Teenage Depression Test
Q: By the time they reach high school, most American students have been screened,
probed and protected from a wide range of ailments: amblyopia and hearing
problems, scoliosis and tuberculosis, mumps and head lice, flat feet and
language delays, measles and myopia.
But these programs very rarely screen for one of the most deadly and
devastating threats teenagers face: the desire to kill themselves.
"We'd like to see screening" for depression and risk of suicide "become more
commonplace, a routine part" of high schools' student health programs, says
David Shaffer, director of the division of child and adolescent psychiatry at
Columbia University in New York. "We want it to become part of the culture."
A:Shaffer is developer of the Columbia TeenScreen Program, a sequence of tests
and interviews designed to sift through a large group of teens and identify the
few kids at high risk for depression and suicide. Along with the mental health
advocacy group Positive Action for Teen Health (PATH), TeenScreen has launched
an ambitious plan to screen -- and, as required, direct to treatment -- every
teen in America.
Each year, around 8 percent of teens report an attempt to commit suicide in the
past year, and about 1,600 succeed, according to the U.S. Centers for Disease
Control and Prevention. For ages 10 to 24, suicide is the third-leading cause
of death, following auto accidents and homicides.
TeenScreen's approach to the problem is different from most other suicide
prevention techniques in that it does not seek to educate, destigmatize or
provide hot lines for troubled kids, arguing that these methods have been
proven ineffective or even harmful. TeenScreen seeks only to identify the youth
at highest risk and get them the treatment they need, leaving the others as
undisturbed as possible.
While the screen-and-treat approach is gaining support and momentum in the
field, it remains controversial. John Kalafat, a professor of psychology at
Rutgers University and president of the American Association of Suicidology,
has researched in-school educational and awareness programs and determined that
many of them do indeed succeed in getting at-risk teens counseling or medical
care. And he sees shortcomings in screening programs, including the fact that
exams' need to be conducted regularly to be fully effective and a research
record not significantly better than other programs'.
TeenScreen "is a good program," Kalafat says, "but why present it as, 'We do
this because the others aren't good'?"
Laurie Flynn, PATH's national director and former executive director of NAMI, a
national mental health advocacy group, is well aware of how devastating teen
depression can be for families. Her teenage daughter attempted suicide 16 years
ago but was able to get help and is okay today, she says. "Since we know we can
identify [kids at risk for suicide] and we know we can help, how can we turn
away from this?" she asks. "We're talking about saving lives here. And reducing
disability. And reducing suffering."
An Illness, Not a Gesture
As part of its campaign to spread the screening program nationally, Columbia
and PATH conducted a survey on teen depression and suicide in December of
parents in Washington,