The recent massacre at Sandy Hook elementary school in Newtown, Conn has dramatically raised our nation’s awareness concerning the need for truly effective gun control, combined with greater support of mental health services in our public schools.

Earlier this week the Daily Star ran an article highlighting findings of a large study of suicidal behaviors in U.S. adolescents: a full report on the study can be found in the most recent issue of JAMA Psychiatry, published this past week.  The study, conducted by a Harvard University research team headed by Dr. Matthew Nock, surveyed 6,483 teenage boys and girls ages 13 to 18.  Findings of this study are truly alarming.

The investigators report that 1 in 8 teens have persistent suicidal thoughts, 4 percent make plans to commit suicide, and 4 percent actually attempt to kill themselves!   Suicide is the third-highest cause of death among U.S. teenagers, after accidents and homicides, accounting for 11 percent of deaths among U.S. youths ages 12 through 19.

Striking differences were evident when the study subjects were broken down by gender.  Of the girls, 15 percent reported episodes of persistent suicidal thoughts, 5 percent made suicide plans and 6 percent made at least one attempt to kill themselves.  While only 9 percent of the boys reported persistent suicidal thoughts, and only 3 percent made plans to commit suicide, a full 2 percent of the subjects actually carried out their plans!  The authors observe that boys’ attempts are more fatal than girls’ because they tend to use more lethal methods, particularly firearms.

The authors clearly contend that teenagers are not being served effectively by the mental health system, underscoring a dire need for effective prevention strategies.  In their words, “Mental health professionals are simply not meeting with adolescents in response to the suicidal thoughts or behaviors”.

Why are mental health services failing to needs the needs of suicidal teens?  Reasons include:

• Schools and other public agencies generally do not place a high priority on meeting these needs.  This is especially true in today’s climate in which both state and local governments are typically strapped for funds.
• Failure to refer troubled teens for help – parents of these adolescents are often in denial, and both teachers and peers generally lack the base of knowledge needed to identify students with potentially serious problems and get them to treatment.
• Teens who are initially evaluated and referred to public clinics may encounter inordinate waits to be seen, despite the fact that many of these kids are desperately in need of immediate help.
• Private hospitals maintaining adolescent psychiatric units are usually for-profit entities.  As such, they focus primarily if not exclusively on treating privately insured patients.  Many units either don’t accept Medicaid patients or severely curtail the number of these patients accepted for treatment.

Toward a solution

Providing adequate mental health services for students in our schools is imperative, both in terms of providing an appropriate crisis response to students at risk of harming themselves, as well as in reducing the risk of violence perpetuated by severely disturbed young men in their 20s.  Regarding the latter, a significant number of future incidents of mass violence might be averted through providing effective intervention to troubled boys during their formative years.

Unfortunately, the current state of affairs will not change until our society makes it a priority to provide effective and readily accessible mental health services for our nation’s youth.  In addition, both parents and teachers need to be trained to identify signs of potentially serious mental disturbance among their children and students, and to take steps to ensure that they get the help they need.

As I discuss in my book “The Tucson Tragedy”, an extremely cost-effective step in this direction would entail initiatives on the part of local, state and federal government agencies to incentivize school districts to integrate age-appropriate mental hygiene education into public school curricula at the elementary, junior high and high school levels.  Had such programs been in place throughout the school districts serving  Oro Valley, Arizona and Newtown, Connecticut, it is possible that the massacres perpetrated by Jared Lee Loughner and more recently by Adam Lanza might have been averted.