When Laurie Flynn's 17-year-old daughter Shannon attempted suicide, it came without warning. "I would have sworn on a stack of Bibles until the attempt that there was nothing wrong with her. I had no clue," Flynn recalls.
The story is disturbingly familiar to many parents. Suicide is currently the third leading killer of teenagers, after accidents and homicide. Each year roughly one in 10 teens ages 15 to 19 attempt suicide at least once, with more than 600,000 injuring themselves badly enough after their attempts to require medical attention.
Past studies have revealed that parents do not know of suicide attempts 90 percent of the time. In fact, roughly one third to two thirds of suicidal teens do not reveal past attempts to anyone.
Teens with mental disorders are at even greater risk—roughly 90 percent of teens who died by suicide had a psychiatric illness at the time of their deaths, according to research by child and adolescent psychiatrist David Shaffer at Columbia University. Nearly two thirds of youth who die by suicide exhibit psychiatric symptoms for more than a year beforehand, which makes this time a significant window for potential intervention.
Flynn is now executive director of TeenScreen, a national mental health and suicide risk screening program based on Shaffer's research. In 2005 the program screened more than 55,000 teens at 460 sites in 42 states and they hope to have exceeded 500 sites by the end of 2006. "The idea is to identify risks early to prevent tragedies," Flynn says. "It's amazing when kids who are really struggling and don't know why then learn what's going on and that there are things that can help."
The program not only helps detect teens at risk for suicide, but also tackles the silent epidemic of mental illness among young people.
"There are people who say, 'Suicide is rare, so why devote such energy to it?' And they're right," Shaffer comments. "The rationale for going ahead is that the disorders predisposing to suicide are very common and extremely disabling. If they can get help, their school attendance can go up, social relationships can improve, grades can get better, and they can feel happier."
Teenage mental illness also has consequences later in life—research from sociologist Ronald Kessler at Harvard Medical School has revealed that more than half of all cases of adult mental illness begin during the teenage years. "Five out of 10 of the leading causes of disability worldwide are significant mental illnesses, and the number one overall cause of disability in the United States is depression," notes Eric Caine, co-director of the Center for the Study of Prevention of Suicide at the University of Rochester, who is not associated with TeenScreen. "If you start to look at their economic impact, the World Bank, which is not exactly a soft-hearted group, found major mental disorders have a huge impact far exceeding infectious diseases and a number of cancers, but there's an inordinate lack of attention toward them."
"The hope is to take away some of the stigma around mental health disorders with the idea of a mental health checkup, as routine and widely available as any other checkup," Flynn explains.
TeenScreen employs a screening process divided into two stages: In the first, teens answer questionnaires with roughly 15 to 50 questions dealing with the most important signs of teen suicide. "For the most part that's depression in girls. Boys are more complicated—often depression with substance or alcohol abuse, or anxiety disorders," Shaffer says.
All teens then go on to a second stage that includes face-to-face discussions. Those that had tested positive by answering yes to a certain number of questions about their mental health meet with clinicians to determine if they are truly at risk. Those teenagers that are deemed so are then offered a referral for a complete mental health evaluation. with negative test results meet with program staff for the chance to ask for help with any problems not covered in the screening.