Be pre­ven­ta­tive not re­ac­tive with youth men­tal health con­cerns

Prairie Post (East Edition) - - Brooks - BY JAMIE RIEGER— jrieger@prairiepost.com

Preven­tion and early in­ter­ven­tion are key, rather than re­ac­tive mea­sures, when it comes to youth anx­i­ety and de­pres­sion, ac­cord­ing to a lead­ing psy­chi­a­trist who has been re­search­ing child and youth men­tal health for years.

Dr. Peter Sil­ver­stone, a pro­fes­sor of psy­chi­a­try at the Univer­sity of Al­berta, said pre­ven­ta­tive mea­sures rather than re­ac­tive re­sponses are the most ef­fec­tive, cost ef­fi­cient meth­ods in im­prov­ing men­tal health is­sues with young peo­ple.

Dr. Sil­ver­stone will be a key­note speaker at the up­com­ing Ru­ral Men­tal Health Con­fer­ence, tak­ing place in Brooks on Nov. 12-14 and will talk about his re­search and in par­tic­u­lar, men­tal health is­sues in ru­ral com­mu­ni­ties.

A num­ber of years ago Sil­ver­stone de­vel­oped a screen­ing pro­gram where stu­dents could an­swer ques­tions about strug­gles with al­co­hol, anx­i­ety, de­pres­sion, qual­ity of life, self-es­teem, and sub­stance mis­use.

One day when he was driv­ing and heard the su­per­in­ten­dent (Stu Henry) of the Red Deer Pub­lic School Divi­sion (RDPSD) talk­ing on the ra­dio about a num­ber of teen suicides that had taken place within the school divi­sion and saw the op­por­tu­nity for a pro­gram that could ad­dress the early signs of youth anx­i­ety, de­pres­sion, and sui­ci­dal thoughts.

"I called him up and he was re­cep­tive to the idea of a com­bi­na­tion ap­proach," said Sil­ver­stone, who was the first sci­en­tific di­rec­tor for the Strate­gic Clin­i­cal Net­work in Ad­dic­tion and Men­tal Health for Al­berta Health Ser­vices be­fore join­ing the U of A.

The Em­pa­thy Pro­gram, de­signed to lower teen sui­cide rates, in­volved the U of A, Red Deer PCN (Pri­mary Care Net­work), Al­berta Health Ser­vices, and RDPSD.

"Red Deer Pub­lic Schools got in­volved and we got fund­ing from AHS," he said.

Start­ing in 2013, the pro­gram ran for 15 months for Grades 6-12 Red Deer stu­dents, with more than 6,000 stu­dents par­tic­i­pat­ing.

Over the course of the pro­gram, the per­cent­age of stu­dents who were ac­tively sui­ci­dal dropped from 4.4 per­cent to 2.8 per­cent.

Rates of anx­i­ety and de­pres­sion also de­creased.

"If you give them the tools they need to deal with their men­tal health is­sues, it will have a pos­i­tive im­pact on them and on so­ci­ety," he said.

De­spite the en­cour­ag­ing re­sults, fund­ing for the pro­gram was cut.

"It was a suc­cess­ful pro­gram; un­for­tu­nately, we didn't get any fur­ther fund­ing," he said.

More re­cently, he has been con­duct­ing re­search at Fort McMur­ray where there is a high rate of de­pres­sion and post-trau­matic stress dis­or­der fol­low­ing the dev­as­tat­ing 2016 fires.

He and his team have col­lected in­for­ma­tion on 3,200 stu­dents, in­for­ma­tion that would as­sist them in re­duc­ing the rates of PTSD among the com­mu­nity's young peo­ple.

"Men­tal health is­sues are so wide­spread and so ne­glected. We have to in­ter­vene early. It's about early in­ter­ven­tion and preven­tion, he said.

The first step is rec­og­niz­ing that some­thing is hap­pen­ing.

"When it comes to preven­tion, aware­ness is ab­so­lutely num­ber one. If you aren't look­ing and aware, you won't find it. If you no­tice a change in a child, that's num­ber one," he said.

Part of that is watch­ing for signs that the child or teen -or adult, for that mat­ter, may be ex­pe­ri­enc­ing de­pres­sion or other men­tal health is­sues.

"Peo­ple will give sub­tle an­swers like "I'm fine" when the op­po­site is true."

Sil­ver­stone un­der­stands that peo­ple in ru­ral com­mu­ni­ties may not have ad­e­quate sup­ports close by, but men­tal health con­cerns are just as preva­lent in small towns as they are in ur­ban cen­tres.

"I rec­og­nize re­sources are lim­ited in ru­ral ar­eas. There are more sup­ports in ur­ban, dense ar­eas than in ru­ral. But men­tal health af­fects peo­ple in ru­ral com­mu­ni­ties just as much. It's very real in small towns and ru­ral home­less­ness is linked to it," said Sil­ver­stone.

It is im­por­tant for peo­ple to not be crit­i­cal when they are aware of some­body hav­ing men­tal health con­cerns.

"Don't crit­i­cize. Bul­ly­ing comes in all kinds of con­texts for young peo­ple and adults. In the work­place, some­times, they rec­og­nize they are do­ing some­thing wrong, but quite of­ten they do not. Peo­ple need to rec­og­nize that what you say may im­pact an­other per­son in a very neg­a­tive way," he said.

Sil­ver­stone is hop­ing peo­ple who lis­ten to his pre­sen­ta­tion at the con­fer­ence will leave with the tools needs for help­ing some­body with anx­i­ety, de­pres­sion, or low self-es­teem. "How do you help some­body who is young? You need to rec­og­nize the con­cerns whether it's anx­i­ety, low self-es­teem, sub­stance abuse or some­thing else. How can I com­bat these things? You ab­so­lutely need to get help and hope­fully,

hope peo­ple have the tools peo­ple can find the tools they can use in their own com­mu­ni­ties," he said.

Sil­ver­stone has done ex­ten­sive re­search on anx­i­ety, de­pres­sion, and sui­ci­dal thoughts over the years and has fo­cused heav­ily on chil­dren, youth, and teenagers over the past sev­eral years.

He came to Al­berta from Ox­ford Univer­sity 26 years ago, where he com­pleted his doc­toral stud­ies and trained in psy­chi­a­try at the Maud­s­ley Hos­pi­tal and In­sti­tute of Psy­chi­a­try.

"I've been here a long time and am now an Al­ber­tan in ev­ery sense. But, we have a big prob­lem here," he said.

While peo­ple can do their part in rec­og­niz­ing and help­ing some­body with men­tal health con­cerns, the gov­ern­ment needs to pro­vide fund­ing for suc­cess­ful pro­grams like the Em­pa­thy Pro­gram that showed en­cour­ag­ing re­sults in Red Deer a few years ago.

"We need to ad­vo­cate so those things are funded and op­er­ated prop­erly," he said.

DR. PETER SIL­VER­STONE

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