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Fall 2009
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Youth Suicide Prevention
through Mental Health Screening |
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Dale Chell, MS, Youth Suicide Prevention
Coordinator
Iowa Department of Public Health |
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Screening for depression in primary care settings
The reality of suicide is devastating. Each year
since 2000, an average of 57 Iowans between the
ages of 10 and 24 have killed themselves.
Thousands more have tried to end their lives and
many required hospitalization for their injuries.
In addition to the tragedy of a life cut short,
suicide takes a toll on those left behind. It can
devastate family members and friends and often
results in isolation, strong feelings of guilt,
struggles with substance abuse, and mental health
problems. Suicide is second only to unintentional
injuries as the leading cause of death.
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Suicide is a major public health problem,
complicated by many contributing risk factors
including mental illness, primarily depression.
The “prevalence of depression is as high as 20
percent in 12- to 18-year-olds and many of these
adolescents are undiagnosed,” according to Thomas
G. DeWitt, MD, FAAP, chair of methodology for the
U.S. Preventive Services Task Force (USPSTF) panel
and director of General and Community Pediatrics
at Cincinnati Children’s Hospital Medical Center.
Because of the stigma attached to mental illness
and mental health treatment, many young people are
reluctant to come forward with problems. Often,
those having difficulty will keep it hidden and
not seek help. |
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Mental health screening programs can help detect
those who are suffering in silence. They can
remove the burden from youth to come forward on
their own. Recently, the Institute of Medicine
(IOM) and the USPSTF recommended that as part of
routine medical care all teenagers receive a
mental health screen for the detection of
depression and other mental health disorders. By
identifying and addressing these underlying
causes, injury and death can be avoided and
quality of life improved.
The IOM’s Preventing Mental, Emotional, and
Behavioral Disorders Among Young People: Progress
and Possibilities report and the USPSTF’s
Recommendation Statement on Screening for Major
Depressive Disorders in Children and Adolescents
recommend that primary care settings take the lead
in the early detection of mental illness and
prevention of suicide.
Some medical clinics are considering administering
a mental health screen as part of an annual
well-child check-up for older youth, or including
the screen as a part of an annual sports physical
examination. By making screenings available to
families during regular physicals, physicians can
underscore the importance of mental health care as
a part of overall health.
For more information about implementing mental
health screening services in primary care
settings, see
www.teenscreen.org/programs/primary-care/.
Materials are provided at no cost.
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Screening for depression in schools
In 2007, the Iowa Department of Public Health
(IDPH) received a grant from the Substance Abuse
and Mental Health Services Administration to
address youth suicide through mental health
screening in schools. Screening can identify youth
who suffer silently from mental health problems
and link them and their families with
professionals who can determine available and
appropriate services.
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TeenScreen
The Columbia University-based TeenScreen program,
already widely used in Iowa,
was selected for use because
of its stringent
implementation criteria. Its
step-by-step process enables those administering the screen to educate families and
youth about making an informed choice to
participate in screening and about the program’s
benefits. Parents or guardians must provide active
consent and no youth is screened without prior
written consent of both parents and youth.
The 10 to 20 minute screen typically is
administered using a computer and headphones and
asks questions about the participant’s feelings
and behavior. After scoring, a screening team
member meets with each student to answer
questions. Students with positive scores meet with
a mental health professional who assesses the need
for a mental health evaluation referral. Parents
are contacted regarding concerns, recommendations,
and evaluation options. Information is
confidential, kept separate from school records
and not shared with administrators or teachers.
The TeenScreen program was developed for youth 12
to 18 years of age. Because this age group spends
many hours at school, it is a primary site for
administering the screen, although it can be given
in numerous settings (foster homes, detention
centers, community agencies, etc). School
screening also meshes with other initiatives that
remove barriers to learning and assist students in
achieving their best academic performance. For
more detailed information about TeenScreen, see
www.teenscreen.org.
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IDPH funding enabled TeenScreen programs to expand
screening at existing school sites and at other
schools in their service areas. Programs last year
screened nearly 2,000 youth in more than 25
schools.
Each program has 2 to 10 sites and last year
screened approximately 400 students.
 IDPH-funded TeenScreen programs include:
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Southeast Polk Community School District
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Great Prairie Area Education Agency (AEA)
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Des Moines Public School District
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Mercy Medical Mobile Screening Program (Cedar
Rapids)
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United Way of North Central Iowa
Two additional programs — Grant Wood AEA and the
Siouxland Health Investment Partnership in Sioux
City — will offer screening services for the first
time this academic year.
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Resources
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Though suicide is devastating, it can be
prevented. Mental health screening programs
identify youth who are suffering, provide
referrals to mental health services, and
ultimately can increase the quality of life for
young people and their loved ones.
For more information about suicide prevention or TeenScreen programs in Iowa, please contact
Dale Chell at
515-242-5122.
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