DefinitionPercentage of adolescents (students in grades 9-12) who responded "Yes" on the [http://www.cdc.gov/healthyyouth/data/yrbs/index.htm Youth Risk Behavior Survey (YRBS)] to the question: "During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?"
NumeratorWeighted number of adolescents (students in grades 9-12) who responded "Yes" on the YRBS to the question: "During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?"
DenominatorWeighted number of adolescents (students in grades 9-12) with complete and valid responses to the question on the YRBS.
Data Interpretation IssuesAlaska has conducted a statewide Youth Risk Behavior Survey in 1995 and biennially from 2003. Weighted data were not obtained in 2005 and therefore no statewide estimates are available for that year. A YRBS survey conducted in 1999 did not include the Anchorage School District and therefore was not considered a valid statewide estimate. No YRBS survey was conducted in Alaska in 1997 and 2001.
Traditional high schools are sometimes called comprehensive high schools. They are public high schools that are distinct from alternative high schools, which serve students at risk of not graduating, charter schools, correspondence schools, and students enrolled in high school in correctional facilities.
Responses are weighted to reflect youth attending public traditional high schools in Alaska.
The question on sad or hopeless for 2 weeks has been asked on the Alaska YRBS since 2003.
Why Is This Important?Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity. Mental health is indispensable to personal well-being, family and interpersonal relationships, and contribution to community or society. Mental health was recognized in the U.S. Surgeon General's 1999 report as being fundamental to overall health.^1^ Poor mental health can occur across the lifespan, affecting persons of all racial and ethnic groups, both sexes, and all educational and socioeconomic groups. Evidence has shown that mental disorders are strongly related to the ^2^physical inactivity, smoking, excessive drinking, and insufficient sleep. In teens, sadness or depression can lead to poor grades at school, alcohol or drug use, unsafe sex, and other problems. National studies have found that mental health issues have been the most commonly identified precipitating circumstance in suicides.^3^[[br]]
1. United States. Public Health Service. Office of the Surgeon General. Mental Health: A Report of the Surgeon General. National Institute of Mental Health, 1999. [http://profiles.nlm.nih.gov/ps/retrieve/ResourceMetadata/NNBBHS].
2. CDC - Mental Health Basics - Mental Health. [http://www.cdc.gov/mentalhealth/basics.htm]. Accessed 4/22/2016.
3. Karch DL, Logan J, McDaniel DD, Floyd CF, Vagi KJ. Precipitating Circumstances of Suicide Among Youth Aged 10-17 Years by Sex: Data From the National Violent Death Reporting System, 16 States, 2005-2008. Journal of Adolescent Health 53 (2013) S51-S53. [http://www.ncdsv.org/images/JAH_Precipitating-circumstances-of-suicide-among-youth_7-2013.pdf]. Accessed 4/22/2016.
Other ObjectivesHealthy Alaskans 2020 Leading Health Indicator 8: Reduce the percentage of adolescents (high school students in grades 9-12) who felt so sad or hopeless every day for 2 weeks or more in a row that they stopped doing some usual activities during the past 12 months to 23% by 2020.
How Are We Doing?In 2015, the mental health of adolescents (grade 9-12) in Alaska as measured by this indicator was moving further away from the Healthy Alaskans 2020 goal of 23.0%. With few exceptions (Alaska Native adolescents and those 14 years of age and younger), there were higher prevalence rates of sadness and hopelessness in 2015 compared to 2013. The rate in 2015 for Alaska adolescents overall was 33.6% and 30.9% for Alaska Native adolescents. No population subgroup was below the Healthy Alaskans goal of 23.0%.
Prevalence rates from the YRBS are initially presented for sad or hopeless for 2 weeks by all Alaska adolescents, Alaska Native adolescents, and the mean of the national YRBS. Subsequent analyses display the prevalence of sad or hopeless by demographic subpopulations (i.e., sex, age, use before age 13, race/ethnicity, ethnicity, grade level, and academic achievement) and regions.
How Do We Compare With the U.S.?In 2015, Alaska adolescents were above, but not significantly so, the national rate of 29.9% for sadness and hopelessness with 33.6%, while Alaska Native adolescents were at 30.9%. This mental health measure for all Alaska adolescents has historically been below the national rate until this year.
Evidence-based PracticesAs part of the Healthy Alaskans 2020 health improvement process, groups of Alaska subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs. Below are the strategies identified for enhancing adolescent support systems.
[[br]]Identify adolescents experiencing or at risk of experiencing severe depression and immediately connect them to screening, treatment, and social support services.
[[br]]Screening for depression and suicide is a strategy identified by the President's New Freedom Commission of Mental Health (Goal 4). Screening programs implemented in schools can expand access to mental health services to health disparity populations, when screening is followed by school-based clinical and support services or a facilitated referral to community based services.
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program ensures that the health needs of children and youth are identified and treated early, before more complex and critical health conditions develop. EPSDT is a federally-mandated Medicaid benefit for all recipients aged 0-21. Comprehensive health screenings, diagnostic services and treatment services, including mental health screenings, are included in the EPSDT program.
[[br]]Smith V, Rosen J. An Assessment of the Alaska YKHC EPSDT Pilot Project. 2002. Retrieved from [http://dhss.alaska.gov/dhcs/Documents/medicaid_medicare/news_medicaid/ykhc_report.pdf]
Stoep AV et al. Universal Emotional Health Screening at the Middle School Transition. J Emot Behav Disor. 2005; 13(4): 213-223.
Joe S, Bryant H. Evidence-Based Suicide Prevention Screening in Schools. Child Sch. 2007; 29(4): 219-227.
[[br]]Provide services and opportunities to support all young people in developing a sense of competence, usefulness, belonging, and empowerment.
[[br]]Research shows that healthy youth development strategies that provide all youth with the supports needed to become successful and competent adults are promising approaches for preventing or reducing a wide range of adolescent health-risk behaviors. Positive Youth Development (PYD) programs promote mental and emotional wellbeing by providing the supports and opportunities youth need to successfully transition to adulthood. PYD programs build on young persons' strengths and talents to help them gain the knowledge and skills they need to become healthy and productive adults. PYD programs are most effective when implemented by entire communities with meaningful youth participation.
[[br]]University of Washington. [http://aspe.hhs.gov/hsp/PositiveYouthDev99/ Positive Youth Development in the United States]
Bernat, DH, Resnick, MD. Healthy Youth Development: Science and Strategies. J Public Health Management Practice. 2006; (Suppl):S10-S16.
A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_8_MentalHealth_Youth.pdf].