Education

There are signs your teens may think about suicide. Here’s how you can get them help.

Collinsville teen learned to cope with anxiety, depression. This is her story.

Collinsville High School graduate Emily Halasey learned how to cope with anxiety and depression, so she could start planning for her future.
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Collinsville High School graduate Emily Halasey learned how to cope with anxiety and depression, so she could start planning for her future.

Sometimes Emily Halasey feels as if she’s in zero gravity with objects flying at her, but she can’t move.

“You just know if you move or if you dodge, there’s another rock that’s just going to hurl at you,” the 18-year-old from Collinsville said, describing her anxiety. Depression is like that, too, except those objects are pushing her down — at least that’s how it feels to Emily.

Emily thinks she’s had anxiety and depression for most of her life. But she only recently found out they were mental illnesses she could cope with and start planning for her future.

A year before she sought help, Emily tried to kill herself. She was 16.

“I thought that it was something that you had to be silent about,” Emily said. “I thought that you weren’t supposed to talk about it; it was supposed to be not seen and not heard at all.”

Children and teens have their own obstacles when it comes to mental health. The similarities between adolescence and a developing mental illness can mean that they, their friends, parents or teachers might not notice when they need help. And their lack of life experience can mean they have trouble seeing past a crisis when it happens to them.

At least 37 teenagers have died by suicide in the metro-east since 2006, including Emily’s childhood friend — an average of three suicides each year, according to local coroners.

The coroners’ data wouldn’t include residents who died outside the county if they were transported to a trauma center in St. Louis, for example.

Suicide has been a leading cause of death locally for children as young as 10 and up to 19 — above cancer — from the late 1990s to recent years, according to the Centers for Disease Control and Prevention.

The rate of suicides in the metro-east was slightly higher than the state and national rates from 2012 to 2016, CDC data shows.

Local: 5.9 deaths per 100,000 teens

National: 5.5 deaths per 100,000 teens

State: 4.4 deaths per 100,000 teens

Area schools, health officials and people like Emily are trying to find ways to help children and teens before they turn to suicide.

Last year, a local researcher started looking to the past for answers. Olivia Johnson studied every case file from the St. Clair County coroner’s office that had been ruled a suicide from 2006 to 2016.

Johnson’s study offers several recommendations to reduce the number of suicides in St. Clair County, which she says could also be used to help the entire state.

People who work in schools, from janitors to teachers and coaches, can get training in St. Clair County to help them recognize the signs that a student might be suicidal, talk to students about suicide and encourage them to get help. In Madison County, local mental health agencies work in the schools to train educators and to counsel students.

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Attendees listen at the Youth Mental Health First Aid seminar, a training for teachers and school employees on issues specific to teens and how best to handle them, at the St. Clair County Regional Office of Education in Belleville.

Suicide among teens has gained national attention in the year since Netflix released the TV series “13 Reasons Why,” which covers suicide, bullying, rape and depression in a fictional high school. Experts are divided on the show and the effect it has had.

“It’s great that (the show) has gotten people talking,” said Jenna Farmer-Brackett, a local mental health professional. But she and many other experts have concerns about the show’s graphic depiction of rape, suicide and grief.

Some educators, including those at middle schools in Highland and Swansea, reached out to parents when they heard students talking about the first season of “13 Reasons Why” in 2017.

When the second season was released May 18, viewers saw a new suggestion from Netflix before the episodes started: For children and teens who have experiences with suicide, sexual assault or substance abuse, the show might not be right for them, or they might want to watch it with an adult they trust. The same message was added to the first season after its release.

“It romanticizes a serious subject and puts some ideas out there I would not want perpetuated,” said Jennifer Roth, executive director of the Madison County Mental Health Board. “It’s not that you want to keep it hidden, but if your child wants to watch it, I would suggest watching it with them, and talk about it with them.”

Meanwhile, Emily is trying to help friends and classmates who have mental health problems feel more comfortable about asking for the support they need.

She started opening up about her own experience after a student she knew from grade school died by suicide earlier this year at age 18.

Emily asked her Facebook friends if they had anxiety or depression and if they’ve ever felt suicidal, too. She said 27 people, mostly classmates and alumni of Collinsville High School, responded on social media. Even more talked to her privately.

“All the people that I know who are anxious, they’re like me; they’re very nerdy, kind of shy,” Emily said. “But there were people on there that I knew were like the stereotypical popular kid, or I thought they had their life together, and I’m sitting here like, ‘Wait. You’re just like me. You’re trying to figure it out yourself. That’s actually amazing.’

“And I kind of stepped back, and it’s really changed my perspective of the people around me. … It can be anyone and everyone.”

Finding support

Debbie Humphrey said the stigma around mental illness and the shame people feel as a result is a reason they often don’t reach out. She’s the associate director of the St. Clair County Mental Health Board in Belleville.

“Your brain is part of your body just like your liver and your heart, and we need to take care of it and care for it and get treatment, just like we would if we had a toothache or appendicitis or whatever,” Humphrey said. “It’s just one body. It all works together. If you’re not mentally well, it affects the entire rest of your physical body as well.”

Emily said she knows asking for help isn’t easy, but her advice to people thinking about suicide is to try not to isolate themselves.

“Whenever you feel suicidal, I would always put yourself with people,” she said. “I would never put yourself alone, because out of all the times, the one time that I did not put myself with other people or ‘burden’ other people with my problems was the time I tried to kill myself.

“You’re not burdening people with your problems. If they say that you’re burdening them, then they’re not the right people for you. … You need to find a better person to go talk to.”

Once, when she was thinking about suicide but didn’t feel comfortable reaching out to friends or family, Emily said she used the Crisis Text Line to anonymously talk about it through text messages. The confidential support is available by sending a text to 741741.

Calling the National Suicide Prevention Lifeline at 800-273-8255 is another option for people who are considering suicide. But it’s also for the people who want to help someone else. Anyone — even professionals — can call to get advice and support.

During a crisis, people can call 911 or go to an emergency room to get help if they feel suicidal or if they know someone who does.

It was a friend who convinced Emily to talk to a doctor a year ago.

“I figured out that I probably had anxiety by another person who actually was calming me down from a panic attack, and she was like, ‘Have you ever been checked for anxiety?’” Emily said. “I kind of looked at her. I was like, ‘Isn’t that just when you’re nervous?’ And she’s like, ‘No, that’s an actual mental disease.’”

On the outside, people might shake or sweat during a panic attack. Inside, they feel like their hearts are racing and their throats are tightening. If the person has an anxiety disorder, it can happen even when there is no real danger, because they feel excessive worry.

Emily describes it as “being fearful of any type of fear.” She can find herself thinking about something that didn’t go right that day or an event that happened five years ago “over and over and over again.”

When Collinsville High School graduate Emily Halasey feels anxious, she tries to focus instead on what's around her: five things she can feel, four things she smells or wishes she could smell, three things she hears, and so on.

Today, medication helps ease Emily’s symptoms. She turns to friends and hobbies such as reading, playing the clarinet and writing her own stories to cope.

A therapist also taught her grounding techniques for those moments when she feels stuck in zero gravity. It helps pull her out of a spiral of anxious thoughts to focus instead on what’s around her: five things she can feel, four things she smells or wishes she could smell, three things she hears, two things she can taste or wants to taste, and one thing she can see.

Emily graduated from Collinsville High School on May 19 as a straight-A student, and she’ll head to Southern Illinois University Edwardsville in the fall with an academic scholarship.

“Right now, I am putting myself in a positive place, and I am working really, really hard,” Emily said. “I’ve been suicide-free for two years, and I’ve been harming-myself-free for a year and a half, so I think that’s pretty good.”

Humphrey also had experience with mental health problems, as a nurse and as a mom, before she got involved through the mental health board.

She worked in a hospital psychiatric unit and at a local mental health agency. Then her son, who is a veteran, was diagnosed with post-traumatic stress disorder, which can make people relive a traumatic event through nightmares or uncontrollable thoughts about it.

Humphrey said she struggled to navigate the veterans’ network of resources, so she knows how people feel when they try to seek help, wondering where to start.

“I did empathize,” she said. “I did have a total understanding of the difficulties, the hurdles and the barriers that you deal with in trying to access services.”

Now, part of her job at the mental health board is making sure services are available in St. Clair County.

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Debbie Humphrey of the St. Clair County Mental Health Board talks about suicide prevention. Steve Nagy snagy@bnd.com

At Madison County’s mental health board, executive director Jennifer Roth said they try to match people up with a provider on their insurance or point them to nonprofit organizations.

Across the metro-east, there are at least 15 public agencies that offer mental health treatments such as counseling.

But there are still a number of health insurance providers that don’t have any coverage for behavioral health, Roth said.

“They may have minimal primary coverage, and they are transferred to public providers and treated as if they don’t have insurance,” she said. “A lot of folks who have serious mental illness, it’s complicated to keep re-enrolling and keeping current, and they fall off.”

The mental health boards are there to try to determine what residents need and budget state money for services. Both of the metro-east boards are focusing on suicide prevention now, among other health concerns.

Learning from the past

The St. Clair County Suicide Prevention Alliance — a mental health board creation — worked with Johnson to come up with the ideas to stop future suicide deaths based on her research.

Johnson is a member of the alliance. She’s also an Air Force veteran and former police officer who trains people working in law enforcement on how to manage stress and recognize the signs of suicidal thoughts in themselves and others. Her previous research has been on the suicides of police officers.

When Johnson looked through a decade’s worth of records for the entire county, she found that 17 of the 273 people who died by suicide were younger than 20. Four were younger than 15.

Jenna Farmer-Brackett said children and teens perceive time differently, and that affects their coping skills. She works for Centerstone of Illinois, a mental health agency with multiple locations in Southern Illinois, including an office in Alton.

“A week doesn’t seem that far for us as adults, but for them, it’s like a month; summer vacation was like a year,” Farmer-Brackett said. “If I’m experiencing pain, it feels everlasting. As an adult, I can say, ‘This will end. Life will move forward.’”

Children don’t have the life experience to know that, according to Johnson. She said it would help for them to learn problem-solving skills while they’re young.

“You will look back one day and go, ‘You know what? Even though that was difficult, I got through it,’” Johnson said. “But when we talk about suicide and someone choosing to complete suicide, what happens is they never give themselves the opportunity to see the future.

“You will look back in a year, five years, 10 years, 15, when you have your own family and you can be stronger from these times. But you have to allow that to be the case.”

Olivia Johnson studied every case file from the St. Clair County coroner’s office that had been ruled a suicide from 2006 to 2016. Her study offers several recommendations to prevent future suicides in St. Clair County, which she says could also be u

The finding that Johnson said “hit me hard” was that half of the suicides she studied in the county were firearms-related, including the deaths of at least five people who couldn’t legally own a handgun because they weren’t old enough.

Johnson said it shows a need to educate people about gun safety: locking weapons securely and separating the bullets from the gun.

“You may have told them a million times, ‘Don’t touch this gun,’ ‘It’s for protection,’ and they’ve never done anything with it,” Johnson said. “What parents don’t understand and what guardians don’t understand is that, in that moment where something has come to a climax and they are under extreme stress and pressure and they don’t know what to do, that is a very easy thing to turn to.”

That’s why Johnson said families should even consider removing weapons from their homes if anyone shows signs that they’re thinking about suicide. Experts recommend the same for medication and other things they could use to hurt themselves.

Johnson found that 117 of the 273 people who died by suicide in St. Clair County’s history (43 percent) made a threat beforehand. She and other alliance members think health care providers or counselors could do more to educate families or close friends when someone they know has a mental health issue.

Her study recommends they start teaching the people in someone’s support system about how to address or report things like verbal or written threats in social media posts and text messages.

It also recommends that primary care doctors keep training and learning so they can better recognize, diagnose and treat mental illnesses and catch the signs of potential suicidal thoughts.

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According to Johnson’s research, more than one-third of the people who died by suicide in St. Clair County had known mental health issues. And at least 30 people who died by suicide (10 percent) had previously tried to kill themselves, the study found.

Johnson and the rest of the alliance members suggest hospital emergency rooms start following the number of people coming in for issues related to mental health, suicidal thoughts, suicide attempts and overdoses that are possible attempts, so they can check in with those people in the days and weeks after their visit to the emergency room, when they might still need some help.

Another suggestion that came out of Johnson’s research is that St. Clair County residents start reaching out on Tuesdays, specifically, to people having problems that might be affecting their mental health — like a student in class.

Johnson created the “Talk Tuesday” campaign because 49 of the suicides she studied (18 percent) happened on a Wednesday.

“And we can’t save everybody. I can’t save everybody on my own and you can’t, but the idea is we can reach one person,” Johnson said. “And I know that there are times that you’ve said something or done something and somebody goes, ‘You know what? That’s changed my day. It made me feel better.’ You don’t know what they were going through up to that point. I mean, you literally could save a life by doing this.

“Let’s talk to somebody before there might be a crisis.”

Starting the conversation

Jamie Martens-Perry said the challenge for parents is identifying the differences between “normal” adolescence and potential mental illness.

Martens-Perry works for Chestnut Health Systems, a mental health agency with offices in Belleville and Granite City. She also provides training for educators at the St. Clair County Regional Office of Education.

She said teens face hormonal changes, mood shifts, awareness of their sexual identity, an increase in peer pressure and more independence while they challenge parents’ authority.

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Jamie Martens-Perry, with Chestnut Health Systems, was one of the experts at the Youth Mental Health First Aid seminar, a training for teachers and school employees on issues specific to teens and how best to handle them, at the St. Clair County Regional Office of Education in Belleville.

An estimated 20 percent of teens will also experience a mental health issue, according to Natalie Ruth, the youth and family support services coordinator with Chestnut Health Systems.

The experts say parents should watch for sudden changes in behavior.

“Don’t ignore it and hope it’ll go away. Don’t think, ‘It can’t happen to my child,’” Farmer-Brackett with Centerstone of Illinois said. “Those are scary things parents have done. Trust your gut; if something doesn’t feel right, ask.”

Humphrey, of the St. Clair County Mental Health Board, said some common warning signs that a child might be depressed or thinking about suicide are lower grades in school, not eating or sleeping, mood changes, isolation, writing about suicide or starting to give things away.

Martens-Perry said parents should try to listen to their children and reassure them without judging them.

“Listening nonjudgmentally is not as easy as it sounds,” Martens-Perry said. “Sometimes it is hard to pull back our judgment when (a teen is) telling us what they’re doing or not doing and we think they should be doing something different. Youth usually don’t want ‘advice,’ as in being told what to do. They want someone to listen.”

But it can also be a relief for them to finally be able to talk about how they feel, according to Martens-Perry.

Someone who had been erratic and acting out who suddenly becomes calm could be in a crisis, according to Ruth. “There’s a calm that falls when they decide to kill themselves,” she said. Asking whether they have a suicide plan can actually help.

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Natalie Ruth, with Chestnut Health Systems, was one of the experts at the Youth Mental Health First Aid seminar, a training for teachers and school employees on issues specific to teens and how best to handle them, at the St. Clair County Regional Office of Education in Belleville.

Yvette Hicks, the social worker at High Mount School in Swansea, said it’s a question she asks as a counselor, and she advises parents to ask, too. She said the next step is to get help immediately. “Don’t question: ‘Oh, you’ll feel OK. You’ll be fine later,’” Hicks said.

Urging the teen to seek professional help doesn’t necessarily mean they will be staying in a hospital or taking medication, Ruth said. Professional help can be a doctor, or it can be a drug and alcohol specialist, school counselor, nutritionist, family or group therapy, academic counseling or other expert help. Medication is rarely the only treatment, Ruth said.

If they don’t want help, Ruth said it’s important to find out why and to talk about ways to address their concerns, such as the stigma of mental health issues or the cost of care.

Emily, the recent high school graduate, said she has had that conversation with a friend.

“They were afraid of the stigma,” she said. “I sat there and I told them, ‘It’s fine. You’re getting help you need, and I think that’s amazing. That’s so brave.’ … It’s doing what you need to do to survive.”

Joining the conversation

A town-hall style talk on addressing suicide in St. Clair County is scheduled for June. Olivia Johnson plans to be there to talk about her research. It’s open to parents, teachers, doctors, lawyers, police officers or anyone else from the community who’s interested.

Here’s more information:

When: 6:30-8 p.m. Thursday, June 28

Where: Second-floor classroom at the St. Clair County Sheriff’s Department at 700 N. Fifth St. in Belleville

Cost: Free

Register online at www.bw-institute.com/upcoming-events.

There are two training sessions for people who work in schools scheduled in June at the St. Clair County Regional Office of Education. They are open to educators across the metro-east who want to learn more about how to help students with their mental health.

Training for parents will also be available this month.

The upcoming six-week program through the National Alliance on Mental Illness is about how to help children and teens who are experiencing symptoms of a mental illness or who have already been diagnosed. It will also touch on self-care for parents and ways to handle stress.

Here are the details:

When: 6-8 p.m. starting Wednesday, June 27

Where: Anderson Hospital at 6800 Illinois 162 in Maryville

Cost: Free

For more information or to register for the classes, call the National Alliance on Mental Illness’ Southwestern Illinois office at 618-798-9788 or email info@namiswi.org.

Getting help 24/7

The following phone numbers are for local crisis lines that metro-east residents can call at any time and on any day for support.

Centerstone Community Counseling Center of Northern Madison County: 618-465-4388

Chestnut Health Systems for southern Madison County and for St. Clair County: 618-877-0316

Community Resource Center near Clinton County: 618-533-1391

Provident Inc. in St. Louis: 314-647-4357

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