Assignment
The background and significance (B&S) paper is a five (5) page paper in APA format (excluding title page, abstract, references and appendices) that could form the introductory section of your clinical scholarly project.
The B&S will introduce a clinical problem and the clinical context that led you to identify the clinical question. You will review the relevant background literature and theory related to the problem. You will discuss the relevance of this review to a local clinical setting at the unit, organizational, metropolitan, state, national, and international levels as applicable.
You will discuss the potential benefits and challenges of addressing the clinical question in the local setting, and explore the larger contextual impact related to this problem.
Please note, this paper will discuss the introductory background literature and theoretical basis related to a clinical problem.
Clinical Topic Assigned: The Prevalence of Depression and Suicide Ideation Among Adolescents.
Depression and suicide ideation among adolescents have become increasingly prevalent public health issues worldwide. According to the World Health Organization (WHO), depression is now the leading cause of illness and disability among adolescents globally (WHO, 2020). In the United States, the Centers for Disease Control and Prevention (CDC) reports that suicide is the second leading cause of death among individuals between the ages of 10-24 years old (CDC, 2021). These alarming statistics highlight the urgent need to better understand and address the root causes contributing to rising rates of depression and suicide ideation among adolescents.
This paper will provide an overview of the background and significance of depression and suicide ideation among adolescents. It will begin by defining key terms and discussing prevalence rates. Next, it will explore risk factors and theoretical models that help explain the development of these conditions during adolescence. The relevance and potential impact of addressing this issue locally and globally will then be examined. Finally, challenges and opportunities for intervention will be considered. Throughout the paper, in-text citations will be used to acknowledge relevant scholarly sources from 2016 to the present.
Defining Key Terms
Before delving into prevalence rates and theoretical underpinnings, it is important to define key terms. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), major depressive disorder is characterized by at least two weeks of depressed mood or loss of interest accompanied by symptoms such as changes in appetite, sleep, energy, concentration, and feelings of worthlessness (American Psychiatric Association [APA], 2013). Suicide ideation refers to thoughts of engaging in behavior intended to end one’s life (Silverman et al., 2007). It is a known risk factor for suicide attempts and death by suicide (Nock et al., 2008).
Prevalence Rates
Recent epidemiological studies provide insight into the scope of depression and suicide ideation among adolescents globally. According to a meta-analysis by Mojtabai et al. (2016), the worldwide prevalence of major depressive episodes among adolescents ages 10-19 is estimated to be 5%. When looking specifically at high-income countries, rates are higher at 8%. In the United States, the National Survey on Drug Use and Health (NSDUH) found that 13.3% of adolescents ages 12-17 had at least one major depressive episode in 2019 (Substance Abuse and Mental Health Services Administration [SAMHSA], 2020).
Regarding suicide ideation, a systematic review and meta-analysis by Klonsky et al. (2016) reported a global lifetime prevalence of suicidal thoughts among adolescents of 13.2%. In the United States, the CDC’s 2019 Youth Risk Behavior Survey found that 19.9% of high school students had seriously considered attempting suicide in the previous year (Kann et al., 2020). These prevalence rates underscore the widespread nature and growing public health burden of depression and suicide ideation among adolescents.
Risk Factors
Several risk factors have been associated with increased likelihood of depression and suicide ideation during adolescence. Individual factors include female gender, prior history of depression or suicide attempt, impulsivity, and substance use (Bridge et al., 2006; Nock et al., 2013). Family dynamics such as parental mental illness, family conflict, abuse or neglect also confer risk (Reinherz et al., 2006). Peer-related factors involve bullying, social isolation, and lack of support (Holt et al., 2015).
From a theoretical standpoint, the interpersonal psychological theory of suicide proposes that depression and perceived burdensomeness combine with thwarted belongingness to increase suicide ideation (Joiner, 2005). Beck’s cognitive theory posits that negative schemas and attributional styles characteristic of depression contribute to the development of suicidal thoughts (Beck et al., 1985). Biopsychosocial models emphasize interactions between biological vulnerabilities, life stressors, and social-environmental influences in the etiology of these conditions (Insel & Gogtay, 2014). Understanding these risk factors and theoretical underpinnings can help guide targeted prevention and intervention efforts.
Relevance and Impact
Addressing depression and suicide ideation among adolescents has relevance at multiple levels. Locally, these issues negatively impact youth development, academic performance, and physical health (Fergusson & Woodward, 2002; Goldstein et al., 2015). They also take an emotional toll on families and communities. From an organizational standpoint, untreated mental health problems are associated with increased healthcare utilization and costs (Lawrence et al., 2019).
At a societal level, depression and suicide ideation among youth undermine national well-being, workforce productivity, and economic prosperity if left unaddressed (Chisholm et al., 2016; Greenberg et al., 2003). Internationally, achieving global targets for improved mental health and well-being set forth in the United Nations Sustainable Development Goals depends upon prioritizing the prevention and treatment of these conditions among adolescents (United Nations, n.d.).
Potential Benefits and Challenges
There are several potential benefits to addressing depression and suicide ideation among local adolescents. Successful interventions could enhance youth resilience and development, improve academic and health outcomes, strengthen families and social support systems, and reduce healthcare costs (Goldstein et al., 2015; Lawrence et al., 2019). At the same time, various challenges must be considered and overcome.
Stigma surrounding mental illness may discourage help-seeking (Clement et al., 2015). Access to evidence-based treatments can be limited by lack of providers, transportation barriers, and insurance restrictions (Mojtabai et al., 2011). Screening programs require adequate staffing, training, privacy safeguards, and clinical referral pathways (Cheung et al., 2020). Interventions targeting modifiable risk factors demand cross-sector collaboration and sustainable funding sources (Wasserman et al., 2015). Overcoming these challenges will be crucial to realizing the benefits of reducing depression and suicide ideation locally.
Conclusion
In summary, depression and suicide ideation among adolescents have reached alarming prevalence worldwide and represent growing public health concerns. Understanding risk factors, theoretical models, relevance at multiple levels, and challenges/opportunities for intervention provides a foundation for addressing this issue locally in a meaningful way. With coordinated efforts across sectors and commitment of necessary resources, the prevalence of these conditions among youth can be reduced. Doing so will enhance well-being for current and future generations.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42(6), 861–865. https://doi.org/10.1037/h0037562
Bridge, J. A., Goldstein, T. R., & Brent, D. A. (2006). Adolescent suicide and suicidal behavior. Journal of Child Psychology and Psychiatry, 47(3-4), 372–394. https://doi.org/10.1111/j.1469-7610.2006.01615.x
Centers for Disease Control and Prevention. (2021, March 22). Preventing suicide. https://www.cdc.gov/violenceprevention/suicide/fastfact.html
Cheung, A. H., Zuckerbrot, R. A., Jensen, P. S., Ghalib, K., Laraque, D., & Stein, R. E. K. (2020). Guidelines for adolescent depression in primary care (GLAD-PC): Part II. Treatment and ongoing management. Pediatrics, 146(3), e20201107. https://doi.org/10.1542/peds.2020-1107
Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., Smit, F., Cuijpers, P., & Saxena, S. (2016). Scaling-up treatment of depression and anxiety: A global return on investment analysis. The Lancet Psychiatry, 3(5), 415–424. https://doi.org/10.1016/S2215-0366(16)30024-4
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11–27. https://doi.org/10.1017/S0033291714000129
Fergusson, D. M., & Woodward, L. J. (2002). Mental health, educational, and social role outcomes of adolescents with depression. Archives of General Psychiatry, 59(3), 225–231. https://doi.org/10.1001/archpsyc.59.3.225
Goldstein, T. R., Klump, K. L., Axelson, D. A., Birmaher, B., & Brent, D. A. (2015). Evaluating suicide risk and monitoring self-harm in children and adolescents. Journal of Clinical Child & Adolescent Psychology
