school shootings? It’s often “put more cops in schools” or even “arm the teachers.”

“But guess what?” tweeted legal analyst and scholar Harry Litman. “There was an armed officer in Uvalde, and then two more arrived on the scene. They didn’t stop the killer, who was in the school for an hour before being killed.”

“Not one, not two, but three armed cops” failed to stop the Uvalde shooter, agreed writer Alex Thomas.

More than 90% of Americans support universal background checks for gun purchases.

“I personally own a closet full of guns. I also have a concealed carry permit. And I will ‘happily’ fill out more paperwork and have my background checked if it means little kids get to go home to their parents at night. The Senate needs to vote on HR 8 now @SenSchumer,” tweeted tech expert Zack Nelson.

Nelson was referring to the Bipartisan Background Checks Act of 2019, which expands background checks to private gun sales and gun shows. It passed the House in March 2021. All 50 Republican senators, plus Democrat Joe Manchin, are opposed to it in the Senate.

National Youth Poet Laureate Amanda Gorman succinctly captured what America has become: “The truth is, one nation under guns.”