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Uploaded: Friday, May 22, 2009, 3:55 PM

Preventing teen suicides
Community gropes for answers, new approaches after latest tragedy

by Chris Kenrick
Palo Alto Weekly Staff

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The morning after a Gunn High School student died on the Caltrain tracks May 5, shell-shocked parent leaders and school officials huddled together and grieved.

"It was all about 'Why? Why? Why?'" PTA Council President Dan Dykwel recalled of the gathering of about about 20 people in the district headquarters.

"'Why did this happen? You look at these profiles (of recent teen suicides in Palo Alto) and you would not expect it from these kids. You just wouldn't. Who would have guessed? This is so unacceptable,'" he said.

The May 6 gathering originally had been scheduled as a regular monthly meeting between the PTA's Executive Council and Superintendent Kevin Skelly, typically a 15-minute exchange on district affairs.

But that day it lasted an hour and there was just one topic. Skelly didn't do much talking, but "took a lot of notes and listened, listened, listened," Dykwel said.

"We had some very passionate individuals in the room," he recalled. "The question was, 'How do we move beyond the conversation (about preventing teen suicides) to something that's strategic, institutionalized, funded and comprehensive so that we really make a meaningful impact on this and not just have intentions?'"

When it comes to the emotional health of its youth, Palo Alto is a wellspring of best intentions.

Starting with kindergarten, teachers, principals and parent volunteers on every campus focus heavily on "character education," working to promote respect, inclusion and prevention of bullying.

Drawing on nationally recognized Stanford University experts and others, PTAs at each school organize seemingly endless calendars of "parent-education evenings" about student stress and emotional health.

"Living Skills," a class required for graduation at both Gunn and Palo Alto high schools, covers "knowledge that will help (students) make informed and responsible decisions about issues that affect personal health and well-being." The curriculum depends in some measure on the choices of the instructor, but generally covers topics such as CPR, sex education and emotional health including depression, though without a sustained focus on suicide prevention.

With school-counseling budgets squeezed, the community for years has welcomed the on-campus presence at every secondary school of Adolescent Counseling Service, a nonprofit organization whose motto is "Helping teenagers find their way."

And yet every few years Palo Alto is confounded when another seemingly promising young student, friend and teammate steps in front of a train or goes off to college and dies of suicide.

And parents, who might have known the youth as a teen much like their own, get a queasy feeling that it just as easily could have been anybody's child.

Former Palo Alto mayor and longtime youth coach Vic Ojakian and his wife, Mary, say this sad cycle not only is unacceptable but is, in many cases, preventable.

And they know more than most people about the subject.

The Ojakians were devastated nearly five years ago when 21-year-old Adam, the third of their four children and a well-liked honor student at Jordan Middle School and Paly, died of suicide a week before Christmas in an apartment he shared with three roommates near the University of California, Davis.

"We were like most parents not trained in mental health, certainly not in anything about suicide, such as what to look for," said Ojakian, a high-tech manager whose wife is a registered nurse.

"Of course you had to know our son, but it was a complete shock."

Investigating Adam's death amid their anguish, Ojakian said he and Mary were doubly shocked to learn that their son had been the fifth suicide at UC Davis that year.

The couple ultimately concluded that Adam had suffered from major depression of which they had been unaware.

"We looked at what the (mental health) program was at the school and, frankly, he didn't stand a chance," Ojakian said. "He was probably affected by major depression and he wouldn't have understood what was happening to him. And frankly, because of the social stigma, most people won't go seek help to figure out what's happening.

"If you have a broken arm you get it fixed, but if you have (depression) you have great difficulty going to get treatment."

Since Adam died, the Ojakians have devoted much of their time to lobbying for stronger mental-health programs in California's public colleges and universities.

In that quest they've become convinced that many student suicides can be prevented if the right mental-health services are in place.

"Every time (a suicide) happens we deal with the shock," Mary Ojakian said. "This is necessary, but that is all we do. We do not take action to prevent this from happening again.

"Suicide can be prevented bottom line. It is preventable but that requires community effort. We need to start the programs that prevent this tragedy.

"Every time we tell students, 'You've got to start listening and not be kept to this code of silence.' But we get new students every year. We all need to learn, as a community, how to prevent these tragedies.

"We all need to learn CPR for the brain. It exists, and it can be taught. We can institutionalize this. So every year when new students come, they learn that there are things they can do to help their peers," Mary Ojakian said.

Assuming that the literature on suicide is correct, "one of the things that jumps out at you is that it suggests upwards of 90 percent of people who die of suicide have a mental illness," Vic Ojakian said. "If you assume that's correct, the next thing you find out is that many of the serious mental illnesses occur in the late teens and early 20s.

"If you assume that's correct, you also learn that most people with a mental illness go undiagnosed and untreated up to 70 percent never get treated."

Accepting those statistics, the Ojakians have aimed their efforts at strengthening mental-health services on college campuses. They point to a list of specific programs in the "best practices registry" of the Suicide Prevention Resource Center as having documented evidence of saving lives. The list includes titles such as CARE (care, assess, respond, empower) and the Columbia University TeenScreen Program.

"A high school or (the Palo Alto school district) could and should take a similar approach to these systems," Vic Ojakian said. "Approaching suicide prevention is not determined by size but program content."

Carol Zepecki, the school district's director of student services, said there is ongoing discussion among school counselors about best practices. This month's Caltrain incident has sparked a re-evaluation, including a scheduled meeting of district officials with the Ojakians.

To date, neither the district nor Adolescent Counseling Service has institutionalized a specific suicide-prevention program, although students are continually made aware that counseling is available.

At Stanford University's Vaden Student Health Center, psychologist Alejandro M. Martinez and his colleagues have trained more than 500 students, faculty and staff members using a one-hour suicide-prevention training session from the QPR Institute, which also is available on the Web.

"It's something we've undertaken more systematically this year," Martinez said.. "It's really about helping individuals not just be bystanders when they see someone in distress but become more proactive in helping in those situations."

QPR, which stands for "question, persuade and refer," is intended not for experts or mental health professionals, but for any individual who wants to help someone in distress."

According to the QPR website, "just as people trained in CPR and the Heimlich Maneuver help save thousands of lives each year, people trained in QPR learn how to recognize the warning signs of a suicide crisis and how to question, persuade and refer someone for help."

Martinez and his colleagues have an ambitious goal to get QPR training to more than half the Stanford community.

"Every university across the country has had to face the tragedy of suicide and Stanford is no exception," he said, adding that Stanford's suicide rate does not stand out from that of other universities. However, he noted, when a student dies, the university does not necessarily learn whether it was from suicide or some other cause.

Between 20 percent and 23 percent of deaths ruled suicides in Santa Clara County in the past two years were individuals under 30 years old, according to the Santa Clara County Medical Examiner's Office. In both 2007 and 2008, the county had 31 suicides of people under 30. The coroner did not provide city-by-city breakdowns.

Philippe Rey, a psychotherapist and executive director of Adolescent Counseling Service, said Palo Alto's teen suicide rate is in line with national statistics.

At "Spring Sounds," the nonprofit's festive annual fundraiser held last Saturday, Rey devoted his remarks to adolescent depression, explaining how Adolescent Counseling Services is responding to the recent tragedy.

The group is launching a community-awareness campaign about teen depression and reminding students that free, on-campus counselors are available to listen. Two town forums entitled "Breaking the Stigma: Adolescent Depression" have been scheduled: the first on June 4 from 7 p.m. to 9 p.m. at Cubberley Theatre, 4000 Middlefield Road, Palo Alto; the second on June 18 from 7 p.m. to 9 p.m. in the Menlo Park City Council Chambers, 701 Laurel St., Menlo Park.

One in five people has suffered from teen depression, which is directly related to substance abuse and suicide, according to Margaret Murchan, the nonprofit's on-campus counseling program director. "This is a very important issue that cannot be ignored."

Besides on-campus counseling, the group has offered and continues to offer off-campus counseling, teen substance-abuse treatment and community education, including information sessions on depression and suicide.

It is hard to be a teenager anywhere, but may be particularly hard in a high-achieving place such as Palo Alto, Rey believes.

Pressure to succeed is such that teens and parents often feel a need to hide their challenges, he said.

"On the outside we all have that smile, we're all healthy, beautiful, drive a Mercedes, have a big house, yet we suffer in silence and alone in our homes because admitting that there's something wrong is a sign that we have failed.

"We think that going out and saying, 'I have a depressed child' is a reflection of the failure of the parents, when it is not. But I think we're all afraid of that so, sadly, we stay in denial," Rey said.

In speaking to the press after the May 5 death on the train tracks, Rey noticed he was saying the same things he said in the fall of 2003, the last time the community was stunned by a teen Caltrain suicide, that time near Paly.

"My message hasn't changed, but here we are again," he said. "The questions were the same; the answers are the same.

"Palo Alto is a wonderful community, so don't get me wrong. But the pressure to succeed here -- to be perfect, bigger, richer, healthier -- is really taking a toll on the children."

Comments

Posted by In the know, a member of the Gunn High School community, on May 22, 2009 at 7:06 am

I could not agree with Philippe Rey more. The pressure in Palo Alto for a teen to be or feel successful is over the top. Very little sleep, too much power given to the grade, competition at a scary level. What about teaching balance and moderation?