The Teen Suicide Epidemic in Kansas City

First person accounts from survivors and the people dealing with the aftermath.



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Depression Medication and Children

   Although great strides have been made in managing depression with medication, some parents are still very leery of getting their children on meds. Patty, a mother with a son at North Kansas City High School, says, “When our son was prescribed Lexapro, the drug scared us. The side effects associated with taking it sounded like he could get worse, not better and we also had heard about the increased suicide risk with depression meds. So why would you give a depressed 16-year-old a drug that could increase his chances of suicide?”

   The National Mental Health Institute says in some cases, children, teens and young adults under 25 may have an increase in suicidal thoughts when starting antidepressants, most especially in the first few weeks. Because of this, the FDA adopted a "black box" label warning, the most serious type of warning in prescription drug labeling, indicating that antidepressants may increase the risk of suicidal thoughts in some children and adolescents with a major depressive disorder. BUT the NIMH says the benefits of taking antidepressant medications “likely outweigh the risk.”

   SSRIs - Selective Serotonin Reuptake Inhibitors (brand names Celexa, Lexapro, Prozac, Luvox and Zoloft) have been used successfully for treating depression in children and teenagers. The SSRIs help restore the balance of certain brain chemicals that regulate mood. Currently, the FDA has approved Prozac for children eight and older and Lexapro for kids starting at age 12.

   Patty says, despite her fears, she went ahead and put her son on Lexapro, and she says the drug and weekly therapy have made a difference. “When he told me that he felt normal again I started to cry.”


The Teacher

Susie whitfield, teacher

 

   I read that doctors who lose patients have a “cemetery in their minds.”  

   I have one, too. I think every teacher does.

   Twenty years ago, I had no real understanding of the autism spectrum. “Matthew” was different from the other students in my sophomore English class, but I didn’t know why.

   He was a diligent student, so it surprised me when he asked if he could come in after school for extra help.  Soon I realized that this was his way of seeking just a little more attention, a little bit more nurturing than I could give him during the 50 minutes of class time.

   I will never forget the day he said passionately, “I just want to be like everyone!”

   I sat silently, trying not to take refuge in a cliché. I think he knew that I didn’t have a single piece of advice that would have made any difference.

   My other students were not actively cruel to him; I would have immediately intervened. But cruelty can come in subtle forms: he wasn’t included in conversations, he wasn’t asked to join study groups, he wasn’t invited to just ”hang out.”

   I called his mother several times to seek her advice. She was compassionate, intelligent, generous. I admired her so much for being such a source of strength for her son. We both knew every day was yet another struggle for Matthew and tried to think of ways to make life a little more bearable.

   So, I was delighted when, in his junior year, I saw him in the hall, and he came right over to chat. He looked happy, and I breathed a silent sigh of relief. He said that things were better — he was enjoying band and his English class.

   Later, I realized that for Matthew, this happiness was the result of his deciding that his struggle would end. That he would take his own life.

   I was utterly unprepared to hear that he had stood in his bathtub, poured gasoline over his body, and burned himself alive.

   He had been taken to KU Med and was on life support, but there was no possibility of his surviving. Oh, the hatred he must have felt for himself.  The absolute despair.

  All I could think was that his mother should not be alone, and so, after I kissed my sons good night, I drove to the hospital. I kept trying to think of what to say. The rain and my tears nearly blinded me.

   I dreaded what I might see in his hospital room, but Matthew was lying with a white sheet covering him to his chin. Life support systems were making rather soothing sounds. His face had not been touched, but it was terribly swollen with intravenous fluids. Only his beautiful hair was the same.

   I sat down next to his mother; we were mute with grief and horror. And then haltingly, we began to share little memories of things he’d said and done.  I like to think that he heard us.

   As I left him, I touched his shining hair and said goodbye. His mother and I held each other for a moment, and then I went home so that I could watch my sons as they slept.

   “Please,” I whispered. “Please.”

   School districts are trying to address the tragedy of suicide; every year at Blue Valley North, teachers show a video to their advisory class and hand out suicide prevention cards. My students would never say much of anything; I would promise that if they had any fear for either themselves or their friends, I would help in any way I could.

   I never told them about Matthew. – Susie Whitfield

Susie Whitfield has taught high school for more than 40 years. She retired in 2017. Her creative writing class, “Writer’s Workshop,” has been credited by former students as a “safe haven” for discussing and writing about their emotions. One student told 435 that “it saved my life.”


Lack of Treatment Facilities

   Imagine having a child that tried to kill themselves being discharged from the hospital six hours after their wounds were treated. This is the scenario Jennifer Henderson describes.

   “One night I went into my daughter’s room to tell her goodnight and she was sitting on her bathroom floor with blood everywhere. She had slit her wrists. We called 911 and she was rushed to the hospital. Six hours later after they treated her cuts, they sent her home. I remember staring at the doctor and the nurses and shouting, “But you don’t understand I’m afraid to take her home! What if she does this again?”

   Henderson says she was told by the doctor that they had “no place to put her” and since her daughter was stabilized, they couldn’t keep her at the hospital. The mother says she took her child home and kept a bedside vigil until morning when she could start making calls to find a treatment facility for her daughter. “It was the worst night of my life. All I could think about was, I don’t want to lose her.”

   Rachel Nelson-Segobia, with Lee Summit Cares, says many times there are waiting lists for kids who need a bed at a psychiatric unit.

   Children’s Mercy’s Dr. Sarah Soden says the lack of treatment facilities locally for children with depression-related mental health issues is a problem that needs to be addressed.

   “Children’s Mercy doesn’t have a psychiatric unit, so what we’ve done is keep kids here longer for inpatient care until we know there is a place for them go. As a pediatric hospital, we’re trying to do the best job possible and work on bigger long-term planning."

 

The Change Agent

dr. todd white, superintendent of blue valley schools

 

   Dr. Todd White, superintendent of the Blue Valley School District, calls teen suicide in Johnson County an epidemic. In the last 12 months, five students who attended Blue Valley schools killed themselves.

   In a district known for having some of the highest test scores in the nation — its schools being on almost every “best” and “most challenging” list, the Blue Valley district, with its motto “Education Beyond Expectations” has for decades prided itself on high standards and even higher academic achievement. But the superintendent says in the continuing quest for excellence, an emphasis on educating the whole child has gotten lost.

   “When the suicides started happening, we knew we had to do a re-examination of what our focus should be.”

   White says the district had two primary goals: to be a world academic leader and to meet the unique needs of every child. But, he said that as a new superintendent, he noticed that while there was a line item for being an academic leader, there wasn’t one for meeting the unique needs of the students. It led him to ask the question, “Just how important is it if we don’t even have a line item?

   White, just months on the job, and only the seventh superintendent in the district’s history, was about to start a discussion that would result in a fundamental change in how Blue Valley now approaches education. It was at a board retreat in January 2017 when things got real.

   “We decided that it was time for us to redefine student success in the Blue Valley schools. Our kids are more than a score.”

   From that board meeting came five pillars and one of those was better understanding the emotional and social requirements of students. White emphatically ensures that the district’s high academic standards aren’t going anywhere, but he says, “We can still maintain excellence and contribute to the needs of our students.”

   To do this, the district is broadening its scope of what educating the whole child means.

   “It’s about knowing our students better, listening, encouraging critical thinking, nurturing mindfulness, perseverance and resilience.”

   For two years, White has had an “advisory council” made up of students from the district’s five high schools. He says he hears from them at every meeting about how stressed they are.

   “They tell me about the burden of the stress they carry with them. The academic pressure they feel. We know kids are struggling and we know we can do better to help.”

   An integral part of White’s plan is what he calls the holistic approach — working with educators, parents and children to do the next best thing. “I think our recent middle school study was groundbreaking for us. We dissected the entire middle school experience, and part of that was making sure students have balance; social and emotional needs are a part of the learning experience.”

   The superintendent says the district is thinking long term. “It’s not just what’s happening at our high schools right now; it’s what we need to do now to help the students that are in kindergarten – the class of 2030. It’s what I would call a thoughtful process.”

   This reimagining of a district built on test scores is not without its skeptics. White says about one-third of the teachers are behind it 100 percent, another third is adopting a cautiously optimistic attitude and he calls the last third less than enthusiastic.

   “I think as educators and parents we need to retrain our brains about not only how children learn, but I also think we can’t be afraid to have the hard conversations. I can tell you that the Blue Valley District isn’t hiding from the issue of our students’ emotional health. For us, it’s a priority.”

 

The Classmate

Jami robben, Student, blue valley

 

   I feel as though the topic of suicide — especially in the Blue Valley district — is ever-evolving; in the sense that I see it being talked about more, but not in the way I want it to be. When someone commits suicide in our school, we are told the news and the teachers let us know that if we need to talk to someone, there are counselors willing to help; but if your suicidal thoughts get in the way of your school work, that’s completely different and totally unacceptable.

   Having been in the district for all of middle and high school, I’ve experienced firsthand the pressure that teachers and parents put on the students and let me tell you, it’s hard. There have been days where I felt as if I would never catch a break and would be engrossed with a tremendous workload for the rest of my life; it felt as if there was no light at the end of the tunnel. They always talk about the “exemplary students” that the district produces but they never talk about what they put them through to get there.

   Students feel alone when they see their peers succeeding and they feel trapped in the never-ending cycle of failure. It isn’t just the school system that causes young kids to feel that they only have one option to put an end to their pain, it can be a countless number of things that could all pile up at once. I can’t even begin to list the number of parents who mindlessly live through their child and accept nothing but perfection, therefore putting an unattainable goal on a child.

   But the worst part of all of this is the numbness that comes along with it. The first time I heard about a suicide I was bewildered. The second time I was horrified. The third time I was angry. The fourth time I was scared. I lost count at that point and that was what scared me; these deaths became another part of the school year. Funerals became a yearly ritual. Death has become normal. – Jami Robben

Jami is graduating high school and will be attending the University of Missouri in the fall majoring in strategic communications and public relations.


The Mentor

Sam johnson, pastor of chad harrell

   I first felt what I call the “darkness” as a sophomore in high school. The darkness was named depression. As I sat in my parents’ basement bathroom as a 16-year-old, I felt hopeless. I felt like no one understood my pain. I felt worthless — like I didn’t want to live another second in the darkness; that my only option was permanent, though my problem was temporary.  

   I live with depression. I know it will never go away because I have a chemical imbalance in my brain. Thankfully, I’m helped by medication. I have recently made it my mission to help other people with their mental health. One of the reasons why is Chad Harrell. He committed suicide almost a year ago. He was just 17.

   I met Chad Harrell when he was an awkward and incredible 6th-grade boy, but I was given the gift of becoming Chad’s youth pastor when he became an even more incredible high school student.

   During a mission trip to Nashville two years ago, Chad asked me if I "ever felt sad for no reason." I was honest with him and told him yes, I did sometimes feel sad for no reason. Then we both shared our common struggle, which was depression. I told him I understood what it was like to walk through life feeling a little different from everyone else. The reality was, Chad felt this darkness in his life sometimes. The reality is many of our kids feel this darkness in their lives today.

   For those that may not understand, depression grips you in a tunnel vision; you can only see the darkness that's ahead of you, but you can't see all the good that's also happening around you.

   We need to talk to each other when we feel sad for no reason, or when our lives seem too dark and heavy to carry alone. We must promise the people around us that we'll talk to each other that we’ll be there for one another because for someone who struggles with depression, just knowing you have someone to talk to can make a difference.

   Since June 12, 2017, the day Chad took his life, I’ve wished every minute I had one last time to talk to Chad. To tell him that the light was coming. – Sam Johnson

Sam Johnson is currently studying for a master’s degree in counseling psychology. She works with families dealing with mental illness. Chad Harrell's family is raising funds for suicide awareness at Keep the Spark Alive.

 

Suicide and the Teen Brain 

It’s all about the prefrontal cortex.

Words Juluis Karash

   The regulation portion of the human brain develops last. Dr. Sara Gould, a child psychologist with Children's Mercy Hospital, says, "Adolescence is a time when demands are significantly increasing, and emotions can feel very intense. And yet the regulation system that can help us think ahead, that can help us calm down, isn't fully developed yet."

   In scientific terms, the hippocampus and amygdala portions of the brain – the segments that swirl with emotions – mature earlier than the prefrontal cortex, which regulates our responses to emotions.

   Gould said this disjointedness in teen brain development could lead to heightened impulsivity, which may increase the propensity for suicide.

   "When adults choose to commit suicide or attempt suicide, generally there are factors leading up to that, and there are warning signs," Gould said. "There's more preparation on the adult's part. When the teenager decides to take action, there generally are only a few minutes between when that decision is made and when the action takes place."

   Or sometimes even less than a minute. Dr. Shayla Sullivant, a child and adolescent psychiatrist at Children's Mercy, recalled the case of a young woman who took pills in an attempted suicide a mere 25 seconds after deciding to end her life. "Young people are usually not planning far in advance," Sullivant said. "Often, if they're going to overdose, they take what's quickly available to them within the home."  

   Gould said teenagers have a tendency to feel that "this moment is the moment. So, if this moment feels intolerable, they often have the perspective that every moment will be intolerable. When cognitive development is more complete, when we are adults, we can understand that, although this moment is very difficult, not all moments will feel that way."

   


Preventing, Questioning, Screening

While there is no 100 percent effective way to prevent teens from committing suicide, there are ways to reduce the risk.

• Universal precautions. Store firearms and medications where your children can’t get to them. Dr. Sullivant says that parents typically don’t anticipate their teenagers falling into a desperate state of mind, "but what if they are? We want to be ready and have those precautions in place."
• Good communication. Parents shouldn’t shy away from discussing issues related to suicide with their teens. If a parent and teenager are watching a TV news report about teen suicide, it’s recommended that parents ask teens if they ever have such thoughts.

   Dr. Gould says parents should "stay calm and accept whatever answer you get." If teens answer yes, they do have or have had suicidal thoughts, parents should not tell them they shouldn't feel that way. "If it's not OK to feel that way it's not OK to talk about it. We don't want kids who are having these thoughts to go underground with them."

   Screening. About half of young people who die by suicide in our country never come in contact with a mental health professional. But they do get medical care for things like step throat, stomach aches and sports physicals. Children's Mercy's goal is to identify children that are at risk of suicide sooner. The need is clear. "You can't tell by looking," Sullivant said. "Most kids thinking about suicide don't look downtrodden. When they come to see us, they look at us and give us a nervous smile. They look like an average kid."


Children's Mercy now asks patients the following questions:
  • In the past few weeks, have you wished you were dead?
  • In the past few weeks, have you felt that you or your family would be better off if you were dead?
  • In the past week, have you been having thoughts of killing yourself?
  • Have you ever tried to kill yourself? If yes how? When?

If the patient answers yes to any of those questions, then he or she is asked: Are you having thoughts of killing yourself right now?

   Sullivant told the story of a Children's Mercy patient who recently went through the screening and revealed an explicit suicide plan. The patient was admitted to the hospital that day. More often than not, the doctor says, patients flagged by the screening are not on the verge of committing suicide. "Most kids will be able to go home, see a therapist and stay at home with their families, because we're catching them sooner, when they're still in the phase of contemplating things. That's our goal, to catch them a lot earlier."

   "Parents should take note of drastic changes in their children's behavior, Sullivant said. And so should grandparents, teachers, neighbors and ministers. "Billy dropped off the soccer team, why is that? Why isn't Sarah coming over to our house anymore after school to do homework? It's a real community effort to notice when these changes are happening, and to not be afraid to ask."

 

Surprise Answer Made Nurse Firm Believer in Suicide Screening

 

   Jamie Neal Lewis, a nurse practitioner at Children's Mercy Hospital, got a huge shock when she administered a suicide screen to a teenage patient a few years ago.

   She was working at that time in the hospital's sleep clinic. Suicide screens are routinely in the sleep clinic, because patients with sleep problems are considered to be at higher risk for mental health issues, depression and suicidal thoughts.

   But Lewis didn't expect to hear anything alarming from that particular patient, whom she had followed for several years. "He was always kind of happy-go-lucky and cracked little jokes," Lewis recalled. "I told him I was screening everybody for thoughts of suicide."

   So Lewis asked the question. The patient hesitated briefly. Then, he looked up at Lewis and said "well, I wasn't going to tell anybody this, but last night I took my whole bottle of medication that you prescribed me. And I woke up this morning and I was alive, so I came to this appointment. I wasn't going to tell anybody, but since you asked, I tried to kill myself last night."

   The answer hit Lewis like a two-by-four. "I felt sick to my stomach," she said. "I was horrified. I felt scared for him. Were his organs failing? What was going to happen to him? I never would have guessed that anything was wrong with him, because he came to me acting like he normally did. It was a striking moment in my career."

   Following procedure, Lewis immediately called the Children's Mercy emergency department, where the patient was quickly admitted. He survived the suicide attempt.

   "I think he was admitted for some mental health problems and then ended up doing OK as far as I know," Lewis said. "I saw him only a few more times after that."

   Today Lewis works in Children's Mercy's kidney center, where she administers several suicide screenings every week.

   She said it no longer surprises her when young people who act normal and happy reveal that they have been having suicidal thoughts. "How they act is not a litmus test. It's all about asking them."   

For help or more information call 800-273-TALK (8255) (National Suicide Prevention Lifeline)