User:HaidaHalibut/sandbox

User:HaidaHalibut
STATEMENT HaidaHalibut 22:56, 4 January 2007 (UTC)

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I drafted the article below in hopes that someone can help me convert it to the proper format. After that I plan to expand it to add a section on related school staff development and then post the article for peer review. HaidaHalibut 22:56, 4 January 2007 (UTC)

LEAD SECTION Mood disorder, such as depression, is the primary factor in suicide (1) yet treatable, and in many cases, entirely preventable. Educators leveraging their knowledge and skills with anticipatory guidance can help adolescents prevent depression. (2) Educators learn the anticipatory guidance – the universal preventive intervention - from manuals written by mental health practitioners(3)  and through Train The Trainer workshops.

Preventing depression and suicide must start early because half of all lifetime cases of mental illness begin by age 14.(4)   School is the default location because of the number of young people that go to school. Arguments against or barriers to implementing school-based universal preventive interventions include concern over creating problems, time constraints, budget constraints and insufficient health resources.

Preventing Teen Depression and Suicide
Preventing adolescent depression and suicide is important, even in addition to the tragedy of completed suicide. Beyond age 5, depression is the leading cause of disability worldwide.(5)  As with many illnesses, treatment for depression and/or suicide ideation is much more difficult and expensive than prevention. Prevention must occur early because half the people who ever suffer mental illness exhibit symptoms by age 14 get a more severe, more difficult to treat illness.(6)  In short, preventing teenage depression and suicide is the prerequisite to preventing depression and suicide in the general population.

Ideally, preventive interventions are implemented before the disease is established and with all of the target population. Nearly all young people go to school so that is the default location for a universal preventive intervention. The barriers to implementing a school-based universal preventive intervention include concern over creating problems, time constraints, budget constraints and insufficient health resources. In addition, some school leaders report receiving conflicting advice which freezes them into inaction. Still others prefer to control the content of all their curriculum and do not want to work with any canned curriculum; this may be particularly important to independent schools.

As to creating problems, the earlier references confirm that intervention prevents or minimizes depression. Between what we know and how we act is a filter of sorts, a filter made of values and beliefs about oneself and others that is developed through individual experiences. This meaning filter is the target of the activities presented in the intervention activities, to help kids make personal connections to the material in order for the information and strategies to become more effective as a prevention tool.(7) Therefore, the creating problems barrier might be defined as concern about owning the problems that may become apparent as students gain the insight and language to describe risks factors in their lives. There is a need for every school to identify and communicate mental health referral procedures before implementing a universal preventive intervention. This school preparation for referral is described as creating a Resource List and conducting Staff Development in Reilly’s manual titled Preventing Depression: A Toolkit For Schools that is distributed by Children’s Hospital Boston.

The barrier of time constraints is severe in every school. Schools need clearly defined goals for each intervention activity to allow integration with existing health programs or in dual use lesson plans. Tobacco or substance abuse health material can be directly integrated with stress, anxiety and depression prevention goals. If the goals are clear, it is easy to imagine using the J. D. Salinger novel titled CATCHER IN THE RYE to illustrate a mood continuum from stress or transient sadness through to clinical or major depression. The barrier for some schools about control of the content is also addressed by providing clearly defined rather than complete lesson plans. Any school can elect to develop the lesson plan appropriate to the activity goal and their school mission statement. Regarding budget constraints, intervention material must be suitable for use by existing staff. This point is reinforced by also recognizing the barrier of scarce health resources. Not only are in–school health resources expensive, they may simply not be sufficient for the demand. Universal preventive intervention material should provide basic instruments to assess which activities are suitable for the class emotional safety and a method for referring students outside the school for services. One byproduct of successfully implementing prevention and earlier management of depression will be to help reduce the gap between the availability and the demand for health resources.

Conflicting advice may be the most difficult of barriers to action because no educator should be willing to do the ‘wrong’ thing for a student. We are fortunate to be at the point where responsible institutions and mental health practitioners are documenting their recommendations. There has even been a collaboration between McLean Hospital and Children’s Hospital Boston resulting in a universal preventive intervention manual for educators.7 The  manual was developed through collaboration by nine specialists, co-edited by their respective heads of adolescent psychiatry and published for free download at www.AdolescentWellness.org.

REFERENCES (1) Suicide in the U.S.: Statistics and Prevention, NIH Pub. 03-4594 (http://www.nimh.nih.gov/publicat/harmsway.cfm) (2) School-Based Program Teaches Skills That Stave Off Depression (http://www.psychologymatters.org/gillham.html) (3) Preventing Depression: A Toolkit for Schools (Reilly, Nadja N., 2007) (4) NIMH National Comorbidity Survey Replication of June, 2005 (http://www.nih.gov/news/pr/jun2005/nimh-06.htm) (5)The Impact of Mental Illness on Society, NIH Pub. 01-4586 (http://www.nimh.nih.gov/publicat/burden.cfm) (6) NIMH National Comorbidity Survey Replication of June, 2005 (http://www.nih.gov/news/pr/jun2005/nimh-06.htm) (7) An Adolescent Mental Health & Wellness Curriculum / A Starter Kit For Schools (DeMaso, David Ray and Gold, Joseph, 2007 HaidaHalibut 22:56, 4 January 2007 (UTC)