The American Psychiatric Association Alliance (APA Alliance) is proud to bring to communities a grassroots collaborative project that promotes opportunities to target the following areas:

a) Stigma: to demystify mental illness, its treatment and prevention.
b) Youth violence prevention: to use as a primary prevention strategy.
c) Mental health literacy: to increase the ability to read, understand and act on health care information.

The APA Alliance initiated "When Not to Keep a Secret" in 1998. Co-sponsored by the American Psychiatric Association and funded for the first seven years by the American Psychiatric Foundation; the project has expanded to 19 states.

The topic sentence continues to be relevant. "When Not to Keep a Secret," challenges an adolescents' sense of immortality and gives permission to break a confidence, when the confidence is life threatening. In order to write on the topic, students have to confront harsh truths and explore a higher level of ethical behavior.

"When Not to Keep a Secret," is a tool educators can use to model appropriate disclosure skills. Educators work hand-in-hand with students through this process, at the same time enhancing a school culture to promote acceptance, moral/civic obligations, and to empower youth to support their peers.

Students are encouraged to seek assistance from a trusted adult. Asking students to identify a trusted adult, gives them the opportunity to proactively think about sources of support when they hear threats of violence.

In order to support educators and students, collaborations with mental health associations; suicide prevention and advocacy groups; local medical associations; their alliances, hospital alliances and law enforcement are an important component in the overall strategy for mental health education; local resource identification and violence prevention.

“When Not to Keep a Secret” has been incorporated into four curricula: English, Social Studies, Civics and Health. Entries submitted are read by the educator and sometimes in conjunction with life skills or guidance counselors. Educators can then learn about topics of concern to students and have the opportunity to talk on the subject or invite a speaker to the classroom.

The APA Alliance would like to acknowledge a special collaboration with the Yellow Ribbon Suicide Prevention Program. The Yellow Ribbon Card says, “It’s Okay to Ask 4 Help®,” and lists physicians as one of the trusted adults. When a young person presents this card, it gives the receiver specific instructions as to what to do. The Yellow Ribbon card gives students an additional tool to communicate when words are hard to come by. www.yellowribbon.org

"When Not to Keep a Secret," and Yellow Ribbon Suicide Prevention Program have been reaffirmed in the Journal of Adolescent & Adult Literacy; 48:5 February 2005. The article by Douglas Fisher, "The Literacy Educator's Role in Suicide Prevention;" states that both programs offer educators another venue for violence prevention and mental health education. http://www.reading.org/Library/Retrieve.cfm?D=10.1598/JAAL.48.5.1&F=JAAL-48-5-Fisher.html

Overall, 90% of the entries submitted discuss depression and teen suicide. The other 10% include eating disorders, physical fighting, relationship violence, self esteem, bullying, substance abuse, sexual gender issues and weapon carrying.

Three to five top entries are selected from each school for final judging. Community leaders (media, legislators, county officials, non-profit directors…) are asked to participate as judges. The involvement of community leaders is critical because they may be able to improve mental health funding and influence allocation of resources.

Local organizations that want to initiate "When Not to Keep a Secret" must sign a Letter of Understanding in order for top essays to be accepted for national judging.

"When Not to Keep a Secret” has given psychiatrists and other mental health professionals an opportunity to meet with 7th-10th grade students in an informal environment in which the mental health professional can replace myth with the facts regarding people with mental illness. The APA Alliance wants young people to know that there is hope, there is treatment, and a confidence shared with a trusted adult can save lives.