Sunday, August 3, 2003

Thousands of kids in distress

Local survey finds depression common

By Tim Bonfield and Susan Vela
The Cincinnati Enquirer

[IMAGE] Heather Smith, 14, and her father, Jeff. She suffered severe depression after her mother died last fall.
(Michael Snyder photo)
| ZOOM |
Thousands of children in Butler, Clermont, Warren and Clinton counties face unbearable amounts of stress, feel depressed on a regular basis, feel completely disconnected from their schools, think frequently about death, or intentionally injure themselves.

These findings come from a massive student survey released this week that reports more young people are struggling with severe mental and emotional problems than experts expected.

The survey's sponsors claim their project is more comprehensive than any attempted in Ohio and ranks among a few of its scale nationwide. The results come from asking 21,915 students from 52 schools in 18 public school districts to fill out a survey normally used to track youths diagnosed with mental or emotional illness.

"We've all been very much struck by the sheer number of students who appear at risk. The sheer number of kids who feel so alone, and who don't feel they have any hope for their future. Those numbers are really disconcerting," said Barbara Perez, school mental health coordinator for the Butler County Mental Health Board, one of the survey sponsors.

The key finding: 6 percent of students report suffering "severe" emotional or behavioral problems. If these students had filled out the forms during doctor visits, experts would have recommended seeking professional help.

That's 1,389 students in the four counties who are trying to learn despite intense problems. The rate was highest in Clermont County, where 8 percent - or 324 students - reported severe problems.

The local rates are higher than the national average of 3 to 5 percent, according to the survey. Adding to the significance, the figures mostly exclude youth already diagnosed with the most severe problems - because many were not in school to take the survey.

"These are 1,389 kids largely on top of the kids we already know about," Perez said. "To be considered severe, the children had to report high scores on several questions at once. We know that most of these children are suffering without being diagnosed and without getting any type of treatment."

Other survey findings included:

• 63 percent said they felt sad or depressed at least once in the past 30 days, and 11 percent said they felt depressed most or all of the time.

• 37 percent said they thought or talked about death at least once in the past 30 days, including 7 percent of 1,409 students who said they thought about death most or all of the time.

Students surveyed: 21,915 students, grades 5-12, in 18 public school districts in four counties: Butler (10,939 students), Clermont (3,962 students), Warren (5,184 students) and Clinton (1,830 students).

When conducted: April to June 2002.

Method: 89-question survey distributed in classrooms by teachers. Parents were sent consent letters in advance. Survey was based primarily on the Ohio Scales, developed by an Ohio University professor and adopted five years ago by the Ohio Department of Mental Health to track the effectiveness of care for children with mental and behavioral problems. The Ohio Scales questions can be viewed in detail at Web site or via Web site

Sponsors: Health Foundation of Greater Cincinnati and the mental health agencies for the four counties. Design and analysis services provided by the Institute for Policy Research at the University of Cincinnati.

Here are several numbers readers can call to seek help for children with mental or emotional disorders:

Butler County Mental Health Board: (513) 860-9240

Clermont County Mental Health and Recovery Board: (513) 732-5400

Mental Health Recovery Services of Warren and Clinton Counties: (513) 695-1695 or its crisis center at (800) 932-3366.

Hamilton County: Mental Health Access Point: (513) 558-8888

Crisis and Suicide Hotlines: 513-281-CARE or 1-800-SUICIDE.

Here are several Web sites offering information about childhood mental health and school services:

National Institute of Mental Health

Federation of Families for Children's Mental Health

National Alliance of the Mentally Ill of Ohio

Miami University Center for School-Based Mental Health Programs

American School Health Association

Ohio Department of Mental Health

• 20 percent said they intentionally hurt themselves in the past month - by cutting, scratching themselves or taking dangerous pills. Five percent of these students reported harming themselves multiple times in the past month.

• 39 percent of students said their future looks very bright while 6 percent said it looks bad or very bad.

• 59 percent of students felt that teachers cared about them most or all the time. But 16 percent felt that teachers rarely if ever cared about them.

Many of the trends examined by the new survey have been concerns for years, if not generations. But rarely has there been a survey this big to put numbers to the trends.

"That survey was huge. The results might not mean anything to students in San Francisco. But you can't argue that the survey doesn't represent the children of those counties," said Benjamin Ogles, chairman of the psychology department at Ohio University.

The survey was the largest based primarily on the Ohio Scales, a questionnaire developed by Ogles and adopted five years ago by the Ohio Department of Mental Health to track the effectiveness of care for children with mental and behavioral problems. Ogles was not directly involved in the new study.

To school administrators, parents and students living with mental and behavioral problems, it's no surprise that kids today face a wide array of difficulties.

Jeff Weir, principal of Felicity-Franklin High School in Clermont County, said today's teens experience an overload of pressures.

"I'm concerned about all of the adult behaviors that are accessible to them," Weir said. "Everyone has a story. You just never know who's burdened at any given time."

Weir says he encourages students to trust their schools. When school officials hear about issues, they usually can offer help.

Students "don't have to bear their burdens alone," Weir said.

One teen's struggle

Fourteen-year-old Heather Smith, of Middletown, was devastated when her mother, Sharell, died last fall.

Soon after Heather was born, Sharell suffered from three pulmonary embolisms and was diagnosed with a rare blood-clotting disease.

During the final years, Heather and Sharell were especially close, said Sharell's husband, Jeff Smith. Some days he'd come home to see them cuddling on a couch together. Other days, he would arrive to see them dancing in the middle of the living room.

Heather, a cheerleader and straight-A student at Verity Middle School in Middletown, changed completely after her mother died. Her grades plummeted. She began to shy away from her friends and classmates.

They wanted to offer her sympathy and she just wanted them to go away. Her father tried to help but he knew that his daughter needed somebody else to talk to.

"She was just going through some emotional times," he said. "People were paying a lot of extra attention to her. It was making her mad. She was not being herself. She knew it and I knew it."

Heather began seeing a counselor but her depression escalated so severely that she began thinking about hurting herself. After a climactic episode with Verity's school nurse, she spent a short spell at an adolescent mental ward.

She has started to rebound, thanks to a combination of counseling, antidepressant drugs and a church youth group that helps her deal with her grief.

Heather has returned to hanging out with her friends and is looking forward to meeting the challenges at Monroe High School this year.

Heather talks about her experience because she believes many teachers and parents do not realize how many teens suffer from depression.

Because of the past year, "I know that there's a lot more people suffering from severe depression," she said. "It's amazing how many people I know who are going through the same kind of issues I am. This is such a trying stage for all of us. Teenagers are going through so many things."

Heather is not surprised at survey statistics indicating that teens are reluctant to seek help.

"They just feel that nobody understands," she said. "(Because of that), a lot of teen-agers don't want help."

Reaching the quiet ones

Paul Varney, former superintendent of Batavia Schools in Clermont County, said the Columbine High School massacre made him realize how truly troubled teens can be. In 1999, teenagers Eric Harris and Dylan Klebold stormed the suburban school and gunned down 13 of their classmates.

Shocked by the tragedy, Varney ordered the district's principals, teachers and counselors to take a closer look at the district's 1,900 students.

The busy superintendent routinely had lunch in the school cafeterias and began paying closer attention to the students who shied away from him. He also encouraged the district's educators to take time with the students who never raised their hands in class.

"It's the minutes spent ... just getting to know the student that tells that student that this teacher cares," he said. "It makes more of a difference than any of us could ever know."

For all his success at school, Christopher Tyo, this year's co-valedictorian at Batavia High School, also recalls experiencing depression.

Just before his freshman year, he and his girlfriend were going through some rocky times. He says writing a poem he called "Blind Sight" helped him make sense of the void he felt inside.

Now ready to start his freshman year at Ohio University, he encourages other teens not to take life so seriously and to rely on friendships during the tough times.

"There are so many things that people say to hurt you, you have to let it go," Tyo said. "If you allow (your friends) to help you see what's making you depressed, you can really benefit from that and pull yourself out of that."

Stephen Renzi, 19, is preparing to enter the University of Notre Dame after a career at Mason High School filled with marching band activities and enough academic achievements to qualify for National Honor Society.

Renzi says he suffered no major problems, but recalls friends who obsessed about their grades and felt overwhelmed by their extracurricular activities. Sometimes, fellow students would spend days berating themselves because they received a B instead of an A.

"I know a lot of kids who are trying to finish near the top of their class," he said. "I got a couple of Bs. Really, there's nothing to freak out about. I'm still going to a college where I want to go."

Renzi's mother, Debbie Renzi, said she often worried about how her son would cope with the high school environment, where smart kids often get ridiculed and popularity seems so important.

"There is a lot of pressure on success and on school and on competition. That would add to those feelings for many students," she said.

School services help

While school years are mostly about growing up and looking forward to the future, a fatal car crash or suicide involving a classmate can suddenly force students to face the very grown-up issue of death.

In recent years, crisis intervention teams have become increasingly common sights at schools. But the potential demand for services goes well beyond that.

Mental health experts say children would do better in school - and in life in general - if more money and effort were put into early detection and treatment of mental and emotional problems.

With proper treatment, the problems that trigger disruptive behavior or cause children to give up on learning often can be controlled.

"There is such a stigma that still exists," said Valerie Robinson, school project manager for Mental Health Recovery Services of Warren and Clinton Counties. "People are living with these issues but they don't realize that they can get better."

Widespread denial of mental health concerns - even within families struggling with affected children - makes school-based services especially useful, said Terre Garner, director of the Ohio Federation for Children's Mental Health.

"People are surprised by these numbers because people really don't want to talk to kids about these things," Garner said. "Who asks their kid, 'Have you thought about killing yourself?' "

Costly needs

The survey, sponsored by the Health Foundation of Greater Cincinnati and county mental health agencies, was conducted about a year ago, with results now compiled for publication.

The survey excluded Hamilton County because sponsors wanted a better picture of mental health needs affecting Greater Cincinnati's outlying areas.

The mental health survey results will be used to redesign services and to seek more funding to expand services - from state and federal governments, private foundations, even to argue for higher county tax levies for mental health services.

County agencies already spend millions of dollars on services to people with mental illness. But most of the money is devoted to services for the most severely ill adults, agency officials say.

Ideally, study sponsors say every school should be getting regular service from a trained mental health therapist or counselor. Currently, many schools provide no service.

For example, in Warren and Clinton counties, two districts have therapists serving eight buildings. The counties have 12 school districts and 60 school buildings.

In Warren and Clinton counties, less than 20 percent of a $10.7 million budget for mental health services goes to services for children. Reaching out to all schools likely would cost millions of dollars.

"We passed a replacement levy, but it doesn't allow us to expand our services for kids," Robinson said. "It's an expensive endeavor. But it's a pay now or pay later kind of thing."

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