Saturday, June 9, 2007

Will Wilton CT Schools Cause More Suicides With Its TeenScreen Program?

I have blogged about TeenScreen before.

It a very questionable mental health screening tool which is being rejected by many school systems across the country.. except places like Wilton, CT, where the Executive Director of the program happens to live.

The Wilton Bulletin had a report about how the Wilton school system is using TeenScreen to screen high school students for suicidal tendencies. The report was very revealing in many ways. For one thing, they did mention that TeenScreen (Columbia University) also disguises its claim that the program is free, ignoring the administrative and follow-up interview costs. But let's examine the survey and why some people believe that suicide rates may actually go up in Wilton as a result. Perhaps they already have since 2003.

Apparently, the TeenScreen survey, being used as a pilot program since 2003, shows more than 25%, or 1 out of 4, of Wilton sophomores who voluntarily took the screening test have suicidal tendencies! That is a shocking number if you believe it. Now that either tells you about how stressed they are from the environment there, or that the screening program is flawed. I believe it to be a little of both, but mostly the latter.

One of the things TeenScreen fails to openly disclose is that the percent of false-positives for their pencil and paper screening "tool" - called the Columbia Suicide Screen (CSS) - is 84%, which means that the chances of your child walking away falsely labeled as "suicidal" or "mentally ill" is 84%! the computer screening version - has false-positives up to 94% (Lucas et al., 2001). Any screening program with that high a rate of false positives is for all intents and purposes useless.

In a study involving ten high schools, the staff reported losing confidence in the screen due to the large number of false positives (Hallfors et al., 2006). In fact, the author of the TeenScreen test, Dr. David Shaffer, acknowledges that his screening tool "would deliver many who were not at risk for suicide, and that could reduce the acceptability of a school-based prevention program."!

The Wilton newspaper report says this:
Kim Zemo, a social worker at WHS, said that The program is “not a diagnostic tool, but a screening tool,” The tool looks for “predictors ... anything that might be linked with suicide.” “It’s looking for risk of suicide, depression, anxiety disorders, substance abuse,” said Colleen Fawcett, coordinator of Wilton Youth Services, in a phone interview on Monday.

Since the pilot program began, 270 sophomores have used the program. Of them, 75, or 27.8%, were determined to need follow-up treatment. According to the faculty who presented the report, 33 students, or 12.2% of these students, were in need of “immediate intervention.” Parents of students deemed in need of immediate intervention are notified within 24 hours by the school, according to the faculty.
The screening is administered in the “privacy of a computer lab.” The students hear questions through headphones and answer them on a computer. After the students answer the questions, they sit down to talk to a staff member. These staff members may recommend a follow-up interview with a mental health professional. The survey has questions like,
"Do you get nervous when you have to do things in front of people",
"Do you worry a lot before a big game or some other activity?",
"Has there been times when you just weren't interested in doing things?"
"Has there been a time when you felt you couldn't do things well or you weren't as good looking or smart as other people?"

Honestly - don't most teenagers feel those things? We all know there's lots of emotion and drama in a teenager's life. They are awkward and unsure. It is all part of "coming into their own". The stress of school doesn't help the situation either.

Aside from that, the direct questions about suicide may even give some of these kids ideas, and suicide ideation is a real possibility after taking these screening tools, especially after they link feeling sad with the question of whether you have tried to commit suicide in the past 3 months. Duke University's School of Business found that asking questions can influence behavior.

Karen Birck, school board chair, said she was concerned that “a child will be labeled because they’ve had a false positive screening.” She should be concerned, as should every parent whose child submits to this flawed screening program.

I would think this would be a tremendous problem to have such a high rate of false positives as the purpose of this screening is to funnel kids with these "identified problems" into the system of therapy and drugs. It has been well documented that with children and adolescents (aged 6-18 years), antidepressant drug treatment was significantly associated with suicide attempts and suicide deaths. Just imagine, with all of those false positives created by TeenScreen in the Wilton schools and the children who will ultimately be "funneled into the system" because of the referrals produced by those false positives, it is a matter of time before the suicide statistics in Wilton will rise because of this flawed screening process, and kids are put on medication that will actually cause them to become suicidal!

I wonder if the school officials will be held responsible and legally liable for condoning the use of this program and leading those children into unnecessary and costly treatment which can ultimately ruin their health and potentially cost them their lives? This may very well create a huge legal liability to the Wilton school district. Screening programs have already spawned many lawsuits from parents whose children were screened without their permission, as well as children who were mis-diagnosed with "mental illness".

The fact is that there is considerable discrepancy within the mental health professions as to the precise definition of "mental illness", appropriate diagnostic means to determine whether a person suffers from such "mental illness", and appropriate and effective means to treat such "mental illness".

The TeenScreen program has not been proven to prevent suicide, and there are strong indications that this program is funded by the pharmaceutical industry. It is basically being used as a marketing tool. Screening and education programs from these types of organizations have NO place in the public school system, because they are designed to create and deliver consumers to the pharmaceutical and psychiatric industry. With all of the false positives that this screening process creates, it won't be long until kids on medications become even more suicidal and some will sadly be successful.