Teen Depression Watch Draws Mixed Reviews
[POST-BROADCAST CORRECTION: The defendants in the lawsuit mentioned in this story are the local school district in northern Indiana, school district officials, and a contractor who helped administer the screening. TeenScreen is not a defendant. Also, TeenScreen officials report that 55,000 students were screened in 2005.]
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Today's personal health report focuses on the mental health of young people. Parents and school boards in some communities are being asked to decided whether to support mental health screening for teen-agers. NPR's Joanne Silberner reports.
JOANNE SILBERNER reporting:
TeenScreen is a six-year-old program that surveys about 14,000 middle and high school students in 42 states. The kids take a 10-minute questionnaire at school. The questions were designed by Columbia University psychiatrists to identify kids with behaviors and feelings associated with suicide attempts. At an orientation for counselors from East Penn School District in Pennsylvania, TeenScreen's Tiffany Haick explained the program's rationale.
Ms. TIFFANY HAICK (TeenScreen): We know that mental illness is so often treatable. We know that most mentally ill and suicidal kids are not already getting any help. We know there's ample time to intervene before a teen dies by suicide. We think that if we ask these kids the right questions in the right safe space and environment that they'll give us the honest answers. And really, and I think most importantly, no one else is asking these kids these questions.
SILBERNER: Haick emphasized the importance of getting consent from both the parents and the students, and she demonstrated the computer program that asks kids a sequence of questions like these.
(Soundbite of computer program)
Unidentified Computerized Voice: Have you often felt very nervous when you've had to do things in front of people? For this question, I want to know if you have ever had a sudden attack of feeling very afraid.
SILBERNER: There are questions about loneliness, about relationships, about personal behaviors, about suicide. Some families say the program is intrusive and dangerous, including the Rhoades family of northern Indiana. Chelsea Rhoades, now 17, went through the TeenScreen program a year ago. She says after her screening, she was pulled aside by a counselor.
CHELSEA RHOADES (Student): She's, like, `Well, by this chart, it seems that you have social anxiety and OCD,' and I'm, like, `For what?' And she goes, `Possibly cleaning,' and I'm just like, `What?'
SILBERNER: Her mother, Teresa Rhoades, was upset when her daughter told her about it.
Mrs. TERESA RHOADES (Chelsea's Mother): I told her that there was absolutely nothing wrong with the fact that she liked to keep her room clean or that she was expected to do her housework when she came home every day because that's the way that we've raised her.
SILBERNER: And most important, Teresa Rhoades says she never signed a permission slip.
Mrs. RHOADES: I was unaware of TeenScreen even being in the school until my daughter came home and told me that she had been put through the TeenScreen survey.
SILBERNER: She and her husband have filed a federal suit against TeenScreen over the question of permission, and she's co-founded an anti-TeenScreen discussion group on the Web.
Ninth-grader Courtney Jones(ph) of Portland, Oregon, had a much different experience. A year ago, she was avoiding her family and friends, and worse.
COURTNEY JONES (Ninth-Grader): I actually thought about hurting myself, not wanting to be here at all. There were a lot of signs that I just then didn't realize were that kind of a sign. I thought maybe it was just me growing up being a teen-ager.
SILBERNER: She didn't say a word to her parents.
JONES: I was afraid that maybe they'd feel like they were failing as parents or that I was just a bad child who, you know, didn't fit in right. I didn't want to disappoint them at all.
SILBERNER: At about that time, her school was doing TeenScreen and her parents gave permission for her to take the test. Looking at the results, a school counselor called the family and recommended that the teen-ager talk to a therapist. She did, but then early on in the therapy, she started to slit her wrists. She got scared and called her therapist who got her to call 911. Courtney Jones says she's fine now. Her parents agreed that she try antidepressants. She hopes not to need it soon.
JONES: I can see my future actually a lot clearer. I look back and kind of see this fog behind me of how bad things were and I can look back and, you know, just be very thankful that I'm out of that dark woods, is what my dad and I call it.
SILBERNER: This is a program that has some very vocal critics. They say TeenScreen usurps parental authority, sends kids to therapy who might not need it and they say the program encourages families to put adolescents on antidepressant drugs. TeenScreen supporters say in almost all cases now parents must sign a consent form. They say in order not to miss any teens at risk for suicide, some who aren't at risk will be included just until a closer look is done. Regarding antidepressant drugs, TeenScreen officials say a very small percent of those screened end up on antidepressants.
There are no easy ways for parents to decide about TeenScreen. It has lots of endorsements from mental health professionals, and it is called a model program by President Bush's new Freedom Commission on Mental Health.
Full disclosure here: NPR correspondent Jacki Lyden is on the board of advisers to TeenScreen. But as to proof, one program that has a questionnaire and offers education about suicide as evidence that it reduces suicide attempts, TeenScreen itself is just beginning to look for that evidence. Joanne Silberner, NPR News.
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Correction April 6, 2006
The defendants in the lawsuit mentioned in this story are the local school district in northern Indiana, school district officials, and a contractor who helped administer the screening. Teenscreen is not a defendant. Also, Teenscreen officials report that 55,000 students were screened in 2005.