HELENA – A panel seeking ways to fix Montana’s highest-in-the-nation suicide rate is recommending mandatory depression screening of all schoolchildren beginning at age 11 and programs teaching coping skills to kids as young as 6.
Preventing suicide and lifting the stigma of depression is a slow process that will require a cultural shift that begins in Montana schools, Karl Rosston, the state Department of Public Health and Human Services’ suicide prevention coordinator, told a legislative committee Friday.
“This is the place where we really want to make an impact,” said Rosston, who is also a member of the Suicide Mortality Review Team. “We need to start at an earlier and earlier age to give them coping and resiliency skills so they can handle life.”
Montana’s suicide rate is more than double the national average, and the rate of children between the ages of 10 and 17 who kill themselves is nearly triple the national rate. American Indians and military veterans in Montana die by suicide at a rate triple that of the national average.
Lack of sunshine, substance abuse, easy access to firearms, social isolation in a relatively unpopulated state and even Montana’s high elevations – at a higher altitude, brains produce less serotonin and more dopamine, leading to riskier behavior – are all contributing factors to the high suicide rate, Rosston said. But the biggest issue is the stigma around mental illness, particularly depression, in a state with a “cowboy mentality” that sees depression as a weakness, he said.
The suicide mortality team, which was created by the Montana Legislature during the 2013 session, recently released its report on 555 suicides in the state between January 2014 and March 2016. The seven-member panel reviewed the death certificates, coroner reports and health and mental health records of each person who died by suicide in that period.
Of the suicides reviewed, 27 were children between the ages of 11 and 17. Nearly two-thirds killed themselves with a gun or a rifle, including an 11-year-old boy who shot himself last year, Rosston said.
The panel’s recommendations include increased training of health care workers, employers and others in communities to spot warning signs and intervene. But several more of the panel’s recommendations focused on reaching children early.
The panel is asking state lawmakers next year to consider legislation that includes mandatory depression screening for children as young as 11, with the rationale that earlier intervention has a higher chance of success. For first- and second-graders, the panel recommends a program called the Pax Good Behavior Game that teaches children coping skills such as self-control and delayed gratification.
The panel’s recommendations also include more widespread use of gun locks and training to help fifth- and sixth-grade students to see warning signs in their classmates.
The mandatory screening of depression in children follows a recommendation made earlier this year by the U.S. Preventive Services Task Force. That task force, an independent panel of health officials and experts in prevention, said adolescents from age 12 to 18 should be screened for major depressive disorder.
The task force concluded that treating children who are detected through screening can see moderate improvement in the severity and symptoms of depression.
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