During
the 2003-2004 academic year, the suicides of three public
high school freshmen in Fond du Lac sent
emotional
ripples around the school district. Bernadette Seefeld,
18, and now a senior at St. Mary’s Springs High
School had attended the same elementary school as one
of the students. Because the boy was two years younger
and attended Fond du Lac High School, Seefeld never
knew him personally, but several freshmen at St. Mary
had,
and talk circulated among students.
“A lot of people were left wondering why he decided to do that,” Seefeld
said. “There was a lot of shock, and a lot of questioning, especially
among his friends.”
A 2004 Fond du Lac School District survey found 26 percent of respondents felt
so overwhelmed they considered suicide in the past year. Tragically, those results
and the three student deaths reflect a growing problem nationwide. The American
Academy of Child and Adolescent Psychiatry lists suicide as the third leading
cause of death for 15- to 24-year-olds.
Which teens are at risk?
What’s behind such distress among teens that puts them at risk for suicide?
The causes, mental health practitioners say, may range from a chemical imbalance
to an emotional upheaval.
“
There is no simple answer,” said professor Larry Reynolds, a licensed clinical
social worker and director of the social work program at Fond du Lac’s
Marian College. “(Teens’ reasons for suicidal behavior) cover the
entire gamut from poor problem solving to feeling lost to being crushed by some
personal disappointment — they failed an exam, they lost a friendship or
a family member, their boyfriend or girlfriend is abusing them in some way, they’re
alienated from their peer group — there are a plethora of reasons why
kids act on their suicidal thoughts.”
“
Suicides are a complex combination of circumstances and emotions and psychological
turmoil that’s going on — it’s not just one thing that’s
happening for an adolescent,” said Sandy Vorath, a therapist for Catholic
Charities in Sheboygan for 37 years. Yet she’s noticed some troubling
relevant factors, like a rise in bullying and harassment in schools, gay teens
struggling
with issues of sexuality, and the emotion seemingly felt by everyone today:
stress.
“
A lot of kids I see who come into the office are depressed because of the stress
they feel academically, or in trying to fit in with their peers. A lot of them
certainly come from divorced families where there’s a lot of conflict going
on, or if the parents are not divorced, there’s a high rate of dysfunction
from within the family. Alcoholism and drug abuse are rampant, or there just
may not be enough money, so finances are a factor,” Vorath said. “Because
of divorce or dysfunctional families, expectations are put upon adolescents to
do a lot of adult tasks in the home. Parents are overwhelmed, so they try to
push it on the kids and don’t realize when the kids start acting out that
the kids are overwhelmed, too, and falling apart. I see more and more stress.
It’s like nobody’s coping well anymore.”
Most teens don’t look for help
A number of adolescents Vorath sees in her practice don’t come to her office
willingly — at least not initially. Unless they are mature and are really
hurting, most teenagers don’t want to turn to adults for help in anything,
especially mental health issues, she said.
Often, it’s up to parents to get help for their children, but some parents
may deny there is a problem.
“
It’s like anything else — if as a parent, we don’t recognize
what’s going on, then we don’t have to deal with it,” Vorath
said, “because it becomes overwhelming. Families are extremely stressed.
Parents are busy with their own lives, especially single parents, and it becomes
like, ‘I don’t have time to bother with this. I don’t need
this.’”
Even if they sense their teenager has become moodier, angrier or more irritable,
some parents think they can handle the problems themselves.
“
When parents see their adolescent behaving differently, they don’t necessarily
think about mental health issues, they think this is just normal adolescence — kind
of this old idea that adolescents are rebellious, but that’s not necessarily
the case,” Reynolds said.
Social stigma surrounded suicide
Part of the problem may be the social stigma that has long surrounded depression
or other mental illness. Reynolds pointed to 1972 Democratic vice-presidential
candidate Thomas Eagleton, who lost public — and political — support
when the news that he had been treated for depression surfaced during the campaign.
Eagleton ended up withdrawing from the race.
More than 30 years later, Reynolds finds little change in society’s attitudes
about mental health. “The public is poorly informed about what mental health
treatment is and what the needs are,” he said. “If kids are having
health problems, you take them to a doctor, but if kids are having emotional
upset, this is viewed as some kind of personal failure. It’s inappropriate
to view it that way, and as a result, people are ashamed that they have these
kinds of problems going on in their lives and keep it quiet.
“
We obviously need a lot of help in terms of making sure that kids are being adequately
served by the community, and their schools and their parents. But (mental health
services) have not been well accepted in public schools. Administrators have
not seen fit to incorporate them — until relatively recently — in
their curriculum.”
Schools implement TeenScreen
Fond du Lac High School implemented TeenScreen, a suicide prevention program
developed by New York’s Columbia University now used in more than 40 states.
It has also been adopted by other Fond du Lac schools, including St. Mary’s
Springs, where the program is in its second year. Locally, the program is funded
in part by the Eastern Area Health Education Center and the Fond du Lac Area
Foundation.
The program screens high school freshmen for behaviors that indicate a student
is at risk for suicide, including depression, anxiety disorders, and alcohol
or drug abuse. The initial screening takes about 10 minutes. Students use a computer
interview called a Diagnostic Predictive Scales to answer questions about depression,
anxiety, and substance abuse. If the results indicate an emotional problem, the
student meets privately with a local mental health practitioner.
TeenScreen staff discuss any recommended additional mental health services
with the student’s parents, who are then responsible for obtaining further
treatment. The program is voluntary and participation requires the consent
of both parents
and students.
Tim Labinski, a guidance counselor at St. Mary, said the school has made TeenScreen
part of freshmen health classes, where students discuss issues that affect their
own health, such as obesity and alcohol use.
He likened TeenScreen to the vision or scoliosis tests schools regularly give
to students. “We do the routine physicals for phys ed, to be a part of
athletics, but do we ever do an emotional check-up?”
Although results for this year’s screening are not available, last year,
out of a freshman class of 45, five St. Mary students who went on to a clinical
interview were referred to mental health services, including one student who
was already receiving treatment, Labinski said.
Reynolds, who directs Marian College social work and psychology majors administering
TeenScreen questionnaires in Fond du Lac schools, conceded a few students who
take the screening might not answer all the questions truthfully, but believes
that most will self-report honestly on matters of their own health.
Medical community
responds positively
Response from the medical community to the program has been positive, he said,
noting that local pediatricians are now using mental health screenings as part
of physical exams for their patients.
“
It’s much easier to take care of a problem early on, as opposed to waiting
until it becomes much more serious, and it’s always more difficult to
treat at that point. The evidence says the earlier you intervene, the better.”
While Reynolds acknowledged recent reports about the risks and side effects
of some anti-depressants, particularly in children and adolescents, he said
research
hasn’t yet found definitive evidence against using such drugs. Medication
is warranted in treating some cases of mental illness, he said, but combining
medication and counseling offers a more efficacious treatment.
Mandatory mental health screenings have sometimes been discussed on a local
or even national level, but Reynolds doesn’t think that measure would
work.
“
I think education of mental health, making services more readily available, and
removing the stigma are more reasonable solutions rather than trying to mandate
something to families and to teens,” he said
Labinski said he makes sure students know that the guidance office at St. Mary
is a place where they can talk about issues beyond academics, college, or a future
career. He pointed to programs at St. Mary such as Peer Helpers, which provide
training for students who want to help look out for peers who are facing difficult
times.
Teens tend to bottle feelings
Jessica Richardson, a St. Mary senior and Peer Helper for four years, said she
was surprised to see how common a problem depression has become for teens.
“
Even in a small school, issues like divorce, drug use and depression are present
all the time and I guess I never really opened my eyes to it until I was in Peer
Helper,” she said. “I think a lot of (emotional problems have) to
do with people not having somebody to turn to. Teenagers tend to keep things
inside, and the longer it burns, and the bigger problem it becomes. If they have
somebody that they can turn to or talk about how they’re feeling and
then realize they need to get some help, that really helps.”
At Milwaukee’s Pius XI High School, licensed school counselor Carrie
Smith said the stigma of depression has been reduced as more knowledge about
the condition
is introduced in the classrooms, and counseling for depression has become more
common.
“
The guidance department teaches a unit on depression and suicide awareness on
a rotating basis in guidance class, and through another program for freshmen.
Therefore, students are informed about the symptoms and know what to do if someone
they know appears depressed or shows signs of suicidal thinking,” Smith
said in an e-mail interview.
Healthy family life is important
Vorath finds that some studies show a healthy family relationship without drug
or alcohol problems, and with an emphasis on academics, can reduce suicidal behavior
among teenagers. Additionally, males who attend religious services and females
who have access to counseling services appear to be less likely to commit suicide.
Those who work with teenagers also encourage frank family discussions. Parents
shouldn’t be afraid to bring up topics like depression and suicide with
their kids.
“
One of the myths is if you bring up suicide, it’s just going to plant the
seed,” Reynolds said. “Asking someone whether they’re thinking
of harming themselves or others doesn’t get them to act on that. What it
does is give the teen an opportunity to express what’s going on with him
with someone who’s willing to listen and is interested in him enough
to question it in the first place.”
“
If your child is limping, you don’t ignore that fact, you ask him if something
is wrong with his foot,” Vorath said. “So if your child is not doing
well emotionally, you would ask, ‘What’s going on? You seem kind
of down lately.’ And I think it would be very simple to ask, ‘Are
you ever having thoughts of hurting yourself or doing anything to yourself?’
“
Most kids who attempt a suicide or complete it have told someone — a sibling,
a friend — that they’re thinking about it before they commit to it.
Many of them have actually been to a doctor with some complaints or other problems
because that’s why they were depressed. In most cases, it doesn’t
sneak up on you. So stay in touch with your kids. Take time to find out in a
positive way what’s going on in their lives.”
Seefeld, a Peer Helper, agreed, adding some advice of her own. “If you
as a parent want to hear what your teenager is going through, be ready to hear
some stuff you’re probably not going to want to hear,” she said. “You
have to be willing to listen and not get angry or take control. And don’t
downplay problems. Minor things to parents are really a big deal to teenagers.” Stigma of suicide affects those left behind
Historically society has always looked askance — and
that’s a mild word, really — at people who
take their own lives,” said Bruce Engle, coordinator
of client services for Loving Outreach to Survivors of
Suicide (LOSS), a grief support program of the Chicago
Archdiocese.
“
Historically people have looked at suicide from a position
of shame, a position of blame. People were thought of
as being weak of character, or not having sufficient
willpower or courage. Mental illness is a disease, and
we’ve only come to understand that recently. It’s
a disease like diabetes or cancer, and it can be treated
effectively. But we’re only starting to understand
that.”
While LOSS’s founder, Fr. Charles Rubey, believes
that over the past 40 years, the Catholic Church has
been supportive and understanding toward suicide, its
attitude has also evolved.
“
The church changed it attitude when it took suicide out
of the moral sphere and put it in the medical sphere
where it belongs,” Fr. Rubey said. “People
take their lives not because they are bad people, but
the vast majority take their lives because the pain that
they are in is so great that they can no longer tolerate
it. It’s important for people to realize that suicide
is a result of illness, not the result of moral lapse.
Overall, survivors have felt nurtured and understood
by their priests and ministers, but there is the occasional
situation where a priest with very strict ideology will
use offensive language like, ‘the person is in
hell’ or terms like that.”
Still, social stigma changing slowly, said Barbara Miller,
facilitator of grief support group that meets in Kenosha.
Friends often avoid suicide survivors, either because
they don’t know what to say or they’re afraid
suicidal behavior will “rub off” onto their
family members, said Miller, whose 29-year-old son committed
suicide in 1996.
“
The only way through the grieving process is to tell
your story over and over and over again until you’re
so tired of hearing it, and that’s the most difficult
part because it can take years to get through it — you
don’t ever get over it,” she said. “Your
friends and your family, their lives go on. Yours has
come to a complete stop. Yet you have to talk about it,
and a support group is a wonderful place to go because
you can go every month for years, if you need to, and
no one ever gets tired of hearing your story.”
Support groups, Miller said, also offer empathy. “Group
counseling allows you to sit in a room with a group of
people and hear their stories, see their faces and realize
that you are not the only one that this has ever happened
to and that they are all good people, so it can’t
be that it just happens in bad families or it just happens
to bad people. And you realize that you can make it through,
that there is hope.”
For more information on the Kenosha support group, call
(262) 694-5744, Information on local grief support groups
can also be found on the Web site for Catholic Cemeteries, <cemeteries.org/services0024.asp>.
— Margaret Plevak
Suicidal symptoms:
what to watch for in teens
Mental health experts say symptoms of depression and
suicide in teens can include changes in eating or sleeping
habits, violent behavior, and drug or alcohol use.
“Often they have more physical complaints: they’re tired, they have
headaches or stomachaches,” said clinical social worker Larry Reynolds.
“
They’re often bored. Their schoolwork declines or they’re not going
to school. They might often just have very low self-esteem and complain of being
worthless or a rotten human being.”
Changes in behavior — especially after a breakup with a boyfriend or girlfriend
or the death of another friend — are noticeable, therapist Sandy Vorath
said. Teens may go through their possessions and give things away. They withdraw,
lose interest in daily activities and have no goals or plans. Parents, she warns,
should take such behavior seriously.
“
When kids come in and talk about (a suicide attempt), and I know they are at
high risk, I tell their parents, but some parents will still minimize it. They’ll
say, ‘Oh, that’s just another way to get attention,’ or ‘That’s
just being manipulative.’ Please don’t ever take that attitude because
adolescents are impulsive,” Vorath said. “Do kids really understand
the whole idea of death? At that age, I don’t think so. They don’t
want to die. They just don’t know how to live.”
For parents with access to a computer, the Internet can provide information on
depression and suicidal behaviors, Vorath said, but she encourages concerned
parents to talk to someone with experience, be it a school guidance counselor,
member of a religious community or a therapist. Some informational sources include
the American Academy of Pediatrics at <aap.org> or the National Mental
Health Association at <nmha.org>. The Milwaukee Mental Health Association
can be contacted at (414) 276-3122.
— Margaret Plevak |
