It has been two years since Jennifer Palacio slashed her wrists, drawing blood that continued to spill from her arms and legs the next day at school.
Luckily she confided her sadness and desperation to a classmate, who urged her to seek help from her high school counselor. That intervention may have saved Jennifer's life.
``Everyone has depressing moments in their lives, but now I don't even remember what the depression was about,'' Jennifer says. ``My mind was totally blank when I did it.''
Suicide is the third leading cause of death for youth ages 15 to 24 in the United States. In Broward County, six youngsters 18 and younger were suicide victims last year. One has died in 2001. All were white males, the youngest 9 years old. The most recent statistics available from Miami-Dade County show six children ages 14 to 17 died by suicide, 4 boys and 2 girls, half of them Hispanic, in 1999. Miami-Dade Public Schools reports losing its youngest child ever to suicide this year, a 10-year-old.
From 1980 to 1996, the rate of suicide among 10- to 14-year-olds increased by 100 percent in the United States; among African-American males ages 15 to 19 by 105 percent. Typically hidden from view by cultural inhibitions, taboo, shame and fear, suicide is coming out of the closet with the release this month of a National Suicide Prevention Strategy. Goal No. 1 of the 11-point plan is to promote awareness that suicide is a public health problem that is preventable.
``It's estimated that for every suicide, there are 25 suicide attempts,'' says Pam Harrington of Jacksonville, whose daughter died of suicide four years ago and whose subsequent activism helped inspire Gov. Jeb Bush to establish a state-level suicide-prevention task force. More than twice as many people died by suicide in 1998 than by homicide in Florida.
``We need to acknowledge it so we can prevent it,'' Harrington says. ``It's been a silent killer in our communities.''
The American Foundation for Suicide Prevention reports that more than 90 percent of suicide victims have a significant psychiatric problem, and that 30 percent of all depressed patients attempt suicide. But treatment for people with depressive disorders has alleviated symptoms more than 80 percent of the time.
Programs to teach the skills considered vital to protecting children -- and adults -- from sinking into suicidal behavior are active in Miami-Dade and Broward schools. The suicide-prevention foundation trained Broward peer-counseling teachers to provide its Solutions Unlimited Now (SUN), a 10-unit program about working together with others, problem solving, developing empathy and recognizing warning signs of depression or suicidal behavior.
``We've been trying to teach life skills to children so they can better cope later in life,'' says Rene Barrett of Coral Springs, executive director of the foundation's Florida chapter.
``The value of the SUN program,'' says chapter board member Victoria Mallow of Weston, ``is that it teaches kids to be friends, how to have compassion for one another. If you can teach that at this level, you can reach the world.''
The pilot programs in Orange, Broward and Palm Beach counties are returning positive results, Barrett says, and the foundation hopes to introduce the program on a national level.
Miami-Dade public schools have provided the TRUST (To Reach Ultimate Success Together) program since 1987, when 321 attempts and 19 suicides were reported among students in the district, along with 784.3 ideations -- distress calls regarding students discussing or thinking about suicide. Within one year the number of completed suicides had dropped to seven, although attempts and ideations remained high. In 1999, the number of suicides dropped to 6 and attempts dropped to 55, although students still reported 687 incidents of thinking about suicide. Of those who discussed their distress with counselors, only two have died in 10 years, said school psychologist Frank Zenere. Clearly, the program is effective at helping students cope with the depressive and fearful feelings that can lead to suicide.
``We're making an impact; we are saving people,'' said Zenere, one of three members of the crisis management team at Miami-Dade Public Schools.
It was a TRUST counselor who came to Jennifer's aid. The counselor helped Jennifer's family admit her to a psychiatric hospital unit, where she spent a few weeks for treatment.
``You just sit in there and you actually think about how to cope and how to solve the problems instead of taking your own life,'' says Jennifer, now an 18-year-old honor student who plans to study veterinary medicine. ``I was helped to realize that I was really screwing up my life.''
Jennifer's mother, Ethia Burkhardt, encourages Jennifer to share her story with others, even though it's difficult. ``It's a way to help other kids,'' Burkhardt said. ``It's very private, but if it can help somebody else, it's great. Parents don't deserve to go through all this.''
One of the biggest roadblocks to preventing suicide is the stigma against mental illness. ``Mental illness is every bit as important as physical illness,'' said Zenere. ``The stigma is why people are not seeking help.'' In fact, mental illness is a physical condition. Recent genetic research is finding correlations between certain genes and bipolar depressive illness, violent and suicidal behaviors.
Science is discovering that there can be a hereditary predisposition to mental illness. Awareness of family histories can help alert individuals to watch for signs of similar illnesses, but that can be difficult when mental disorders and addictions are cloaked in secrecy.
``We've swept it under the rug and not talked about it -- called these people crazy and stuffed them in institutions,'' says Mallow, who never knew her own mother had spent weeks in a sanitarium for mental illness until after one of her children required emergency hospitalization for a severe depressive attack.
Mallow realized her child needed help when she discovered that prized personal belongings were being given away to friends -- a sign that a person is saying goodbye.
``Imagine how much easier it would have been for me to help my child if I had known this was in my family. We've got to change how they're thought of -- it's just like any other illness -- you get medication, you need people's help with it. Getting balanced on medication is something that has to be constantly monitored for the rest of your life.''
Jennifer credits her boyfriend with helping her to break old habits and maintain a positive outlook. A musician and member of an underground peer group called Straight Edge, Manny Carvallo, 19, says no to drugs, premarital sex, alcohol and meat. ``It's a philosophy of life that tells you we don't have to take any poison into our bodies,'' Carvallo says. His friends in underground rock bands helped him see the light when his own life was in tatters. Carvallo, of Miami, says he lived on the streets for about nine months at age 16, thinking about nothing but using drugs, until friends helped him.
Another method of suicide prevention recommended by U.S. Surgeon General David Satcher in his National Suicide Prevention Strategy is to reduce access to lethal means and methods of self harm. Guns are used in 57 percent of suicides. The Centers for Disease Control reports that the death rate of individuals exhibiting suicidal behavior doubles when a gun is kept in the home. Physicians for Social Responsibility say that a gun in the home is 11 times more likely to be used against oneself in a suicide attempt than in self-defense.
GET RID OF GUN
``If a kid is in crisis and you've got a gun in the house, you are going to increase the likelihood of tragedy,'' says Harrington, who wishes her own daughter, who died at 15, had recognized her own depression and known help was available. ``Get the gun out of the house, at least until the crisis has passed,'' Harrington says.
Recognizing the symptoms of illness and getting help is the key to suicide prevention. ``What a great difference it makes when your child gets the proper help,'' says Mallow. ``What a relief it is to know that your child can live the life that you want them to live -- to be normal and happy like everyone else.''
Trish Riley is a South Florida freelancer who writes about children, health and the environment.