Early suicide detection trial

A new move to address NZ's teen suicide rates could soon be seen in schools and clinics.

A simple new early screening scheme - developed at Auckland's Starship Hospital - could help bring down New Zealand's suicide rate. Dr Hiran Thabrew, a child psychiatrist and paediatrician at Starship Child Health, has been tracking the effectiveness of YouthCHAT from November to July this year.

An electronic, tablet-based, self-report screening tool, developed by Professor Felicity Goodyear-Smith from the University of Auckland, YouthCHAT assesses health-related behaviours and mental health concerns including those that may lead to suicide. 

Thabrew hopes YouthCHAT can be used to help cut the youth suicide rate that saw New Zealand topping the world in last year's Unicef report - ranked first in the rate of teen suicides (aged 15-19) out of 41 OECD and EU countries.

It is also an example of the type of research new Starship Foundation CEO Aisha Daji Punga is hoping to foster as she accelerates the Foundation's revenue targets to $20m a year, to help provide better health and brighter futures for children in New Zealand and at Starship Hospital.

At present, routine screening for possible mental health factors that may lead to suicide is undertaken by health nurses in some schools using a face to face procedure known as HEEADSSS assessment.  Due to funding limitations, only Year 9 students in decile 1-3 schools have been eligible. 

Although Youth 2012 survey results confirm that 70-80 per cent of young people visit their general practitioner each year and most GPs and practice nurses are trained in HEEADSSS assessment, routine screening for mental health problems is often not done due to lack of time.

Thabrew says: "We miss many opportunities to check in with young people and identify problems early enough."

The Starship Foundation-funded trial undertaken at Auckland's Tamaki College involved Year 9 students (13-year-olds), half of whom completed YouthCHAT first, then HEEADSSS - with the other half completing these screens in reverse.

"What we discovered using YouthCHAT was that the screening was done in half the time," says Thabrew. "Kids found it more acceptable to be answering questions in a digital environment, particularly those of a sensitive nature such as around anger or abuse.  School nurses also rated YouthCHAT positively and told us that it made the school health team work better together - that was good to hear."

Screening uncovered a few young people who required follow-up.  Thabrew says numbers were "not as great as some people may fear.  Most students were able to be helped by members of the school health team and did not require referral to external services."

The trial is continuing at Tamaki College, using the same Year 9 (now Year 10) students to see if life as a 14-year-old throws up any different results from life as a 13-year-old.  If the Year 10 trial also produces good results, it raises the possibility of piloting YouthCHAT screening in other schools, GP practices and nurse-led youth clinics. 

YouthCHAT is also being trialled at Starship Hospital in the general, diabetes and cardiology clinics to see if it could be useful for routine psycho-social screening of young people with long-term physical conditions (chronic illness).  Due to the level of stress associated with their illnesses and treatment, they are at increased risk of developing anxiety and depression.

"At the moment, around a third of New Zealand young people experience anxiety and depression while a quarter of high school students engage in hazardous alcohol use and we have one of the highest youth suicide rates in the world. 

"We need better ways to detect psycho-social problems early and to offer young people support in acceptable ways within their natural environment," says Thabrew.  

"Due to the number of factors involved, it may take years to demonstrate the value of a screener such as YouthCHAT in reducing suicide. 

"However, medium-term evidence of the impact of routine psycho-social screening would include a reduction in the number of young people being referred to specialist mental health services. Shorter-term evidence of impact would include the normalisation of discussing psycho-social issues and increased use of support within schools."

*If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call 111. If you need to talk to someone, the following free helplines operate 24/7:

LIFELINE: 0800 543 354
SAMARITANS: 0800 726 666
YOUTHLINE: 0800 376 633 or text 234
1737 NEED TO TALK? Call or text 1737