Statistics may not always be reliable, but the writing on the wall seemed pretty legible: many teenagers are having a hard time on the Island. This year’s Island-wide youth survey showed a spike in the number of students who said they attempted suicide in the last year and Martha’s Vineyard Hospital records showed a spike in the number of teens admitted for attempting suicide this year.

But Dr. Diane Becker, a professor of medicine at Johns Hopkins University and an expert in statistical analysis, warns that the new data might not mean much at all. At the request of the Gazette, Dr. Becker reviewed the numbers and found several alternative reasons for the apparent increase in suicide attempts that do not point to a worrisome trend.

“The most recent [survey] data look so discordant with prior data that I think there is an artifact,” said Dr. Becker, who is a longtime summer resident of the Island and chief author of the Health Report of Martha’s Vineyard, a recent scientific study of health trends in the adult population on the Island. She explained that statistical artifacts are outside influences that could throw off survey results, such as a small group of students not answering honestly. It would not take many students to skew the results, Dr. Becker said.

“The change is too fast so that if it is real, it is a cohort effect and not a trend,” she said of the survey data. This means that the apparent dramatic increase in attempted suicides is actually an isolated group of students with a shared life experience or temporal experience that would not appear in future survey results.

“Maybe a group of kids who are friends have some shared beliefs in these classes — [which] would not be unusual — and this is their culture,” Dr. Becker said. “It will not be a trend until you see it in at least two more measurements,” she added.

After evaluating the numbers, Dr. Becker also found that the statistical jump in the youth survey results is within the survey’s margin of error — meaning there might not be an increase in attempted suicides at all.

The results of the Youth Risk Behavior Survey, taken by students in grades seven through 12 in February of this year, show that 12 per cent of high school students and 11 per cent of middle school students report attempting suicide in the previous year. In similar surveys done in 2005, 2002 and 2000, only five per cent of high school students and two to three per cent of middle school students said they attempted suicide.

“The 95 per cent confidence intervals calculated on the data . . . for all three [suicide-related] questions in all years overlap, suggesting that they are not really different,” Dr. Becker said. “It is within the realm of normal variance,” she added.

The survey also asks students whether they seriously considered attempting suicide and whether they made a plan to attempt suicide.

In past years and on state and national levels, the number of students who said they seriously considered attempting suicide was higher than the number of students who said they actually did. But this year, that pattern did not emerge. In the high school, the same number of students who said they seriously considered attempting suicide also said they did attempt suicide. Among middle school students, more students reported that they actually attempted suicide than seriously considered it.

“I would have some real problems believing that 100 per cent of all kids who considered suicide planned or acted on it,” Dr. Becker said. “This would be discordant with anything we know about suicidal ideation in adults or youth.”

In general, Dr. Becker has a positive view of teen mental health on the Island.

“These kids are actually better on all three dimensions of suicide than the U.S. and Massachusetts youth population throughout the years. If anything, you would have to say that kids are healthier on Martha’s Vineyard,” she said. “I do not believe that problems are any more serious here than elsewhere. If anything, the kids do well with regard to the risk dimensions on the survey. Try inner-city Baltimore or New York for a contrast!

“These children lead healthy lives relative to the average youth in America — they have excellent eduction, a plethora of free outside and indoor activities that are encouraged, summer jobs available and a pleasant, nonviolent, unpolluted physical environment not rife with drugs and alcohol — relative to mainstream America. They boat, fish and are involved in physical activities and are less obese than youth elsewhere.”

Dr. Becker also questioned the reliability of the data coming out of the Martha’s Vineyard Hospital’s emergency room records.

Hospital records show that between January and May of this year, 14 youths — meaning people 19 years old or younger — were admitted to the Island emergency room for attempted suicide. That would appear startling, considering there were not more than two youths admitted for attempted suicide in all of 2006, according to hospital records. In the previous year-and-a-half period, from June 2004 through 2005, there were seven youths admitted to the emergency room for attempted suicide.

“Those data need to be looked at relative to the extent they are representative of Martha’s Vineyard youth,” Dr. Becker said. “People may move here or bring their kids here if they are having problems elsewhere — so time living on the Island, among many other variables not presented, are important.”

The only way to really know whether teen suicide attempts are on the rise is to do a more focused research project — which can be difficult with young people, Dr. Becker said.

“A good study could answer the queries,” she said. “Without more data, I would not go off willy-nilly and start new programs. You need to know what groups are affected and reasons, to the extent possible.”

Taking action before the problem is well understood could be risky, she said.

“Hitting the community hard with a program may actually backfire. There is a body of literature that says that giving at-risk youth more information about these behaviors actually increases the probability that they will engage in them. So I would take care not to over interpret — yet,” Dr. Becker said. “The Island [should be] sure it has real issues, knows what they are and uses well-tested solutions before it introduces a program,” she added.

Island psychiatrist Dr. Charles Silberstein also believes the Island needs to take a deeper look at the mental health of its youth.

“As a community, we need to do more to understand why so many young people feel such despair and what we can do to help,” he said. “Many of their lives are stressful and often filled with angst. There are tools available that can help. We need to know more and dialogue more to understand the problems and to find solutions.”

Ultimately, it doesn’t really matter whether the new data from the hospital and youth survey are accurate, he said.

“Diane is the expert at interpreting this kind of data,” he said. “Whether or not we have a higher level of emotional distress than other similar communities is an unanswered question. What is even more important though is that there are a substantial number of youth in our community — and nationwide — who are in enormous emotional pain and many of them are suffering from psychiatric illnesses. Despite the fact that there are some truly gifted mental health professionals in the schools, my sense is that many of these kids are not getting adequate psychiatric evaluations and help.”