The Senate Health, Education, Labor, and Pensions Subcommittee on Substance Abuse and Mental Health Services held a March 2 hearing to examine efforts to prevent youth suicide. Subcommittee Chair Mike DeWine (R-OH) opened the hearing, citing alarming statistics: “Approximately every two hours a person under the age of 25 commits suicide…Between 1992 and 1995 the rate of suicide among young adults tripled.”
Sen. Christopher Dodd (D-CT) said that “suicide is both a public and mental health tragedy,” adding that suicide is “intricately linked to mental health issues” and that the stigma surrounding mental health issues often discourages youth from seeking help. “We have a societal obligation to instill in our young people a sense of value,” he said.
The subcommittee heard moving testimony from several witnesses, including Sen. Gordon Smith (R-OR) whose 22-year-old son committed suicide in September 2003 after battling bipolar disorder. “I have determined that the best way to find meaning in Garrett’s life is to find ways to help others…We decided to tell the truth about our boy…who after years of struggling with his mental health…took his own life to escape his anguish.” Sen. Smith and his wife Sharon have established the Garrett Lee Smith Memorial Fund in their hometown of Pendleton, Oregon. The fund will screen all sixth grade students on an annual basis to identify children who are at-risk for mental health issues and suicide.
Additionally, Sen. Smith discussed legislation he will introduce with his colleagues, the Youth Suicide Early Intervention and Prevention Act. The legislation would authorize $25 million per year for grants to organizations to implement early intervention suicide prevention programs. He also will introduce the Senate companion to H.R. 3593, the Campus Care and Counseling Act, sponsored by Reps. Danny Davis (D-IL) and Tom Osborne (R-NE). H.R. 3593 would amend the Higher Education Act to authorize funding for campus-based mental and behavioral health centers.
Dr. Cheryl Ann King of the University of Michigan detailed the statistics around youth suicide, pointing out gender differences in completed suicides, attempted suicides, and ideation [thoughts of suicide] among 15- to 19-year-olds. “From 1980-1997, 83.8 percent of all suicides among this age group were committed by males,” she said, adding, “Approximately 4 to 10 percent of boys versus 10 to 20 percent of girls report a history of suicide attempt. Thus, two to three times as many girls as boys report having made at least one suicide attempt.”
Racial and ethnic differences exist as well, she said: “American Indian/Alaska Native adolescents are more than twice as likely to commit suicide as any other racial/ethnic group…In addition, 30.3 percent of Hispanic female high school students reported seriously considering suicide, the highest rate of any racial or ethnic group in the country.”
Focusing the remainder of her remarks on the need for early intervention, Dr. King said, “A goal of suicide prevention strategies is to alter developmental trajectories, moving individuals onto healthier pathways fraught with less suicide risk. Effective suicide prevention strategies need not be specific to suicide, and, they need not be implemented only in close temporal proximity to imminent suicide risk.” She recommended two prevention strategies—universal interventions, which are directed at the entire population and include health promotion and educational efforts, and selective interventions, which are directed at subgroups of the population at increased risk. “School-based prevention programs are critical in helping children at risk for suicide,” she stated, adding, “Because the school is the community institution that has the primary responsibility for the education and socialization of youth, the school context has the potential to moderate the occurrence of risk behaviors and to identify and secure help for at-risk children.”
Fran Gatlin, a school psychologist at Robinson High School in Fairfax, Virginia, agreed and described the Signs of Suicide (SOS) program, which provides depression screening in her school. “We offer the screening on a voluntary basis, but require parental permission. We enlist students to make posters advertising the screening and a videotaped ‘commercial’ that is played on the televised morning announcements…In the four years we have been offering depression screening, well over a hundred students have been screened. One was immediately hospitalized and many have entered therapy,” she told the subcommittee. The school also provides a peer support group for students who have lost friends and loved ones to suicide. Ms. Gatlin also pointed out the need for services. “While the use of screenings and assessments are critical…, they are only a first step. There must be an established system to address the needs of the students who screen positively for mental health service needs,” she said, pointing out that there is “tough competition” for limited funds under the No Child Left Behind Act and the Safe and Drug Free Schools program.
Laurie Flynn of The Carmel Hill Center for Early Diagnosis and Treatment at Columbia University described another suicide prevention program, the Columbia University TeenScreen Program. The program has a “simple purpose,” she said, “to screen youth for mental illness and suicide, identify those who are at risk, and link them to appropriate treatment.” The program currently operates 108 screening sites in 34 states, Guam, Canada, and Panama, and in 2003, approximately 14,200 teens were screened, of which 3,500 were identified and linked to treatment. “The TeenScreen Program works by creating partnerships with communities across the nation to implement early identification programs for suicide and mental illness in youth…Most screening programs take place in schools, but the program can also be implemented in residential treatment facilities, foster care settings, clinics, shelters, drop-in centers, and other settings that serve youth.”
