A note from Center Director Julie Drizin: JCCF mourns the passing of journalist Sara Fritz, who served as a judge in the 2013 Casey Medals for Meritorious Journalism. Sara was a longtime supporter of the Journalism Center on Children and Families and the former publisher of Youth Today. She wrote about her son's suicide in the Winter 2004 issue of Children's Beat, a journal JCCF used to publish.
On the night of Oct. 27, 2000, my son, Daniel, 12, hanged himself with a belt in his bedroom. He was already dead when my husband and I found him dangling from a chin-up bar with his feet only inches from the floor.
The horror of that night still lives within me, as if it were just yesterday. My feelings of loss have never diminished. My arms still ache with the memory of how it felt to hug Daniel.
In an effort to deal with the pain, my husband and I embarked on an intense period of research into the reasons why children kill themselves. We read stacks of books and interviewed many experts. We carefully matched everything we learned to our recollections of our son’s life.
If we had known then what we know now, our son might still be alive.
As a parent, I now realize that we were lacking the necessary information about the symptoms of childhood mental illness, the treatment of these problems and the urgency of the task. As a journalist, I now understand that the media can do a much better job of providing parents with the information they need to help their children.
With my new sensitivity, I see that many people writing on these topics are no better informed than I was. That frightens me. As long as the stories we report are uninformed, parents who read them will never understand how to detect mental illness in their children.
I wish I had seen the Bucks County (Pa.) Courier Times when Daniel was alive. Their 2001 series, “Kids In Crisis,” offers a readable, comprehensive explanation of child mental health issues.
It demonstrates how helpful even a small newspaper can be in informing parents about a complex topic.
The piece included this quote from a psychologist: “In my mind, the main problem for young- sters in this country is misdiagnosis – especially of attention deficit disorders, which touches on the issues of bipolar disorder and plain old depression and anxiety. Misdiagnosis is widespread, which leads to improper treatment across the board.”
Daniel’s suicide is evidence that he was misdiagnosed.
It’s been harder to find helpful reporting on suicide. The worst mistake many journalists make when writing about suicide is trying to determine a cause. Was it a break-up? A bad grade? Inattentive parents? That’s missing the bigger story. Suicide experts will tell you that suicide is the act of an irrational person. Put another way, mental illness is the cause of suicide.
Speculating about what triggered a suicide also tends to romanticize the act, which reporters must avoid. Researchers have found strong evidence that mass media hypothesizing tends to encourage other unstable people to try to kill themselves.
You might focus instead on the pain that a suicide causes the family.
Losing a child to suicide hurts even more than other kinds of death. You feel your child is not only dead, he has rejected you. This is one revelation that occasionally discourages suicidal people from acting on their impulses.
Another idea I would suggest to every person covering children and families is to interview young people who realized they needed help and got it. So many depressed teenagers are unaware of their illness. They often think they are just losers.
Many schools have programs designed to teach students how to recognize depression and other emotional disorders. The success stories from these programs can alert parents and children to the signs of depression and produce very interesting articles as well.
Parents also need to be prepared to assess the competence and attentiveness of the profes-sionals who claim to treat childhood mental health disorders. Here again, reporters could do more. Parents should know to ask for a treatment plan when they take their child to a therapist. And they should inquire regularly how much progress is being made on that plan.
Instinct and intimidation
In the weeks leading up to Daniel’s suicide, we suspected that he was becoming deeply depressed. During a two-week vacation at Smith Mountain Lake, Va., he spent most of the time in a windowless basement room watching television.
When we returned from vacation, we told the therapist who had been treating Daniel for ADHD of our suspicions. He scoffed at our amateur diagnosis. Daniel was already on Adderall, a stimulant similar to Ritilin, to help him concentrate in school. “What do you want,” he asked, “more drugs?”
The therapist suggested that Daniel needed a “good kick in the pants.” We accepted this stupid advice instead of following our instincts, which told us our son needed more aggressive treatment for whatever was ailing him.
Before Daniel died, I wasn’t even sure that children suffered depression in the same way that adults do. Nor did I realize that it could be fatal. I attributed my son’s strange behavior to the developmental changes that a boy undergoes at puberty.
I was unaware until recently that 70 percent of children diagnosed with ADHD are believed to have other emotional problems, such as depression or bipolar disorder. The professionals we consulted never mentioned this, and because we didn’t know better, we let ourselves be intimidated by Daniel’s therapist.
David Shaffer, an expert on child suicide and a professor of child psychiatry at
Columbia University, believes my son probably suffered from undiagnosed bipolar disorder. Despite Daniel’s depression, he had many upbeat moments that could have been the result of mania. Unlike bipolar adults, children with this disorder can move between manic and depressive states several times in a single day.
If Shaffer’s guess is right, then Daniel’s doctors erred by prescribing Adderall because stimulants can precipitate or intensify early onset bipolar disorder. Again, our doctors never told us this, even though they knew our family had a history of mental illness. It now seems possible that the medicine we gave Daniel may have brought on the condition that killed him.
At the time, we chose our son’s therapist as best we knew how: through a friend’s recommendation. After Daniel’s death, we learned that his therapist never prepared a treatment plan for any of the 30 children he saw every week. And his notes on Daniel’s case were judged to be substandard by the Virginia agency that oversees the work of psychiatrists and psychologists.
When the agency, acting on a complaint we filed, found that Daniel’s therapist had failed to keep adequate professional records, his reprimand was posted on the agency’s Web site for only 90 days. There is no way for current patients to know that he was reprimanded by the state.
Take a close look at the credentialing of child psychiatrists and psychologists in your state. How many professionals have been reprimanded? What are the most common shortcomings? Why are the records of these cases not available to the public?
Make sure your story includes this advice: Parents who are dealing with their child’s mental health and the choice of a professional counselor need to follow their instincts. If you fear there is something wrong, don’t ignore it. If the professional advice seems flawed, go elsewhere.
Several years ago in Swanzey, N.H., Gregory Kochman, 17, was cast in a school production of “Ordinary People,” a play about the disintegration of a family after the death of the eldest son. Gregory’s father, David Kochman, did not want his son to participate in the play because the boy’s oldest brother had committed suicide one and a half years earlier.
“I thought it was a sick joke,’’ Kochman told The Boston Globe, recalling the day when Gregory was selected for the role.
But Gregory’s therapists, teachers and high school principal thought the experience would be good for him.
Gregory ended up killing himself.
“I should have followed my gut instinct and stopped it,” Kochman said after the funeral.
Stats and sources for reporting on childhood depression and suicide
- Suicide is the third-leading cause of death among people ages 10 to 19.
- Each year, about 1,600 American teenagers die by suicide, one million attempt it and 1 in 5 consider it. Only 60 to 70 preteens kill them- selves in the United States each year.
- The National Institute of Mental Health estimates that at least 2.5 percent of children under the age of 18 (1.8 million children) are “severely depressed.” The American Academy of Child and Adolescent Psychiatry places the number at 5 percent (3.4 million).
- Some published authorities believe that depression is significantly under-diagnosed and that 1 in 4 children will experience a severe episode of depression by their 18th birthday.
- Depression in children and adolescents is associated with an increased risk of suicidal behavior. This risk may rise, particularly among adolescent boys, if the depression is accompanied by conduct disorder and alcohol or other substance abuse.
- Daniel’s father, James Kidney, has created a website on childhood depression. The resources page contains a number of helpful links www.depressedchild.org