Responding to Youth Who Have Depression or Suicidal Thoughts

In between wilderness hikes and zip lining, teens attending the weekend Camp Mariposa® addiction prevention and mentoring program learn to recognize signs of depression in themselves and those they love. Surrounded by other kids who have faced similar circumstances as well as trained adult mentors, young people impacted by the substance use disorder of a family member participate in traditional camp fun combined with education and support activities — including a DVD showing vignettes they may encounter and followed by open discussion about depression and ways they can seek help.

Nationally, suicide is the second-leading cause of death among youth aged 11 to 18 — a major public health crisis. Kids are much more likely to talk to each other about emotional struggles than to adults, so it is important for them to learn the symptoms of depression and what to do if they are worried about a friend.

The SOS Signs of Suicide® Prevention Program is an evidence-based, universal prevention program for schools and youth-serving organizations like Eluna-created Camp Mariposa, which began incorporating the SOS program into its activities in 2014. Research indicates that children and teens who live with a family member who struggles with a substance use disorder are at a higher risk for developing their own depression, both while growing up as well as into adulthood.

Using the acronym ACT — Acknowledge, Care and Tell — this tool teaches all young people and adults who work with them to know how to respond if they are concerned.

Acknowledge

Mention what is concerning you. You have likely noticed changes in a young person’s behavior. Point out the changes and ask what’s going on. “You haven’t been joining the activities like you used to, and your mood seems to have changed these days. Can we talk about how things are going for you?”

Don’t be afraid to ask if someone has been thinking about suicide. Many people fear that mentioning suicide could make things worse by putting the idea into someone’s head. In fact, the opposite is true. Asking the question may open the door for someone to tell you how they are truly feeling. You could say: “It sounds like you are really struggling with some tough stuff. Are you feeling so bad that you’ve thought about suicide?”

Care

There is no perfect script for this tough conversation. It can be difficult to hear how much a young person is suffering, and you feel like you don’t know how to respond. Remain calm, be supportive, and reassure the young person that help is available. Say: “I’m really concerned about you trying to deal with all of this on your own.”

If a young person is struggling with suicidal thoughts, it is very likely there is an underlying mental illness at work, most likely depression. The good news is that depression is treatable. You can help connect a child to the treatment they need to get better.

Tell

Each youth-serving workplace should have procedures in place for next steps when concerned about a young person’s safety. Stay with the young person until they are safe. Maybe that procedure is to take your concern to the program director or an administrator. Maybe it’s to work with them to call a family member.

The most important thing to remember is that you can never keep a child’s secret when it comes to safety. Lean on your team for support and ensure that parents or guardians are contacted promptly. You can say: “There are people here who know how to help kids dealing with big problems like this, let’s go talk to Ms. _____.” Or: “We need to get you some help, and the first step will be talking to your parents about what’s going on. Let’s go down to the main office and call them together.”

Trust your gut. If you notice changes in a child’s mood or behavior, ACT to ensure they are connected to the help they need.

Statistics from Camp Mariposa’s national network during the past two years show approximately 25 percent of camp attendees score high on the screening tool for depression and suicidal thoughts that is administered as part of the SOS program. In some locations, the number of youth scoring high exceeds 50 percent.

All the kids who score high on the screening tool meet with a clinician to complete a more thorough assessment and develop an action plan, including referrals to or connections with support groups and/or mental health professionals in their community. And they all create a safety plan that is shared with parents or guardians at the end of the camp weekend. In fact, at most locations, all campers complete a safety plan that focuses on safe adults and places they can turn to if they need help.

Many camp attendees talk about the ACT message, even on the weekends when SOS is not offered. One girl recently shared that she sought help for a good friend who started to show signs of depression — and said she would have never done so prior to participating in the SOS program. Many campers write in their reflections that they have learned about the importance of expressing their feelings, especially difficult ones such as sadness, grief and anger, through Camp Mariposa and the SOS program.

About the Authors:

• Meghan Diamon is program manager at Screening for Mental Health, a national nonprofit and pioneer in large-scale mental health screenings for the public.
• Brian J. Maus, MA, LMFT, is director of addiction prevention and mentoring programs at Eluna.