TREATING SUICIDAL TEENS WHERE THEY'RE LIKELY TO BE

Nearly 4,000 teen-agers and young adults committed suicide in the United
States in 1999, at a rate almost triple what it was 50 years ago. It's the
third-leading cause of death among young people aged 15-24, behind
unintentional injury and homicide.

Dr. Doug Gray, a child and adolescent psychiatrist at the University of
Utah, has an idea for lowering that number - put good suicide-prevention
programs in juvenile detention and corrections centers.

From August 1996 to June 1999, Gray and his colleagues tracked 151 teens
who committed suicide in Utah. He found that nearly two-thirds had previous
contact with the juvenile justice system.

"And most of them had multiple contacts," Gray said.

His conclusion: once teens get arrested, or otherwise get pulled into
juvenile justice, their chances of someday committing suicide increase
fivefold. "And the more often you have involvement with the juvenile
justice system, the greater risk you have for suicide."

But his findings also suggest that the local detention center, with its
literally captive audience, may be a good place to reach teens most at risk
for suicide.

"When we've thought about suicide prevention, we've always thought about
schools, and that's not bad," Gray observed. "But a lot of these kids are
not in school."

Teen suicide is, almost by definition, a mental health issue. Dr. David
Brent, the University of Pittsburgh's internationally recognized expert on
teen suicides, found in a five-year study that nine of 10 teens and young
adults who committed suicide had a definite or probable psychiatric
disorder. A high number had serious mood disorders such as depression, yet
only 5 percent to 20 percent were getting psychiatric treatment at the time
of their deaths.

As Gray's research shows, many teens who commit suicide have something else
in common - at least one brush with the law, usually for minor offenses.

"These aren't gang members. It turns out that most of these kids have
multiple minor offenses, usually for things like marijuana or truancy -
those kinds of things, as opposed to assault and battery, or felony
burglary. They're just not functioning well, and they are not going to get
better because no one's treating them," Gray said.

Gray plans to launch a study to see if involving a psychiatrist more and
using intensive family counseling will make it less likely that emotionally
ill teens will get into trouble with the law again.

The final answer, he said, may be to develop a mental health system within
juvenile justice, "not the typical system where you have an appointment
every three weeks, but where you work with families and provide parenting
classes."

It's not that justice officials are callous toward teens, he said.

"The juvenile justice system wants to help them. They just don't have the
resources."