Why Doesn’t Montgomery County Know More About the Risks Its Students Take?

According to the Centers for Disease Control and Prevention (CDC), “among 15- to 24-year-olds, suicide accounts for 12.0 percent of all deaths annually” (for additional suicide facts click here: www.cdc.gov/violenceprevention/pdf/Suicide-DataSheet-a.pdf ). Unfortunately, even in Montgomery County, teenagers kill themselves. In early February, a Montgomery Blair High School senior committed suicide (for details see this Silver Chips Online article: silverchips.mbhs.edu/story/9847 ).

Suicide is just plain sad. But the really sad thing about our county is how little we know about our teens and the risky behaviors they engage in—be it thinking about committing suicide, drinking and driving, carrying weapons, or having unprotected sexual intercourse. Through the Maryland Adolescent Survey, we know some details about their drinking and use of illegal drugs, but that is it. Otherwise, we as a county know very little about our teens. And even what we know about alcohol and drugs, we are not able to associate it with other risk behaviors (for details about the Maryland Adolescent Survey click here:
www.marylandpublicschools.org/MSDE/newsroom/special_reports/adolescent_survey.htm ).

While Montgomery County is not able to associate student demographics and behaviors (e.g., I’m pretty sure that we cannot describe county teens who belong to gangs nor could we come up a statistical profile of teens most likely to commit suicide), other large city and county school districts in the nation can. Why? Because these districts conduct a regular CDC Youth Risk Behavior Survey (YRBS – for details click here: www.cdc.gov/HealthyYouth/yrbs/index.htm ). And what is regular? Normally, the YRBS is conducted every 2 years.

Based on 2007-08 enrollment counts, here is the list of the nation’s largest public school districts, with the Montgomery County Public Schools (MCPS) coming in at number 16. Among them, only MCPS does not conduct a YRBS. Nearly all of the districts listed below conduct an official CDC YRBS, meaning they receive federal funds to support their survey activity.

1. New York City
2. Los Angeles
3. Chicago
4. Miami
5. Clark County
6. Broward County
7. Houston
8. Hillsborough County
9. Hawaii
10. Orange County
11. Philadelphia
12. Palm Beach County
13. Fairfax County
14. Dallas
15. Gwinnett County
16. Montgomery County

I know about this YRBS work because I manage the CDC YRBS technical assistance federal contract for my employer—a private social science research firm located in Rockville, Maryland. I have been involved with the YRBS since 2000. In 2005, the state of Maryland joined the YRBS surveillance system and since then has conducted three statewide surveys (2005, 2007, and 2009). Regionally, since the early 1990s, the cities of Washington, DC, and Baltimore have conducted YRBSs. In 2006, MCPS attempted a YRBS—thanks to the pressuring of County Council member George Leventhal, but that attempt resulted in unreliable survey findings because of low student response rates. No effort to conduct the survey has been made since then.

Frequently, money, time, and resources are cited by the county’s decision-makers as roadblocks to the YRBS being conducted in MCPS. However, our friendly across-the-Potomac competition—the Fairfax County Public Schools managed to conduct their own YRBS for years and they did so without federal dollars. For details on what Fairfax does click here: www.fairfaxcounty.gov/demogrph/youthpdf.htm . (Note: MCPS is the likely place to conduct the YRBS because that is where we find the vast majority of the county’s teens. It is possible to conduct a YRBS via the telephone or in-person through home visits; however, both survey methods are extremely expensive when compared to traditional paper-and-pencil surveys conducted in school buildings.)

But let’s return to the suicide issue. Let’s look at how San Diego Unified School District, the Orange County Public Schools, and New York City use their YRBS suicide surveys results to improve program services for their teens. What I have summarized below is taken from recent email exchanges with the individual in each location who manages the YRBS.

San Diego. Here is what Marge Kleinsmith-Hildebrand of the San Diego Unified School District told me about how they use their YRBS suicide data. “As you know, we have a series of questions, so we are able to see the different degrees of depression and suicide ideation. One of the best examples comes from YRBS data from 2003. We saw that we had unusually high suicide thought and attempt with Filipinas. We knew which high school had the largest population of Filipinas, so that was our target area. We were able to engage the school site counselors and community agencies that worked with this population. The agencies did some outreach to parents and to the teens and we found that there was some cultural pressure for these young women. If we did not have that hard data, I don’t think we would have had the same response. We have also used the information to encourage school sites to set up support groups for students and to take a closer look at school climate. I believe the counseling department also created a partnership with Yellow Ribbon campaign (http://www.yellowribbon.org/) and we had students participate in an essay contest each fall. In general, we were able to raise awareness of the issue which resulted in education for staff and students; a targeted campaign for highest risk students; and new partnership for ongoing education.” (Note: San Diego posts its YRBS results at this website: www.sandi.net/depts/sex_ed ).

Orange County. Here is what Brenda Christopher-Muench of the Orange County Public Schools told me about how they use their YRBS suicide data. “Our Safe and Drug Free Schools department used the YRBS data (at that time, they used comparative data from 2001-2007) along with other information to justify that a resource teacher was needed to strictly work with suicide prevention. A private donor gave money to the district to fund a full-time position for this school year and it appears as if they will fund the position again next year.” (Note: You can learn more about Orange County’s YRBS at this website: http://www.health.ocps.net/ .)

New York City. New York City does a wonderful job of summarizing and sharing its YRBS suicide data with city policymakers. Click here to view the most recent publication: http://nyc.gov/html/doh/downloads/pdf/survey/survey-2008youthmh.pdf . Kinjia Hinterland of the New York City Health Department also told me that the city has used the suicide data to better target mental health messaging for Hispanic youth in the city schools. In addition, the city uses data to support some of the content on Teen Mindspace (for details click here: www.myspace.com/nycteen_mindspace ). Mindspace is a beautiful website full of useful health-related details that teens and others can use to avoid risks.

For blog readers, let me end with these thoughts. By itself, the mere collection of YRBS data from teens solves nothing—it does not stop teens from thinking about, planning, or attempting suicide. So, let me be clear. Yes, I want our county to commit to collecting YRBS or YRBS-like survey data, and I want a long-term commitment. But more importantly, I want the county and the schools to commit to using the data to improve the lives of our teens. Perhaps we can never hope to prevent or stop every teen suicide, but I know if we had better data and information on our teens we could do a better job at suicide prevention.

Joe Hawkins

Suicide prevention hotlines
Call 301-738-CALL: http://www.mhamc.org/html/index.html
Call 800-273-TALK: http://mentalhealth.samhsa.gov/suicideprevention/concerned.asp