Tools & Resources

• New! Featured Resource: TeenScreen Connect Facebook Group
• Webinar: Schools & Teen Suicide: How to Effectively Respond to Crisis and Help Prevent Future Tragedies
• Postvention as Prevention: One Community’s Story
• Updated TeenScreen Partner Presentation
• Fact Sheets:
  • Setting the Record Straight About TeenScreen
  • Adolescent Mental Health in Your State

Spotlight: Research & Trends

Preventing Suicide: Research Connects Onset of Depression with First Attempt
High school students who attempt suicide are far more likely to have experienced serious depression that same year, while those who attempt suicide in middle school most often suffer from chronic depression, according to new findings in the Journal of Adolescent Health. The research assessed the validity of retrospective self-reporting of depression and suicidal behaviors in predicting suicidal risk.

Using data from the Raising Healthy Children (RHC) preventive program, researchers from the University of Washington asked 883 men and women (ages 18-19) four questions on past suicidal behaviors via a computer-based questionnaire. The young adults had all participated in the RHC program, which assessed their depressive symptoms via the Seattle Personality Questionnaire from 1993 – when most were in first grade– through their high school graduation 12 years later.
In the retrospective analysis, researchers found that those who made only one suicide attempt (36) did so in high school. They reported elevated depressive symptoms in the year of the attempt in comparison with symptoms in prior years. However, those who made multiple attempts were more likely to make a first attempt in elementary or middle school. In addition, they showed no increase in depressive symptoms in the years they reported their attempts, indicating chronic, elevated depression over time.

Researchers concluded that asking questions about suicidality offers professionals a reliable tool in assessing a patient’s suicidal risk. With their data showing that nearly 40% of repeat attempters were in elementary/middle school at the time of their first attempt, they urged increase attention to suicide prevention in earlier grades.

The Social Network: Impact of social support on adolescent mental health and achievement

When middle school students perceive their parents as supportive, they are more likely to be satisfied with their lives, and somewhat less likely to experience mental health problems, according to a new study published in Psychology in the Schools. Researchers Tiffany Stewart and Shannon Suldo at the University of South Florida investigated the impact of relationships with parents, classmates and teachers on the mental health of middle school students, and whether these connections influenced academic achievement.

The researchers assessed both internalizing and externalizing psychopathology and wellness, as measured by the Youth Self-Report form of the Achenbach System of Empirically Based Assessment, and the Student’s Life Satisfaction Scale, respectively. Social support was assessed through the Child and Adolescent Social Support Scale. The study was conducted in an ethnically and racially diverse sample of 390 students between the ages of 10 and 15. Slightly more than 60% were female, and 25% were of low socioeconomic status.

The results showed that perceived social support from parents was a strong predictor of life satisfaction, accounting for a 25% variance versus a 1% variance from classmate support. The impact on mental health, while significant, was smaller, accounting for a 6% variance from parent support and a 1% variance from classmate support. Teacher support was found to have a positive impact on externalizing problems only.

The impact of social support on academic achievement differed depending on a student’s achievement level. Low achieving students perceiving positive classmate support were at greater risk for externalizing problems, with the opposite holding for average and higher-achieving students. However, academic achievement was protective against psychopathology in students reporting low social support from parents.

Given the strong impact of parental support on adolescent life satisfaction, researchers recommended school psychologists focus on using newsletters and other forms of outreach to parents to offer guidance to improve parent-child relationships. The authors also recommend in-services for teachers to help them promote supportive classroom environments.

School-based Health Centers: New Initiative Improves Collaboration and Integrated Care

A new collaborative initiative with primary care and mental health providers in school-based health centers (SCHC) improved mental health service delivery to students while maximizing efficiency and fostering communication between professionals, according to a review of the program in School Mental Health.

Created to address gaps in SBHC mental health services, the program focused on implementing a collaborative model to guide professionals in working together to foster greater integration of students’ physical and mental health care.

The program was piloted in Colorado, Louisiana, Michigan, New Jersey, North Carolina and West Virginia. SBHCs were selected via a competitive Request for Proposal (RFP) process and were required to have at least one mental health and medical/nursing professional on staff throughout the school year. All programs took place in middle or high schools.

SBHCs received training and technical assistance from one of 19 multi-disciplinary MHET teams of social workers, counselors, nurses, nurse practitioners, physicians, and physician assistants. Additional sessions with a physician, nurse practitioner, psychologist, social worker and health educator focused on mental health screening and assessment, diagnosis of mental disorders, referral, follow up, coding and risk and protective factors. SBHC professionals also received skills training in evidence- based best practices for depression, anxiety, disrupted behavior disorders and substance abuse. Throughout, the MHET team provided ongoing consultation as needed.

In post-assessment, the majority of SBHC participants reported a perceived improvement in collaboration between mental health and primary care providers, reflecting improved communication and referrals, increased sharing of diagnostic information, and improved joint case conferencing.

The authors note that challenges remain, however, notably the differences in “common language and agenda” between primary care and mental health providers, program funding issues, and the lack of any large-scale national movement to guide and support integration efforts.

Still, nine of the 10 site leaders interviewed in follow up indicated that the changes and improvements initiated during the program had been sustained. The expansion of the SBHC model is expected to intensify with funding from the Patient Protection and Affordable Care Act.

Making Teen Mental Health a Priority: Mike Brose, MSW, Mental Health Association in Tulsa

It was the early years of TeenScreen, and our first partner met with community uncertainty and lack of awareness. How did Tulsa overcome the challenge? Mike Brose discusses the key ingredient that sparked momentum.

It was late 1997, and Tulsa, Oklahoma, was reeling from tragedy. A recent suicide cluster in a suburban high school had shaken the community. Mike Brose, MSW, the Executive Director of the Mental Health Association in Tulsa was working with a task force to find some solutions.

Consisting of students, school officials, mental health professionals, and faith-based organizations, the task force did a search and identified TeenScreen as the best partner in its effort to prevent adolescent suicide.

“We thought, ‘why should we reinvent something, when there may be something out there,’?” Brose recalled. Soon after, the Association forged a partnership with TeenScreen and Tulsa’s adolescent suicide prevention effort began to take shape. After more than 10 years, the Tulsa program is one of the most successful in the country. But getting there, Brose recalls, was not without its challenges.

When Screening Was ‘Novel’

“Mental health screening in schools was a very novel thing back then,” said Brose, “and schools were very reluctant and unsure. The lack of awareness about screening was an obstacle in those days.”

Recognizing that acceptance would require thoughtful dialogue, Brose and his task force focused on engaging people on the personal level. They connected with parents, school professionals, organizations and community leaders to answer questions and address concerns. Throughout, they provided solid information about adolescent depression, suicide and the impact of early identification and treatment for mental disorders.

School officials, local Parent Teacher Associations and local organizations such as the Oxley Foundation and the United Way soon offered their endorsement. Meanwhile, the input and testimony from the earliest parent supporters lent credible and authentic insight to the community’s conversation. As more parents and teenagers communicated their positive TeenScreen experiences, more people embraced the program’s ability to make a difference in the lives of adolescents.

“It was a snowball effect,” said Brose. “Strong relationships, participation, and feedback from teens and their families have been the keys to our success. Today, every school district in our area knows about TeenScreen and welcomes us into their schools. We’ve had schools lined up waiting for TeenScreen for years.”

Since 2000, the Association has provided voluntary screening for 2,865 teens in 19 high schools and middle schools, two alternative schools, one community center, and one shelter. The Association hopes to expand its TeenScreen program in the future. It eagerly anticipates opening additional sites in primary care settings.

“People are now starting to understand that mental and physical health care one in the same. Locally and nationally, the culture of healthcare in this country is moving towards overall wellness. TeenScreen is at the center of what that means
and what that represents,” says Brose.

Have a Question? Up Against a Challenge? Join TeenScreen Connect
You’ve told us you need a place to meet others who share your dedication to teen mental health. TeenScreen Connect is a new private Facebook group that makes it easy to reach out to TeenScreen members from across the country. Connect with your community. Join Today!