Grand Challenges Team 6 System Map

Jared Farrior, Alexander Haag, Josh Kirshenbaum, Owen Cardwell

Problem Statement:

Depression can lead to suicide. In the US, suicide is the 2nd leading cause of death among college students and 8.6% of them have had considered suicide. Depression also can cause distraction and fatigue resulting in lowered student performance. How can we work to reduce depression, helping college students perform better in school and reducing their suicide rate?

Initially our problem statement was geared towards climate change and inefficiencies in the energy grid but we didn’t like the direction we were heading in so we pivoted.

One team members Top 4 → Combined with other member ratings for top 3 and final decision.

We all voted on our favorite topics of interest so we knew what we would be passionate about, and then debated about the top 3 to ultimately choose Depression.

Systems Map:

https://kumu.io/CloudmanGC6/depression-systems-map#untitled-map

Stakeholder Analysis:

The stakeholders we identified were: Students, Parents of Students, Teachers, School Faculty, Therapists.

Students were an obvious stakeholder since they are directly impacted by the suicide rate and lowered student performance. Also, many students have first hand experience dealing depression. For interviews, we decided to focus on Georgia Tech students since we had the most access to them.

Parents: We saw parents as important stake holders because of their extension to students. Our student interviews illuminated that a bad family situation leads to depression because students won’t feel cared for, while good family relationships help prevent it. This gives parents an important position in the solution.

Teachers: Teachers interact with students in the classroom, assigning work, setting deadlines, and grading. We identified these through research as some of the depression causes for students, making teachers an important stakeholder in stopping depression.

School Faculty: Faculty are an important stakeholder because of their breadth in the problem space. They deal every day with reduced student performance and the overall health of their school. This can give them good insights on the systematic changes that need to be made to the school system.

Therapists: Therapists are directly involved in helping treat depression. They can both do behavioural therapy and prescribe medications. This first hand knowledge of depression patients make them optimal stakeholders for solving the problem.

Experts:

Dr. Deanne Haag (Pediatrician and Mother): Dr. Deanne Haag defined depression as a spectrum of diagnoses which impair a person’s day to day function. She adds early intervention is very important in managing depression, and that there is a startling amount of stigma surrounding the topic despite its prevalence. In order to combat this stigma, she suggests normalizing it and explaining where it comes from so that people understand that it is a scientific phenomenon, not just a person being “weak” as the stigma might suggest. Most people who get treated visit their primary care provider first, which is a great point of intervention to add resources that doctors can provide to their patients. Sometimes, physicians are visited because it can be incredibly difficult and time consuming to get an appointment with a psychiatrist. In fact, she states that the average wait for a child psychologist is about 6 months. While there are counselors in schools, it can be hard to connect with providers outside of the school environment, and some students may feel uncomfortable going to the school counselor for various reasons. Sometimes, life changes and the patient no longer desires treatment, which can lead to relapses. Otherwise, it may be hard for a student relocating to a new area to find a new psychiatrist they feel comfortable with. In her experience with counselors as fellows on her medical staff, she says that there is a very high turnover rate for the position, and it is very hard to find child psychiatrists because they can be more difficult to work with due to the nature of the manifestations of their depression, which can be more violent and angry rather than sad and sedentary. One important method of detection for depression is the screening undergone at regular health visits such as the PHQ9 questionnaire, which can sometimes yield surprising results. There are also varying mentalities in the patients who come in. Some just want medication, some want no treatment, and some who are too young to decide themselves have parents who are opposed to medication for various reasons. Many children are experiencing incredible levels of stress at school, especially for how young they are. For younger, elementary school children, there is a lot of toxic competition, social anxiety, cliques, worries about friendships, and a lack of self-confidence. In some of the older grades such as middle school, students start to have higher expectations for school work and preparing for successful careers, which can increase rates of depression. No matter their situation at home, issues can arise from a variety of sources. Even the best families can experience depression. Bullying is a very common cause of situational depression, and can start at a young age, which can lead to deeper mental health issues that move from situational to clinical depression. While situational depression, depression which results from a single event or a certain source, is very recoverable, while major clinical depression usually does not go away. Most people with major depression are either in an episode or in remission. The symptoms can be managed to keep the patient in remission, but much like cancer, it can come back at any time. The point of medicine in treating depression is getting people to the point where they can access the skills/resources they need in order to live free of medication.

Mrs. Nichole Farrior (Social Worker and Mother): Mrs. Nichole Farrior defined depression as a clinical disorder that is diagnosed by a psychiatrist. The mental illness is more than just sadness, it can leave a person hollow compared to who they were before. Depression leads to a lack of interest in school work, friends, and family. People suffering often feel unable to leave their bed in the morning, and often can be found crying for no obvious external reason. Their depression simply makes them sad constantly and it can be expressed at any time. Mrs. Farrior mentioned several causes of Depressions including a biological predisposition, seasonal affective disorder, trauma, grief, and a chemical imbalance. Some of these causes can lead to a short diagnosis of depression, but a person can also be diagnosed with depression for life. In these cases, they need antidepressants like prozac to combat the negative emotions. Mrs. Farrior also laid out many different methods that can be used in tandem with medication to combat depressions. The first is to reduce the stigma that surrounds depression and mental illness as a whole. This allows people to learn more about illnesses, and makes it easier for people to talk about their challenges. Posts on Instagram or Twitter can help normalize depression, and once people are talking more, those suffering from depression are much more likely to reach out to those around them for help. She emphasized the idea that there is no strength in trying to fight depression alone, it’s best to have some outlet, whether that is journaling or talking with loved ones. Other potential ways to fight depression include psychotherapy, behavioral therapy, play therapy for kids, herbal remedies, and even medical marijuana. Using a mix of different methods is the best way to fight and lessen the effects of depression and mental illness.

Students:

Ethan Wang (First Year at Georgia Tech): Our conversation with Ethan focused on his experience with depression. He initially defined depression as a condition brought on by stress and losing things on your life. Building off that definition, he explained how depression can be a loop of failure to make friends, losing confidence, then not attempting to make friends. This provided an interesting framework for us to evaluate depression. Maybe it is possible to focus on giving students opportunities to make friends.

Ethan also discussed solutions he has witnessed. He cited that both small and large changes can help end depression. The little things including people talking to the person, not about their depression, just their interests. For the big things he cited life changes such as getting into college or finding a good job. Maybe it will be possible for us to reach into these areas in helping people find a job or giving them small pieces of encouragement.

Jeannie Zhang (First Year at Georgia Tech): Jeannie initially defined depression as a constant feeling of sadness. She noted that it primarily occurred due to fundamental issues in peoples life. Family issues and school struggle with school can cause either of these problems.

When asked about solving the problems she explained two different possibilities. Changing the fundamental issues in peoples life by talking with the family or attempting systematic school change can help long term. She moderated these big changes by also stating that it important to include small changes like better education methods for mental health. Looking at her response it would be interesting to explore the process of combining both the small and big issues.

Gabby Lee (First Year at Georgia Tech): Gabby described depression as a prolonged feeling of sadness and an overwhelming feeling of worthlessness and hopelessness. She said that it puts a person in a state where they are unable to function and lose interest in everything. Something she emphasizes was that depression is something that has to persist. Being sad occasionally for short periods of time is not depression. Depression is consistent or recurring feelings of abject worthlessness. Gabby believed that school and grades result in self-reflection, which in turn causes feelings of worthlessness and then depression. From her friends, Gabby knows that tragedy and loss can cause depression that is extremely hard to get rid of in individuals.

For solutions, Gabby firmly believed that there is no one general cure for depression because it is something so deeply personal and unique to everyone. She said that some current solutions, like therapy, can help. However, it really depends on the person. For Gabby, the best way to help people with depression is to give them someone that they can be open with. She believes that this would make it much easier for people with depression to cope with their mental illness. As a final note, she mentioned that raising awareness about mental illness would help people with depression by allowing them to be more open about their depression.

Zohir Khawaja (First Year at Georgia Tech): Zohir initially described depression as a mental illness with associated symptoms such as feelings of sadness, loneliness, constant self-loathing, and believing that one doesn’t deserve happiness. He also mentioned that he believes that depression is specifically common in young people, although it is also present in older people, and that young people are more open about their depression and more willing to talk about it. For the causes of depression, Zohir’s first thought was about social media. He said that social media results in people comparing themselves to one another and then thinking they aren’t good enough.

When asked about solutions, Zohir had a lot to offer. He said that therapy was a great option, but it doesn’t work for everyone. When asked to elaborate, he said that sometimes the therapist isn’t compatible with a person and it can be really difficult for a person to find the right therapist that works for them. Zohir’s other solutions were common stress-reduction tactics, such as engaging in things one enjoys, like video games or tv shows. He also mentioned that staying healthy physically by exercising and eating healthy is very important to staying healthy mentally.

Possible Points of Intervention:

Lack of Discussion on Depression

People not able to pay for therapy/medication

Positive and negative usage of social media

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