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School of Medicine
News from the Johns Hopkins Department of Psychiatry and Behavioral Sciences
Losing Depression’s Dunce Cap
In 1999, the more Karen Swartz poked around, asking what people knew about depression, the more shocked she became. A clinician specializing in mood disorders, she had leaned toward genetics research. But that year, a cluster of suicides in Baltimore high schools found Swartz addressing students and their parents at several school assemblies. Afterward, she shook her head. “What struck me was how little people know about depression,” she says, “and how even that is often inaccurate.”
So raw necessity pushed Swartz into public health. With initial financing from concerned Baltimore businesses, she and a nidus of psychiatric nurses and clinicians set up ADAP, the Adolescent Depression Awareness Program. Its aim: to increase basic depression literacy, starting with high-schoolers. Now in its seventh year, ADAP teaches the symptoms of depressive and bipolar illness, distinguishing them from short-term “glooms” or bursts of energy. Students learn how clinicians diagnose and treat depression and why ignoring it courts danger. The program defuses blame while increasing awareness of societal stigma. “Our mantra,” Swartz says, “is that depression is a treatable medical illness.”
ADAP clearly differs from the national “TeenScreen” in the headlines, whose goal is to spot students in the midst of depression or other psychiatric problems. “We wanted an education focus,” Swartz explains, “something compatible with schools’ basic mission.” And since she and the other founders aimed for a large, immediate impact, they opted to sidestep screening’s sticky issues of parental permission and privacy.
“Also, our focus isn’t suicide-prevention,” says Swartz, though ADAP certainly aims to block suicide. “Many more teens experience depression than try to commit suicide; we need to reach them all. Recognizing and treating depression early on, we believe, is the best suicide deterrent.” Still, program materials clearly display a phone number to call for help or referrals.
ADAP’s tutors spend their three high school days working through a smorgasbord of ways to spread the word: award-winning films, interactive videos, group techniques—even lowly homework. Separate sessions target parents and teachers. Throughout, the program has been burnished to an effective shine, both through Swartz’s formal research that weighs teaching techniques and from seasoned teachers’ advice.
So far, ADAP has reached some 8,000 students in three states and Washington, D.C. Recently, in collaboration with the School of Nursing, trained nursing student volunteers have joined the psychiatry residents, med school students and other Hopkins professionals to round out Swartz’s original team. The hope is to go national with a program high-school health teachers will present.
Does it work? “Pre- and post-tests of 3,000 students show we’re changing attitudes,” Swartz says. Anecdotally, evidence is undeniable. “Teachers tell us they reach out to students they wouldn’t have noticed; parents say they’ll get help for sons or daughters. One student who’d dropped treatment told me she realized she needed to go back. That’s as good as it gets.”
For more information on ADAP, call 410-502-3447.