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Flower Swensrud Depression Prevention Initiative
Image While depression is one of the most common, severe and least detected mental illnesses among young people, it can be prevented. The Swensrud Depression Prevention Initiative at Children's Hospital Boston is working to prevent and treat depression in school-aged children and train educators and parents about mental health issues.

The Initiative:

  • teaches children and teens how to identify depression and promote overall mental health
  • trains educators and parents how to recognize the signs of depression and other mental health problems
  • creates innovative tools for the prevention of mental illness
  • is led by a specially trained preventionist who trains two Swensrud Fellows per year
A portion of our program is also focused on promoting the elimination of depression through Preventing Depression: A Toolkit for Schools and The Adolescent Mental Health & Wellness Curriculum.
Upcoming Forum and Training Dates
View training dates for school nurses
"Drinking, Drugs, and Depression" forum, Jan 18, 2007
Curriculum
Preventing Depression: A Toolkit for Schools The Preventing Depression: A Toolkit for Schools manual was created based on the work originated through an Adolescent Mental Health and Wellness Curriculum: A Starter Kit for Schools. The current manual focuses on the implementation of a program specifically designed to address depression prevention for students in grades 7-12. We define prevention as a process -- a process of increasing awareness, resilience and coping skills with the purpose of promoting early recognition and intervention in order to prevent serious crises from occurring.

We understand that some factors associated with the development of depression are beyond the scope of what schools are able to target. However, there are many skills that adolescents can use to help bolster their emotional well-being, and these can be incorporated into every school day. It is our hope that we can prevent emotional disturbances from becoming more serious crises by teaching students to actively employ recognition and coping skills.

This curriculum is comprehensive in its approach -- it includes information about preparing a school system for initiating a depression prevention program, provides staff development exercises, student and classroom activities, and resources to assist staff in working with students who need more individualized mental health services.

Our goal is to provide a tool that describes how to create a program from onset to finish and includes information relevant to a wide spectrum of students ranging from those whose needs are only for prevention, to those who confront daily struggles to succeed in school while battling a mental illness.

The contents of this manual are divided into three sections: preparation, curriculum and evaluation.

Preparation
The preparation section introduces the philosophy and purpose of the activities, and discusses how a school system prepares to implement a prevention program with its students. A "top-down" approach is recommended, where administrators and school leaders are equally as invested in the prevention of depression as the staff conducting the interventions. While we recognize that not all staff will be directly involved in implementation, the entire school system should feel comfortable with this information so everyone is prepared for the response from students and parents.

A range of resources are also offered, including surveys for needs assessments, sample organizing guides and exercises for guiding staff development workshops. Finally, suggestions for best practices are offered. These suggestions are based on the feedback provided by many students, teachers, and parents.

Curriculum
The second section, curriculum, focuses on the implementation of the activities. Clear, step-by-step instructions are provided for presenters, and interspersed throughout the activities are sample questions and responses that students have given while participating in the activities.

Sample adaptations to meet the needs of specific classes/circumstances, as well as handouts to be used for individual use with students are offered. Also in this section, readers will find information regarding the correlation between aspects of the activities and Massachusetts Department of Education English Language Arts and Comprehensive Health Curriculum Frameworks.

We understand that initiating conversations about depression will likely generate some questions from students and might lead some to seek additional assistance. It is indeed our hope this will be the case, and that students will seek help early rather than wait until a crisis arises.

To help students with these questions or self-referrals, we have created a "toolkit" for staff which includes sample interview questions, contracts for safety, case management sample forms, tips on how to work with students already diagnosed with depression and post-hospitalization re-entry plans.

Evaluation
Finally, the third section, evaluation, discusses how to approach outcomes. It is critical to evaluate the effectiveness of any tool designed for prevention. Educators are encouraged to determine the initial one or two outcome measures most appropriate to their school systems for measuring the impact of interventions. Sample student, teacher and parent evaluations for use after activities are also included in the manual.

Need for the Initiative

Unfortunately, depression and other mental health issues are affecting school-aged children at staggering rates.

  • The Surgeon General's Report on Mental Health stated that the majority of children and adolescents do not receive the mental health services they need.
  • More than 800,000 American teenagers suffer from depression each year, and more than 500,000 make a suicide attempt that requires medical attention.
    (Columbia University 2003)
  • Sixty to 80 percent of adolescents with depression go undiagnosed or untreated - and untreated depression can lead to deteriorating schoolwork, high absenteeism, dropping out, strained peer and adult relationships and potential suicide.
  • Depression directly or indirectly results in 1700 teen suicides per year; in a Youth Risk Behavior Survey administered annually in Boston, 20 percent of high school students reported considering suicide.
  • Suicide is the second leading cause of death for Massachusetts young people, ages 15-24, and suicide rates nationwide have tripled since 1950.
  • In Boston, two in five high school seniors report recent (within the last 30 days) alcohol use, and one in five reported binge drinking. Marijuana use is also prominent among Boston high school students, with over 20 percent reporting current use.
    (Boston Public Health Commission 2003)
  • Of youngsters who reported making a suicide attempt in the past year, over one-third used illegal drugs in the past month, and more than a quarter reported binge drinking.
    (Boston Public Health Commission 2003)
  • According to a statewide survey, high school students in Massachusetts who reported alcohol use were twice as likely to have attempted suicide in the past 12 months as their non-drinking peers.
    (Boston Public Health Commission 2003)
Contact us

Swensrud Depression Prevention Initiative
CHNP/Beardslee
1 Autumn Street, #715
Boston, MA 02215-5366
Phone: 617-355-6730
Fax: 617-730-0271
Director:
Email Nadja Reilly, PhD

Resources
Article: Swensrud Depression Prevention Initiative: Self-defense for the Soul (pdf)
Guide: Project INTERFACE - What Should Parents Expect of Their Pediatrician when They Are Worried about a Child?
Press Release: INTERFACE Forum
Report: Mental Health: A Report of the Surgeon General
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