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National Depression Screening Day, held as part of this week's Mental Illness Awareness Week, started in 1991 with just 90 screening sites. This year, some 3,000 sites across the country are participating.

According to the National Institute of Mental Health, more than 19 million adults in the United States will suffer from a depressive illness this year, and many will be incapacitated for weeks or months because their illness goes untreated.

Part of the problem is that some people don't know the difference between clinical depression and a simple case of the doldrums. "Depression can be defined as a constellation of symptoms that evolves over time," says Joelle Reizes, assistant director of the National Mental Illness Screening Project (NMIS). "The key to depression is not just the symptoms but how long they persist," Reizes says, adding that symptoms of depression will linger for at least two weeks.

In the wake of the recent explosion in school violence, administrators are making a special effort this year to screen students. "We've always offered adolescent screenings," Reizes says. But he says the bloodshed at Columbine and other schools around the country has "created an increased interest" in screening students for signs of depression that could lead to violent behavior.

This year, nine high schools, three middle schools and three school districts are participating in California, Colorado, Delaware, Illinois, Massachusetts, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Wisconsin and Canada.

Between 500,000 and 800,000 American teenagers experience clinical depression each year, according to Dr. Douglas Jacobs, a professor of psychiatry at Harvard Medical School and founder of National Depression Screening Day. But only a portion of those teenagers are receiving regular treatment.

Reizes says that depression is difficult to diagnose in teenagers because the symptoms -- irritability, low self-esteem and poor school performance -- are easily confused with the symptoms of conventional teenage angst. "And depression in teenagers can be dangerous when we don't catch it," Reizes adds, alluding to the blow-up at Columbine.

The National Association of School Psychologists lists social withdrawal as one of the early warning signs of violent behavior, and the withdrawal is rooted in depression. "The withdrawal often stems from feelings of depression, rejection, persecution, unworthiness and lack of confidence."

Despite this year's increase in screening, some school administrators are worried that they won't be able to help students who show signs of depression because the questionnaires are filled out anonymously. Donna Moilanen, a school psychologist in Boston, told the Associated Press, "My concern is, we're going to have an inventory come back saying this kid is suicidal, this kid is going off the chart on this, and we're not going to know who that kid is."

But Reizes says that schools should view the screening as only the starting point for helping kids. "Students should have the opportunity to talk to a mental-health professional. The concept is not just to screen them but to provide them with counselors, too."

So can depression screening put an end to school violence? It's not that simple, Reizes says. "The idea is community education and early intervention. By providing [students] with a way to talk about depression, we can try to help individuals."

To find a screening site near you, call (800) 573-4433.
salon.com | Oct. 7, 1999

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