BY JOAN GOODCHILD
According to statistics from organizations that research mental health, about 20 percent of all teens experience depression before they reach adulthood, and between 10 to 15 percent suffer from symptoms at any one time.
The problem with teen depression is a public health burden that demands our attention, according to Tracy Gladstone, Ph.D., a senior research scientist at the Wellesley Centers for Women (WCW) who has developed a program called CATCH-IT to target teen depression and prevent it, or treat it early.
Adolescents who experience minor or major depressive episodes have a higher incidence of medical illness and social adjustment challenges than those who don't suffer from depression, said Gladstone. They are also at risk for suicide and recurring depression throughout their lives.
"Given the substantial prevalence of adolescent depressive disorders, associated functional impairments, the risk of unhealthy behaviors, and life-long illness, it is vital that we develop, evaluate, and disseminate preventative programs for adolescent depression," said Dr. Gladstone.
CATCH-IT is a self-guided, internet-based intervention, said Gladstone, and is aimed at teens, ages 13-19, who are at risk for depressive illness. Initially developed by Dr. Benjamin Van Voorhees of the Children's Hospital University of Illinois, Gladstone continues the work now with Van Vorhees, and they recently wrapped up a six-month study of its effectiveness.
CATCH-IT incorporates character stories and graphics, and uses therapeutic modalities.
"It includes online modules that teach standard, evidence-based approaches to depression prevention," explained Gladstone. "The idea is that kids will spend a few hours online, over a few months. It asks them questions, and asks them to do homework, like scheduling fun activities for themselves."
"The idea is that if kids work through these modules that they learn strategies and skills for managing negative life events that all kids encounter, so they are less likely to be depressed," she said
Initial results of the six-month study period of CATCH-IT are encouraging, said Gladstone. Over the study period, teens at risk for depression in the Chicago and Boston areas were assigned randomly to the CATCH-IT intervention, or to a health education control, and were assessed over time for depressive symptoms, depressive episodes, and other functional outcomes.
"We found kids currently experiencing some symptoms of depression and who completed at least 10 percent of program were less likely to evidence threshold episodes of depression," she said.
CATCH-IT also includes a parent component, said Gladstone, which she believes is key to its effectiveness.
"We're really focusing on understanding the role of parents. It teaches parents how to recognize depression. It includes an optional module for parents because we know there is a connection between teen and parental depression. "
Gladstone encourages parents, whether involved with CATCH-IT or not, to have an open conversation with their children regularly about depression.
"It's OK to check in with your child and ask them if they are feeling depressed or thinking about hurting themselves. I think some parents are reluctant to do that out of fear. But asking that will not make healthy children think about suicide or hurting themselves."
Gladstone also stressed that while CATCH-IT shows promise in treating and preventing teen depression, there are still many gaps in the US healthcare system's approach to it. She believes behavioral health should be more closely integrated with primary medical health services. Primary Care Physicians (PCPS) are not always equipped to ask the right questions about depression and mental health, she noted. Referrals are not always followed up on when a PCP suggests a patient seek mental health treatment.
For those interested in assistance with mental healthcare provider referrals and information, Gladstone recommends checking out the William James College Interface Referral Service, which helps navigate the challenges of finding mental health service.