Youth Mental Health Report

HEALTH n EDUCATION n ACHIEVEMENT n RESPONSIBILITY n TRUTH
Youth Mental Health
and Substance Use
Rochester Report 2006
Coalition for a Drug Free Rochester
c/o City of Rochester Dept. of Recreation and Youth Services
400 Dewey Avenue, Rochester, NY 14613
(585) 428-7287
© 2006

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About This Report
This report summarizes local information about Rochester youth, their mental health and
their use of alcohol, tobacco and other substances. The report refers to several sources of data
including the Youth Risk Behavior Survey (YRBS). The YRBS is a survey for adolescents designed
by the Centers for Disease Control and Prevention that measures health issues and behaviors.
The survey asks students questions about asthma, drug use, weapons, injuries, sexual behaviors,
physical activity, medical and dental care. School districts administer this survey to high school
youth every two years. In 2005, Rochester City School District administered the survey to 4,435
high school students.1
Also in 2005, the Monroe County Department of Health, in partnership with local school
districts, compiled the Monroe County Youth Risk Behavior Survey. The Monroe County YRBS
reflects the responses of 2,010 randomly selected high school students in eighteen Monroe County
School Districts, including the Rochester City School District. The Centers for Disease Control
and Prevention compiles a national Youth Risk Behavior Surveillance Report. Students’ responses
to the Monroe County Youth Risk Behavior Survey and the national survey are included here for
comparison purposes.
Limitations: The Youth Risk Behavior Survey is administered only to youth who are present
in high school. Significant numbers of City youth do not attend high school. (For example, in
2005-2006, only 1,449 students were enrolled in twelve grade in the Rochester City School District
high schools; four years earlier, about 3,244 students were enrolled in ninth grade.2)
HEART Coalition
The HEART Coalition for a Drug-Free Rochester is led by the City of Rochester with the
assistance of the Metro Council for Teen Potential and the Rochester City School District. The
Coalition enlists community-based organizations and youth leaders to work together to promote
mental health and to prevent, postpone and reduce the use of alcohol and marijuana. HEART
works with parents, teachers and the larger community to increase the supports available to young
people, to reduce youth access to alcohol and marijuana, to raise awareness about manipulative
marketing practices, and to change community norms. Our youth members chose the name HEART
to reflect our aspirations for Rochester: Health, Excellence, Achievement, Responsibility and Truth.
Funding for the HEART Coalition is provided by the Substance Abuse and Mental Health
Services Administration and the Office of National Drug Control Policy, as part of the Drug-Free
Communities program.
For More Information:
For comprehensive information about local youth health issues, see the Monroe County
Health Action Report: Adolescent Health Report Card, 2006; www.healthaction.org.
1 54% of the 4,435 students who completed the RCSD survey were female; 46% were male. 30% were in ninth grade; 29% in tenth
grade; 22% in eleventh grade and 18% were in twelfth grade.
2 Rochester City School District 2005-2006 Districtwide Enrollment Statistics; and Rochester City School District Enrollment Statistics
2002-2003
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Economic Security
There are 51,240 children living in the City of Rochester (birth to age 17). 42% of Rochester
children live below the poverty level; and 30% of all City residents live below the poverty level.3
Youth Mental Health
City of Rochester youth, Monroe County youth and youth across the country report significant
levels of depression.
City
County YRBS
U.S.
City
YRBS Question
YRBS
2005 (combines
YRBS
YRBS
2005
City & suburbs)
2005
2003
In past year, felt so sad or hopeless almost every day for
2 or more weeks in a row that they stopped doing their
26%
26%
29%
30%
usual activities
Seriously consider attempting suicide in the past year
12%
15%
17%
15%
Attempted suicide in the past year
10%
14%
8%
13%
Attempted suicide in past year that resulted in
5%
5%
2%
6%
injury/overdose that needed medical treatment
City of Rochester and Monroe County youth are more likely to report attempted suicide
resulting in injury/overdose than U.S. youth.
Youth Safety
City of Rochester youth also report significant levels of stress, fear and exposure to and
risk for violence.
City
County YRBS
U.S.
City
YRBS Question
YRBS
2005 (combines
YRBS
YRBS
2005
City & suburbs)
2005
2003
Carried a weapon in the past month
24%
17%
19%
20%
Carried a gun in the past month.
10%
6%
5%
8%
Carried a gun, knife or club on school property in the
10%
6%
7%
7%
past month.
Did not go to school on one or more days the past
month because they felt unsafe at school or on their way
8%
6%
6%
8%
to school
Were teased, harassed or attacked at school or on way
25%
26%
—
26%
to school in the past month
Were threatened or injured on school property in the last
8%
8%
8%
8%
year
3 U.S. Census, American Community Survey, 2005
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Youth Safety (continued)
City
County YRBS
U.S.
City
YRBS
2005 (combines
YRBS
YRBS
YRBS Question
2005
City & suburbs)
2005
2003
Engaged in a physical fight in the past year
43%
34%
—
36%
Engaged in a physical fight on school property in the
20%
13%
14%
15%
past year
Were hit, slapped or physically hurt by a boyfriend/girl-
20%
13%
14%
15%
friend the past year
Forced to have sexual intercourse
14%
11%
9%
13%
Two Rochester high schools were recently named as “persistently dangerous” by the NYS
Education Department, based on the number of violent incidents in the 2004-05 and 2005-06
school years. These schools are Charlotte High School and Jefferson High School.4 The
Rochester City School District is taking steps to try to improve school safety. Police Resource
Officers (Rochester Police Department) are assigned to most City high schools, and metal detec-
tors are in use. The District uses the Olweus Bullying Prevention Program to improve school cli-
mate.
Youth in Rochester are more likely to carry weapons than County youth or youth in the
U.S. Youth in Rochester report higher rates of dating violence and being physically forced to have
sex. Homicide is the leading cause of death among adolescents living in the City of Rochester 5.
In 2005, thirteen City adolescents (age 12 to 19) were victims of homicide (Rochester Police
Department).
Substance Use
The following chart summarizes the responses of the high school students to questions
about tobacco.
City
County YRBS
U.S.
City
Question
YRBS
2005 (combines
YRBS
YRBS
2005
City & suburbs)
2005
2003
Have tried smoking cigarettes, even one or two puffs
46%
45%
54%
51%
Smoked a whole cigarette before age 13
14%
12%
16%
14%
Current smokers – used cigarettes on one or more days
13%
19%
23%
15%
in past month
Smoked daily (1 cigarette or more a day for 30 days per
8%
11%
—
—
month)
4 NYS Education Department, Press Release, “Seventeen Schools Named as Persistently Dangerous Under NCLB”, Aug. 22, 2006,
www.emsc.nysed.gov
5 Monroe County Health Action, Adolescent Health Report Card, 2006
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As compared to 2003, fewer City youth report that they have tried cigarettes, and fewer
youth currently smoke cigarettes.
Students reported the following about their use of alcohol, marijuana and other drugs.
City
County YRBS
U.S.
City
Question
YRBS
2005 (combines
YRBS
YRBS
2005
City & suburbs)
2005
2003
Ever drank one or more drinks of alcohol in their life time
62%
74%
74%
65%
Drank one or more drinks of alcohol before age 13
27%
20%
26%
26%
(other than a few sips)
Had at least one drink of alcohol in past month
33%
45%
43%
33%
Engaged in binge drinking in the past month (5 or more
16%
27%
26
16%
drinks in a row)
Have used marijuana in their lifetime
44%
40%
38%
43%
Used marijuana before age 13
15%
10%
9%
13%
Used marijuana in past month
25%
22%
20%
23%
Used cocaine in their lifetime
4%
6%
8%
4%
Used cocaine in past month
3%
5%
3%
3%
Ever sniffed glue, paint, spray cans to get high
6%
11%
12%
7%
Used heroin in their lifetime
3%
3%
2%
3 %
Used methamphetamines in their lifetime
2%
6%
6%
3%
Used ecstacy in their lifetime
4%
5%
6%
5%
Used steroids without a doctor’s prescription in their life-
4%
3%
4%
4%
time
Used a drug prescribed for someone else to get high in
5%
10%
—
6%
their lifetime
Injected any illegal drug in their lifetime
3%
2%
2%
3%
Used any other illegal drugs such as LSD, PCP or mush-
4%
8%
9%
5%
rooms in their life
Were offered, sold or given an illegal drug on school
32%
32%
25%
33%
property in past year
In past month, rode in a vehicle driven by someone who
25%
27%
28%
25%
had been drinking alcohol
In past month, drove a vehicle when they had been
8%
12%
10%
8%
drinking alcohol
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More City youth report drinking and using marijuana before age 13, as compared to the
County survey; but levels of current drinking are lower among City youth. One third of City
students say they had a drink in the past month; one quarter used marijuana. About one-third of
the youth say they were offered drugs on school property in the past year. About one quarter of
the young people say that, in the past month, they rode in a car driven by someone who had
been drinking.
Access to Medical Care
Students were asked about their access to preventive medical care.
City
County YRBS
City
YRBS Question
YRBS
2005 (combines
YRBS
2005
City & suburbs)
2003
Saw a doctor / health care provider for a check up in past year
71%
77%
68%
During their last check up, doctor or health care provider dis-
36%
31%
36%
cussed ways to avoid alcohol use
During their last check up, doctor or health care provider dis-
36%
32%
37%
cussed ways to avoid tobacco
In last 12 months, got a chance to talk with a doctor or other
61%
66%
64%
health care provider privately
Family and School Supports and Self-esteem
Students were asked about their self-esteem and their family and school supports.
City
County YRBS
YRBS Question
YRBS
2005 (combines
2005
City & suburbs)
“I like myself”
— students strongly agree
64%
46%
— students agree
29%
45%
— students disagree or strongly disagree
7%
9%
“My family gives me help and support when I need it”
— students strongly agree
47%
48%
— students agree
34%
34%
— students disagree or strongly disagree
19%
18%
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Family and School Supports and Self-esteem (continued)
City
County YRBS
YRBS
2005 (combines
YRBS Question
2005
City & suburbs)
“In my family there are clear rules about what I can / cannot do”
— students strongly agree
46%
39%
— students agree
34%
41%
— students disagree or strongly disagree
20%
20%
When I have important questions about life,
— I know 3 or more adults that I feel comfortable going to for help (not counting parents)
38%
37%
— I know 1 or 2 adults that I feel comfortable going to for help (not counting parent)
43%
46%
— I don’t know adults that I feel comfortable going to for help (not counting parent)
20%
17%
“I get a lot of encouragement at my school”
— students strongly agree
25%
20%
— students agree
39%
41%
— students disagree or strongly disagree
36%
39%
Adult Substance Use
In the United States, young people grow up in environments where alcohol abuse is common
among adults. Nationally, about 45% of adults in their early 20s report binge or heavy drinking.6
(“Binge” drinking is defined as consuming five or more drinks at one time in the past month.
“Heavy” drinking is defined as five or more drinks at a time on each of five or more days in the
past month.) Rates of reported binge drinking and heavy drinking decline with age, but about 25%
of adults in their late 40s still report binge or heavy drinking. About one-third of heavy drinkers
report using illegal drugs. A significant number of adults report driving under the influence of
alcohol in the past year (rates range from 28% among adults in their early 20s; to 13% among
adults in their early 50s.)
Nationally, about 6% of adults, ages 25 and older, reported use of illegal drugs in 2005.7
In Monroe County, rates of adult alcohol abuse are similar to these same rates for NYS.8
6 Substance Abuse and Mental Health Services Administration, “Results from the 2005 National Survey on Drug Use and Health:
National Findings” 2005, pages 27, 28
7 Ibid., page 20
8 NYS Office of Alcoholism and Substance Abuse Services, “Prevention Risk Indicator Services Monitoring System for Alcohol and
Substance Abuse, 2005 Profile (PRISMS 2005), page C-2
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Alcohol Risk Indicators
Monroe County
NYS Average
Adult driving while intoxicated arrests
50%
48%
Adult alcohol-related hospital diagnoses (discharged from a hospital with
13.1%
12.7%
a diagnosis of acute alcoholic hepatitis, cirrhosis of liver, etc.)
Adult OASAS alcohol treatment (in treatment during past year with alco-
43.6%
46.5%
hol as the only problem substance)
Adult probation cases, evidence of alcohol use at time of offense
48.1%
33.1%
All rates are per 10,000 adults, ages 21 and older
In Monroe County, rates of adult abuse of illegal drugs are higher than NYS rates.9
Adult Illegal Drug Use
Monroe County
NYS Average
Adult drug arrests
51.2%
40.6%
Adult drug-related hospital diagnosis
60.1%
45%
Adult OASAS drug treatment (in treatment in past year with drugs and
46%
33.9%
not alcohol as the problem substance)
Adult probation cases, evidence of drug use at time of offense
15%
8.7%
All rates are per 10,000 adults, ages 21 and older
What It Means
Youth Assets and Risk Factors
Parents have the greatest influence over their children’s decisions to try and to use cigarettes,
alcohol and drugs.10 The vast majority of City youth report that they are growing up with the
essential family supports (“My family gives me help when I need it”; and “There are clear rules about
what I can and cannot do”.) About 20% of City youth who answered the 2005 YRBS said that they
do not have these supports; 20% also said that they don’t know adults to whom they could go to
for help (other than parents).
Family dynamics around substance abuse are a key factor. Children of parents who abuse
alcohol or other substances are more likely to engage in problem drinking, abuse other drugs,
and are at greater risk for mental health problems.11
Whether youth feel connected to school also influences their behaviors. 36% of City students
(and 39% of County students) are not sure about or do not agree with the statement: I get a lot of
9 NYS Office of Alcoholism and Substance Abuse Services, “Prevention Risk Indicator Services Monitoring System for Alcohol and
Substance Abuse, 2005 Profile (PRISMS 2005), page C-4
10 National Center on Addiction and Substance Abuse at Columbia University, “Family Matters, Substance Abuse and the American
Family”, 2005, page 3
11 Ibid, pages 10-12
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encouragement at my school. 25% of City students say they were teased or harassed in school or
on their way to school in the past month, and 10% said they carried a weapon to school in the
past month.
It has been shown that youth who feel “connected” to school and youth who attend
schools with a positive school climate are at lower risk for drug use, dropping out, risky sexual
behavior and violence.
School climate encompasses the following: a) the opportunity to affect school
classroom policies and procedures; b) positive relationships with adults, c) the
perceptions that adults as a whole at school did not discriminate based on
appearances, and d) opportunities for creative engagement… In schools with zero
tolerance policies, which mandate harsh punishments for first infractions, students
felt less connected and less safe at school Small school size, but not class size, was
important as well… When youth feel connected to school, they are buffered from
risks that jeopardize their health and social development12
Medical providers have a role to play. The American Medical Association recommends that
medical providers communicate with adolescents about the risks of tobacco, alcohol and other
substances, ask questions about youth use of drugs and provide appropriate supports as needed
(cessation plans, counseling, referrals, early intervention, etc.)13 While most City students report
having had a physical in the past year, only about one-third say that their medical providers
discussed ways to avoid alcohol and tobacco. This is consistent with what doctors reported (in a
national survey) about their practices in screening adolescents patients for alcohol use and in
providing prevention education to their adolescent patients.14 Medical care providers often
underestimate the severity of adolescents’ substance-related problems.15 “This is unfortunate,
because it is these teens who might benefit most from early intervention services.”16
Depression / mental health problems
20% of City youth report feelings of depression in the past year (they felt so sad or hopeless
almost every day for 2 or more weeks in a row that they stopped doing their usual activities). In
recent years, more youth have received mental health services at public mental health clinics.17
Besides depression, the most common diagnoses among Monroe County youth who use public
mental health services are adjustment disorders, behavioral disorders and anxiety. Those who
work with youth believe that many students are still not receiving the services they need.
Barriers include:
— Cost: virtually all commercially available health insurance policies require that families
pay half the cost of mental health treatment.
12 Whitlock, Janis, “Research Facts and Findings, Fostering School Connectedness” ACT for Youth Upstate Center for Excellence, Nov. 2003
13 American Medical Association, “Guidelines for Adolescent Preventive Services (GAPS)”, 1997, pages 4, 5
14 Millstein S, Marcell A, Screening and Counseling for Adolescent Alcohol Use Among Primary Care Physicians in the U.S., Pediatrics,
2003, Vol. 111, page 114
15 Wilson C, Sherritt L, Gates E, Knight J, Are Clinical Impressions of Adolescent Substance Use Accurate?, Pediatrics, 2004, Vol. 114,
page 539
16 Ibid.
17 Adolescent Health Report Card 2006, pages 48 - 52
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— Lack of mental health screening services in the schools and community.18
— Stigma, believing problems can be handled without treatment, and not knowing where
to go.19
When youth with mental health challenges do not receive the help they need, they often
end up in school suspension rooms, at hospital emergency departments, or in the courts and jail.
These places can become the de facto mental health system when medical care is not provided.
Smoking
Use of tobacco among students has declined since the late ’90s. In group discussions, Rochester
youth are well informed about the risks of cigarettes. Reduced rates of youth smoking are probably
attributable to: increase taxes on cigarettes, local social marketing and youth media literacy
campaigns (Reality Check, led by Huther Doyle; and TOBACCO LIES, led by the Smoking and Health
Action Coalition of Monroe County); and the national counter-marketing Truth® campaign.20
The Truth® Campaign was an anti-smoking media campaign funded as part of the master
settlement agreement between tobacco companies and 46 states. The successful national campaign
portrayed youth as “nonsmokers, rebels against the tobacco industry and cool and edgy…”21
Researchers attribute the success of this public health campaign to its use of images of teens who
are risk takers, popular, in control and rebelling against large tobacco companies; and to the
successful development of the Truth® campaign as an anti-smoking brand that can compete
with cigarette brands.
Use of alcohol and marijuana
City youth report lower rates of current drinking than County youth (33% vs. 45%). 27%
of City youth, however, say that they drink alcohol (other than a few sips) before the age of 13.
Use of alcohol at a young age is associated with alcohol-related problems in adulthood.22 Binge
drinking is also a concern. 16% of City youth (and 27% of County youth) say they engaged in
binge drinking in the past month (five or more drinks in a row.)
Alcohol puts youth at risk for accidents and teen pregnancy. 25% of City youth say they
rode in a car in the past month driven by someone who had been drinking alcohol; 8% said that
they drove a car after drinking.
Sale of alcohol to minors is highly profitable to the alcohol industry; one estimate puts
the value of alcohol sales to minors nationally at $22.5 billion.23 Alcohol is heavily marketed to
youth via magazines, radio, TV and billboards.
18 Adolescent Health Report Card 2006, page 52
19 Substance Abuse and Mental Health Services Administration, “Results of the 2005 National Survey on Drug Use and Health:
National Findings”, page 84
20 Adolescent Health Report Card 2006, pages 26-28
21 Evans, W. D., “Evaluating the Truth Brand”, Journal of Health Communication Oct. 2005, page 183
22 Community Anti-Drug Coalitions of American in collaboration with National Institute on Alcohol Abuse and Alcoholism, Using
Science to Combat Underage Drinking, The Practical Theorist, page 4
23 National Center on Addiction and Substance Abuse at Columbia University, “The Commercial Value of Underage and Pathological
Drinking to the Alcohol Industry”, 2006, page 4
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