Anxiety, Depression, and Suicide in the Adolescent Population

• Printer friendly version of this teaching strategy
• Suggested responses for the Jerry unfolding case study

• Identify resources for youth who are experiencing anxiety and depression.
• Discuss socioeconomic and cultural factors that influence access to mental health resources.
• Describe signs and symptoms of depression, anxiety, and suicidal behavior in youth.
• Develop teaching material related to youth anxiety, depression, and suicide for families, peers, adolescents, and educators.

1. How much do you know about mental illness? Take this short quiz from the CDC to find out: https://www.cdc.gov/mentalhealth/quiz/index.htm

The following resources contain statistical information about suicide and depression in the adolescent population. These may be helpful when developing your educational material.

• https://www.cdc.gov/mmwr/volumes/66/wr/mm6630a6.htm
• https://www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf
  • Focus on the statistics included under the bullet “Among students in grades 9-12 in the United States in 2013.”
• https://www.cdc.gov/healthyyouth/data/yrbs/slides/2015/injury_slides_yrbs.pptx 
  • Focus on slides 76–95.

2.  Complete the table below as you gather information about resources available in your area for adolescents who are experiencing anxiety and depression. Identify resources located within 5 miles, 20 miles, 100 miles of your current location by searching the internet or visiting local settings that provide support for adolescent mental health. Are there other resources in your state beyond the 100-mile radius? The following website may be helpful as you search for resources in your area: https://findtreatment.samhsa.gov/

1.  Develop a concept map that identifies resources available to a 14-year-old who has a diagnosis of anxiety and depression and has attempted suicide. Consider the accessibility of the resources identified in the Learner Pre-work exercise for adolescents who come from a variety of backgrounds. For example, you could consider how transportation, education, financial status, social support, family form, culture, and mental illness stigma might influence the adolescent’s ability to access the above resources. 

2.  Select one of the groups below and develop an educational resource/presentation about anxiety, depression, and/or suicide in the adolescent population. Use the links beside each group as the starting point for gathering information to include in your educational material.

• Educators – https://www.mentalhealth.gov/talk/educators
• Families – https://www.mentalhealth.gov/talk/parents-caregivers and https://www.mentalhealth.gov/talk/friends-family-members
• Youth/self – https://www.mentalhealth.gov/talk/young-people 
• Peers – https://www.mentalhealth.gov/talk/friends-family-members 

Your educational material should include: signs and symptoms of illness, strategies for support, and where/how to access help. When developing your teaching material use the resources you discovered in the Learner Pre-work.

Some ideas for creating your educational material include: PowerPoints, posters, games, and/or pamphlets. Once your educational material has been approved by your instructor you may want to consider presenting at local schools or local health care centers. Your educational presentations should use active learning strategies and your pamphlets should be colorful and easy to read.

3.  Unfolding Case Study

You are working in the pediatric emergency department (ED). Jerry, a 14-year-old male, is brought to the ED by his mother after a fall from his bicycle. Jerry tells the triage nurse that he had been riding his bike over a jump because some of the boys at school had dared him to do it.

Your assessment findings are as follows: vital signs stable, alert and oriented x 3, pain 6/10, the fall was witnessed, he did not hit his head, large laceration on right forearm, abrasions to his upper right arm and right leg, previously healthy, immunizations up to date, behavior – quiet, gives one-word answers, family – mom is calm and appropriately concerned.

While you are completing your assessment and waiting for the physician to do an assessment you ask Jerry about his interests. When you ask him about school he says, “It’s okay.” His mom tells you that Jerry used to love school but has started to lose interest in some of his favorite subjects. You ask what his favorite subjects are and he ignores you, focusing instead on the TV. Laughing, his mom tells you that he really likes science and tells Jerry he needs to answer your questions. You ask him if he has any special interests outside of school. Again, he ignores you. His mom states, “I’m sorry he is being difficult. He seems to be going through some sort of teenager phase. It started a while back when his best friend moved away. Jerry and his friend used to love to explore in the park behind our house. They brought home all kinds of interesting plants and animals, but since his friend moved he is spending more time at home alone in his room. He doesn’t really like us to bother him. Isn’t that right, Jerry?” Jerry continues to ignore the conversation. Mom asks, “Is this normal for a teenager? Jerry’s father and I, well we think it might just be a phase Jerry is going through because he is a teenager and his friend just moved away. What do you think?”

1. What is your main concern? Why is this a concern?

2. How would you answer Jerry’s mother’s question?

3. What are the family’s strengths?

4. What additional assessment data would you want? (Use the mental health assessment tools linked below to answer this question.)

Mental Health Assessment Tools:
General mental health assessment tool - filled out by parents http://www.familytherapeutics.com/forms/ChildAdolescentPscychiatryScreenCAPS.pdf 

Another tool that can be filled out by parents of the teen https://www.brightfutures.org/mentalhealth/pdf/professionals/ped_sympton_chklst.pdf 

Two hours later: The physician assessment is completed. The doctor writes an order for acetaminophen 500 mg po q 4-6 hrs prn. The laceration will need stitches.

5. What additional information would you need prior to administering the acetaminophen? 

Jerry’s mom asks you if she can leave the room for a few minutes to call Jerry’s dad. While she is away you ask Jerry again about his accident and if he likes jumping his bike. He states, “I don’t really like jumping my bike, but a few of the boys at school have been bugging me about being a nerd. I wanted to prove to them that I’m tough. I don’t really care if I get hurt or if I die.”

6. What would you do with this information? Will it change your care? If so, how?  

7. What community resources might you refer this family to?

Download the suggested responses to this unfolding case study.

Anxiety and Depression Overview
https://www.cdc.gov/childrensmentalhealth/depression.html#anxiety

Anxiety
https://adaa.org/about-adaa/press-room/facts-statistics#

Depression
https://www.teenhelp.com/teen-depression/teen-depression-statistics/

Suicide prevention

Risk factors
          http://www.sprc.org/about-suicide/risk-protective-factors

Warning signs
          http://www.sprc.org/about-suicide/warning-signs

Bullying and suicide
https://www.cdc.gov/violenceprevention/pdf/bullying-suicide-translation-final-a.pdf