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Screening Teens for Suicidal Tendencies


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July 16, 2001 (Washington) -- In a 1999 survey, one in 10 American high school students reported having made a suicide attempt in the previous year, according to mental health experts gathered here to discuss the problem of teen depression and suicide. Reducing that statistic is the goal, they agree, but the effort is complicated by the difficulty in identifying the kids most at risk for taking their own lives.

Teenagers don't often use suicide hot lines, they point out -- especially boys, who are far more likely to kill themselves than girls.

Taking a proactive, first-strike approach is essential when dealing with mental health problems in teens, says Sharon Lobaugh, an Alaska official with the National Alliance for the Mentally Ill, or NAMI. "Just ask," she tells WebMD. "The talking is the prevention, making them feel that they have someone who listens."

Recognizing that, researchers speaking at the NAMI convention were promoting a school-based screening test that teens can self-administer.

The screening initiative is "a grassroots effort to intervene" with at-risk kids, says Laurie Flynn, director of the center for families, communities, and health policy at Columbia University, where the program was developed.

To take the test, a teen first takes a brief written test that asks about sadness and unhappiness. Then he or she puts on a pair of headphones and responds to a longer, prerecorded "interview." If a possible pattern of depression is detected in the answers, a case manager will contact parents and arrange further evaluation.

The program has so far been used in Colorado, Connecticut, Florida, Indiana, New Hampshire, New York, Oklahoma, Oregon, and Alaska. Overall, results have been promising, although officials face stern tests in expanding the program nationwide.

For one, parental consent is required for teens to take the test. In a trial of the screening program in five New York City high schools, more than a third of parents refused to give consent.

Parents may have privacy concerns in mind. Even though the test is usually guided by outside mental health experts, school guidance counselors are still provided a list of the teens who take the test as well as those who were identified as potentially having a depression problem. The test results do not go into a student's academic record.

Another question is whether kids taking the test are mocked or scorned by other students. To reduce potential stigma, says Leslie Craft, director of Columbia's teen-screen program, the participants take the test in a special, dedicated room, away from classmates, and are not sent back to a class if they finish the test early.

It's ultimately up to school guidance counselors to address referrals of kids who are highlighted as having possible problems, Columbia officials say, so schools need to have a mental health referral network set up before they start giving the test.

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