Validating the voices of young women around depression
Abigail Pugh, Crosscurrents

"I have great friends and an awesome family who support me ... but they don't fully understand. The girls do!" - VALIDITY participant, Northern Ontario

Research over the past decade has shown that throughout childhood and preadolescence, depression rates tend to be fairly equal among boys and girls. But between ages 10-14, rates rise among adolescent girls - as much as three times the rate among boys. A 2004 study published in the International Journal of Behavioral Development, which examined symptoms of depression in 1,322 Canadian adolescents aged 12-19, found that the rate of depression among girls was double that of boys, with nine per cent of the girls reporting depression in the past year. Other research suggests that the gender differential is even more pronounced in major depression, which is so widespread among women that it constitutes the leading cause of disability in adult women up to age 44, starting at age 15. Depressed girls are also twice as likely as their male counterparts to attempt suicide.

Yet despite these startling realities, not enough is known about what causes depression in adolescent girls. It appears that the voice of adolescent girls and young women is missing in the research.

Creating a space where the voices of young women can be heard was the impetus behind a youth-led initiative called VALIDITY - Vibrant Action Looking into Depression in Today's Young Women. Sponsored by the Centre for Addiction and Mental Health (CAMH) in Toronto, VALIDITY was created in 1999 to hear and learn more about what young women have to say. In partnership with a youth action team, VALIDITY has engaged young women to talk about their lives in their own words, and to identify risk factors and prevention strategies through focus groups and a provincial conference in 2001. More than 200 young women across Ontario, aged 15-24, have joined in this participatory action research since its inception.

In the words of participant Tanya Champagne, "I decided to participate because I wanted other young girls to know they are not alone and to feel comfortable going to a service provider who will have a better understanding of what we go through."

Acknowledging what young women feel lies at the heart of VALIDITY. As another participant put it, "I don't want to be treated; I want to be heard!"

Dr. Bonnie Leadbeater, a psychology professor at the University of Victoria in British Columbia, and co-author of the Canadian adolescents study, says that existing resources for depressed youth are inadequate. In addition to increased collaboration among health care professionals to address teen depression, she also advocates "safe spaces" for young girls, where adults merely facilitate but do not seek to treat or advise.

The VALIDITY project strives to do just that. "VALIDITY is more than a project," says Christine Lebert, a project consultant with CAMH, and a former lead on VALIDITY. "It's a movement to bring voice and power to young women with respect to preventing depression and identifying helpful strategies for those who are experiencing it. Young women need to take leadership roles and be given opportunities to make meaningful contributions toward informing service providers, teachers, the public and others about this important issue."

Cathy Thompson, project lead on VALIDITY, says that the target group is diverse young women who are not already diagnosed with depression. "VALIDITY is not a treatment program," she says. "It is a prevention measure through education. We want to make young women more aware of depression and its treatments so they are not so fearful."

Champagne values the safe environment created by VALIDITY during a weekend workshop she attended. "The sharing allowed me to see that we are all in the same boat," she says. "That helped a lot - being able to talk to other people who actually understood and wouldn't judge us. We knew that if we wanted to talk about anything, we were in a safe spot to do so; we didn't have to worry about being judged, slandered, hurt or even offended."

Based on their explorations, the youth action team made recommendations that included preparing a resource guide for health care providers written by young women, called Hear Me, Understand Me, Support Me . Woven throughout with powerful personal stories from participants, the resource discusses risk factors, prevention strategies and what young women want - and don't want - from service providers.

Another VALIDITY initiative is "Girls' Talk" - an eight-session program providing adolescent girls with the chance to share ideas, experiences and insights in a safe and nurturing environment. The pilot ran in spring 2004 at two high schools in the Toronto-area Halton region and in Ottawa. Girls' Talk groups were held this autumn with First Nations women and francophone women, as well as with young women in mainstream high school settings.

Service providers are encouraged by the fact that the risk factors that participants have identified match those suggested by years of research. But just what are those risk factors? Although they include genetic and hormonal variables, VALIDITY focuses more on what the girls identify as "challenges" - cultural and personal risk factors such as friendships and relationships, family patterns, peer pressure and body image because they are susceptible to change.

The effects of sharing personal stories have lingered for Champagne: "It helped me move forward. After that workshop weekend, I was a lot more confident about talking and sharing. It's nice to get e-mails from other participants and know we can still talk with each other."

Talking with service providers is also important. The opening salutation for Hear Me, Understand Me, Support Me is: "Dear teacher, physician, therapist, nurse, youth worker, researcher, community worker or person who cares about girls and young women." This broad and inclusive address acknowledges that many people have a part to play in listening to the voices of VALIDITY and helping to protect the next generation of young women from the dangers and distress of depression.

Lebert feels it has been a worthwhile journey so far: "Both elder and younger 'sisters' have become passionate about exploring depression further and ensuring that young women's voices are given a platform to be heard, recognized and valued. At some points, the project seems to take on a life of its own and we passionately sprint to catch up!"

Hear Me, Understand Me, Support Me is available online at www.camh.net. For more information, please contact Cathy Thompson at cathy_thompsonATcamh.net, or tel. 905 525-1250, ext. 8153.