School
Suicide Screening Proves Impractical; Improvements Needed to Identify
Teens at Risk, Study Says
CHAPEL
HILL, N.C., Feb. 13 (AScribe Newswire) -- Screening students may
be one of the best ways to identify youth at high risk of suicide,
the third leading cause of death among teens. But recent research
shows that a well-known screening test is not practical, and that
more development is
necessary for schools to partner in prevention.
A
national push to reduce teen suicide, highlighted by the passage
of the Garrett Lee Smith Memorial Act in 2004, has resulted in millions
of dollars authorized for state and local prevention programs. But
the feasibility and
effectiveness of suicide prevention programs need to be thoroughly
evaluated, said Denise Hallfors, senior research scientist at the
PIRE Chapel Hill Center.
When
a well-known, school-based program called the Suicide Risk Screen
was tried at ten urban high schools, officials found the two-step
questionnaire with follow-up interviews so impractical that that
they decided to discontinue it, she said.
Her
evaluation of the screen, published in the February edition of the
American Journal of Public Health, found that it produced too many
false positives - students identified as at risk by the questionnaire
but shown not to be at risk by interviews.
"We
want to underscore the seriousness teen suicide and the importance
of identifying young people with suicide-related mental health problems
through schools," Hallfors said. "Awareness programs among
youth haven't been effective, and may even increase suicide risk.
Screening followed by assessment is a much better idea, but it needs
to be carefully tailored to fit with the current school environment."
The
Suicide Risk Screen identified nearly 30 percent of students to
be at risk for suicidal behaviors. Many school officials were dubious
of those figures and reluctant to act on them for fear of unduly
alarming students and parents. Nor did the schools have the resources
or personnel to assess that many students for potential risk. One
school official quoted in the research said her school would have
had to assess up to 25 students a week, which she called "totally
unrealistic." Insufficient staffing and budgets, overloaded
teachers and counselors, legal concerns and
complaints from administrators are real-world roadblocks to current
school-wide suicide screening and assessment programs, according
to the report.
Analyses
showed that for a comparable group of students, who were at risk
of school dropout, about 15 percent would be at risk for suicidal
behaviors. Among regular high school students, about 11 percent
would be identified as at risk.
According
to the Centers for Disease Control and Prevention, almost 2,000
young people ages 10-19 died from suicide in a single year; for
every death among this age group, many more attempt suicide. About
1 in 11 students reported that they had attempted suicide in the
past year.
The
Garrett Lee Smith Memorial Act, named after the late son of Sen.
Gordon Smith, R-OR, authorized $82 million over three years to develop
comprehensive youth suicide prevention strategies.
Hallfors'
study, entitled "Feasibility of Screening Adolescents for Suicide
Risk in 'Real World' High School Settings," was funded by the
National Institute on Drug Abuse (NIDA). PIRE, or Pacific Institute
for Research and
Evaluation, is a national nonprofit public health research institute
with centers in seven cities and funded mostly by federal research
grants and contracts.
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