Crisis Line

People often tell me I’m lucky to do work that makes a difference. I don’t take the opportunity for granted. In fact, I’ve never had a job I felt was meaningless.

Earlier in my career, as a television medical reporter, I received letters from people telling me that a report I did on colon cancer, heart disease, or HIV motivated action on their part, and may have saved their life. Twenty years later I can still remember some of those gratifying letters.

Today, another unforgettable one. It was sent from a high school guidance counselor to Partners HealthCare in Boston. Partners – which includes Mass General Hospital – sponsored the distribution of our DVD, Depression: True Stories, and Words Can Work booklets to attendees at a State House Forum on Depression a few months ago. The guidance counselor writing the letter had received a complimentary copy.

Here’s what she wrote:
__________
“I am writing to express my gratitude for providing [our high school] with the DVD Depression: True Stories. Having worked with two of the psychiatrists who contributed to the publication, I knew it would be a valuable resource for our students.

This week, the documentary was shown to the freshman class as part of a lesson on adolescent depression and suicide. I received overwhelming feedback from students, faculty and administrators. Students shared how helpful it was to learn about the symptoms of depression, and how they felt better able to support peers in crisis. This was evidenced by the number of students who came forward after the activity with concerns about the wellbeing of their friends.

One such case involved two girls who were very worried about a friend of theirs who had attempted suicide only two days earlier. With the comprehensive information and empowering message they received from the documentary, the girls felt able to come forward to seek desperately needed help for their friend. Our guidance staff was able to intervene and secure resources for this young man and his family.

Your kindness in providing our school with this documentary was instrumental in saving a young man’s life. I cannot thank you enough.”

Maureen M. Sanford, LICSW
Guidance Counselor
___________

A response like this is why I get up in the morning. It’s why I continue to feel gratitude to our advisors, who generously gave their expertise to Depression: True Stories, and to sponsors whose donations get the DVD into the hands of people who are using it to help save lives.

Depression can be treated when people find out what to do and where to turn for help. Effective tools can set them on the path, and lead them in the right direction.

Resources
Depression: True Stories
Words Can Work: When Talking About Depression and Other Mental Health Disorders

Related Issues and Answers columns
Depression: A treatable disease
Preventing suicide

Related columns for young people

Civil Rites

On occasion, I meet a young person with exceptionally good manners. A few days ago, I was introduced to 10-year-old Tyler. He extended his hand, gripped mine firmly, and said with confidence, “It’s nice to meet you.” Ahhh, a child with good manners. I loved it. In my opinion, good manners show both self-respect and respect for others.

Maybe it was meeting Tyler, but I’ve been more aware than usual of kids’ manners. Based on recent observations, here are a few suggestions.

1) Teach your children that restaurant waiters are not servants.
In an ice cream store, the child in front of me – about 7 years old – said to the young woman behind the counter, “Give me two scoops of chocolate mint chip.” It was none of my business, but I impulsively piped in, “May I please have two scoops of chocolate mint chip?” The boy and his mother gave me a vacant look, and went on their way. I suspect the child is still demanding service everywhere he goes.

2) Teach your children to say, “Excuse me.”
I picked up 8-year-old Sophie, a friend’s child, at school. Backpacks and jackets were flying around the gym where the children were gathering. A classmate of Sophie’s accidentally ran into me. She looked up, and kept going. “Excuse me” would have been nice. I know Sophie, who’s been taught good manners, would have automatically apologized.

3) Teach your children to say, “You’re welcome.”
Cecilia, a friend’s five-year-old, brought me a glass of water. I thanked her and she said, “You’re welcome.” I was reminded of a comment I overheard at a party a few weeks ago. “No one says, ‘You’re welcome’ anymore.’ ” I started listening and, sure enough, most people respond to “Thank you” with, “No problem.” “Sure thing.” “O.K.” “Absolutely.” But rarely, “You’re welcome.”

4) Teach your children to say, “I’m finished,” rather than, “I’m done,” when they finish meals, if they announce it at all.
My friend Chad brought his four-year-old son Javier over for dinner. After our meal, Javier said, “Daddy, I’m done.” My friend Dierdre was at the table. Never one to hold back, she said, “Javier, cakes are done, people are finished.” We all laughed. A few days later, Chad announced after dinner, “I’m done,” and Javier corrected him. “Daddy, cakes are done. People are finished.”

5) Teach your children telephone etiquette.
When the 10-year-old of a friend answers the phone and I ask for her mother she always asks, “Who’s this?” How about, “Hi. May I ask who’s calling?”

Why do I consider these important? Last week, my 23-year-old nephew Robb and I were talking about all bad news in the world: financial meltdowns, infidelity, flooding. “Everything’s a mess,” he said, “and that’s about all I have to say about it.”

With things around us seeming in turmoil, the world can use more civility. Even if it's something as simple as a firm handshake or a polite thank you.

© Blake Works 2008

Stress Test

Some high schools are funding stress-reduction workshops to help kids relax. The Boston Globe reports in Stressed-out teens get lessons in relaxing about the growing trend.

The Globe article quotes Marilyn Wilscher, the director of a program offered to schools by Mass General Hospital. She says kids from every economic background are stressed. Privileged kids worry about getting into Harvard, while kids from the inner city worry about survival. (I’ve talked with plenty of inner city kids fretting over getting into college too.)

As I’ve written before, there are lots of sources of stress on kids – pressure kids put on themselves, and pressure others impose.

Seventeen-year-old Angie lives in the Bronx. “It sounds really cliché, but there’s so much pressure to fit in, and in trying to fit in,” she says. “Like whether to do drugs, or drink, or smoke, or skip classes. Without a good head on your shoulders, it’s really easy to get into it.”

And there is the pressure some parents put on their kids. And it can start early. Recently, at an eight-year-old’s birthday party, I listened in amazement as a group of moms discussed what language class their kids should take to increase their chances of getting into the “right” college. Spanish? Chinese? Eight-year-olds!

Globe reporter, Jan Tracy refers to “helicopter parents” – those who “obsessively monitor their children’s attendance and grades via the web-site set up by the school.” Many parents defend this behavior saying it’s for their kids’ own good. But young people have told me that this kind of scrutiny can feel like judgment, and does more harm than good. As high school principal, Paul Richards, tells the Globe, “Overtaxed and overcommitted students have more trouble understanding what they are suppose to be learning. … their academic performance plummets.”

Last year, Richards quit publishing the honor role in the local newspaper. His town, by the way, has experienced a series of teen suicides.

Add up all the texting, testing, talking, and worrying kids do, and they do need time to decompress. It’s great that some schools are teaching kids techniques to help them cope. These are skills kids can carry into adulthood. But how parents and other adults interact with the kids in their lives can also make a huge difference.

Every kid wants to hear that doing his or her best is all we expect.

Angie has another suggestion that doesn’t cost a cent: Just put down the blackberry or cell phone and connect.

“Every kid wants to be heard out,” Angie says. “We all want somebody to listen to us. Be really supportive. That makes us feel good about ourselves. We need that the most.”

Toe to Toe With Culture

Before you know it, seven-year-old girls will be waxing their legs.

The headline in this morning's New York Times reads, Never Too Young for That First Pedicure.

The article, by New York Times correspondent Camille Sweeney describes a seven-year-old having her toenails painted with watermelon pink polish. The little girl waves a copy of People magazine in the air, telling her mother, “Look, we’re reading an adult magazine.” Britney Spears is on the cover.

And we wonder why kids are growing up so fast.

Apparently, group pedicures are the new birthday party fad. Whatever happened to pizza parties at Chuck E. Cheese?

I’m from a different generation – way different. I have fond memories of birthdays centered around frosted angel food cake with pink lettering dripping down the sides. My friends crowded around our dining room table set with our best china. In my seven-year-old mind, that was playing grown up.

Teaching young girls to take care of themselves needs to be encouraged. I can see that a mother might occasionally paint her daughter’s toenails, or take her daughter along when she goes for a pedicure, and have her toes painted, too.

It’s the larger context of the pedicures described in the Times article that’s troubling. Sweeney writes about a Texas salon for 5- to 11-year- olds that offers a little-girls’ pink limo service at $150. Another franchise, called the Dashing Diva, offers children virgin Cosmos in martini glasses.

A year ago, an American Psychological Association Task Force released a landmark report showing evidence that the sexualization of girls is linked to common mental health problems in girls, including eating disorders, low self-esteem and depression.

The APA Task Force, of which I am the public member, studied published research on the content and effects of virtually every form of media, from TV to video games and the Internet. The researchers also examined the merchandising of products aimed toward girls and recent ad campaigns.

The New York Times article quotes marketing specialist, Samantha Skey, as saying, “Our little girls now grow up thinking they need to be ready for their close-up, lest the paparazzi arrive.” Talk about pressure.

I’m not saying that because seven-year-olds get pedicures they’re going to develop emotional problems. But, like many adults, I do worry about girls growing up in a culture that is hyper-focused on how they look, more than who they are. You get my point. Girls’ obsession with their appearance begins early early enough. Why can’t we just let little girls be little girls?

Resources
Raising Healthy Kids: Families Talk About Sexual Health
Words Can Work: When Talking With Kids About Sexual Health

Related Issues and Answers columns
Sexualization of girls


Related columns for young people

Dying to Talk

I was leaving the house this morning, heading for the Massachusetts State House. We were co-hosting the educational forum on teen depression and featuring our new DVD, Depression: True Stories. I grabbed the Boston Globe. Front-page headlines read: Three teen suicides shake Nantucket.

I’d heard that the Island off Cape Cod had been dealing with what was called “a spate of teen suicides,” and that a Globe reporter was writing a story. As healthcare providers, educators, lawmakers and work/life professionals arrived at the State House, many were discussing the article. It added a sense of urgency to the day’s event.

People filled the 300 seats. Another 50 or so lined the back of the room. State Commissioner of Mental Health Barbara Leadholm welcomed them. “If we can all remember that mental illnesses are treatable, there is hope,” she said. “And I want you to spread the word. Treatment, recovery and hope.”

The co-chairs of the Joint Committee on Substance Abuse and Mental Health also spoke. “When I was growing up, the response society had to depression was simply to ‘pull yourself up by your own bootstraps,’ which we now know is a ridiculous answer to the problem,” said Senator Gale Candaras.

Eighteen-year-old Mike, his parents and sister, who are profiled in the film, said things would have likely been different if depression had been more openly discussed when Mike was needing help.

The expert panel, including two experts from Massachusetts General Hospital, answered audience questions – ranging from how to recognize the difference between normal teen angst and depression, to how to access care within the mental health system.

The two-hour forum was coming to a close when I took a question from the back of the room. I called on a tall, bearded man.

“I’m Buck Weaver,” he said. “I’m a clinical psychologist, and we have an office in Nantucket where we’ve suffered these losses …. the most recent [deaths] over the last three weeks, have been honor students. They’ve been terrific athletes. They’ve had good social networks, and it’s an unbelievable tragedy that we’ve lost four kids over the last year or so. How do you talk to other kids that … know kids that have committed suicide?

I asked Dr. Joe Gold, the medical director of McLean Hospital, one of the finest psychiatric hospitals in the country, to address the question.

Dr. Gold said we have to make it OK to have and to talk about strong emotions. We all know how difficult that is. So many adults want to avoid subjects they’re either uncomfortable with, or don’t know how to handle.

Mike Haas raised his hand. In the past few years, his hometown has lost four teens to suicide. In Depression: True Stories, Mike describes how his suicidal feelings led him to ask his school counselor for help.

“This is in response to Nantucket,” he said “ [In my city,] we went through a very similar phase…. We were being told ‘the time for grieving is over, and it’s time to go back to regular life, and it’s time to get back on track.’ And it really messed up a lot of kids.”

Mike said what everyone in the room already knew: There’s no time limit on grieving. There’s no rule about how soon someone should move on.

There was a collective groan. Can you imagine anyone saying to a kid in that situation “It’s time to move on?” Translation: Your feelings – whatever they are – aren’t legitimate. Stuff them. Ignore them. Pretend something didn’t happen.

The message is clear: Kids need to be able to talk. We have to make the time and create a comfortable environment to help them open up. It means listening, being available, and not judging. Not just because it’s right. But because, in some cases, it will save lives.


Resources
Depression: True Stories
Words Can Work: When Talking About Depression and Other Mental Health Disorders

Related Issues and Answers columns
Bi-polar disorder
Coping with stress
Depression: A treatable disease

Related columns for young people

The Silent Illness

Mental illness is a topic often hushed or ignored. We produced our newest DVD, Depression: True Stories, to try to bring discussion on the topic out into the open.

2.2 million American teenagers are suffering from depression. Every year, 5,000 take their own lives. Most suicides occur among people suffering from untreated depression.

To try to inspire a statewide dialogue, we are co-hosting an educational forum at the Massachusetts State House January 16. It’s co-sponsored by Partners Health Care (Massachusetts General Hospital and Brigham and Women’s Hospitals). It will feature Depression: True Stories and a panel of leading mental health experts.

Health care providers, advocates, policy and lawmakers, and educators have been invited.

Planning these events is always a leap of faith. People are busy. Will they take the time from their multitasking lives to attend? Will people want to talk about teen depression?

So many say the stigma surrounding mental illness keeps it closeted, thus hurting those who are suffering. The response to our e-mailed invitation is overwhelming – and ironic. Some, by their emailed comments, seem to be bursting to talk about the illness. Each RSVP tells me more about the scope of the problem.

When I learned that one school district is sending 10 school nurses I wondered, What’s going on in their school district? Teen depression is no secret to them. Are they looking for answers?

Corporations are sending staff of work/life programs. They know that when their employees’ kids are sick or suffering, productivity at work is hurt. Are they looking for answers?

Executive directors of mental health organizations plan to attend. They’re on the front lines. They know there’s a difference between the normal angst of adolescence and kids who are depressed. Are they looking for answers?

My goal is to let the young girl or boy who feels depressed – or feels bad and doesn’t know how talk about it – know they can ask for help. I understand that doing so is hard. Young people might not ask for help because of shame or confusion. That’s why the adults in their lives need to recognize the signs and know how to talk with them. Then, if kids do need help, they’ll get it.

More than 300 people want to join in this community dialogue. We will start the conversation. And together, as a community, we may be led to some answers. But there are no answers in silence.

Resources
Depression: True Stories
Words Can Work: When Talking About Depression and Other Mental Health Disorders

Related Issues and Answers columns
Bi-polar disorder
Coping with stress
Depression: A treatable disease

Related columns for young people

Steroid Stud or Athlete?

The headlines in the New York Daily News read, “CHEATERS” over pictures of Roger Clemens and Andy Petite. In USA Today, the headline read “A Collective Failure.”

I was in awe Roger Clemens’s power. His Cy Young awards. His World Series rings. I was living in Boston, but he dazzled baseball fans everywhere. He was the Rocket.

When I heard that his trainer told Senator Mitchell that he’d injected Clemons with steroids, I felt sick. One of my first thoughts was for young people who looked up to him. How would they respond?

The evening news included short interviews with kids. One, about eight years old, said sadly, “I thought Roger Clemens was all about the work ethic. It was all about the steroids.”

Clemens vehemently denies the allegations. We’ll be hearing more from him. But some news analysts say the players named in Senator Mitchell’s are forever tainted.

Talk about a colossal teachable moment. I hope that parents are using the release of the Mitchell Report to talk with their kids. The conversations can reach far beyond steroid use, although, according to colleagues who work in high schools, steroid use is not uncommon there, and many kids know it.

This is one of those times to ask kids questions, listen to their answers, and then follow up. You can ask, “Why would someone cheat?” “When someone wins by cheating, how do you think they feel?” “If you worked for and got something you wanted a lot, and then you were charged with cheating, how do you think you’d feel?” “What do you love most about winning or doing well at something?” “If you were playing a game – clean and honestly – how would you feel playing against people who were cheating?”

These questions help kids think through situations without actually living them. They learn by trying to put themselves in another person’s head. Then maybe when they’re faced with the decision to cheat or not to cheat, they’ll make the right choice.

Jose Ruiz, age 18, loves baseball. He dreams of playing in the Major Leagues. Here’s what he told me when I interviewed him for Words Can Work: When Talking About Steroids. “Using steroids will catch up with you. At first you might be seen as the stud, one of the guys everyone talks about. But when you get caught, it’s going to be devastating because everyone will think of you as that steroid person, not the great athlete.”

Red Sox pitcher Curt Schilling hosts the Words Can Work DVD, Steroids: True Stories Hosted by Curt Schilling which profiles two young adults and their choices around steroids. On his blog, 38pitches.com, Schilling writes about the Mitchell Report. “The amount of damage done to the sport will be far reaching,” he says, “and I don’t know that we’ll ever truly know how bad it is until people a few generations from now are looking back on this era.”

In his closing narration of Steroids: True Stories Hosted by Curt Schilling Schilling says this:

“If you’re faced with the choice of using steroids, remember what you’ve heard in these stories. Steroids can harm you and the people around you. And the benefits of staying strong naturally will last a lifetime.”

Resources
Steroids: True Stories Hosted by Curt Schilling
Words Can Work: When Talking About Steroids

Related Issues and Answers columns
A sister’s story
A story of addiction
Avoiding steroids
Girls and steroids

Related columns for young people