'Behavioral vaccine' for teen depression

Can an online prevention program keep mental health problems at bay among teens who are already at risk of suffering from severe depression?

A team at the University of Illinois Medical Center hopes so, and has spent more than a decade developing and testing the best way to teach coping strategies to at-risk youth.

Benjamin Van Voorhees, M.D., the hospital’s chief of general pediatrics, heads the project, which is funded by the National Institute of Mental Health. Van Voorhees is teaching children coping skills through a combination of online learning and traditional counseling. He hopes a technology-based “behavioral vaccine” can reduce the risk of mental illness for a diverse group of young people, from teens struggling with issues of sexuality to those living in neighborhoods mired in violence.

“Just as a vaccine works in fighting infections, this approach may stop a major depressive disorder before it starts,” he says. “We want to convey to primary care practitioners that these individuals are coming through your office every day, and we are not doing enough for them, and in some ways we are ignoring the enormous future potential adverse trajectory toward mental disorder.” 

Van Voorhees developed an online, self-guided depression prevention program called Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training or CATCH-IT. It is aimed at teens showing early signs of depression or pre-depressive symptoms as determined through screenings during well checks or other medical visits. 

The program includes a self-contained learning component on the Internet that focuses on changing behavior and improving cognitive thinking and social skills. The website, which has evolved over time, teaches resiliency skills in part by allowing parents to read stories about other teens to learn how they overcame adversity and became more successful in school, their relationships or on the job.

“There are no widely available, low-cost effective and acceptable depression prevention interventions for adolescents,” Van Voorhees says. “Developing a feasible, cost-effective Internet-based intervention for this age group that is universally deployable would be of great value.”

Van Voorhees’ pursuit of preventive approaches to mental illness in high-risk adolescents comes as the suicide rate for adolescent boys and girls has been steadily rising. The Centers for Disease Control and Prevention in August reported that the suicide rate for girls ages 15 to 19 doubled from 2007 to 2015, while the suicide rate for boys increased by 50% over the same period.

Van Voorhees and his team are analyzing data outcomes for the latest phase of the CATCH-IT project, which includes 500 teens age 13 to 18 in Chicago and Boston. He believes CATCH-IT’s online intervention model could reshape the way health policymakers and professionals approach mental health care.

“We want to understand what is going on in the environment of the primary care clinic to find these people, identify them and motivate them, and give them something relevant enough to complete,” he says. “Then, let’s see if it changes their behavioral trajectory. We hope we will save lives.”