When the grand-prize winner of the APA Alliance’s "When Not to Keep a Secret" National High School Essay Project, 15-year-old Philadelphian Amatise Wiley, described the progression of her older brother’s schizophrenia, Philadelphia became the City of Sisterly Love.

Wiley’s essay illustrated the conflict that arises when a choice must be made between an apparent betrayal of a confidence and the truth; for her, between honesty and the loss of her brother’s trust.

Speaking with pride for both of her children, Carla Wiley said, "Amatise has learned from her brother, and he from her."

Wiley also told Rosalind Hayes, the APA Alliance’s public affairs chair, that Amatise had placed third in the Philadelphia SATs and has already had many colleges contacting her. She wants to be a teacher, like her mother.

"I often felt that if I told anyone, my brother would see me as a tattletale," Amatise Wiley wrote in her awarding-winning essay. "I feared that he would see me as untrustworthy and not speak to me anymore. This caused me to keep silent for a long period of time.

"I finally did report the dangerous secrets my brother told me to my parents. My brother was diagnosed with schizophrenia, received treatment, and lives happily in a home that allows him to pursue his life successfully despite his illness."

"When Not to Keep a Secret" was not an easy topic for Wiley, nor is it for other students, commented Hayes.

"The topic specifically refers to those times when secrets should not be kept," she said. "In keeping with the APA Alliance’s mission to educate and do community educational outreach, the essay project teaches students that violent talk may lead to violent behavior and that threats to self or others should be taken seriously and always reported to a trusted, significant adult, regardless of any commitment made to secrecy."

When confronting the chain of silence that surrounds threats of violence, young people are often paralyzed by a lack of knowledge and the fear that they will be seen as traitors if they "out" a friend. They worry that being honest could potentially cost them a friendship, continued Hayes.

"The ‘When Not to keep a Secret’ National Essay Project was created and produced to provide a stepping stone on the path of an increasingly necessary social change—a sea change required to counterbalance the almost instinctual adolescent need for peer protection."

Each year the essay project asks ninth and 10th grade students to look within and without themselves in examining their own reality and what must be faced when they tell an adult when they have heard threats of violence. In turn, the APA Alliance invites psychiatrists into schools for informal chat sessions, with a question-and-answer format designed to teach students that psychiatry is not like its Hollywood stereotype, to convey the message that effective treatments are available and that they are not frightening, and to reveal the warm and caring face of psychiatry.

The 1999-2000 essays overwhelmingly repeated a theme common in many of last year’s essays: suicide, which in some way touched the paths of more than 90 percent of the participants. Other essays dealt with the fear of guns at school, the importance of school security, and life with mentally ill family members.

The Pennsylvania Psychiatric Society sponsored the project statewide, and Wiley entered the contest as a result of outreach under the guidance of Michael Feinberg, M.D., chair of the Philadelphia Psychiatric Society’s Philadelphia Advocacy Committee.

Other state associations and district branches that participated in nine other states were San Diego Psychiatric Society (Friends), Southern California Psychiatric Society, Georgia Psychiatric Physicians Association, Minnesota Psychiatric Society, Psychiatric Medical Association of New Mexico, New York County District Branch, Western New York Psychiatric Society, Oklahoma Psychiatric Association, Rhode Island Psychiatric Society, South Dakota Psychiatric Association, and Texas Society of Psychiatric Physicians.

Among the national judges were U.S. Rep. Marge Roukema (R-N.J.) and her husband, psychiatrist Richard Roukema, M.D.; Helen Chickering, NBC syndicated medical reporter; Sheila Wellstone, wife of Sen. Paul Wellstone (D-Minn.); Jackie Shannon, president of the National Alliance on Mental Illness; and Rodrigo Muñoz, M.D., former APA president.

The top two national winners came from Pennsylvania. Wiley won a $2,500 Gateway Gift Certificate for a computer system and an all-expense-paid trip to Chicago for her and her parents during APA’s annual meeting. The second-place winner, Jennifer Nobles, won a $500 EE savings bond and plaque. The third-place winner, Jessica Worde of Austin, Tex., received a $300 EE savings bond and plaque.

APA state associations and district branches needed additional personnel to help with the project outreach this year, observed Hayes. To meet that demand and facilitate the project’s expansion, the APA Alliance began to develop alliances with other volunteer organizations with educational networks. The Light for Life Foundation, devoted to high-school suicide intervention, has aligned itself with the project. Final arrangements are under way to forge a relationship with the California Medical Association Alliance and the California PTA. Within the year, national support alliances should be in place so that the project can reach more schools throughout the nation, said Hayes.

APA Alliance President Gail Fuller, R.N., of South Dakota has formed a special essay-project subcommittee for 2000-01, chaired by President-elect Alicia Muñoz.

The 1999-2000 "When Not to Keep a Secret" national outreach was supported by the American Psychiatric Association Foundation, said Hayes. In addition to the countless volunteers who worked on the project this past year, she thanked her husband, APA member Stephen G. Hayes, M.D., for donating 750 hours of clerical time to the project.