COLUMBUS DISPATCH: TeenScreen critic from Florida

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The Columbus Dispatch (Ohio)
Poll tries to gauge mental health;
Schools, critics argue value of TeenScreen in preventing suicide
By Jennifer Smith Richards
January 30, 2006

Teens: Have you ever felt nervous around a group of other young people, say, in the cafeteria? How about in front of people?

Have you thought about killing yourself recently?

Hundreds of Ohio teens answer questions such as these at their high schools with a click of a mouse. A computerized survey called TeenScreen prompts New Albany and Pickerington high-school students to divulge anxiety, suicidal thoughts, drug use, obsession with hand-washing and more. It’s coming to Beechcroft and East high schools in Columbus, too, and is in at least 60 other schools statewide.

The point, educators and mental-health professionals say, is to identify troubled teens and get them help. Critics, mostly small but vocal groups scattered across the country, say the program doesn’t belong in schools.

Schools say the survey takes about 10 minutes and can prevent teen suicide. The program was developed by Columbia University and is reputable and well-researched, TeenScreen proponents say.

“It kind of gives us a feel for kids who aren’t on anyone’s radar screen. They’re doing OK, their grades are OK, but they are having some issues,” said Susan Guy, a New Albany school nurse who oversees TeenScreen there. “A lot of times, the parents are unaware as well. These kids might be suffering silently and no one knows.”

Opponents say the program too often misdiagnoses illness, scares students and funnels them into a mental-health system that prescribes psychotropic drugs to youths too frequently.

“There’s no study that shows (TeenScreen has) ever reduced any suicide,” said Ken Kramer, a TeenScreen critic from Florida. “There’s no evidence that screening for suicide reduces suicide.”

Suicide among young people is relatively uncommon in Ohio and the nation. Between 2000 and 2002, 42 people ages 15 to 24 committed suicide in Franklin County, according to the most recent figures available from the Ohio Department of Health. Vehicle accidents remain the leading causes of death.

“Youth suicide is a really serious problem. There are more young people that die from suicides than many other causes of illness put together, after accidents and homicides,” said Michael Hogan, director of the Ohio Department of Mental Health.

“(They) represent a whole lifetime that is not lived. It’s a terrible loss of life.”

The department would like to see TeenScreen used more widely. So would Children’s Hospital.

All participating Ohio schools send home a form parents must sign if they’d like their children to be tested. School nurses, often with the help of mental-health clinicians, have students take the computerized survey.

Students can refuse to answer any question. All students speak to a professional after the screening.

Those who answer “yes” to some of the questions about mental health are interviewed further by a clinician. At New Albany, for example, a Children’s Hospital clinician talks to students. She and hospital social worker Heather Feehan can call the student’s parent and suggest the student seek treatment.

Students often are very open about their concerns, Feehan said. They’re glad someone is listening — even if it’s the voice on the computer survey.

Everything is confidential between the parent, student and school nurse or clinician.

More than half of New Albany parents have agreed to the screening, the school and hospital say.

Beechcroft will seek parents’ permission early next month. The school will start screening this spring.

“For students at this age, communication and articulation skills can be somewhat prohibitive. This is an instrument that gives them a way to help describe what is happening to them,” Beechcroft Principal Thomas Reed said.

Some New Albany High School parents opted to keep their students out of the program, but administrators would not say how many and they did not ask the parents why.

There hasn’t been any public outcry against the program in central Ohio.

“The reason for that is they don’t know what it is,” Kramer said. “They’re not informed. They think it’s good because ‘They’re looking out for our kids.’ It’s a big scare tactic.”

National critics also worry about “passive consent,” which is when schools send home notices that they’re going to start mental-health screenings, but require parents to respond only if they don’t want their children to participate.

Schools here use “active consent,” where parents must sign if they want their children to participate.

Web sites such as teenscreentruth.com and Kramer’s site, psychsearch.net, point out that the mental-health department’s Hogan served on boards and commissions such as President Bush’s New Freedom Initiative, which recommended TeenScreen as a way to help prevent teen suicides. They also note that Ohio has twice as many schools using TeenScreen as any other state.

“A lot of the critics of (screening) approaches cite mostly exaggerated links between different mental-health experts, including myself, and the drug companies,” Hogan said. “It is the most outrageous and preposterous proposition I’ve ever heard in my life.”

Bev Carter, Beechcroft’s school nurse, said the program is not meant to diagnose illness. The goal is to connect teens who need help to the right people. It’s up to the mental-health professional to decide what treatment, if any, is best, Carter said.

“I would refer a student I believe has asthma or strep throat to a medical doctor, and I would much rather refer them, even if I’m wrong,” she said.

“This is a family decision,” Reed said, “and the school needs to play a support role.”