News


Guest Opinion: Community embraces responsibility to help our youth

The December article in the Atlantic magazine addressing the two teen suicide clusters we've experienced in Palo Alto -- in 2009 and again in 2014 -- highlights some critical issues in our community. Some of our challenges are mirrored elsewhere, and others may hope to learn from our experience and our responses.

As we grieve the loss of any youth, we are gratified by the enormous dedication and collaboration of local community leaders, teens, and families to address the myriad challenges the suicides have brought to light.

The community -- including health care professionals, school officials, city officials, parents, students, various public and private agencies -- are facing these issues candidly, publicly, and with heartfelt compassion. We are guided by the scientific evidence about what works, by advice from national and local experts, and by the voices of our own youth. We have asked the Centers for Disease Control and Prevention (CDC) to help assess local suicide risk factors, to advise what we should supplement from the "best practices" already implemented.

We are addressing the risk factors that can lead youth from stress to distress, to overt depression and anxiety, to suicidal thoughts and actions. Over the past six years, we have implemented and continually refine many specific steps and programs to improve youth well-being: decreasing stigma about addressing mental health concerns, reducing academic and performance pressure, improving mental health care, reducing access to means of self-harm, and improving public and media communication about these issues.

Our city convened "Project Safety Net," coordinating the work of the many public and private organizations focused on teen well-being (psnpaloalto.com).

We have worked with media about how to write responsibly about suicide and to reduce the risk of contagion fostered by sensationalistic reporting. Many resources for teens and families with concerns can be found at AFSP.org, HEARDAlliance.org, and 1-800-273-TALK (8255). Comprehensive school resources can be found in the Suicide Prevention Toolkit written by the Palo Alto Unifies School District and now disseminated statewide: pausd.org/comprehensivesuicidepreventiontoolkit.

Our schools bolstered living skills courses to reduce stigma and address well-being holistically, eliminated early morning academic classes, implemented block scheduling, reduced homework, started peer and teacher-mentor support programs, educated parents about teen mental health (including meeting with multiethnic groups), added mental health specialists, and adopted nationally known programs (Sources of Strength, Break Free from Depression, etc).

Our major local health care organizations formed a collaborative (heardalliance.org), with initial focus on training primary care physicians to screen and treat teens routinely for mental health issues, and know when to refer. New "navigators" surmount notorious difficulties in accessing mental health care specialists, linking teens directly to therapists and psychiatrists. A new youth well-being center at Stanford's Department of Psychiatry will consolidate clinical care and research.

Our city has addressed "means restriction," limiting access and improving visibility along the rail line, adding motion detectors, and staffing guards at rail crossings 24/7.

Finally (and really firstly), many student-led efforts to manage stress and pressures to succeed have been put in place. Students' projects include a high school peer support program ("ROCK:" Reach Out, Care, Know), a documentary ("Unmasked"), and a newspaper series ("Change the Narrative"), where students share stories of strength, hope, and healing.

We embrace our responsibility to help our youth grow into happy, healthy, well-rounded adults. We are grateful to have the commitment and talents of a diverse, passionate, fully engaged community.

Dr. Meg Durbin is a pediatric and internal medicine doctor at Palo Alto Medical Foundation. She is also co-founder of a collaborative of health professionals, the HEARD Alliance, addressing youth well-being.

Comments

14 people like this
Posted by Parent
a resident of Palo Verde
on Nov 20, 2015 at 7:34 am

I would like to say that many of our churches and other faith based institutions are working hard to provide a non-judgmental and safe place for kids to spend a couple of hours a couple of times a week.

These are run by people who care who are not parents, teachers, coaches, and are willing to spend time getting to know the teens and allowing them to talk as well as providing some fun activities to give a break from the grind of the weekly treadmill.




14 people like this
Posted by thanks for clarifying
a resident of Another Palo Alto neighborhood
on Nov 20, 2015 at 9:58 am

It's anyone's guess as to why the woman who wrote the Atlantic article didn't mention any of the things Dr. Durbin shares.

What Hanna Rosin reports leads the reader to the opposite conclusion, saying that Palo Alto's mental health professionals and civic leaders were eerily devoid of "feeling" and Palo Alto students had moved on ("forgotten").

Instead of Rosin interviewing the Stanford University medical experts who have been on the ground working with troubled teens and their families through both clusters for a half a decade, the Atlantic picked Suniya Luthar, an Arizona State professor, as its expert to talk to because Luthar had been flown in for a day or two to share her research.

How did it come to pass that Suniya Luthar walked away from that seminar these medical professionals invited her to with the idea that she should then go to the national press with scathing criticism of them? Really?

It sounds like they planned this seminar because they did care and because they were not in denial.

Perhaps Suniya Luthar was misquoted. But it doesn't look that way. I see that she's already featured the Atlantic story, that came out two days ago, on her website.

Perhaps Suniya Luthar was unhappy that what she shared that day wasn't fully embraced. The Atlantic reports that Luthar claims that children in high income communities have higher rates of delinquency, anxiety and depression AND parents who are NOT involved in their lives.

Delinquency here? Not that I've heard of. Distant parents or helicopter parents? Helicopter parents is much more likely.

Maybe our local professionals, whom I suspect knew the teens we lost and their families, heard Luthar and realized that her assessment did not match what they knew was happening locally and challenged her on it, which she interpreted as their being "in denial."


19 people like this
Posted by thanks for clarifying
a resident of Another Palo Alto neighborhood
on Nov 20, 2015 at 10:06 am

Dr. Durbin: "we have worked with media about how to write responsibly about suicide and to reduce the risk of contagion fostered by sensationalistic reporting."

This advice was squarely ignored.

Here's an assessment of how the Atlantic article did on that measure from the reader comments to the Weekly's article "Palo Alto Officials Brace for Story in The Atlantic magazine":

CDC's Media Rules -- What to AVOID

1. Big or sensationalistic headlines. Check. ("The SV Suicides")

2. Describing the method. Check. (28 times, with a picture)

3. Including photos/videos of the location or method of death, grieving family, friends. Check. (3 of them)

4. Describing it as an "epidemic," "skyrocketing," or other strong terms. Check. (at least 3 times)

5. Describing it as inexplicable or "without warning." Check. (at least 5 times)

6. Mentioning a note. Check.

7. Reporting it the same why as one would a crime story. Check.

8. Saying it was "successful," "unsuccessful," or something similar."


8 people like this
Posted by thanks for clarifying
a resident of Another Palo Alto neighborhood
on Nov 20, 2015 at 11:50 am

Curious about how Luthar might have left Palo Alto with such a sour feeling, here is a note she wrote right after the seminar which conveys respect for the work being done here, not the sentiment the Atlantic attributed to her:

Her note: "I write this to you today with complete respect and supportiveness...I remain at your service, and I remain with you in spirit, steadfastly, through this extremely painful time."

Were any of the others who spoke on that suicide prevention expert panel interviewed by Rosin? If so, how did they feel afterwards I wonder.

Dr. Meg Durbin, Regional Vice President, Care Coordination, Palo Alto Medical Foundation & Sutter Health, on primary care response and HEARD formation

Dr. Shashank Joshi, Associate Professor of Psychiatry and Behavioral Sciences (Child and Adolescent), Stanford School of Medicine, on schools and mental health responses

Dr. Rebecca Bernert, Assistant Professor of Psychiatry and Behavioral Sciences at Stanford School of Medicine, leading researcher in the field of sleep and mental health and directs the Suicide Prevention Research Laboratory at Stanford, on Sleep and suicide risks

Dr. Mort Silverman, Clinical Associate Professor of Psychiatry at the University of Chicago, Senior Advisor to the Suicide Prevention Resource Center (SPRC) and Senior Medical Advisor to The Jed Foundation, on Epidemiology, Strategies for best practice, and Developmental Issues (Transition Aged Youth)

Dr. Scott Poland, Center for Psychological Studies, Co-Director of the Suicide and Violence Prevention Office, Co-Director SAMHSA Grant for Expansion of Suicide Prevention Initiatives Off Campus speaking on the Challenges to implementation of best practice, school Postvention Response and containment of contagion I

Dr. Doreen Marshall, American Foundation of Suicide Prevention, psychologist with experience that spans clinical, educational, and professional settings, on Working with the Media in Postvention; and Containment of contagion II

Dr. Peter Wyman, Professor of Psychiatry, University of Rochester School of Medicine, on Peer Leader and other upstream interventions

Dalene Dutton, University of Washington Center for Communities That Care, on CTC

Rob DeGeus, Assistant Director, Community Services Department, City of Palo Alto, on behalf of Project Safety Net.

Luthar, ASU psychology professor, was paid a $1,000 for her one hour session on "Cultural issues when engaging higher SES families." Web Link


17 people like this
Posted by A parent
a resident of Gunn High School
on Nov 21, 2015 at 9:59 am

Dr. Durbin,
How does a parent having problems with the school district, or who notices an issue not addressed by the above, reach you or anyone in the HEARD alliance?

All if this sounds wonderful but belies our experience in the trenches.


39 people like this
Posted by Former Paly Mom
a resident of Palo Alto High School
on Nov 21, 2015 at 10:43 am

Simple Solution: Neurotic parental units need to chill out.
School administrators need to grow a pair & fend off tiger parents.
Teachers - demand more respect for front office staff, parents, & students
Students - stop the shaming of your peers over GPAs, APs, sexual identity, etc.
Real estate agents - back off the over selling of the PAUSD schools to your customers
School board - get your heads out of your butts and visit the schools - often
Max & Churchill mob - preserve & create TRUE diversity in school staffing, don't over react or
under react to neurotic parents


16 people like this
Posted by A Parent
a resident of Gunn High School
on Nov 21, 2015 at 4:43 pm

@moderator,

The blaming of parents, as in the last poster's note, is pernicious and akin to blaming parents of kids who died for their mental illness or circumstance. Western society has a long unfortunate history of this: women whose kids had autism were blamed for the autism, the moms were considered overbearing or neurotic, or whatever else was the mysogynistic shame blame of the day. This happened within our generation. Children's asthma has similarly been blamed on overbearing parenting. Women's cancers, multiple sclerosis, pretty much any disease we didn't understand going back to TB and before, has been blamed on women being "hysterical" or neurotic, especially diseases women were more prone to getting.

The public conversation notably lacks any consideration of all the efforts parents have made within their homes to cope with and deal with the schools and what happened. Parents as a group are constantly slammed, without a constituency in the conversation. I note with irony that the Atlantic article finally mentioned that the "conversation" with the parents that the district staged was entirely one-sided and no parents were allowed to speak up. I am deeply offended by what is implied by the omission - all the things the schools have done and others are listed, but this whole conversations proceeds as if parents, i.e., moms, are neurotic monsters oblivious to all of this and the needs of their children. It turns the soul searching into a power play for those who find parents who have to stick up for their kids inconvenient.

We get the message - some people in our community want to blame parents for everything. But until someone can explain how Palo Alto parents are so incredibly different than parents in all the surrounding wealthy successful communities, and how that actually causes suicide here where it doesn't elsewhere, and until the other possible reasons have been addressed, I would really appreciate as a parent not to be constantly "screamed at" like this. All the blaming started with the suicides, too. I personally have close ties in parent communities all over the area and don't see any connection between the ugly stereotypes and the community of Palo Alto parents. Until this happened, Palo Alto schools were actually seen as less of those things than surrounding districts. The parent blaming is hurting in another way, too, because it's something that can't be "solved". Parents are becoming afraid to move here, either because they believe that about the community, or they think they will be accused if they come here.

That does both a disservice to our community, and to parents. I already feel as if parents if anything have too little backbone, and the district people overtly work to keep them isolated (grassroots nust not be allowed to grow) or divided and conquered.

Allowing the constant slandering of the parent community while deleting actual problems with the district that can be proven as true is unhelpful at best. Please consider the bias against parents who do not have a voice and need the fourth estate to hold organizations and the powerful to account.


10 people like this
Posted by A parent
a resident of Gunn High School
on Nov 21, 2015 at 4:48 pm

@former Paly Mom,
How nice that you have all the answers and the experts, doctors, and community are so clueless. Since you know all the answers and are so much smarter and a better parent than the rest, why didn't you do something just as smart to solve the problem instead of letting kids die and suffer? Since the root causes are so obvious to you, why didn't you do something before the first cluster?


17 people like this
Posted by Not in this life
a resident of Charleston Meadows
on Nov 21, 2015 at 4:59 pm

Durbin and Joshi are Skelly enablers. May God forgive you.


29 people like this
Posted by Denial
a resident of Jordan Middle School
on Nov 21, 2015 at 5:10 pm

I have not, in thirteen years, seen any teachers, administrators, parents, or students do ANYTHING to aid or abet positive change in the schools or residential communities of Palo Alto, Los Altos or Stanford ( oddly, the most critical of parents and schools!).

The only visible or tangible changes have been in the large increase of Asian nationals in the schools and residential communities......and a single factor such as this is never the only cause.


8 people like this
Posted by A parent
a resident of Gunn High School
on Nov 21, 2015 at 9:54 pm

@Denial,
I have tried to make positive change, have sacrificed to try, and have the bruises to prove it. Just because you haven't seen change doesn't mean people haven't tried. The trouble is that school districts are uniquely insular governmentally. The state goals for districts are to provide local control, but in reality, the checks and balances either don't exist or are the weakest of any lrpevel of gobpvernment. If you want to change things, remedy that, because dynamic change will then be possible through checks and balances, and even innovative forces that are now all but shut out.


10 people like this
Posted by jenece poree
a resident of another community
on Nov 21, 2015 at 10:20 pm

I learned the hard way with my kids: to practice Unconditional Love.
This means that you love those kids no matter what. And that they know this. Every day.
That your joy and wonder since the moment of their birth has never lessened.
Did you cherish your darling infant and toddler? Your teenager is essentially the same person, only more so.
That sweet baby was not that long ago. Can you remember the squirmy, happy-to-be-alive energy, of that little person in your arms?

Our babies come into this world and if all goes right, we send them on their way as young adults: happy to be alive; full of curiosity about this vast world ; and hopefully, equipped with a few tools and some knowledge as to how to proceed.
Somehow, though, our own deep needs for affirmation, for parental success as measured by the performance of our children in relation to their peers, trumps all.
We pit our children against their peers at the first opportunity. Remember pre-school? How early it starts?

In the end, it's all about you, Mom/Dad. Not the unique and talented individual that you brought into this world...
That youngster plays but a supporting role to his parent's overwhelming desire for recognition as the producers of
Something special.
Ironically, your kids are Something Special. Let up on the relentless and suffocating pressure to succeed at all cost...Let them shine. Let them breathe. Let them be.







16 people like this
Posted by Reader
a resident of another community
on Nov 21, 2015 at 11:33 pm

The Atlantic article does not address major incongruities about the Palo Alto suicides: the fact that these are largely public school suicides and not parochial school children suicides.

It also does not adequately address why this is happening mostly to Palo Alto kids. Children from other similar academically rigorous school districts do not exhibit the same mortality rate.

There appears to be something particularly toxic about the PAUSD, something that The Atlantic was unable to adequately unveil.

I suggest that each PAUSD-involved adult (administrator, staff, faculty, parent) look into him/herself. There is something that you are doing that is killing children.

The article from The Atlantic unveils no solutions because the problem lies in the adults.


8 people like this
Posted by A parent
a resident of Another Palo Alto neighborhood
on Nov 22, 2015 at 10:42 am

@Reader,
There is a way that PAUSD is different than surrounding communities, that can be directly related to depression and suicide. I have tried to get it addressed and sadly have emails to school people predicting if not addressed the district might have depression and even suicide that would not get better despite major socioemotional efforts. This was before the first cluster and again before the second. And despite their own hired expert recommending the same, and clear ability to address it, they overtly avoided doing anything about this. It went way beyond inertia to overt antagonism. If I am right, no matter what they do to the programs in the 2 schools, there will be subsequent depression or worse in the future. (First consider how rare an echo cluster is and that someone could predict it relative to something that can cause depression and that the district could fix).

The trouble in this community is that so many district decisionmakers, except maybe Ken Dauber (and he has only been here recently) are emotional rather than logical thinkers. They can't make a decision based on the weight of evidence, and principles like putting safety first even when inconvenient, rather, they go with more political measures like whether you are "someone" in the pecking order. McGee sadly has been drawn into that.


9 people like this
Posted by Harold A. Maio
a resident of Adobe-Meadow
on Nov 22, 2015 at 11:56 am

---decreasing stigma about addressing mental health concerns


The Women's Movement did not ask us to decrease stigma/rape. They told us to stop empowering it. Must one say stop again?

Harold A. Maio

Florida


9 people like this
Posted by outisder
a resident of Old Palo Alto
on Nov 23, 2015 at 10:41 am

I find this whole article stupid. She recycled others comments and the same old stories posted over and over again. I would love to see a real in depth article that actually talked to more types of families, more children and the entire community that has been dealing with this. without pointing fingers, looking at the school's practices factually and objectively would be interesting. AP exams in general classes. Homework assigned over breaks and weekends, teachers not available during paid contracted time for tutorials. Teachers' time spend on computers disengaged with students. These events are all researchable. One thing that is not researchable is the notion that there are parent goups that have kids take pics of tests and pass it on to their friends. Hope the CDC will really not just talk to the same people and I hope the Paly administrations can eventually look at the result of their above practices and maybe consider that ap testing in gen. classes might not be the best practice. Maybe. Also consider that these children are not all "resilient" and can obviously break.


5 people like this
Posted by Marc Vincenti
a resident of Gunn High School
on Nov 23, 2015 at 8:54 pm

Dear Fellow Onliners,

All thanks to Meg Durbin for her work on this Guest Opinion and for her vigilance towards our kids--in her consulting room, on campus, and at board meetings.

I'd like to single out one of the school changes she praises: block scheduling. (Classes at Gunn, as of this semester, are somewhat longer, but meet fewer times per week. The goal is a more leisurely daily pace--though the school is as yet in a period of adjustment.)

This kind of out-of-the-box, creative change--in how our high schools are run--is the direction to move in. The really good news: it can be implemented in many areas besides scheduling.

The first one is class-size. Our classes are overcrowded--making teachers unavailable to kids. (Gunn and Paly have 407 classes with 30 or more students). That's too many!--and that's a box it's easy to climb out of! (The District has the $$$ right now.)

Second: without any flashing yellow light of cautionary guidance counseling, we let kids in for multiple APs (the District recommends a maximum of two, but 680 kids are taking 3 or more).

Third we could think refreshingly outside the box and give kids a nightly, personal, confidential voice in their homework amounts through a website allowing them to respond to their teachers "minutes assigned" with "minutes worked."

Fourth, our schools could return to reporting grades only four times a year instead of twelve--hopefully a step toward "reducing academic and performance pressure," a goal of Ms. Durbin's that I, too, treasure.

And our high schools would feel much more close-knit, and kind, if our children were not so continually, emotionally distracted, in class and out, by social media and texting, and if night after night they didn't feel themselves in a culture of cheating, mixed with a culture of competitiveness, that is so overheated that our students violate their collective conscience at a rate of 87%.

Won't you join us, parents and students, in implementing further changes in the way our schools are run, such as the one Ms. Durbin has so aptly noted here?

To do so, please visit the website for Save the 2,008--a grassroots organization, 400 strong, that's bringing hope to Palo Alto's high-schoolers!

Sincerely,

Marc Vincenti
Campaign Coordinator
savethe2008.com




Don't miss out on the discussion!
Sign up to be notified of new comments on this topic.

Email:


Post a comment

Posting an item on Town Square is simple and requires no registration. Just complete this form and hit "submit" and your topic will appear online. Please be respectful and truthful in your postings so Town Square will continue to be a thoughtful gathering place for sharing community information and opinion. All postings are subject to our TERMS OF USE, and may be deleted if deemed inappropriate by our staff.

We prefer that you use your real name, but you may use any "member" name you wish.

Name: *

Select your neighborhood or school community: * Not sure?

Comment: *

Verification code: *
Enter the verification code exactly as shown, using capital and lowercase letters, in the multi-colored box.

*Required Fields

Cherries and Berries
By Laura Stec | 3 comments | 1,250 views

Being deeply loved by someone gives you strength . . .
By Chandrama Anderson | 2 comments | 614 views

Meeting Other New Parents
By Cheryl Bac | 0 comments | 442 views

 

One more week to vote!

Don't forget to cast your ballot online. Voting ends May 29th. Stay tuned for the results in the July 21st issue of the Palo Alto Weekly.

VOTE HERE