Recognizing the signs

Eight percent to 12 percent of adolescents are depressed.
By WILLIAM K. ALCORN
VINDICATOR HEALTH REPORTER
YOUNGSTOWN -- Yes, children can be clinically depressed, and yes, something can and should be done about it.
That is the primary message of the Red Flags Program, which recently provided training on childhood depression for about 80 Mahoning County middle school and health agency personnel.
The key, said Penelope Frese, founder of the program, is to get schoolteachers, counselors, nurses, administrators and pupils to recognize the symptoms of depression, and get the child into treatment.
The Red Flags Program, a school-based adolescent depression awareness and intervention program, is three-pronged, said Frese, a mental health advocate and former teacher and school administrator.
The first step is training for school personnel; the second is a video-based curriculum for pupils called "Claire's Story: A Child's Perspective of Childhood Depression," written and produced by Frese; and the third is a seminar for parents, pupils and the community.
Claire, now 24, is Frese's daughter.
Target group
The target age group is 11 through 15, the time when adolescents most often begin exhibiting signs of depression, Frese said.
"If we can catch it then, perhaps we can prevent the consequences of untreated mental illness," she said.
Mental health professionals estimate that 3 percent to 5 percent of children and 8 percent to 12 percent of adolescents experience clinical depression each year.
Be kind to parents, Frese said. "You can't imagine the disruption a mentally ill child causes in a family."
Frese said Claire was very bright, but unable to concentrate.
"She screamed when we said we were going to do something, so I learned to walk on eggs. The screaming continued at school. She became violent and had emotional seizures and started to threaten suicide. At age 11, she melted down," Frese said.
Frese said she went to the library at Kent State University, where she was teaching, and could find no materials on childhood depression.
That's when she developed the video, with Claire's help and funding from the Mental Health Association of Summit County and Ohio Department of Mental Health.
Genetic illness
The cause of children's mental health problems is not bad parents. Mental illness is genetic. When a child has mental illness, most often so does the parent, Frese said.
Don't look at the signs of depression in isolation, she urged her audience. When symptoms last a long time and appear in clusters, and functioning is impaired, take the child to a doctor. It is depression. Mental illness is not a dirty word, it is just a brain disorder, she said.
Among the 80 people attending the seminar were three teachers from Jackson-Milton Middle School: Anne Downs, Melanie Hulett and Kimberly Bauer.
They said they see pupils in their school exhibiting the symptoms of depression, and when the symptoms were described, heads nodded in recognition all over the room.
The Jackson-Milton teachers said they planned to take the Red Flags Program back to Jackson-Milton and try to get it made part of the health class curriculum.
The good thing about Red Flags, Frese said, is that it is free to schools.
She said that when children see Claire's video, they say "I'm just like in the video."
Others using program
Red Flags is now in its fourth year and is being used in other Ohio counties, including Columbiana, and other states and countries.
It was introduced to school personnel in Columbiana County schools in May 2003, said Nancy Swanson, coordinator of CASH -- Coordinated Action for School Health.
"We believe Red Flags has a good chance of working. It has been implemented in some districts in the county, but not all. We're working on it," she said.
Duane Piccirilli, executive director of Help Hotline, which helped sponsor the depression training, said there is a steadily growing number of calls to Help Hotline from the middle-school-aged kids with signs of depression.
How educators can help
The problem is overwhelming for mental health providers. They need the help of educators, Piccirilli said.
Look at the child, know there is a problem, and get him help, said Ron Marian, executive director of the Mahoning County Mental Health Board, which also helped fund the training session.
Frese said school personnel are not being asked to diagnose depression; just have a heightened awareness of symptoms and get the child to professional treatment.
Also, Frese said, the program doesn't impose a new social problem on the school.
In fact, she said, if schools deal with this, they will solve other problems. Academic performance will improve, there will be less classroom disruption, and most importantly, the children who need help will get it.
"Suicides are real," Frese said.
alcorn@vindy.com