The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #54315

Jennifer P Wisdom, PhD, Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd. CSB 669, Portland, OR 97201-3098, 503-335-6308, wisdomj@ohsu.edu

Depression is a major problem among adolescents and is related to decreased academic performance, extensive emotional distress, and an increased likelihood of suicide attempts. Most teenagers with depression never access formal health care for their symptoms. Even when teens talk to medical professionals about depression, rates of treatment adherence are low. This qualitative study talked with teenagers about what they do when they are depressed, how they access medical care, and their experiences obtaining medical services. Teens described social and external factors (e.g., stress) as causing their depression and tended to reject a biomedical model of depression etiology. They also attempted to alleviate their symptoms by engaging in numerous self-help strategies that were often not acknowledged by providers. Teens initially accessed care when their mothers became concerned by changes in behavior and brought them to the doctor. Teens reported positive and negative treatment experiences. When providers listened to teens’ concerns, gave them adequate information about depression, and offered choices for treatment, teens viewed their experiences as positive. Negative experiences often included teens not being included in discussions between provider and parent, providers’ violations of confidentiality, and teens feeling disrespected or abnormal (like they are “mental”). In this presentation, teens’ words will be discussed in the context of what teens indicate they want as they negotiate both identity formation and a depressive episode: to feel normal, to connect with a provider, and to be autonomous. Providers’ actions that support or disempower teens to reach these goals will be discussed.

Learning Objectives:

At the conclusion of the session, the participant/learner will be able to:
• Recognize developmental issues salient for teenagers seeking care for depressive symptoms.
• List aspects of help-seeking that are related to teens' understanding of depression and willingness to engage in treatment.
• Articulate specific actions helping professionals (including primary care physicians) can do to increase teens' disclosure of symptoms, understanding of depression, and treatment outcome.

Keywords: Depression, Adolescents

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.