“Suicide prevention is everyone’s responsibility” was the message at the unveiling of Caltrain’s new webpage for suicide prevention at the San Mateo Caltrain Station on Wednesday, Oct. 1.

As part of Railroad Safety Month, Caltrain launched a special page on its website dedicated to suicide-prevention information and outreach. The page includes a crisis hotline number and links to local, regional and national resources.

“I would venture to say that everyone here has some personal experience with suicide or mental illness,” said Caltrain spokeswoman Jayme Ackemann. “I, myself, lost my husband and high school sweetheart when my daughter was just 1 (year old) to suicide, so it’s a very personal issue for me. We are experts at running a railroad; we are not experts at preventing suicide, and that is why we work with our community partners to look for answers.”

Ackemann said there is no single solution, but “we know suicide can be prevented … and people in our community are working toward prevention and erasing the stigma surrounding mental health by shining a light on this issue.

“We hope that of the millions of people who visit Caltrain’s web page every year, some will be helped by the information,” she said.

Four experts who have been affected by suicide spoke at the event, including Victor Ojakian, Suicide Prevention Oversight Committee co-chair; Dr. Ken Smith with the Suicide Prevention Speakers Bureau of the Santa Clara County Mental Health Department; Bevin Love, assistant director of Stamp Out Stigma; and deputy Sal Zuno of the Caltrain Transit Police Bureau.

Former Palo Alto councilman and mayor Ojakian lost his son Adam to suicide in 2004 at the age of 21. Ojakian and his wife, Mary, have since lobbied to ensure California’s public colleges have student-mental health advisory committees so that students on campus are as safe as they can be and individuals who are considered at-risk can receive help.

The Ojakians have advocated for suicide-prevention resources for students at every level. He referenced the cluster of deaths of five Palo Alto students in 2009 and 2010 on the Caltrain tracks.

“I was asked at one stage if I would help set up a committee in Santa Clara County to address the matter of suicide — not just because of the deaths of the children in Palo Alto but because of the deaths of so many people in Santa Clara County,” Ojakian said.

Nearly 40,000 suicides were reported throughout the United States in 2011, Ojakian said. But what doesn’t get talked about is the state statistic — just under 4,000 people.

“There is a good possibility when next year’s data gets release that we will cross that threshold,” Ojakian said.

“California has a public health crisis,” he said. “People don’t want to talk about it that way, but that’s what it is. You don’t lose that many lives and cavalierly go by without recognizing the magnitude of how many people have died.”

There has been an average of 13 deaths a year on Caltrain tracks, the majority were caused by suicide, according to a Caltrain press release.

“Although suicides on the Caltrain right-of-way make up only 3 percent of suicides in the Peninsula region, they are the focus of public attention because they impact so many people,” according to the press release.

“Caltrain has been a significant partner in trying to prevent suicide,” Ojakian said. “They understand that it’s not just the deaths on the tracks where people are taking their lives, but there is something that happens before that and there is a significant impact on our community.”

Other suicide-prevention efforts Caltrain has been involved in include spending $110,000 to erect 250 new “There is Help” signs along a 10-mile stretch that includes Palo Alto, Menlo Park and Mountain View in 2010 and in 2012; and a team of San Mateo County Transit District employees raised nearly $12,000 in the Out of the Darkness Overnight fundraiser, an 18-mile walk in San Francisco, which benefits the American Foundation for Suicide Prevention.

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18 Comments

  1. I would just like to point out, on the topic of doing everything possible, that a Brown University epidemiologist found in a very large well-controlled study that there is (up to a point) a dose-dependant association between indoor mold and depression:

    “The physical consequences of living in a damp, moldy house are well documented and include increased asthma attacks and other respiratory ailments, headaches, fatigue, and sore throats. People who live in moldy environments may also have more depression, finds a study of 5,882 adults living in 2,982 households, published in the October 2007 issue of the American Journal of Public Health.

    “The connection between mold and mental health surprised even the lead author, epidemiologist Edmond Shenassa of Brown University, who was skeptical of the mold–depression link suggested by smaller studies. “We thought that once we statistically accounted for physical factors like crowding and psychological aspects like not having control over one’s living environment, then the association between mold and depression would vanish,” he says. But rather than debunking the notion, Shenassa found an association between mold toxins and depression.”
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2072855/

    While it may never be possible to know how much of a factor such an influence would be in any given depression case, it’s like global warming — we do know it is very real and doing something about it will save lives.

    Our school district’s focusing on creating a healthy indoor environment, using best practices to create good quality indoor air, will reduce or prevent this factor from being an issue for our district’s children. Unfortunately, we do not now have that. In my observation, even after renovations (that have helped), all of our district middle school have unacceptable problems with air quality, specifically with mold. It’s not irreparable, in fact the problems are fairly common for schools and buildings of that construction type and age, it’s just the district initially dealt with notice of it by parents in characteristic fashion: ignore, isolate, deny, cover up. (I’m happy to say, that has been changing, and McGee seems to have a different attitude. We should be the Whole Foods of healthy school facilities, not just playing catch up! Particularly when we realize from these studies just how significant a factor the health of the FACILITIES is to the mental health of the occupants.)

    For example, one of the most common construction practices in our older buildings was for gutter downspouts to drain right at the foot of uninsulated slab foundations. Water is wicked into concrete slab like a sponge and travels long distances. This is a perfect recipe for persistent low-level condensation on the indoor slab and indoor mold to grow unseen at the base of carpeting and carpeting underlayment, and other flooring materials, released in the air every time anyone walks around. Stains in the ceilings from condensation go unattended for years.

    The district does not have an indoor air quality management plan, but adopting one and truly supporting its proper implementation will not only reduce asthma, it will also reduce other illnesses and absenteeism from other causes (thus generally reducing stress), and reduce the influence of this specific contributor to depression. A well-implemented IAQ management plan would mean we could eliminate at least this one factor contributing to the depression problem, while also just keeping everyone healthier in general.

  2. There are MANY causes of depression and suicide….social, genetic, home environment and dynamics, demographic.

    Mold may or may not be a cause, but public buildings have been doing environmental remediation for years. Not so much in private residences, until the property is sold.

    As the article says “Suicide prevention is everyone’s responsibility” and I’m glad to see CalTrain’s effort to make a difference.

  3. I think it is great that Caltrain is doing this and I hope that it does help some people. However, I have to believe that much earlier intervention is much more desirable and much more likely to be successful. What kind of proactive mental health programs do we have in our schools and work places? I do hear an anti-suicide commercial on the radio from time to time (apparently targeted at military veterans), but can we do something on a wider scale?

  4. “Mold may or may not be a cause, but public buildings have been doing environmental remediation for years.”

    Actually, while mold may or may not be a cause in a given case, statistically, it IS a cause, and it can amplify other causes, so if we want to make prevention everyone’s responsibility, it’s one cause we should be doing something about because we CAN, and doing so WILL have many other benefits.

    And no, our schools in PAUSD have NOT been undergoing environmental remediation for years, they have mostly been resisting doing so for years. I speak from personal experience. When we pointed out that the district promised us improved indoor air quality in the Measure A bond improvements, we were told they only intended to provide for that in the newly constructed buildings, not in the older buildings where it is most needed. It was a huge lost opportunity.

    Where some of the renovations have produced improvements, it has mostly just been coincidental, not because of deliberately trying to solve indoor air problems and make improvements. If you are interested in doing the best for our kids on this score, don’t just argue about it here, I challenge you to arrange a comprehensive tour of the middle schools with a group of mold-allergic individuals. Reach out to parents with mold allergies to find out where the biggest problems are. Adopting an IAQ management plan, by the way, would lead to setting up ways to get feedback from the public. If you want to do something easy to help in this regard, support efforts to get our district to adopt an indoor air quality management plan. http://tinyurl.com/iaq-pausd. Then volunteer to help do the walkthroughs to find problems, and support efforts to implement a plan to improve our district’s air quality as well. It will help kids’ health in general, AND eliminate this one known contributor to depression.

    Also, I heard that Vic Ojakian was supporting a bill requiring mental health professionals to have the same level of training for suicide prevention that they would have for domestic abuse, for example. Last I heard, it was passed by both houses in CA and but vetoed by Gov Brown, who felt the issue should be deal with by licensing boards. Vic Ojakian speaks in this article about the bill:
    http://www.news10.net/story/news/local/california/2014/08/14/bill-would-require-psychologists-to-have-suicide-prevention-training/14042125/
    Does anyone know what’s happening as a consequence on the licensing board end of this issue?

  5. @neighbor,
    “Not so much in private residences, until the property is sold. “

    I would agree with you there. People who have the same issue – older, uninsulated slab foundations – would do well to pay attention to how to remediate, seal, and insulate. Unfortunately, if one is depressed because of indoor mold, it’s kind of a vicious cycle because it also causes fatigue…

  6. Most of the details of Caltrain suicides are not made public. It’s even hard to get the names of the people involved–much less any insight into why they killed themselves.

    The suggestion that suicide is everyone’s responsibility is quite naïve. Very few of those who end their lives on the Caltrain tracks do so without advertising their intentions, or providing much in the way of evidence that the end is near for themselves.

    The people of Palo Alto, or any community in which Caltrain suicides take place can not be responsible to stopping these people from these drastic actions, or wringing our hands as if there were more that we could have done—so that somehow, their deaths are somehow our fault.

    From time to time, various public health agencies claim that as many as 1 in 10 teens contemplate suicide. It’s very difficult to believe these statistics—particularly given the low numbers of teen suicides. However, if these numbers are in anyway correct—then the parents of these teens would be the first point of detection of these kids problems. The responsibility falls on the parents before anyone in the community can claim the rest of us have a role in dealing with these areas of mental health.

  7. Error in post above. Should have been–

    Very few of those who end their lives on the Caltrain tracks do so by advertising their intentions, or providing much in the way of evidence that the end is near for themselves.

  8. “The suicide & depression problem is much more complicated than “mold” and it is NOT A POLITICAL ISSUE.”

    It is, you are right, and luckily we are doing something about most of those other causes, but our school district has not done anything at all about reducing the contribution of indoor mold to the problem.

    I would say it back to you: healthy schools should not be a political issue. Please tell that to our district, we could make this aspect of the problem a non-issue by dealing with it virtually overnight. And our kids will be healthier to boot.

  9. From the article (involving a 5,000 household study):

    “About 40% of the residents lived in visibly damp, moldy households, and overall their risk for depression averaged 34–44% higher than that for residents of mold-free dwellings, with moderate exposure associated with the highest increase in risk. “

    That’s not a small or insignificant potential contributor to the problem. Add that to stress, missed school from illnesses or asthma, and it adds up to something our schools can do to make an impact on the problem by doing something they should be doing for our kids anyway.

    It really shouldn’t be a political issue. And definitely shouldn’t be made political by school personnel who think that ignoring it will somehow reduce their liability. (It will ultimately do the opposite.)

  10. “The suggestion that suicide is everyone’s responsibility is quite naïve.”

    Can you say that with certainty from a study or facts? If ordinary people can save lives through learning how to administer CPR to heart attack victims, they can learn how to help look out for signs of depression and simple things that might help.

    Does someone have a simple guide? What can we do to get people who are depressed to help before they are in crisis?

  11. @Palo Alto Mold Person – seriously? I think more harmful than mold is your own disproportionate focus on that aspect of/influencer on mental health. No pun intended, but you’ve kind of derailed the necessary _broad_ focus on _lots_ of influences on mental health. We get your niche focus even though it doesn’t seem to be a shared interest, even if you think it should be. But get over yourself and stop trying to foist this around. Does mold thrive on hot air?

  12. Palo Altan — clearly you are on a crusade about mold. But any psychologist will tell you that suicide is a complex issues. Family and social networks, history, and dynamics are critical.

    And, you don’t need the data on the families of suicides. They would need to give you permission to release private information on their loved ones and homes.

    Government is not answering you because it is illegal for them to release private info on the suicide victims and their families without proper permissions.

    Your crusade against government in this case seems irrational.

  13. @ neighbor,
    With all due respect, in this article and forum about depression being everyone’s responsibility, this is exactly the place to finally bring up a proven, major contributor to the problem of depression, one that is not being dealt with at all in any of the traditional ways or specifically by Project Safety Net (I’ve spoken with them, it’s out of their scope). Your post evidences understanding virtually nothing at all about it. (I can’t even understand some of what you have said – where have I asked for or brought up data on families with suicides?)

    When you have a complex problem, with many things contributing, and there is a huge, proven contributor that no one else is dealing with, and which could and should be dealt with, when children’s health, wellbeing, and lives are at stake, why wouldn’t we? In fact, why would anyone take to kneejerk resistance and making strange arguments that have nothing to do with it as you are doing now? The whole point of this article, the whole point of this thread, is that we should not turn away when we can help.

    The mind and body are not wholly separate, and environmental mold is one physical pathway that can overlay the psychological. Why would you argue, in such an irrational way divorced from the facts, I should add, against taking that burden away from the mix? Really? What possible justification could you have for arguing about this, when it could reduce the overall burden of depression in our young people in this district?

    At the risk of sounding like a broken record, I would like you to finally read and hear this: Mold has been proven in an unusually large and well-controlled study to confirm other studies showing a dose-dependent increase in depression from indoor mold. One CANNOT tell in an individual case – even if there is unhealthy levels of mold in that person’s home or school, understand? – whether mold is a primary reason for a given individual’s depression, a contributor to or an amplifier of that person’s depression, or not at all an issue in a given individual’s depression. We don’t know the mechanism. All we know is that statistically, it is a big contributor to the problem.

    We simply do not know enough to tell at an individual level, anymore than we know whether a given hurricane is caused by global warming. But we do know nevertheless that dealing with the problem of global warming will help reduce the extreme weather events it effects. And we do know that having healthy indoor air is associated with far lower rates of depression. Which is great, because we have some low-hanging fruit when it comes to making our school facilities healthier and doing something concrete that will absolutely and tangibly reduce rates of depression, and we have a bond measure that promises it if we need funds to do it. The district just hasn’t dealt with the issue yet (anymore than you are). Is that more clear?

    Far from speaking in vague, general terms about “government” answering me, I have spent the last several years specifically trying to improve the environmental health of our schools, and with all due respect, it has nothing at all to do with private information of the suicide victims. What a bizarre thing to bring up.

    To the poster who thinks there is no mold, I was not able to see your post before it was removed, but based on your handle, you also do not know what you are talking about. We have conditions in most of our schools that are classic for producing unhealthy indoor air and mold in, not all, but many classrooms, and we could be doing something about it – in fact, were promised the district would do something about it in Measure A – but as yet, inertia and personal politics have superceded interest in understanding best practices and doing what’s best for the students. I think that will change under McGee, it’s very hopeful.

    Our own elementary school was mostly pretty good, but there were places that had problems — including mold — that would have been easy to identify before they caused kids asthma and other problems (about which I later learned other parents had complained). When we began in one of those rooms, it was obvious there were mold problems. I asked the principal for help, and pretty soon they sent through an expert to evaluate the problem. The principal told me they found nothing. Years later, I got a copy of the report, and quite the contrary, the district’s own expert found the carpet was WET (not just damp) and STAINED, which in the field of environmental health today, means you have a reason to remediate for mold. The expert also found an illegal OSHA ventilation violation.

    The expert’s first conclusion and recommendation was to tell the district to adopt or to continue (if it had one) an indoor air quality management plan. If you are familiar at all with expert reports like this, that was about as big a dope slap as anyone is going to make to someone who hired them in a report that might have legal implications. The expert just told the district it was obvious they didn’t have or weren’t following good practices for healthy indoor air. (For the record, the district ignored this advice.)

    As far as that room itself, the pipe in the floor broke soon after and the district had to replace the carpet – on uninsulated, cold slab. The teacher and I cleaned the room from top to bottom, and it was thereafter (per the data), the healthiest room in the school, at least for the years I could get information, with the fewest absences.

    If we were to speculate about why the resistance to doing something so incontrovertibly beneficial? I don’t know, one of the first things anyone does in an IAQ management plan is to do a walkthrough with a checklist to identify problem areas. Can you think of any reason anyone in our district’s administration would not want a group of experts and parents walking through our older buildings and looking for problems in need of addressing? (McGee, on the other hand, has every motivation to find and fix problems left over by his predecessors or he will be saddled with them eventually.) Specifically, these district personnel seem more concerned with the appearance of anything that the lawyers at FFF tell them might incur liability over doing the right thing (that would actually reduce liability). Yes, this is my crusade, if you want to call it that, because it’s something easy we could be doing to improve ALL kids’ health and to reduce the burden of depression in our schools. Why would we argue about that? It’s time to just do it, even if we aren’t experts, we can care, and we can weigh in, and we can do something for our own kids, as Caltrain employees are doing here.

    (If you want to add your voice to the friendly signature drive to ask our district to adopt an indoor air quality management plan – which among much else, reduces indoor mold and improves student performance – the link is http://tinyurl.com/iaq-pausd This is not a law, a rule, it is just showing support for adopting best practices at our schools, so anyone can sign.)

  14. @neighbor,
    And by the way, I already know that one of the students who committed suicide was a student in that room, which by all indications probably had a slow leak for years before the pipe went.

    It doesn’t mean anything in an individual case, because you can’t draw any conclusions. And although the district could look for data on whether the kids in rooms with lesser indoor air quality have more depressed students than in rooms with healthier air — why would we? Why wouldn’t we just follow best practices to keep our school facilities as safe and healthy as possible, and eliminate this one potential contributor to the levels of depression in our young people?

  15. @neighbor,
    I would love to hear back from you. Do you understand now? Even if someone’s depression is entirely because of environmental pathways, they’re not going to think that. They’re going to think it’s the result of other challenges that virtually every child faces in puberty. It’s impossible to know in a given case what influence the known environmental factor plays. But that doesn’t mean we ignore the environmental influence, because it’s such a major one.

    We do know moldy indoor environments play a role in depression. We do know that our district doesn’t currently follow best practices and has older construction in many of the buildings with specific challenges that could be addressed but haven’t yet been.

    You can make a difference in people’s lives by being vigilant as Cal Train is asking. You can make a difference by helping our schools be healthier so there are fewer kids who face depression. Yes, all those other complex issues will remain, but the part of it we know how to minimize, we should.

  16. If anyone is reading this, and going to the candidate forum today, please ask them:

    Measure A bond promised “improved indoor air quality” which includes reducing mold and potential for mold growth. Given that the prevalence of depression can be 44% higher in buildings with even moderate levels of indoor mold, what specific measures or programs were put in place to ensure improved IAQ? (Note: the district administration says the CHPS standards mentioned in the bond only apply to the new construction, but not to the older buildings and renovated spaces where mold would be a problem which still make up the majority of our school buildings, and which most needed the improved IAQ.)

    This is also something everyone can do.

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