Spotting Students Who Are Suffering from Depression

“Depression is a quiet crisis in schools,” say John Desrochers (Fairfield University, CT) and Gail Houck (Oregon Health and Science University) in this article in Principal Leadership. About 11 percent of adolescents experience depression serious enough to require expert help. Suicide is the third leading cause of death among young people; in 2009, there were 1,934 suicides in the 5-19 age bracket. 

Desrochers and Houck tell the story of a ninth-grade girl who attempted suicide. She appeared to be popular, high-achieving, and involved in school and community activities, but upon further investigation, it turned out that as early as elementary school, she had periods of moodiness and withdrawal and a psychological evaluation documented occasional depressed behavior. In the weeks before her suicide attempt, several teachers noticed that her class participation, grades, and social engagement had fallen off. Her English teacher mentioned “dark themes” in some of her writing, and the school nurse said the girl had visited her with vague physical complaints that were followed by absences. The girl also quit the volleyball team, dropped out of all her school activities, and was no longer singing in the church choir. 

“To recognize and effectively address depression and other mental health problems, schools must have systems in place to connect the dots and provide appropriate support,” say Desrochers and Houck. “Depression is a developmental process. Early (even mild) episodes of depression left untreated make it more likely that major depression will develop later. Early intervention is essential.” 

The authors recommend a multi-tiered system of supports paralleling Response to Intervention (RTI) and Positive Behavioral Interventions and Supports (PBIS): prevention and wellness promotion for all students, universal screening for academic and behavioral barriers to learning, effective interventions that increase in intensity as needed, monitoring students’ responses to interventions, and systematic decisions about services. Even if a systematic approach like this is not in place, principals should work with their mental-health team to:

• Review current problem-solving structures and identify how they can help spot and intervene with students suffering from depression. 

• Facilitate planning by and close collaboration among school mental-health professionals.

• Establish some form of universal screening for depression and other mental-health disorders.

• Provide parent education sessions and professional development for school personnel on signs, symptoms, outcomes, and how to refer students who are showing signs of depression. Here is a list of symptoms (of course, not all students who show these are clinically depressed):

• Disengagement from family and friends;
• Difficulty with interpersonal relationships;
• Increased irritability, anger, sensitivity to criticism, and classroom misbehavior;
• Excessive time spent with video games and other solitary activities;
• Lack of interest in activities that had been giving enjoyment;
• Declining school achievement;
• Changes in eating habits, frequent physical complaints, fatigue, or sleep disturbance;
• Increased tardiness and absence from school;
• Lack of grooming or self-care;
• Feelings of boredom, apathy, sadness, hopelessness, helplessness, or worthlessness;
• Low self-esteem;
• Self-destructive thoughts or thoughts of suicide or death;
• Crying;
• Difficulties paying attention, remembering, completing tasks, or making decisions.

“Depression: A Quiet Crisis” by John Desrochers and Gail Houck in Principal Leadership, April 2013 (Vol. 13, #8, p. 12-16), www.nassp.org 

From the Marshall Memo #481