Helping Schools Deal With Your Depression/Suicide/Violence

Helping Schools Deal With Youth Depression/Suicide/Violence

"I am sad all the time"
"I do everything wrong"
"Nothing is fun at all"

(items from the "Children's Depression Inventory")

VIOLENCE
Too many young people are not very happy. This is quite understandable among those living in economically impoverished neighborhoods where daily living and school conditions frequently are horrendous. But even youngsters with economic advantages too often report feeling alienated and lacking a sense of purpose. Youngsters who are unhappy usually act on such feelings. Some do so in "internalizing" ways; some "act out;" and some respond in both ways at different times.

The variations can make matters a bit confusing. Is the youngster just sad? Is s/he depressed? Is this a case of ADHD? Individuals may display the same behavior and yet the causes may be different and vice versa. And, matters are further muddled by the reality that the causes vary. The causes of negative feelings, thoughts, and behaviors range from environmental/system deficits to relatively minor group/individual vulnerabilities on to major biological disabilities (that affect only a small proportion of individuals). It is the full range of causes that account for the large number of children and adolescents who are reported as having psychosocial, mental health, or developmental problems. In the USA, estimates are approaching 20 percent (11 million).

Recent highly publicized events and related policy initiatives have focused renewed attention on youth suicide, depression, and violence. Unfortunately, such events and the initiatives that follow often narrow discussion of causes and how best to deal with problems. Shootings on campus are indeed important reminders that schools must help address violence in the society.

Such events, however, can draw attention away from the full nature and scope of violence done to and by young people. Similarly, renewed concern about youth suicide and depression are a welcome call to action. However, the actions must not simply reflect biological and psychopathological perspectives of cause and correction. The interventions must also involve schools and communities in approaches that counter the conditions that produce so much frustration, apathy, alienation, and hopelessness. This includes increasing the opportunities that can enhance the quality of youngstersą lives and their expectations for a positive future.

ABOUT SUICIDE AND DEPRESSION
In the Surgeion General's "Call to Action to Prevent Suicide 19999", the rate of suicide among those 10-14 years of age is reported as having increased by 100% from 1980-1996, with a 14% increase for those 15-19. (In this latter age group, suicide is reported as the forth leading cause of death.) Among African-American males in the 15-19 year age group, the rate of increase was 105%. And, of course, these figures don't include all those deaths classified as homicides or accidents that were in fact suicides.

Prescriptions often are provided without the type of psychological assessment generally viewed as necessary in making a differential diagonsis of clinical depression. Instead, there is overreliance on observation of such symptoms as: persistent sadness and hopelessness, withdrawal from friends and previously enjoyed activities, increased irritiability or agitation, missed shcool or poor school performance, changes in eating and sleeping habits, indecision, lack of concentration or forgetfulness, poor self-esteem, guilt, frequent somatic complaints, lack of enthusiasm, low energy, low motivation, substance abuse, recurring thoughts of death or suicide. Clearly all of thse are indicators for concern.

GENERAL GUIDELINES FOR PREVENTION
Various efforts have been made to outline guidelines for both primary and secondary prevention. A general syntheses might include:

Systemic changes designed to both minimize threats to and enhance feelings of competence, connectedness, and self-determination. Such changes seem easier to accomplish when smaller groupings of students are created by establishing smaller schools within larger ones and small cooperative groups in classroms.
Ensure a program is integrated into a comprehensive, multifaceted continuum of interventions.
Build school, family, and community capacity for participation.
Begin in the primary grades and maintain the whole continuum through high school.
Adopt strategies to match the diversity of the consumers and interveners.
Develop social, emotional, and cognitive assets and compensatory strategies for coping with deficit areas.
Enhance efforts to clarify and communicate norm about appropriate and inappropriate behavior.

Feedback? Questions? Email me at db@itascapsych.com