This is the seventh article in a series exploring the health concerns affecting Gloucester residents tht were identified through a 2005-06 Community Health Needs Assessment.

"I think people are unaware that so many kids are feeling depressed and thinking about suicide," says Amy Kamm, program coordinator for the Student Assistance Program in Gloucester's schools.

The recent Gloucester health needs assessment revealed troubling statistics about the mental health and safety of area youth. In the survey, 10 percent of Gloucester High School students and nearly 6 percent of middle school pupils reported that they had made plans to commit suicide, and 17 percent of middle-schoolers and 26 percent of the high-schoolers reported they were depressed.

Kamm pointed out that the incidence of violence and mental health concerns is not higher in Gloucester than the rest of Massachusetts or the United States, but that many adolescents are struggling and need help.

"We need to keep recognizing that this is an issue," she said, "and try to provide the staff, resources and best practices to work with these issues."

From a school perspective, health coordinator Anne-Marie Jordan said the data on youth safety is "profoundly alarming," and that "too often, students do not have enough access to trusted adults they can confide in at school." Nearly 61 percent of middle school pupils have a teacher or other adult in the school system to talk to, but only half of the high school students do. Most students have more support at home, however. More than 82 percent of middle-schoolers and approximately 76 percent of high school students report having a parent or adult relative to whom they can talk, although 18 percent to 25 percent of the students lack this relationship at home.

To deflect any feelings of isolation, the Student Assistance Program (SAP) is striving to provide a safe haven at both Gloucester High and O'Maley Middle schools.

"We provide a place students can come to," Kamm said. "The program helps students access the support they need, and also helps adults with the skills they need to become better identifiers of students at risk."

The program teaches basic skills that students need to make healthy decisions and encourages goal-setting, so students do not "make decisions in the moment and be impulsive or reactive," Kamm said.

The numbers of kids grappling with emotional and violence-related issues is roughly the same in both the high school and the middle school, she continued. "Mental health, substance abuse, violence — all these things are interconnected. There's still not enough dialogue about the mental health disorders that kids present with, which impact their learning and their social, family and academic life."

She added that kids usually enter her program for a certain reason, then reveal other problems after they feel comfortable. "It's usually not what it seems," Kamm said of her student encounters. "A student may show anxiety and actually have been date-raped." Such emotional disturbances and suicidal ideations are reportedly more prevalent amount young women in Gloucester, and sexual violence is also not uncommon. Among the GHS girls polled, nearly 13 percent said they had been sexually harassed in school, and 7.5 percent had been forced to have sex against their will. Adolescent boys are also reporting forced sex, although in smaller numbers (2.1 percent).

For this and other reasons, many students are afraid of their peers in Gloucester's schools. In fact, up to 5 percent of students have skipped school because they were afraid, and there is quite a bit of bullying going on, especially at the middle school level, where nearly 40 percent of the students report this.

"What shocked people is the number of kids who stayed home because they felt unsafe at school," Kamm said. "This should be a safe place where kids feel free to learn."

She added that the schools have mechanisms in place to address safety, but that students who feel bullied often don't reveal their discomfort, so don't receive the school's protection. Bullying can also occur "underground," Kamm said, often in cyberspace when the student uses a computer at home.

When fearful students cut themselves off and don't reach out to parents or to school professionals, they increase their risk of mental health problems, and isolated teens who don't believe they have any control over their environment can become suicidal.

Kamm said teens who are suicidal may not explicitly talk about killing themselves, but may say instead they wish they could sleep all day, or make other statements that reveal they are withdrawn. Students in trouble may also change or reduce their activity level and have failing grades.

To alert students and teachers about the specter of suicide, a suicide prevention training program is being implemented at both the middle and high schools in coming months. This evidence-based program, titled "Signs of Suicide," is targeted to students who are dealing with this issue or whose friends are. School staff will also receive training about which students to refer for help, either to the Student Assistance Program, guidance counselors or community mental health providers. This program is sponsored by the Tower Foundation, which gave the schools a three-year grant to respond to mental health issues by involving youth, professionals and parents.

"It's a school-based program on how to implement some of the strategies to decrease stigma and reduce barriers to care," Kamm explained.

She said the school district will also become more pro-active regarding student well-being through a universal mental health screening initiative. The "teen screen" tool developed by Columbia University will be used to flag suicidal feelings, depression and substance abuse in the student body and signal when intervention is needed. This will be available to every student at the middle and high school.

Jordan said teachers are not expected to become therapists but, through such tools and training, will soon "have the tools to make referrals and become the linkage" to other resources, and "know the social and emotional indicators." Likewise, Kamm said the Student Assistance Program is not a mental health counseling center, but offers support services and provides advocacy for students and their families so all can receive what they need.

"We are better off if we identify kids more effectively and earlier, and can partner with the community resources we have available to get kids into programming," she said.

For more information about the Student Assistance Program or suicide prevention contact Amy Kamm via Gloucester High School or the Gloucester Health Department at healthdept@ci.gloucester.ma.us Watch in two weeks for the final article in this series about concerns noted in the recent Community Health Needs Assessment.

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This article is part of a regular health education series provided by the Gloucester Health Department and Addison Gilbert Hospital.

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