New Orleans
middle-school students
describe high rates
of depression
Children watch as New Orleans police investigate a murder in Algiers in July. New Orleans children had elevated rates of witnessing violence and feeling concerned about their safety, a new study shows. (Photo by Eliot Kamenitz, NOLA.com | The Times-Picayune)By
The Times-Picayune
on December 03, 2012New Orleans middle-school students cite symptoms of depression and post-traumatic stress at much higher rates than typical teenagers, according to data based on interviews collected by a local non-profit organization. Perhaps not surprising in a city with the highest murder rate in the country, the interviews conducted by the Institute of Women and Ethnic Studies also showed the New Orleans children had elevated rates of witnessing violence and feeling concerned about their safety.
The screenings were part of a federally funded teen pregnancy prevention program the IWES has run in schools and churches since 2010. As part of the program, the group’s team interviewed children for over a year beginning in the summer of 2011 about their mental health, asking specific questions to figure out what could be contributing to their problems.
Dr. Denese Shervington with the Institute of Women and Ethnic Studies.
“At least a third of our kids are really experiencing symptoms of depression and post-traumatic stress disorder, which on a simple level means it is hard to attend school and do well,” said Dr. Denese Shervington, a psychiatrist and IWES president. At the other extreme, these symptoms could lead to acting out, including committing crimes, she said.
Shervington’s team screened about 700 kids through the program. A researcher on the group’s board pulled out a sample of 232 students for a presentation at the organization’s recent conference in New Orleans on youth mental health.
The middle-school students ranged from 11 to 15 years old, although most were between 11 and 13. Sixty-one percent of the respondents were girls, while 39 percent were boys.
Almost 25 percent exhibited symptoms of depression, with almost twice as many girls showing signs of being depressed as boys.
A third of respondents had symptoms of going through post-traumatic stress disorder at some point in their lives, while 21 percent were dealing with such problems when interviewed.
In comparison, Shervington pointed to data collected by the National Institute of Mental Health, which showed far lower rates of depression and PTSD nationally. One national survey found that eight percent of 12 to 17-year-olds showed signs of depression. Another study showed 11 percent of 13 to 18-year-olds experienced a “major depressive disorder.” Rates of post-traumatic stress were even lower nationwide, occurring in just four percent of 13 to 18 year-olds, according to one study.
Some of the most striking data in the presentation were the number of children who said they’d witnessed serious violence, including assaults and murder. More than 29 percent said they’d seen assaults, which the group specified were committed with weapons, while almost 14 percent had witnessed murders.
More than half of the students classified concerns about “personal safety” as a source of worry, more than twice the number who worried about “being unloved.”
“I am sorry to say I’m not surprised at all,” said Joshua Perry, head of the public defender office in juvenile court, pointing to the fact that 16.7 percent of boys said they’d witnessed a murder. “My anecdotal sense, it is higher in the population that we represent.”
Even for those young people who haven’t actually seen someone killed, many are dealing with the stress of living in unsafe neighborhoods, he said.
“A lot of what is perceived as a public-safety problem is also a public-health problem,” Perry said. “That is not to say we shouldn’t be worried about violence in our society and delinquent behavior youth may be involved in. But we have to understand what the right responses are going to be.”
The data collected by Shervington’s team is a small sample and not part of a peer-reviewed study. But during a presentation last week, Stephani Hatch, a sociologist at King’s College in London who analyzed the data, pointed to peer-reviewed studies in South Florida that showed similar links between witnessing violence and psychological disorders in young people.
The 2004 study by researchers at Florida State University found that both experiencing traumatic events -- whether a sexual assault or abandonment by a parent -- and witnessing violence led to a higher risk of developing depression and anxiety disorders.
Current middle-school students were very young at the time of Hurricane Katrina. Some are showing lingering effects from the now-distant storm, Shervington said.
“Nobody paid attention to them. Who is thinking that a four- and five-year-old would be wrapped into the storm?” she said. “But now we are getting stories from them that they are remembering they saw dead bodies and all the traumatic experiences they had during Katrina.”
As part of her program, Shervington said they tried to provide some assistance to children identified as having problems. But the group’s recent conference, called “The Root Of It All: The State of Mental Health of New Orleans’ Youth,” was aimed at identifying how the community as a whole could intervene in more children’s lives.
“Over the extreme continuum where kids are killing each other, everyone jumps up,” she said. “But there are many things we can do along the way.”
In New Orleans, there are clear gaps in the mental health system for adolescents, with both insufficient psychiatric hospital beds and intensive, short-term, in-patient treatment, said Dr. Karen DeSalvo, the city health commissioner.
“Sometimes it is just that the kid needs to be pulled out of the situation and have an opportunity for the family or caregivers to rest,” she said. “Then they can go back into the community.”
There is also a need for substance-abuse treatment for young people, DeSalvo said.
The Louisiana Department of Health and Hospitals is in talks with two psychiatric hospitals in the New Orleans area to provide inpatient services previously offered by the Southeast Louisiana Hospital in Mandeville, an agency spokeswoman said.
Orleans Parish was added in October to a new state program that attempts to provide coordinated services for youth with mental health problems. DeSalvo said the program, although just getting off the ground in New Orleans, holds real promise.
The program, called “Coordinated System of Care,” is run by Magellan of Louisiana. Lisa Faust, Magellan’s communications director, said the company is seeking providers to offer the kind of short-term care DeSalvo described.
Other components of the program include helping teenagers develop independent living skills, providing short-term therapy while a child remains in the home, youth support to help them develop the skills to deal with mental illness and programs for parents. The services are available to children covered by Medicaid, as well as some who aren’t eligible for the federal health insurance program.
Since Oct. 22, when the system began offering services in New Orleans, 30 children have been referred, according to a Louisiana Department of Health and Hospitals spokeswoman. Nine children have so far been enrolled.
Across the state, a total of 625 children are enrolled, including 88 in the greater New Orleans area.
DeSalvo said the plan is for New Orleans to get at least 150 slots in the system, which she thinks might be too few to meet the tremendous need in the city. She noted about a third of the juveniles housed at the Youth Study Center, the city’s detention facility, need mental health care.
“There is a potential that the need is going to overwhelm the capacity we have,” she said. “What is really encouraging for me is that people are talking about it and are open about the idea that mental health is a health issue that should be prevented, identified, treated and people can recover.”
People in need of mental health services can contact Magellan at 1.800.424.4399.
