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School Suicide Screening Proves Impractical; Improvements Needed to Identify Teens at Risk, Study Says

CHAPEL HILL, N.C., Feb. 13 (AScribe Newswire) -- Screening students may be one of the best ways to identify youth at high risk of suicide, the third leading cause of death among teens. But recent research shows that a well-known screening test is not practical, and that more development is
necessary for schools to partner in prevention.

A national push to reduce teen suicide, highlighted by the passage of the Garrett Lee Smith Memorial Act in 2004, has resulted in millions of dollars authorized for state and local prevention programs. But the feasibility and
effectiveness of suicide prevention programs need to be thoroughly evaluated, said Denise Hallfors, senior research scientist at the PIRE Chapel Hill Center.

When a well-known, school-based program called the Suicide Risk Screen was tried at ten urban high schools, officials found the two-step questionnaire with follow-up interviews so impractical that that they decided to discontinue it, she said.

Her evaluation of the screen, published in the February edition of the American Journal of Public Health, found that it produced too many false positives - students identified as at risk by the questionnaire but shown not to be at risk by interviews.

"We want to underscore the seriousness teen suicide and the importance of identifying young people with suicide-related mental health problems through schools," Hallfors said. "Awareness programs among youth haven't been effective, and may even increase suicide risk. Screening followed by assessment is a much better idea, but it needs to be carefully tailored to fit with the current school environment."

The Suicide Risk Screen identified nearly 30 percent of students to be at risk for suicidal behaviors. Many school officials were dubious of those figures and reluctant to act on them for fear of unduly alarming students and parents. Nor did the schools have the resources or personnel to assess that many students for potential risk. One school official quoted in the research said her school would have had to assess up to 25 students a week, which she called "totally unrealistic." Insufficient staffing and budgets, overloaded teachers and counselors, legal concerns and
complaints from administrators are real-world roadblocks to current school-wide suicide screening and assessment programs, according to the report.

Analyses showed that for a comparable group of students, who were at risk of school dropout, about 15 percent would be at risk for suicidal behaviors. Among regular high school students, about 11 percent would be identified as at risk.

According to the Centers for Disease Control and Prevention, almost 2,000 young people ages 10-19 died from suicide in a single year; for every death among this age group, many more attempt suicide. About 1 in 11 students reported that they had attempted suicide in the past year.

The Garrett Lee Smith Memorial Act, named after the late son of Sen. Gordon Smith, R-OR, authorized $82 million over three years to develop comprehensive youth suicide prevention strategies.

Hallfors' study, entitled "Feasibility of Screening Adolescents for Suicide Risk in 'Real World' High School Settings," was funded by the National Institute on Drug Abuse (NIDA). PIRE, or Pacific Institute for Research and
Evaluation, is a national nonprofit public health research institute with centers in seven cities and funded mostly by federal research grants and contracts.


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