Screening tool can help predict risk of teen suicide, save lives
Hit show set in Kentucky now has its own driving tour
A new digital screening tool for use in emergency rooms could better detect and prevent youth suicides, Michigan Medicine said this month.
The tool — named CASSY, short for Computerized Adaptive Screen for Suicidal Youth — is one of the latest efforts to address youth suicide, which is an increasing concern during the pandemic.
“Too many young people are dying by suicide and many at high risk go completely unrecognized and untreated,” the study’s lead author, Cheryl King, said. “About half of the youth who die by suicide have never received any mental health services.”
King, a clinical child psychologist and director of the Youth and
Young Adult Depression and Suicide Prevention Research Program in the Department of Psychiatry at Michigan Medicine, said there is an urgent need to improve youth suicide screening.
Among teens, suicide is the second leading cause of death, and King and other researchers hope the computerized suicide prevention system will be used by emergency departments nationwide.
The tool is designed to predict an adolescent’s suicide risk, alerting caregivers to which ones need follow-up interventions, according to Michigan Medicine-led findings published in the Journal of the American Medical Association Psychiatry.
The study included two groups of adolescents, aged 12 to 17, that visited the emergency departments.
The tool was developed in the first group with
2,075 youths and validated in a second, independent group with data from 2,754 youths. In the second group, 165 adolescents — 6% — made at least one suicide attempt during a three-month period.
The screening system predicted suicide risk attempts with 88% accuracy.
Emergency departments, the researchers said, are a good place for suicide risk screening because nearly 1 out of 5 adolescents visit them during a year. In addition, emergency room visits for youth suicide risk and self-harm have also doubled.
Between 2007 and 2018, the latest year the data were available, the suicide rate among those aged 10-24 increased nearly
60%, according to the Centers for Disease Control and Prevention.
A CDC survey in August on how the pandemic is affecting mental health found 75% of respondents ages 18-24 reported at least one adverse mental or behavioral health symptom and 25% considered suicide within 30 days of taking the survey.
Yet researchers say there are not enough data to draw conclusions for why it has so dramatically increased and many at-risk youths aren’t receiving the mental health services they need, according to the health system.
The algorithm for the new screening system was based on data from multiple centers that participated in the Emergency Department Screen for Teens at Risk for Suicide, which is funded by the National Institutes of Mental Health.
When adolescents and teens are admitted to an emergency room for any reason — whether it’s a psychiatric concern or unrelated injury — they complete an adaptive questionnaire on a digital device.
The follow-up questions are based on their answers so that the screening is tailored to the individual patient.
The tool asks adolescents whether they have had suicidal thoughts and other factors that may put them at risk of taking their lives, such as trouble sleeping and concentrating, agitation, depression, feelings of hopelessness, and family and school issues.
A score — and suicidal risk level — is calculated from the answers and risk factors.
“Different combinations of risk factors can place youth at risk,” King said, adding that better tools are needed. “If we screen only for suicidal thoughts, we will miss some high risk adolescents.”
“This screening tool,” King said, “has the potential to be a step forward in our effort to improve clinical care models to adequately meet the needs of youth mental health.”
LEXINGTON, Ky. — Lexington, a city in the heart of Kentucky that’s surrounded by 250 thoroughbred horse farms, has always been known as home to the Sport of Kings. Now, thanks to “The Queen’s Gambit,” a bestselling novel by the late Walter Tevis and a Netflix miniseries viewed by upward of 62 million people worldwide, it is also known as the home of the Game of Queens.
The last time the city got this kind of entertainment visibility was with a reallife equine hero, Seabiscuit. This time around, it’s a fictional anti-heroine — Elizabeth Harmon, a chess whiz whose success is due in equal parts to her math genius and her addiction to hallucinogenic drugs.
Tevis’ novel and, hence, the miniseries are set mainly in Lexington, a fact that VisitLEX, the city’s tourism arm, was quick to pounce on.
“‘The Queen’s Gambit’ put a spotlight on Lexington and piqued people’s interest in the city that served as the backdrop for Beth Harmon’s rise to fame,” says Mary Quinn Ramer, president of VisitLEX.
Knowing that they wanted to take advantage of the show’s global popularity, the VisitLEX team has developed a Queen’s Gambit Driving Tour, designed, as Ramer puts it, “to roll out the red carpet for visitors smitten by the show.”
The tour is a mix of places that currently exist and those that no longer do. For example, you won’t find Ben Snyder’s Department Store where Beth and her adopted mother shopped; on the site of the former store is the city’s neo-classical courthouse with its array of dancing fountains
— a favorite place for locals to cool off during the sultry summer months.
Likewise, the Phoenix Hotel, where Harry, Beth’s friend and chess mentor, had a room is no longer there, having been demolished to make way for the central branch of the Lexington Public Library. Step inside to see the world’s largest ceiling clock, a Foucault pendulum that rises five stories high, as well as a frieze depicting the history of the horse in Lexington. Then stop for a selfie at adjoining Phoenix Park, a lovely pocket park.
Several of the places prominently featured in the miniseries can still be seen. The former Henry Clay High School on Main Street, now home to the city’s Board of Education, was the site of several of the show’s chess tournaments. Magee’s Bakery across the
street is a great place to stop for a doughnut and cup of coffee.
New Circle Road, a loop around Lexington, gets a shout-out in the early moments of the first episode, and it’s the best way to get to some of the area’s gorgeous horse farms.
It’s the Chevy Chase neighborhood that really gives Queen’s Gambit fans a sense of place. This area of quiet, tree-lined streets and upscale shops and restaurants, just a stone’s throw from the University of Kentucky, wasn’t just Beth’s home in the series, it was also Tevis’ real-life ’hood. He learned to play pool at a friend’s house here before going on to write “The Hustler.”
Chevy Chase is also home to iconic spots that make for obligatory stops: the one-of-a-kind shops housed in bungalows on
Clay and Euclid avenues; the college hangout Charlie Brown’s, with its worn leather sofas and fireplaces; and the Chevy Chase Inn, Lexington’s oldest bar and always worth a visit.
Roy Coffee, whose picture hangs on the wall of the 88-year-old bar, certainly thought so. Roy rode his horse in Lexington’s Fourth of July parade every year and decided the Chevy Chase Inn would make for a good watering hole post-parade. On his first visit, he hollered inside for the bartender to bring him a beer. The barkeep hollered back that he didn’t deliver; if he wanted a beer to come in and get it. Undaunted, Roy, accompanied by his horse, proceeded inside and a tradition was born. They do love their horses here in Lexington.
While you’re in the area, you can spend time walking the spacious grounds of Ashland, 19th-century statesman Henry Clay’s palatial home or the campus of the University of Kentucky, Tevis’ alma mater, where he earned bachelor’s and master’s degrees in English and studied with Pulitzer Prize-winning novelist A.B. Guthrie Jr.
Wheeler’s Pharmacy, a Chevy Chase-area icon for half a century, is a fitting substitute for the series’s fictional Bradley’s Pharmacy. If you’re at Wheeler’s during lunch time, grab a stool at the soda fountain and enjoy a meal.
And while, sad to say, there’s no real-life counterpart to reel-life Lex Liquors, the Lexington area is home to 14 distilleries and the Brewgrass Trail of craft beers, so there are plenty of opportunities to imbibe. Just make sure you designate a nondrinking driver and know that you owe him/her a dinner at Tony’s or Jeff Ruby’s, two of the city’s upscale steakhouses.
Even Beth Harmon would be impressed with the Harmon Room at 21c Museum Hotel, a pop-up suite that is a collaborative effort of the hotel and VisitLEX.
The Harmon Room is a time capsule of American midcentury modern design, accented by vintage accessories and period furniture loaned by local antique shop Scout and private collectors.
“I’ve been collecting furniture from that era for three decades,” says Lucy Jones, who loaned the hotel a pair of parasol chairs and the vintage TV cabinet. “It’s a joy to bring to life the rich scenes from page and screen.”
The room’s serene color palette of sand, apple green, light blue and dark brown promises guests a peaceful night’s sleep, in contrast to Beth’s vivid nighttime hallucinations. Custom wallpaper features images of chess figures. Scattered throughout the room are copies of Chess Review Magazine and rare chess books on loan from vintage bookstore Black Swan Books. There is even a handmade walnut and maple chessboard from Iron Bridge Woodshop for guests’ use during their stay.
“Everyone working on this project did an incredible job,” says Brian Pulley, the hotel’s director of sales. Pulley isn’t sure how long the Harmon Suite will stick around, although he admits that “we’re planning to have it available at least through late spring.” (Rates begin at $234 and fluctuate depending on the night of the week.)
After immersing yourself in Beth Harmon’s Lexington world for a few days, there’s no guarantee you’ll become a chess pro like she did, but one thing’s for sure — you’ll feel like one.
For many of us, canceling vacations has become all too familiar. But as people begin to get vaccinated against COVID-19, the prospect of taking a trip seems a little less like a pipe dream.
Certainly, it will be a while before vaccines are widely available (and even then we will need to continue certain practices to stop the spread of the virus). However, just thinking about a future getaway can yield surprising benefits.
“Anticipation is such a valuable source of pleasure,” said Elizabeth
Dunn, a professor in the psychology department at the University of British Columbia, who has studied anticipation and happiness.
I first spoke with Dunn more than a decade ago when I wrote about spending and happiness on the heels of the Great Recession. Recently, I called her again to talk about travel and the art of anticipation in light of the pandemic. The result?
Practical tips from social science on how to cultivate anticipation, what type of trips to take if you want to maximize happiness post-pandemic (the answer may not be what you think), why now may be an excellent time to plan and how discussing your future adventures can help others who are feeling isolated.
The happiness reset: You don’t have to go far
When we begin traveling again after months holed up at home, we will likely experience what Dunn referred to as a “happiness reset”— the result of which may be that even modest, less costly vacations will give us extreme pleasure.
“You can do something pretty simple and it’s going to feel fantastic,” she said.
That’s especially good news for the legions of travelers whose incomes have been hurt by the pandemic.
The theory behind why a more low-key trip may be a smart strategy is because at some point (faster than you think), you’ll get used to vacationing again.
“The more people travel, the less likely they are to savor each trip,” wrote Dunn and Michael Norton, the Harold M. Brierley Professor of Business Administration at the
Harvard Business School and a member of Harvard’s Behavioral Insights Group, in “Happy Money: The Science of Happier Spending.” Dunn was involved with studies that investigated the notion that “an abundance of desirable life experiences may undermine people’s ability to savor simpler pleasures.” In the resulting paper, published in Personality and Social Psychology Bulletin in 2015, Dunn and her fellow authors wrote that “being a world traveler — or just feeling like one — may undermine our proclivity to savor visits to enjoyable but unextraordinary destinations.”
So, in a sense, our current travel deficit may end up replenishing our wonder of exploring.
To take advantage of a happiness reset, begin with a simpler trip — a beach getaway close to home, a cross-country road trip, a fishing expedition with friends. No need for an extravagant getaway on the other side of the world. Even low-key trips are likely to feel novel after the pandemic. Dunn, for example, said she is planning a vacation with friends to a ranch in her home province of British Columbia when vacation travel there is allowed again.
“The happiness reset won’t last forever,” she said. “We’ll ramp up our expectations again. You might as well take advantage of this moment.”
How to cultivate anticipation
Ideally, you want to book a vacation far enough in advance that you have time beforehand to gather details about the destination, to build excitement and positive expectations. This is as true for a trip to a state park as it is for a trip to Sicily. Since you don’t know what will happen on a hike, an escape to distant coastal cliffs or an Italian getaway, you can use the time beforehand to fantasize, to imagine the Mediterranean Sea, food and sunshine. It’s through this cultivation of anticipation that the pleasure of a vacation can be extended beyond the trip itself.
When you don’t give yourself enough time to actively anticipate a vacation — to pore over photographs of places you plan to see, read about history, browse things to do — you miss out on a potent source of pleasure. As the authors of investigations that examined people’s anticipation of, experiences in and recollections of, meaningful life events (including a trip to Europe, a Thanksgiving
vacation and bicycling in California) wrote in the Journal of Experimental Social Psychology: “people’s expectations of personal events are more positive than their actual experience during the event itself.”
So yes, you need time to cultivate anticipation. But not too much time. The problem with things that lie in the future, researchers have found, is that we almost think of our future selves as other people. Dunn, for example, said she essentially thinks of her older, retired self as a different person. And it’s difficult to get excited about a distant, future self. But, she said, planning a trip with a “reasonable length of runway” (maybe a year as opposed to five years away) still feels like you’re the one who will be taking it.
In fact, the moment we’re in may offer the perfect amount of runway to cultivate anticipation. “The pandemic is forcing us to prioritize our future selves,” Dunn said. “January Liz feels pretty excited about what Summer Liz is going to be doing.”
Invite others to reminisce
Perhaps the most unexpected benefit of planning your own trip nowadays is that it can give great joy to someone else. Wherever you’re considering going, Dunn suggests calling a parent or grandparent, for instance, and providing them with an opportunity to reminisce about their own travels. Ask them if they have ever been where you wish to go.
Reminiscing, after all, has been shown to give us a happiness boost. We can do this for ourselves by looking at our old travel diaries or photographs. But we can also give the pleasure of reminiscing to others by inviting them to share their memories — something that may be particularly welcome amid the isolation of the pandemic.
“Creating opportunities for others to reminisce is a really kind thing to do,” Dunn said.
The planning phase is also an opportunity to virtually gather and touch base with the people you’re hoping to travel with someday, be they friends or extended family members. Make your future travel a reason for virtually interacting now, said Dunn, which is what she and her friends are doing in lieu of going out to dinner.
“I think starting to plan a vacation feels like this active step toward hope,” she said, “and the end of this terrible time that we’ve all been in.”
As we’ve had to postpone our travels because of the pandemic, I believe a weekly dose of travel dreaming can be good medicine. Here’s one of my favorite European memories from Florence — a reminder of the artistic wonders that awaits us at the other end of this crisis.
After my first day in Florence, I remember thinking, “I’ve seen more great art in a few hours than many people see in a lifetime.”
Geographically small but culturally rich, Florence is home to some of the finest art and architecture in the world. In that single day, I looked Michelangelo’s David in the eyes, fell under the seductive sway of Botticelli’s Birth of Venus, and climbed the first great dome of the Renaissance, which gracefully dominates the city’s skyline today as it did 500 years ago.
After Rome fell in AD 476, Europe wallowed in centuries of relative darkness, with little learning, commerce, or travel. Then, around 1400, there was a Renaissance: a rebirth of the culture of ancient Greece and Rome. Starting in Florence, it swept across Europe. Wealthy merchant and banking families — like the Medici, who ruled Florence for generations — showed their civic pride by commissioning great art.
With the Renaissance, artists rediscovered the beauty of nature and the human body, expressing the optimism of this new age. The ultimate representation of this: Michelangelo’s David. Poised confidently in the Accademia Gallery, David represents humankind
stepping out of medieval darkness — the birth of our modern, humanist outlook. Standing boldly, David sizes up the giant, as if to say, “I can take him.” The statue was an apt symbol, inspiring Florentines to tackle their Goliaths.
Until 1873, David stood not in the Accademia, but outside Palazzo Vecchio, the former Medici palace and now Florence’s City Hall. A replica David marks the spot where the original once stood. With goony eyes and a pigeon-dropping wig, this Daid seems dumbfounded, as tourists picnic at his feet and policemen clip-clop by on horseback.
Next door to the palace were the Medicis’ offices, or uffizi. Now the Uffizi Gallery holds the finest
collection of Italian paintings anywhere, sweeping through art history from the 12th through
17th centuries, with works by Botticelli, Raphael, Giotto, Titian, Leonardo, and Michelangelo. In the long, arcaded courtyard, a permanent line of tourists (who ignored my guidebook’s advice to book reservations online in advance) waits to buy tickets.
For me, a highlight of the Uffizi is Venus de’ Medici. Revered as the epitome of beauty, Venus is a Roman copy of a 2,000-year-old Greek statue that went missing. In the 18th and 19th centuries, wealthy children of Europe’s aristocrats made the pilgrimage to the Uffizi to complete their classical education. They stood before the cold
beauty of this goddess of love and swooned in ecstasy.
Classical statues like this clearly inspired Sandro Botticelli, my favorite Florentine painter. His greatest paintings, including the Birth of Venus, hang in this gallery. According to myth, Venus was born from the foam of a wave. This fragile Venus, a newborn beauty with flyaway hair, floats ashore on a clam shell while flowers tumble in slow motion. For me, Botticelli’s Birth of Venus represents the purest expression of Renaissance beauty.
In Florence, art treasures are everywhere you turn. The small, uncrowded Bargello Museum features the best collection of Florentine sculpture anywhere, including works by Michelangelo, Donatello, and Ghiberti. And hiding out at the underrated Duomo Museum, you’ll see one of Michelangelo’s Pietàs (which he designed as the centerpiece for his own tomb) and Ghiberti’s Gates of Paradise panels. Revolutionary in their realism and three-dimensionality, these panels were created in response to a citywide competition in 1401 to build new doors for the Baptistery.
Across the street from the Duomo Museum towers Florence’s famous cathedral. Gaping up at the first great dome built in Europe in more than a thousand years, I celebrated the structure that marked the start of the architectural Renaissance.
After a day filled with so much great art, I retreat to a stately former monastery and unwind in a Renaissance-era cell. It’s my favorite Florentine hotel, Loggiato dei Serviti, and that cell is my bedroom.
Directly across from my window is the Accademia, filled with tourists clamoring to meet David. The peaceful courtyard in between is gravelly with broken columns and stones that students are carving like creative woodpeckers. I hear the happy chipping and chirping of their chisels gaining confidence, cutting through the stone. Five centuries later, it’s comforting to know that the spirit of the Renaissance remains alive and well in Florence.