In an assessment of their "depression literacy" program, which has already been taught to tens of thousands, Johns Hopkins researchers say the Adolescent Depression Awareness Program (ADAP) achieved its intended effect of encouraging many teenagers to speak up and seek adult help for themselves or a peer.
The researchers say the program was designed to prevent suffering at a time when adolescent depression rates are on the rise and many believe awareness, early recognition, and effective therapies can lead to better outcomes.
"We believe that early treatment and self-recognition of depression are essential for reducing suffering in young people, and our results validate the overall effectiveness of the program," said Karen Swartz, founder of ADAP at the Johns Hopkins University School of Medicine.
The curriculum focuses on how to recognize symptoms of depression and how clinical depression is diagnosed and treated. It also seeks to take the stigma out of acknowledging and treating depression and recognizes that suicide can be a consequence of depression.
Now in its 19th year, ADAP has been taught to more than 80,000 high school students. The six-hour training for ADAP instructors is in-person and the three-hour program is taught to students in two to three consecutive classes. Tools include lectures, videos, group activities and homework.
For the evaluation, Swartz and her team looked at data collected from 2012 to 2015 from 6,679 high school students in 54 high schools in Maryland, Delaware, Pennsylvania, Michigan, and Oklahoma. In all, 3,681 students were taught the ADAP curriculum and 2,998 students were not exposed to the curriculum (control group).
All students filled out the Adolescent Depression Knowledge Questionnaire and the Reported and Intended Behavior Scale just before starting the curriculum, six weeks after taking the course, and four months after the classes to assess improvements in depression literacy and mental health stigma.
Those students who received the ADAP curriculum were considered more likely to be depression-literate as defined by scoring an 80% or more on the 17-question Adolescent Depression Knowledge Questionnaire. More than 54% of students were depression-literate four months after the curriculum, compared with 36% of students in control group.
In all, 201 students (average age 16) completed the online Child and Adolescent Services Assessment survey and got parental consent to participate in the study. Of these, 64% were girls, and 77% identified as white.
Sixteen percent of students said they had sought help for depression or another emotional concern after completing the ADAP curriculum and 19% of these students said they needed help, and out of these, 44% ultimately received treatment for their depression within four months of taking the ADAP curriculum.
"In participating schools, ADAP is delivered as part of the standard health education curriculum, which facilitates its sustainability," said Holly Wilcox, associate professor at the Johns Hopkins Bloomberg School of Public Health.