‘Anybody can instill hope.’ Efforts to end youth suicides continue after Stark contagion
Panic gripped the Stark County community as the new year began in 2018.
Nine teenagers had killed themselves within the past five months, with five of the deaths occurring in the first 24 days of January. Two teenagers died by suicide on Jan. 24.
Parents and community members demanded to know what was causing the youth suicides: Was it bullying? Was it the social media game involving a blue whale? Was it a suicide pact?
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How could they make sure their child wasn’t next?
‘A suicide contagion’
Stark County mental health leaders labeled the deaths a suicide contagion, explaining that simply being exposed to suicide or suicidal behaviors can result in an increase in suicide and suicidal behavior in others.
Local health officials turned to the state for help. The state called in the U.S. Centers for Disease Control and Prevention to examine the factors contributing to the increased suicide behaviors among Stark County youth and to provide prevention recommendations.
By the time the CDC released the first portion of its report in July 2018, 13 Stark County students from six different school districts had died by suicide. The rate was seven times higher than the national youth suicide per capita rate.
CDC experts told local leaders to brace themselves: They should expect a higher-than-usual number of youth suicides for at least the next three years.
Turns out, they were wrong.
Youth suicides have decreased since contagion
Stark County, which annually saw an average of three youth suicide deaths a year before the contagion, recorded two youth suicides in 2019, and the number of youth suicides has continued to remain at pre-2017 levels since then, according to information from the Stark County Coroner’s Office.
As of Aug. 30, Stark County has reported zero suicides by children aged 18 and younger this year.
An annual youth behavioral health survey administered in every Stark County traditional public middle school and high school also shows that fewer students are considered at an elevated risk of suicide compared to four years ago.
But just like no one can say for certain why the suicide contagion began, no one really knows why it ended so abruptly.
School, health and mental health officials remain vigilant and on edge about youth suicides, especially in the wake of the coronavirus pandemic that has jeopardized the progress that was being made.
Since the contagion ended in 2018, most Stark County students in grades 7-12 have answered a range of questions about their mental health, suicidal thoughts and behaviors, social media, alcohol and drug use and their relationships with friends, family and school as part of a survey that was created by local and state health, mental health and school officials in collaboration with the CDC.
Are Stark County youth still at an increased risk for suicide?
Results from the three Northeast Ohio Youth Health Surveys that have been administered ― in April 2018, spring 2019 and fall 2021 ― show fewer students countywide considered suicide, attempted suicide or were considered at an elevated risk of suicide last year compared to the two previous surveys. A Canton Repository request for a breakdown of the survey results by school district has been denied because the district-level reports are considered protected health information, according to the Stark County Health Department, which helps the Ohio Department of Health administer the survey and distribute the county-level and district-level reports.
According to the county-level survey for 2021 that included results from 16,420 students:
- 6.5% of them had thought about suicide and had a plan to carry it out last school year. In 2018, 10.7% of the students answered “yes” to the same question.
- 2.8% of the students had attempted suicide during the school year compared to 5.6% in 2018.
- 20.7% of the students had an elevated risk of suicide, compared to 2018 when 22.8% of students were considered to be at an elevated risk.
- 21.4% of students reported being bullied, a significant reduction compared to 2018 when 30.9% of students reported being bullied during the school year. In 2019, 27.2% of students reported being bullied, which the survey defines as when at least one person teases, threatens, spreads rumors about, hits, shoves or hurts another person over and over again.
- 55% of students said they felt safer at school, compared to 50.3% of students in 2018 and 51.7% of students in 2019.
But in the year following the height of the COVID-19 pandemic, some of the survey’s measures that indicate a potentially greater risk of suicide have either returned to 2018 levels or have become even worse than they were immediately following the contagion.
“The pandemic affected all of us,” Dr. Anju Mader, chief integration officer at Stark County Mental Health & Addiction Recovery. “None of us has gotten free from the stressors and the anxieties of the pandemic. So, on the survey, when we see some of these data trends for our youth, they are just indicative of the challenges they experienced from the pandemic.”
What were some of the more concerning trends in the survey?
Nearly 61% of the students surveyed in 2021 reported feeling lonely and a third of the students said they felt hopeless. In 2018, 56.9% of students reported feeling lonely and 28.7% said they felt hopeless.
Nearly 35% of students said they had been diagnosed with a mental health issue, such as depression, anxiety, attention-deficit/hyperactivity disorder, autism or Asperger’s syndrome, during the last 12 months, with anxiety as the most common diagnosis. In 2018, 29.9% of students had a recent mental health diagnosis.
The comparison of the three surveys also shows that students feel less connected to their school and community, which are key factors in reducing suicide risk.
Nearly 79% of students said they were involved in a school activity in 2021, which is lower than the 84.5% of students who were involved in a school activity in 2018.
Fewer students in 2021 compared to 2018 reported that they felt close to people at school, felt they were a part of the school or felt happy to be at school.
Fewer students also reported feeling as though their friends and/or family care about them compared to 2018.
Just over half (53%) of students last year were considered highly resilient, meaning they had the skills to bounce back when faced with challenges. In 2018, 59.5% of students were considered to be highly resilient.
What’s being done to lower the risk of suicide for Stark students?
In the past five years, Stark County schools, health, mental health, law enforcement and community organizations who work with youth have deployed a range of initiatives to help lower the risk of suicide among Stark County youth.
StarkMHAR now employs one of Ohio’s few suicide and community response coordinators. Elena Aslanides-Kandis’ job is to work with school and community organizations to help eliminate suicides through prevention, intervention and postvention, a term used to describe activities that reduce risk and promote healing after a suicide.
The countywide agency also has worked with Coleman Health Services to beef up Stark County’s youth mobile response unit, which was just beginning when the contagion began. The unit, whose average response time is 19 minutes, responds to diffuse any immediate mental health concerns and to connect those involved with the resources available to them. The services are provided regardless of a person’s ability to pay.
Stark County’s traditional public schools have increased the number of mental health counselors available to students, with all students having access to an onsite counselor at least weekly.
The number of school resource officers also has increased to where every Stark County school district employs at least one officer or sheriff deputy. Most Stark County school districts also offer the Say Something Anonymous Reporting System, which allows students to use a mobile app or phone number to anonymously report concerns about a classmate or friend who might be displaying at-risk behaviors.
Each school also has a dedicated CARE Team, which stands for Coordinates and Aligns Resources to Engage, Empower and Educate. Only a third of Stark schools had the team five years ago.
The CARE team is comprised of administrators, school counselors, teachers, staff, family support specialists, community agency providers and school resource officers. These team members seek to identify at-risk students early and help them and their families overcome the challenges they face that have become barriers to learning.
Many schools now offer suicide prevention programs or lessons in resiliency. By next school year, all Ohio schools must provide suicide awareness and prevention lessons as required under the Safety and Violence Education Act. Parents can opt their children out of the lessons.
“I know from the survey that we’re doing better,” said Joe Chaddock, superintendent of the Stark County Educational Service Center. “The kids are telling us we are doing better, but we still have a long way to go. We still have a lot of need out there.”
Chaddock called the contagion a “wake-up call” that schools have to do more to support students and their families.
“Mental health is important to learning,” he said. “When you are not feeling good physically or mentally, you are not going to learn.”
How Stark schools are creating connections for students
Aslanides-Kandis said her most common recommendation to school districts is to ensure that every student is connected to a trusted adult.
One exercise she recommends is that each school lists the name of every student. Then, each school employee marks the students they have a relationship with. School leaders then develop a plan to create a relationship with any student who didn’t receive any marks.
“Every school is doing something, it just looks a little bit differently,” Aslanides-Kandis said.
Several districts have established mentoring programs, where either district personnel or community members have lunch with students or meet with them after school to establish positive relationships.
Northwest High School has taken its traditional after-school clubs and built them into its school day to allow every student the chance to be a part of a group.
Principal Larry Tausch said holding the clubs during the school day, which is called advisory time, has allowed the high school of roughly 200 students to expand its offerings from a handful of clubs to roughly 40. The clubs are led by a variety of staff members, including teachers, school counselors, the school resource officer and even the superintendent’s administrative assistant.
Among the offerings: knitting, card games, board games, yoga, women’s and men’s chorus, Spanish, walking and running, National Honor Society, math, science club, LGBTQ+, social justice, investing, photography, Bible study, and nutrition and wellness. It’s even spurred the high school’s first guitar club, which has led to the school’s new pep band.
The dedicated time also gives heavy metal rockers Anna Metzger and Kari Heiner, both sophomores, along with group newcomer Luke Schwendiman, a senior, time to practice together. Now in their second year, they hope to play a Metallica rendition of the National Anthem at an upcoming football game.
To carve out the 29 minutes for the clubs, Tausch shaved 3 minutes from each class period, started the school day five minutes earlier and reduced the time in between periods from 4 minutes to 3 minutes.
“I saw a lot of wasted time in class,” he said. “We now go bell to bell with instruction.”
Tausch said the Northwest’s results on the latest Northeast Ohio Youth Health Survey show a positive trend and he believes the advisory time is helping, along with the school’s philosophy of hiring student-centered teachers.
“The kids still are coming to us with the same amount of problems,” he said. “Now they have an adult in the building that they know really truly cares about them.”
What are community agencies doing to reduce youth suicides?
John Aller, executive director of Stark County Mental Health & Addiction Recovery, said the effort to reduce youth suicides must extend beyond the school district.
“The school is certainly an important component around prevention and giving resources, but it’s a community initiative that we are trying to promote,” Aller said. “It takes a whole community to provide these protective factors that were trying to encourage to be developed.”
The countywide agency also funds the Stark County Suicide Prevention Coalition, which is a partnership of residents and more than 20 local community organizations who meet regularly to discuss ways they can provide education, guidance and resources around the topic of suicide.
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StarkMHAR also offers training for residents interested in learning how to identify the signs of suicide and to ask someone directly if they are having thoughts of suicide. The “Question. Persuade. Refer.” training will be offered monthly until July. The next 90-minute training is Sept. 21. It is free but registration is required.
Aslanides-Kandis, who began in her role in 2018, said the training is important because suicide prevention happens more often during everyday conversations among ordinary people than in a counselor’s office.
“Anybody can instill hope,” she said.
Reach Kelli at 330-580-8339 or firstname.lastname@example.org.
On Twitter: @kweirREP
How to find help
Counselors are available 24 hours, seven days a week every day of the year. If you or someone you know is in crisis, contact:
- National Suicide Prevention Lifeline: 800-273-8255 (or, simply dial “988”)
- Stark County Crisis Hotline: 330-452-6000
- Crisis Text Line, text ‘4hope’ to 741-741
- Trevor Project Lifeline for LGBTQ youth: 866-488-7386
- Trans Lifeline: 877-565-8860
- Military & Veterans Crisis Line: 800-273-8255, press 1
- Military & Veterans Crisis Text Line: 838255
- CommQuest Detox at Aultman Hospital: 330-830-3393
Learn how to make your home a “Safe Home” by removing unnecessary risks for substance abuse and suicide at starkmhar.org/prevention-resources/safe-home.
Know the warning signs of suicide
Roughly 80% of people who die by suicide have given warning signs to their families, friends and neighbors. Warning signs include:
- Talking or writing about suicide
- Giving away belongings
- Withdrawing from loved ones and activities
- Feeling hopeless, helpless, worthless
- Seeking ways to suicide, such as guns or pills
- Major eating or sleeping changes
- Increasing use of alcohol or other drugs
- Losing interest in things previously enjoyed
Who is at risk for suicide?
Research has shown that no single cause or event makes a person suicidal. Suicide is a result of multiple stressors that make an individual feel out of control, trapped or unable to change what is happening. Someone may be more at risk of suicide if they:
- Have attempted suicide before
- Have family or friends who have attempted or completed suicide
- Experienced a recent breakup, loss or other major change
- Have severe problems at work or school
- Have an untreated mental illness such as depression or bipolar disorder
- Have problems with alcohol or other drugs
Factors that can help people from becoming suicidal include:
- Getting effective care for mental, physical and substance disorders
- Having easy access to care, especially in when in crisis
- Developing skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
- Feeling connected to others, such as family or community
- Not having access to weapons
Source: Stark County Mental Health & Addiction Recovery