Two leading experts on adolescent mental health have debunked the myth ofany link between the Leaving Cert and suicide. But parents must still learnto read the signs. Kathryn Holmquist writes.
Even mentioning stress and the Leaving Cert in one sentence lays anyone open to the accusation of adding to the hype that creates the stress in the first place. There are certain popular beliefs, however, that we need to debunk in the interest of young people. In order to do this, we have to discuss a taboo subject: the urban myth that there is an alleged link between the Leaving Cert and the Republic's soaring suicide rates.
There is absolutely no link between the Leaving Cert and mental distress, including the kind of distress that can lead to self-harm, says Dr John Connolly, a psychiatrist and secretary of the Irish Association of Suicidology. Yet he has seen parents giving their students valium going into exams, with the results that the young people fall asleep.
Nobody is blaming parents, but educating parents to help maximise their own and their children's mental health is an urgent issue, and one that will be addressed on Saturday, May 17th at the Parenting Matters conference in Galway. The main sponsor of the event is the National Suicide Review Group, which reflects concerns that parents' own mental and emotional health are crucial in helping young people to manage their own anxiety. The Leaving Cert and other school-related problems, such as bullying, will come up in the context of dealing with normal problems and stresses.
International research supports the view that exams are a normal part of life and not the core of the problem of mental distress amongst students.
According to Professor David Schaeffer of Columbia University, an expert in adolescent mental distress, who was in Dublin recently at the invitation of the Mater Hospital Child Guidance Clinic, it is the way the young person handles anxiety that is the issue, not the exam itself.
In reality, Leaving Cert students are at relatively low risk. Education is a protective factor. School drop-outs involved in alcohol and drug abuse are most likely to experience mental distress resulting in self-harm.
Dr Connolly agrees: "Exams are only exams. You can only do your best. If you don't do as well as you'd like, you have to realise that one door never closes but another opens. And, sometimes, not getting the points you want may create other opportunities which may be best for you in the long-run. As doctors, we all know of people who were pushed into medicine and would have been better off doing something else."
Learning to cope with the natural anxiety that young people may feel going into exams is a normal part of growing up, he adds. "It's really not a big deal. So let's not create hysteria. Programmes in the schools like the SPHE (Social Personal Health Education) and the Mental Health Matters project are equipping young people better for life than the school system has to date. They are learning problem-solving and coping mechanisms for dealing with reality," he says.
If we want to criticise the Leaving Cert, then criticise the exam itself and its educational implications, not its alleged effects on mental health because there are none, he says. "The Leaving Cert isn't perfect, but what else is there? Continuous assessment isn't perfect either."
The Leaving Cert is no more responsible for mental distress than taking a driving test or relocating with a family to a new school, says Schaeffer. It's not the specific difficult events that are the problem, he says. The core issue is the personality of the young person and they way they cope with these challenges. He strongly believes that we need to talk about the taboo issue of suicide openly in order to prevent it.
The type of young person who becomes overwrought over exams shows certain traits, he says. An obvious one is that he or she spends an excessive amount of time on homework. A worrying sign is when the student works hard, then tears the work up and starts again, says Schaeffer.
These teenagers are usually good at sports, popular and "nice", he says. "They tend to be people-pleasers who are not provocative in their behaviour." Connolly adds that they tend to be perfectionists and self-obsessed - unable to see the larger picture beyond themselves.
These young people are perfectionists, so much so that they find it hard to imagine themselves being delighted with their exam results, no matter how well they do, says Schaeffer. But this feeling about exams is not in itself a cause of severe mental distress. These young people are perfectionists in all areas of life, not just when it comes to studying. In many cases, these young people are suffering from an unrecognised anxiety disorder. Parents are not culpable, Schaeffer stresses (as does Connolly). This anxiety is something that is in the person's biochemical make-up and it can be treated.
With early diagnosis (the earlier the better), such young people respond well to treatment. Research has shown them doing particular well on anti-depressants that enhance the take-up of serotonin by neuro-transmitters.
Unfortunately, "it is very difficult to get help in Ireland," says Schaeffer. He blames this lack of help for the fact that the Republic has the second highest suicide rate amongst young people in the world. Alcohol and drug abuse are factors, but they would not be as much of a problem if help were readily available, he believes.
He says it is "quite common" for teenagers to have suicidal thoughts. Depression is experienced by one in five adolescents. "Yet kids go to great lengths to disguise depression. What parents tend to see is ill-temper and irritability."
He would like to see screening for depression in schools as a matter of routine. "We've developed a questionnaire that works like magic. It's confidential and the young person only has to answer yes or know to a computer. Young people tell the computer things they would never tell an adult face to face," he says.
Age 16 would be an ideal time to do such screening, he believes. In boys, suicidal behaviour tends to start around age 16 and reaches a peak at age 24 or 25. In girls, the rate is the same for 14 to 19 year olds.
Connolly sees the value in screening, but adds that there is no point introducing it until the services are available to help young people with anxiety and depression.
"We should look at the structures first. It's a crying shame that there is no adequate adolescent psychiatric service in this country. Conditions go undiagnosed, or are diagnosed too late, because of waiting lists. What's the use of screening if you can't help?"
That is the key question. Bringing together Education and mental health services to provide proper screening and treatment for adolescents, is the real issue, says Professor Schaeffer. Not the Leaving Cert.
