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SEIU Local 535 Dragon--Voice of  the Union-- American Federation of Nurses & Social Services Unioin  

The Tools to Deal With Depression

May 2002

Licensed clinical social worker Jean O’Brien travels from school to school. Many of the students she sees suffer from severe depression.

The day before we spoke with O’Brien, a student with a previous history of suicide attempts had threatened to kill herself. After spending four hours talking with the girl, her parents, and her therapist, O’Brien decided that she had no other choice but to call the police and have the student placed in a psychiatric hospital.

O’Brien estimates that she has already had seven to ten kids hospitalized this year. “I have to assess if a child is suicidal or not,” she explains. “If there is any question, I err on the side of caution. I call the parents to see if they can take the child to the hospital. If they are not supportive, I have to get the police involved, and they place the child under a 5150 psychiatric hold. One of the problems is that there are not enough psychiatric beds for high school aged kids, so a lot of times they get sent to San Francisco, which causes transportation problems for the parents.”

“I have a lot of kids cutting and burning themselves. The kids don’t know how to deal with their problems, and they will say that it makes them feel better when they cut on themselves. Sometimes a group of kids will hang out and cut on themselves and burn themselves.

“These kids are under so much stress. This area is not safe for them. They can get jumped by gang members. The community is not safe for them, and sometimes even their homes are not safe. There is a lot of financial pressure. Both parents will work, and many of the kids are trying to hold down jobs while they go to school. It is overwhelming. I had no idea how severe their problems would be. The kids have so many problems, and the families have so few resources.

“I try to help them develop tools they can use. I give lots of homework assignments and journal writing. I have a work sheet for depressed kids. Lately I’ve been working on getting them to reframe their negative self-talk. That is a big problem, and they don’t understand how that ties in to their depression. I do lots of listening and give lots of support. I want the kids to know that I am here and want to help. This is a safe place and it is confidential. The only thing is that we are required to report child abuse or if there is a threat they will hurt themselves or others.

“The first week here I had a Tarasoff situation. [Tarasoff is a court decision requiring therapists to report a client’s threat to others.] One kid threatened to kill another child. And that was my first week. I worked with that boy up until a month ago. Now he is in a school for the severely emotionally disturbed, where he is finally getting the help he needs. But that didn’t happen without a lot of pushing from a number of people.

“Can we make a difference? I think that there are several kids that would have killed themselves if they hadn’t had somebody to talk to. I know that there are kids who would be back in gangs and on drugs if they didn’t have a support system. That one student who threatened to kill somebody, he would have never made it out of school. Now I think he will graduate, and he is in a setting where he will get the support he needs.”