Program Overview. Karen L. Swartz, M.D. Johns Hopkins University School of Medicine

Transcription

1 Program Overview Karen L. Swartz, M.D. Johns Hopkins University School of Medicine 0

2 has generously funded the expansion of ADAP in Washington DC and Texas

3 Objectives Why was ADAP created? What ADAP is and what it is not ADAP: past, present and future Your thoughts about Depression

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5 The Surgeon General's Call To Action To Prevent Suicide 1999 Department of Health and Human Services U.S. Public Health Service

6 Death Rates for Suicide in year olds from Death Rates per 100,000 population Year White males African American males White females African American females Data from National Center for Health Statistics. Health, United States, 2004

7 Death Rates for Suicide in year olds from Death Rates per 100,000 population Year Data from WISQARS Injury Mortality Reports,

8 Rates of Depression and Death for Suicide for year olds 6,000 5,000 Rates per 100,000 population ~ 5,000 4,000 3,000 2,000 1, Depression vs. Suicide Deaths Data from National Center for Health Statistics. Health, United States, 2002

9 Suicide Prevention Programs Theories of Suicide Theory Adherents (%) Youth suicide is most commonly a response to extreme stress or pressure and could happen to anyone Suicide is most commonly a complication of drug and alcohol abuse Suicide is usually a consequence of mental illness Other 9 Garland, et al., J Am Acad Child Adolesc Psychiatry, 1989

10 90-98% of youth suicides are due to mental illness Shaffer, et al., Arch Gen Psychiatry, 1996; Brent, et al., J Am Acad Child Adolesc Psychiatry, 1993; Rich, et al., Adolescence, 1990; Runeson, Alcohol & Alcoholism, 1990; Marttunen, et al., Arch Gen Psychiatry, 1991

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12 Shaffer s Model of Suicide Prevention ACTIVE DISORDER Find and Treat STRESS EVENT ACUTE MOOD CHANGE SUICIDAL IDEATION Hotlines FACILITATION Social Mental State SURVIVAL FACILITATION Underlying Trait Social Mental State Available Method SUICIDE Media Guidelines Method Control

13 Goal of public health education Destigmatize the illness Depression Stigmatize the behavior Suicide

14 ADAP Program Mission To develop a school-based curriculum to educate high school students, teachers, and parents about teenage depression nationwide

15 Long-Range Plan Phase I: Develop the program Pilot the program in local schools Phase II: Finalize the curriculum Pilot the training Phase III: Finalize the training Expand to other states Phase IV: 2009-Present Expand nationally with school-based educators as the instructors

16 Depression Literacy Symptoms of Depression Process of medical thinking comparing Depression to other medical illnesses No one is to blame Suicide is a serious symptom of Depression Message of hopefulness Depression is a treatable medical illness

17 What ADAP is High quality, fundamental, current information about depression A universal intervention for high school students, teachers and parents Educational program to increase depression literacy

18 What ADAP is not Not a clinical program with direct assessment or treatment of individuals Not an opportunity for group therapy or personal disclosure Not an evaluation of current situations or current treatment Not a research study of the participating students or schools

19 ADAP Student Curriculum Multiple Teaching Modalities Lecture and discussion Videos (Day for Night & Psychiatry 101) Video Assignments Homework Group interactive activities Teaching the process of medical thinking, comparing other medical conditions to depression Multiple options for diverse student populations

20 Cumulative number of students taught ADAP

21 ADAP Depression Knowledge Questionnaire (ADKQ) 20-item questionnaire 13 individual yes-no questions Number of symptoms of depression identified (asked to list 5) Number of symptoms of mania identified (asked to list 2)

22 Test: Knowledge examples Depression can be controlled through will power (Y or N) A person with depression always feels sad (Y or N) Depression runs in some families (Y or N) Someone who has major stress always develops depression (Y or N)

23 ADAP Student Pre-test vs. Post-test Percent of students with Total Score of 80% Correct on the ADKQ Percent Correct on ADKQ 70% 60% 50% 40% 30% 20% 10% 0% 20% *** 62% ***p<0.001 Pre-Test Post-Test

24 Summary Results: ADKQ Statistically significant improvement in 13 of 13 individual yes-no questions Number of symptoms of depression identified Number of symptoms of mania identified Improved attitudes about seeking help for Depression

25 Training Initiative Results: Student Pre-test vs. Post-test Percent Correct on ADKQ 80% 70% 60% 50% 40% 30% 20% 10% Percent of students Scoring 80% Correct on the ADKQ by Type of Instructor 0% *** 15% 68% Experienced Psychiatrists and Psychiatric Nurses *** 22% 62% Nursing Students ***p<0.001 Pre-Test Post-Test

26 ADAP to Date In our 15 th year Trained over 1,100 instructors Taught over 40,000 students Multi-year collaborations in Delaware, Florida, Illinois, Indiana, Maryland, Ohio, Pennsylvania, Texas, and Washington, DC

27 Comprehensive Instructor Kit

28 ADAP s Progress Distributing the program Training Program Parent Perspective DVD Web-based training Collaborating with other academic institutions Partnering with the National Network of Depression Centers (NNDC) Training school-based personnel Establishing collaborations in other states

29 National Expansion CA OR WA NV ID AZ UT MT WY CO NM 40,101 students taught in 152 schools in 18 states ND SD NE KS OK TX MN NY WI MI PA IA MD DC IL IN OH WV VA MO KY NC TN AR SC MS AL GA LA FL DE VT NJ NH MA CT ME RI

30 Your thoughts about Depression?

31 ADAP Team ADAP Staff Karen Swartz, MD Katie Heley, MPH Haley Eldridge Anne Ruble, MD Elizabeth Kastelic, MD Lizza Gonzales Sallie Mink, RN Trained Instructors Psychiatric Clinicians SON & SOM Students School-Based Professionals JHU SON Staff Janet Berg, RN Collaborating Schools High Schools: public, private and parochial Advisors Student focus groups and feedback forms Education specialists Adults and adolescents living with mood disorders Family members affected by mood disorders and suicide Film team Family & Friends