Youth suicide leaves family wondering - California

[Guest guest]

Notice Shaffer of Teenscreen is ny on the Spot to explain things

away....

http://www.insidebayarea.com/dailyreview/localnews/ci_2867588

Article Last Updated: 07/18/2005 02:43:39 AM

Youth suicide leaves family wondering

Medication taken for depression could have played a role in tragedy

By Katy , STAFF WRITER

HAYWARD - The family of 13-year-old Jake Henry doesn't know what made

him want to end his life this month on the railroad tracks near his Hayward

school. They don't know if the medications he was taking to treat his

depression had the opposite effect.

But to Young, Jake's aunt and godmother, one thing is clear:

More needs to be known - by the general public and the medical profession

alike - about the risks of antidepressants for children.

" I can't conclusively say that the reason my nephew stepped in front

of a train and committed suicide was because of the two drugs, but it's the

only conclusion I can come to, " she said.

The debate over the risks of psychotropic medication for children is

nothing new. Last year, the U.S. Food and Drug Administration required all

makers of the drugs to include a warning that antidepressants might be

linked to suicidal tendencies.

But Jake's death - and the fact that the Tennyson Health Center will

soon have a part-time psychiatrist on staff who will be able to prescribe

psychotropic drugs to middle school and high school pupils - has brought the

issue closer to home.

Shortly before the end of the school year, the health clinic run by

the nonprofit Tiburcio Vasquez Health Center Inc. received MediCal money to

add therapists and a part-time psychiatrist to improve the overall mental

health of the pupils - many of whom would not otherwise have the resources

for such treatment.

Alameda County Supervisor Gail Steele called the upcoming expansion of

the center a " godsend, " and Tennyson High School Principal Theresa McEwen

expressed optimism about the additional therapists available for her pupils.

As the center prepares to expand, however, few people - including

school administrators - are aware that its new services will include

prescriptions.

fina Ibarra, whose son attends Cesar Chavez Middle School and who

is active in parent groups, said she had heard nothing about the changes at

the health center, which serves children from that middle school and the

HaywardProject School, in addition to Tennyson.

While she was enthusiastic about having more therapists to work with

the children, she was wary of increased access to prescription drugs.

Many parents and students, she said, know little about the risks and

benefits of the drugs. Although the center will require parental consent

before prescribing them, Ibarra worries that uninformed parents will accept

the doctor's advice without weighing it for themselves.

Ibarra also thinks parents should be made aware of the center's

statistics as the year unfolds. " I definitely think, as parents, we need to

be told, 'These are the numbers of kids that are on antidepressants at our

school,' " she said.

The black box warning

Last year, the FDA released a public health advisory based on the

results of several short-term trials involving more than 4,400 children and

adolescents diagnosed with psychiatric disorders.

About 4 percent of the patients who took antidepressants reported

suicidal thoughts, compared to 2 percent of those taking placebos, the FDA

reported.

In October, the agency decided to place " black box warnings " on all

antidepressants. It urged health care providers to " balance the risk of

increased suicidality with the clinical need, " and to closely monitor their

young patients - especially those first starting the therapy - for

behavioral changes.

The FDA also cautioned parents to watch their children carefully and

to stay in close touch with the doctor who prescribed the medication.

Young, who said her family was " still raw " from Jake's death on July

1, said she didn't know Jake had been on Zoloft and Effexor, two

antidepressants, until after his death.

When she learned of the tragedy, she said, she instantly recalled the

heart-wrenching testimony she heard last year on the radio about a troubled

girl who seemed to improve dramatically after treating her depression with

Zoloft.

The girl hung herself one day, without warning, after her mother left

for work.

" The first question I asked my sister-in-law was, 'What was Jake on?' "

Young said.

Young said she didn't know what kind of dialogue the doctor had with

Jake's mother before writing the prescriptions, or what kind of monitoring

her nephew received thereafter. Jake's mother, Donna Lee, was not ready to

talk about it, Young said.

" My question is, 'When doctors prescribe that medication and give it

to teenagers, do they engage the parents and the teenager that's taking it

of the risks?' " Young said.

Although many doctors say that the clinical findings released by the

FDA were far from conclusive, some acknowledge that the advisory has

prompted some important changes in the field.

Dr. Shaffer, a professor of child psychiatry at the Columbia

University College of Physicians and Surgeons, said many of his colleagues

have since re-evaluated the way they monitor their young patients.

Before, he said, doctors were apt to see the child, make a diagnosis,

prescribe antidepressants and schedule a follow-up visit in a month.

Now, he said, more doctors are setting aside a few hours each week to

call the families to check up on the child's progress and behavior.

The FDA warning also seems to have curbed the steady rise in the use

of prescribed antidepressants by young people - a consequence that some

psychiatrists regard with concern.

" I do worry that there are children and adolescents with serious

psychiatric problems that are not getting the treatment they need and

deserve, " said Dr. Fassler, clinical professor of psychiatry at the

University of Vermont College of Medicine.

" But at the same time, " he added, " I know that not all children and

adolescents with depression need to be treated with medication. "

While researchers estimate that just half of children with depression

receive any treatment, the number of antidepressant prescriptions has grown

dramatically since the late 1980s.

In 2002, 6.36 percent of commercially insured high school girls in the

United States were prescribed the drugs, up from 3.74 in 1998, according to

data posted on The Center for Health and Health Care in Schools Web site,

http://www.healthinschools.org.

Over 4 percent of boys in the same age group - 15 to 18 - took

prescribed medicine in 2002 to treat depression or anxiety, up from 3

percent in 1998.

An online handbook for parents created by national psychiatric

associations in the wake of the FDA warnings -

http://www.parentsmedguide.org - notes that the suicide rate among children

dropped by 25 percent between 1992 and 2001, at the same time a growing

number of children were being treated with antidepressant medication.

Like most in his field, Shaffer believes the risks of not medicating a

severely depressed child outweighs those associated with the drugs. Still,

the psychiatrist hopes that longer-term studies - such as those sponsored by

the National Institute of Mental Health - will shed more light on the

relationship between the drugs and suicidal tendencies.

Because many depressed patients contemplate or attempt suicide with or

without medication, Shaffer said, it is difficult to know whether the drugs

cause suicidal thoughts or if they simply fail to help with a patient's

depression.

And while psychiatrists and researchers can't with certainty explain

why, they have recognized an unnerving pattern in patients with depression.

Shaffer wasn't surprised to hear that the 13-year-old Hayward boy

ended his life despite the great progress he had shown during his treatment.

" The greatest risk of suicide is when they start to get better, " he

said.

Mental health treatment in schools

Although on-site psychiatrists are quite rare, schools around the

country are increasingly being used for mental health screening and other

services.

Lear, director of the nonpartisan Washington, D.C.- based Center

for Health and Health Care in Schools, called schools the " default mental

health system for kids " in an interview earlier this month.

According to the center's Web site, 70 to 80 percent of all children

receiving mental health services are treated in a school setting.

Jane McGrath, the school health officer for the New Mexico Department

of Health and a professor of pediatrics at the University of New Mexico,

said a doctor working at a school should more easily be able to provide the

close monitoring patients need - especially during the initial phase of

treatment.

Though parents might have misgivings about the services, she said,

open houses and other ways of involving families have proved successful.

" People can be scared about things they don't understand, " she said.

As the fall semester approaches, Ibarra hopes she and other parents

will have the opportunity to share their concerns and questions about the

complex issues facing their children - and the appropriate treatments for

them.

" Just the age alone is so hard, " Ibarra said. " We want them to succeed

in life, " she said.

Katy covers education in Hayward, Castro Valley, San Leandro

and San Lorenzo. Call her at (510) 293-2479 or E-mail

kmurphy@....

[Guest guest]

Notice Shaffer of Teenscreen is ny on the Spot to explain things

away....

http://www.insidebayarea.com/dailyreview/localnews/ci_2867588

Article Last Updated: 07/18/2005 02:43:39 AM

Youth suicide leaves family wondering

Medication taken for depression could have played a role in tragedy

By Katy , STAFF WRITER

HAYWARD - The family of 13-year-old Jake Henry doesn't know what made

him want to end his life this month on the railroad tracks near his Hayward

school. They don't know if the medications he was taking to treat his

depression had the opposite effect.

But to Young, Jake's aunt and godmother, one thing is clear:

More needs to be known - by the general public and the medical profession

alike - about the risks of antidepressants for children.

" I can't conclusively say that the reason my nephew stepped in front

of a train and committed suicide was because of the two drugs, but it's the

only conclusion I can come to, " she said.

The debate over the risks of psychotropic medication for children is

nothing new. Last year, the U.S. Food and Drug Administration required all

makers of the drugs to include a warning that antidepressants might be

linked to suicidal tendencies.

But Jake's death - and the fact that the Tennyson Health Center will

soon have a part-time psychiatrist on staff who will be able to prescribe

psychotropic drugs to middle school and high school pupils - has brought the

issue closer to home.

Shortly before the end of the school year, the health clinic run by

the nonprofit Tiburcio Vasquez Health Center Inc. received MediCal money to

add therapists and a part-time psychiatrist to improve the overall mental

health of the pupils - many of whom would not otherwise have the resources

for such treatment.

Alameda County Supervisor Gail Steele called the upcoming expansion of

the center a " godsend, " and Tennyson High School Principal Theresa McEwen

expressed optimism about the additional therapists available for her pupils.

As the center prepares to expand, however, few people - including

school administrators - are aware that its new services will include

prescriptions.

fina Ibarra, whose son attends Cesar Chavez Middle School and who

is active in parent groups, said she had heard nothing about the changes at

the health center, which serves children from that middle school and the

HaywardProject School, in addition to Tennyson.

While she was enthusiastic about having more therapists to work with

the children, she was wary of increased access to prescription drugs.

Many parents and students, she said, know little about the risks and

benefits of the drugs. Although the center will require parental consent

before prescribing them, Ibarra worries that uninformed parents will accept

the doctor's advice without weighing it for themselves.

Ibarra also thinks parents should be made aware of the center's

statistics as the year unfolds. " I definitely think, as parents, we need to

be told, 'These are the numbers of kids that are on antidepressants at our

school,' " she said.

The black box warning

Last year, the FDA released a public health advisory based on the

results of several short-term trials involving more than 4,400 children and

adolescents diagnosed with psychiatric disorders.

About 4 percent of the patients who took antidepressants reported

suicidal thoughts, compared to 2 percent of those taking placebos, the FDA

reported.

In October, the agency decided to place " black box warnings " on all

antidepressants. It urged health care providers to " balance the risk of

increased suicidality with the clinical need, " and to closely monitor their

young patients - especially those first starting the therapy - for

behavioral changes.

The FDA also cautioned parents to watch their children carefully and

to stay in close touch with the doctor who prescribed the medication.

Young, who said her family was " still raw " from Jake's death on July

1, said she didn't know Jake had been on Zoloft and Effexor, two

antidepressants, until after his death.

When she learned of the tragedy, she said, she instantly recalled the

heart-wrenching testimony she heard last year on the radio about a troubled

girl who seemed to improve dramatically after treating her depression with

Zoloft.

The girl hung herself one day, without warning, after her mother left

for work.

" The first question I asked my sister-in-law was, 'What was Jake on?' "

Young said.

Young said she didn't know what kind of dialogue the doctor had with

Jake's mother before writing the prescriptions, or what kind of monitoring

her nephew received thereafter. Jake's mother, Donna Lee, was not ready to

talk about it, Young said.

" My question is, 'When doctors prescribe that medication and give it

to teenagers, do they engage the parents and the teenager that's taking it

of the risks?' " Young said.

Although many doctors say that the clinical findings released by the

FDA were far from conclusive, some acknowledge that the advisory has

prompted some important changes in the field.

Dr. Shaffer, a professor of child psychiatry at the Columbia

University College of Physicians and Surgeons, said many of his colleagues

have since re-evaluated the way they monitor their young patients.

Before, he said, doctors were apt to see the child, make a diagnosis,

prescribe antidepressants and schedule a follow-up visit in a month.

Now, he said, more doctors are setting aside a few hours each week to

call the families to check up on the child's progress and behavior.

The FDA warning also seems to have curbed the steady rise in the use

of prescribed antidepressants by young people - a consequence that some

psychiatrists regard with concern.

" I do worry that there are children and adolescents with serious

psychiatric problems that are not getting the treatment they need and

deserve, " said Dr. Fassler, clinical professor of psychiatry at the

University of Vermont College of Medicine.

" But at the same time, " he added, " I know that not all children and

adolescents with depression need to be treated with medication. "

While researchers estimate that just half of children with depression

receive any treatment, the number of antidepressant prescriptions has grown

dramatically since the late 1980s.

In 2002, 6.36 percent of commercially insured high school girls in the

United States were prescribed the drugs, up from 3.74 in 1998, according to

data posted on The Center for Health and Health Care in Schools Web site,

http://www.healthinschools.org.

Over 4 percent of boys in the same age group - 15 to 18 - took

prescribed medicine in 2002 to treat depression or anxiety, up from 3

percent in 1998.

An online handbook for parents created by national psychiatric

associations in the wake of the FDA warnings -

http://www.parentsmedguide.org - notes that the suicide rate among children

dropped by 25 percent between 1992 and 2001, at the same time a growing

number of children were being treated with antidepressant medication.

Like most in his field, Shaffer believes the risks of not medicating a

severely depressed child outweighs those associated with the drugs. Still,

the psychiatrist hopes that longer-term studies - such as those sponsored by

the National Institute of Mental Health - will shed more light on the

relationship between the drugs and suicidal tendencies.

Because many depressed patients contemplate or attempt suicide with or

without medication, Shaffer said, it is difficult to know whether the drugs

cause suicidal thoughts or if they simply fail to help with a patient's

depression.

And while psychiatrists and researchers can't with certainty explain

why, they have recognized an unnerving pattern in patients with depression.

Shaffer wasn't surprised to hear that the 13-year-old Hayward boy

ended his life despite the great progress he had shown during his treatment.

" The greatest risk of suicide is when they start to get better, " he

said.

Mental health treatment in schools

Although on-site psychiatrists are quite rare, schools around the

country are increasingly being used for mental health screening and other

services.

Lear, director of the nonpartisan Washington, D.C.- based Center

for Health and Health Care in Schools, called schools the " default mental

health system for kids " in an interview earlier this month.

According to the center's Web site, 70 to 80 percent of all children

receiving mental health services are treated in a school setting.

Jane McGrath, the school health officer for the New Mexico Department

of Health and a professor of pediatrics at the University of New Mexico,

said a doctor working at a school should more easily be able to provide the

close monitoring patients need - especially during the initial phase of

treatment.

Though parents might have misgivings about the services, she said,

open houses and other ways of involving families have proved successful.

" People can be scared about things they don't understand, " she said.

As the fall semester approaches, Ibarra hopes she and other parents

will have the opportunity to share their concerns and questions about the

complex issues facing their children - and the appropriate treatments for

them.

" Just the age alone is so hard, " Ibarra said. " We want them to succeed

in life, " she said.

Katy covers education in Hayward, Castro Valley, San Leandro

and San Lorenzo. Call her at (510) 293-2479 or E-mail

kmurphy@....