Early sui­cide de­tec­tion trial

A new move to ad­dress NZ’s teen sui­cide rates could soon be seen in schools and clin­ics.

Havelock North Village Press - - News -

Asim­ple new early screen­ing scheme — de­vel­oped at Auck­land’s Star­ship Hos­pi­tal — could help bring down New Zealand’s sui­cide rate. Dr Hi­ran Thabrew, a child psy­chi­a­trist and pae­di­a­tri­cian at Star­ship Child Health, has been track­ing the ef­fec­tive­ness of YouthCHAT from Novem­ber 2016 to July this year.

An elec­tronic, tablet-based, sel­f­re­port screen­ing tool, de­vel­oped by Pro­fes­sor Fe­lic­ity Goodyear-Smith from the Univer­sity of Auck­land, YouthCHAT as­sesses health-re­lated be­hav­iours and men­tal health con­cerns in­clud­ing those that may lead to sui­cide.

Thabrew hopes YouthCHAT can be used to help cut the youth sui­cide rate that saw New Zealand top­ping the world in last year’s Unicef re­port — ranked first in the rate of teen sui­cides (aged 15-19) out of 41 OECD and EU coun­tries.

It is also an ex­am­ple of the type of re­search new Star­ship Foun­da­tion CEO Aisha Daji Punga is hop­ing to fos­ter as she ac­cel­er­ates the Foun­da­tion’s rev­enue tar­gets to $20m a year, to help pro­vide bet­ter health and brighter fu­tures for chil­dren in New Zealand and at Star­ship Hos­pi­tal.

At present, rou­tine screen­ing for pos­si­ble men­tal health fac­tors that may lead to sui­cide is un­der­taken by health nurses in some schools us­ing a face to face pro­ce­dure known as HEEADSSS assess­ment. Due to fund­ing lim­i­ta­tions, only Year 9 stu­dents in decile 1-3 schools have been el­i­gi­ble.

“We need bet­ter ways to de­tect psycho-so­cial prob­lems early and to of­fer young peo­ple sup­port in ac­cept­able ways within their nat­u­ral en­vi­ron­ment”.

Although Youth 2012 sur­vey re­sults con­firm that 70-80 per cent of young peo­ple visit their gen­eral prac­ti­tioner each year and most GPs and prac­tice nurses are trained in HEEADSSS assess­ment, rou­tine screen­ing for men­tal health prob­lems is of­ten not done due to lack of time.

Thabrew says: “We miss many op­por­tu­ni­ties to check in with young peo­ple and iden­tify prob­lems early enough.”

The Star­ship Foun­da­tion-funded trial un­der­taken at Auck­land’s Ta­maki Col­lege in­volved Year 9 stu­dents (13-year-olds), half of whom com­pleted YouthCHAT first, then HEEADSSS — with the other half com­plet­ing these screens in re­verse.

“What we dis­cov­ered us­ing YouthCHAT was that the screen­ing was done in half the time,” says Thabrew. “Kids found it more ac­cept­able to be an­swer­ing ques­tions in a dig­i­tal en­vi­ron­ment, par­tic­u­larly those of a sen­si­tive na­ture such as around anger or abuse. School nurses also rated YouthCHAT pos­i­tively and told us that it made the school health team work bet­ter to­gether — that was good to hear.”

Screen­ing un­cov­ered a few young peo­ple who re­quired fol­lowup. Thabrew says num­bers were “not as great as some peo­ple may fear. Most stu­dents were able to be helped by mem­bers of the school health team and did not re­quire re­fer­ral to ex­ter­nal ser­vices.”

The trial is con­tin­u­ing at Ta­maki Col­lege, us­ing the same Year 9 (now Year 10) stu­dents to see if life as a 14-year-old throws up any dif­fer­ent re­sults from life as a 13-year-old. If the Year 10 trial also pro­duces good re­sults, it raises the pos­si­bil­ity of pi­lot­ing YouthCHAT screen­ing in other schools, GP prac­tices and nurse-led youth clin­ics.

YouthCHAT is also be­ing tri­alled at Star­ship Hos­pi­tal in the gen­eral, di­a­betes and car­di­ol­ogy clin­ics to see if it could be use­ful for rou­tine psycho-so­cial screen­ing of young peo­ple with long-term phys­i­cal con­di­tions (chronic ill­ness). Due to the level of stress as­so­ci­ated with their ill­nesses and treat­ment, they are at in­creased risk of de­vel­op­ing anx­i­ety and de­pres­sion.

“At the mo­ment, around a third of New Zealand young peo­ple ex­pe­ri­ence anx­i­ety and de­pres­sion while a quar­ter of high school stu­dents en­gage in haz­ardous al­co­hol use and we have one of the high­est youth sui­cide rates in the world.

“We need bet­ter ways to de­tect psycho-so­cial prob­lems early and to of­fer young peo­ple sup­port in ac­cept­able ways within their nat­u­ral en­vi­ron­ment,” says Thabrew.

“Due to the num­ber of fac­tors in­volved, it may take years to demon­strate the value of a screener such as YouthCHAT in re­duc­ing sui­cide.

“How­ever, medium-term ev­i­dence of the im­pact of rou­tine psycho-so­cial screen­ing would in­clude a re­duc­tion in the num­ber of young peo­ple be­ing re­ferred to spe­cial­ist men­tal health ser­vices. Shorter-term ev­i­dence of im­pact would in­clude the nor­mal­i­sa­tion of dis­cussing psycho-so­cial is­sues and in­creased use of sup­port within schools.“ To do­nate to the Star­ship Foun­da­tion, please visit www.star­ship.org.nz/do­nate.

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