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May 20, 2001
Israel's Birthday
Stigma and isolation to blame
Expert views on suicide say openness of parents and teachers is
key.
PAT JOHNSON REPORTER
This is the second of a two-part series on teen suicide and
what the
Jewish and general communities are doing to prevent it. (Read Part
One here).
Depression is the common cold of the psyche. Left untreated, it
can turn into pneumonia. That's the image that Sherry Small, school
counsellor at Talmud Torah high school, would like to get across
to parents and teens.
Among teenagers, depression is disturbingly prevalent, according
to a recent British Columbia study. So it is urgent that educators,
parents and health care providers be aware of the signs of depression
- especially when they become so overwhelming that they lead to
thoughts of suicide.
When dealt with, Small said, depression is a minor ailment. "It
is so treatable," said Small, a counselling psychologist who
also has a private practice. "Depression can be cured. It's
the easiest thing to get rid of."
Many cases of depression can be overcome with exercise, nutrition
and improved sleep patterns. Good counselling will help victims
of depression assess their personal relationships to see what is
working and what is not, in addition to correcting self-defeating
ideas.
If those remedies do not work, the new generation of anti-depressants
marks a revolutionary turn in the treatment of what was once seen
as a weakness of character and is now generally accepted to be due
to physiological factors.
When a student comes to Small with depression, she has a standardized,
one-page test that she generally asks them to complete. The questions
include "Has there been a time when nothing was fun for you,
even things that you used to like?" and "Have you been
more down on yourself than usual, when you felt that you couldn't
do anything right?" It then asks about specific actions or
thoughts about suicide.
Depending on the results of the questionnaire, Small will determine
a course of action. She likes to contact parents as soon as possible.
Although she acknowledged that there are confidentiality issues
and that she must have the trust of the student, she finds most
young people are relieved to have their parents working with them
to iron out their problems.
In her work with the Jewish community, through Talmud Torah, she
has found families especially willing to participate in a young
person's recovery from depression. Although there is often pressure
for a Jewish family to maintain the outward impression of ideal
family life, Small said that families always seem willing to confront
the problems and attempt to make them better.
In fact, the stereotypes can be reversed in a sense, she said.
Some non Jewish cultures are known for their reticence to discuss
personal issues. Jewish families, she said, may be more open to
frank, emotional discussions, thereby aiding in the healing process.
Yet, the very fact that consideration is given to "image"
in the discussion of depression is notable. Small said that people
do not hesitate to gettreatment for physical health issues, but
mental health issues still evoke a strong taboo, something that
must be changed.
"It's a whole process of de-stigmatization," she said.
Discussion of suicide - to take the stigma issue further - has been
officially forbidden in some sectors. Generations of educators,
parents and professionals were led to believe that suicide should
not be discussed because of the view that talking about it will
have the perverse effect of encouraging it.
"It's like, 'Don't teach about birth control because they'll
use it," she said. "That's a myth."
Small also takes on the view that there is something pathological
about young people's reactions to the world around them. Josh Platzer,
a young Vancouverite who committed suicide in 1999 and whose family's
story was featured in last week's Bulletin, was deeply troubled
about the state of the world.
Small said that, as young people develop a more sophisticated understanding
of the world around them and see the injustice and pain suffered
by people next door and around the world, they have every right
to be upset about those conditions.
"Usually, they're reacting really normally," she said.
There is a line though, she acknowledged, between determining the
proper emotional response to everyday events and identifying a potentially
dangerous depression.
Startling statistics
A recent, comprehensive study of youth health issues painted a
picture that may be startling to some parents and educators. Among
the findings of the study was the discovery that urban-rural differences
are significant factors in the health of young people. Vancouver
and Victoria have the lowest rates of teen suicide in the province.
This parallels lower rates of smoking, sexual activities and drinking
and driving.
The report, by the McCreary Centre Society, a non-profit adolescent
health agency, also noted that young people with strong family connections
are less likely to experience emotional distress or to attempt suicide.
Predictably, factors such as sexual or physical abuse have a dramatic
impact on increasing a young person's risk for depression and suicide.
The study was the largest youth health survey ever done in this
province and involved a 127-item questionnaire completed by more
than 25,000 students in Grades 7 to 12.
Of these students, 14 per cent had thought about suicide, 11 per
cent had actually planned a suicide, seven per cent had attempted
suicide and two per cent were injured in a suicide. In 1999, the
last year for which statistics are available, there was a total
of 496 suicides in this province.
In 1999, the McCreary Centre raised warning flags about the shocking
results of a similar survey of gay and lesbian youth. Of this group,
25 per cent had attempted suicide in the previous year, and almost
half had low self-esteem. Gay young people overwhelmingly reported
feeling isolated, unsafe at school and subjected to homophobic remarks.
Interestingly, there has been a dramatic rise in awareness of the
dangers of bullying, especially since the suicide of Hamed Nastoh,
a Surrey high school student who jumped to his death from a bridge
after intolerable harassment from schoolmates. His mother has begun
a courageous battle against school bullying.
There are many complex factors that can lead a young person to
depression and to take their own lives and parents, friends and
educators must watch for warning signs.
All people who work in the field of depression treatment and suicide
prevention agree that the most important thing is awareness and
openness to approach the issue. Removing the stigma of depression
is a first step in preventing the tragedy that affects too many
British Columbian families.
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