Editor's note: Resources for any person who is feeling depressed, troubled or suicidal are listed at the bottom of this article.
For a community that has done much soul searching in the wake of two youth suicide clusters over the last eight years, the findings of a Centers for Disease Control and Prevention report on the subject released Friday are sobering, but not surprising.
The value of the report, experts and community leaders said in interviews with the Weekly, is to provide an endorsement of efforts already underway, a roadmap for work going forward and a reminder of the importance of work yet to be done to prevent youth suicide in Palo Alto and Santa Clara County.
"This report does not identify a silver bullet that is somehow unique to this community or this school district," said school board Vice President Ken Dauber. "What I think it does do is to remind us that this problem is not in the past and that we need to continue to make this issue a top priority, even as the most recent cluster fades from our memory.
“We can't let that urgency slip away,” he said.
At various levels of the community, leaders and experts said the report will be used to inform critical suicide-prevention and mental-health efforts.
For the Palo Alto school district, it affirms work already in place or planned while also pointing to gaps to be addressed. Among the existing efforts: programs that connect cohorts of students with teacher-mentors for all four years of high school, social-emotional education at all schools, the opening of wellness centers on campus, student efforts to reduce the stigma around mental health, and evidence-based programs like Sources of Strength, which trains students to become peer leaders on mental health.
But more, district leaders said, can be done, including ensuring improved access to mental health services on campuses, better evaluation of existing programs to determine their effectiveness, and awareness of the common precipitating factors for suicide, among others.
Terry Godfrey, president of the school board, said she will be looking for specifics in the report to help guide the district's work to address these gaps, such as how to reverse the trend of young men being less likely to receive treatment for mental health problems and resources for evaluating the effectiveness of programs.
Dauber said he will continue to push for action on areas that impact student well-being that the school district has control over, like implementing its homework policy, reducing project and test stacking, and looking for "innovative" ways to increase access to quality school-based mental-health services. (He said he's in conversations with Stanford University providers and the district about having practitioners on campus, paid for by students’ insurance.)
Godfrey said she's also eager to see the results of the latest Developmental Assets survey in Palo Alto, referenced in the CDC report, which was last conducted in 2010. The new survey results are due out later this month, she said.
The school board is tentatively scheduled to discuss the CDC report as part of a larger student-wellness discussion in mid-April, Godfrey said.
Gunn High School senior Chloe Sorensen, who has spearheaded mental health efforts at the school and served on a community coordinating committee for the CDC investigation, said she hopes the report will encourage continued conversation around teen mental health.
Despite progress made — for example, Gunn's new wellness center is increasing awareness about available support services, she said — stigma and access hinder some teenagers from seeking and receiving help.
"A lot of kids still don't feel comfortable accessing these resources even if they are accessible," she said. "There's a lot to be said for having more conversations about mental health."
Vic Ojakian, a former Palo Alto mayor who became a staunch suicide-prevention advocate after his college-aged son died by suicide in 2004, criticized a preliminary report released by the CDC last July as too broad and even counterproductive. But on Friday he said he was pleased to see a more extensive, useful final report.
The report addressed the phenomena of suicide contagion (the CDC said that there is "limited scientific evidence supporting the hypothesis that suicidal behavior is contagious" and given that, the term should be used with caution) and clusters and included information about hospitalization rates, among other data points, he noted.
Now is a time to redouble evaluation efforts, Ojakian said, to carefully examine what's working and what isn't at both the county and local level. The report recommends continuous evaluation to better understand if programs and policies are actually changing behavior and reducing youth deaths by suicide.
Local health care providers said they were heartened to see gaps and at-risk populations they are already working to address given visibility in the report.
The CDC found, for example, that deaths by suicide were more common among 20-to-24-year-olds in Santa Clara County. Michael Fitzgerald, director of mental health and addiction services for El Camino Hospital in Mountain View, said its intensive outpatient program for this age group is in high demand and providing critical support to an age group that, unlike high schoolers, can have weaker ties to family and peers.
Similarly, the Stanford Center for Youth Mental Health and Wellbeing is working with agencies across the county to open two youth mental-health centers that would serve 12-to-25-year-olds in need of support for everything from a bad relationship breakup to severe mental illness. Common precipitating factors among deaths by suicide in Santa Clara County included relationship problems with an intimate partner and school-related behavioral issues as well as diagnosed mental illness and release from a hospital or rehabilitation facility.
"One of the things ... that's important is the capacity to have crisis intervention support for people to have places to go in easily, even after something like a breakup ... to be able to easily walk in and get some support without it necessarily being perceived as a full-blown mental health related issue," said Steven Adelsheim, director of the Stanford Center for Youth Mental Health and Wellbeing.
The new youth centers will also help move Santa Clara County toward an integrated care model, Adelsheim said, with direct connections to primary care physicians who are ideally, as the CDC recommended, better trained to recognize early warning signs of mental distress.
The CDC report comes at a time when youth well-being collaborative Project Safety Net, formed in response to the first Palo Alto suicide cluster in 2009, is preparing to reboot itself with new leadership and a new structure. Mary Gloner, Project Safety Net's executive director, said the report's findings will inform the organization's priorities.
The report is also an opportunity for Project Safety Net to "encourage advocacy of more research" into the issues it identified, she said.
Project Safety Net plans to make available to local organizations and researchers the full data from a survey the collaborative conducted last year to provide fresh data to the Centers for Disease Control and Prevention, Gloner said. The results will also be presented in part at a forum on the CDC study on Wednesday, March 22, in Palo Alto.
At the county level, the Suicide Prevention Oversight Committee will use the report to refine its strategic plan, which addresses suicide broadly in Santa Clara County, according to Sara Cody, health officer for the Santa Clara County Public Health Department.
"It's a very well-referenced report — (there are) 175 different references and many link to recently published best practices or a single resource that will contain evidence and suggestions," Cody said. "What might be most helpful is that it's all in one place. It's like a reference document."
For some community advocates, the report's very existence is a signal of progress on a subject often stigmatized and silenced. In 2009, when Kathleen Blanchard's teenage son died by suicide in Palo Alto, she said there was a reluctance to even broach the topics of suicide and mental health.
"Now we invite the federal government in to bring expertise ... and we're open to that external, expert view as opposed to 'We know better and we can do it ourselves,'" she said Friday.
Another shift she is seeing: "The fact that we are not going to be afraid of the data."
"The data has its limits, but we will not be afraid to seek it and understand it and see where else we need data," Blanchard said.
Leaders, advocates and experts urged the community to appreciate the CDC report for what it is -- a description of a complex public-health issue with no single solution -- and as a call to action for the progress that remains to be made.
"I want people to understand that regardless of who writes what, we need to increase our level of awareness about suicide prevention and what is available," Ojakian said. "I hope the CDC report sensitizes people more. They shouldn't take the report as an end-all be-all, but the message, the takeaway for you if you're just an everyday person or a suicide preventionist like me is: We can do more."
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Any person who is feeling depressed, troubled or suicidal can call 1-800-784-2433 to speak with a crisis counselor. People in Santa Clara County can call 1-855-278-4204. Spanish speakers can call 1-888-628-9454.
People can reach trained counselors at Crisis Text Line by texting 741741.
Links below provide more resources where one can receive help:
• Resources: How to help those in crisis
• Guest opinion: How to help those in crisis
• Q&A about mental health: Local experts offer their advice, guidance
Comments
Los Altos
on Mar 4, 2017 at 12:15 pm
on Mar 4, 2017 at 12:15 pm
The CDC report found that the majority of youth who have died by suicide in our community had some form of mental illness. Families whose children are having a severe mental health crisis often have no where to get their children help. These children require immediate hospitalization. There is no hospitalization at all for children under 14 years of age in our county. Hospitalization for youth 14 to 17 is now available for youth (except those with co-occurring medical needs or special needs) at San Jose Behavioral Health. However, SJBH is at the intersection of 85 and 101, the southern part of our county. Not at all easily accessible during commute times. We should be able to take our children into any local emergency room and have them admitted to the hospital for treatment. Imagine being told in the ER that your child who is struggling to breathe from a severe asthma cannot be treated. Our children are dying because mental health hospitalization is not profitable enough for our local hospitals. The next time you are on the Stanford campus, go to the psychiatry building on Quarry Road (across from The Container Store). Stand at the entrance to the building. Turn around and you will have a great view of the new Children's Hospital. Think for a moment about how every family who has just been told that their child needs hospitalization will have this view knowing that their child will be refused care there. Some of these families will be going to Sacramento for care. We must require that our county officials and hospital administrators treat children with mental health diseases the same as they treat children who have physical illnesses.
College Terrace
on Mar 4, 2017 at 5:46 pm
on Mar 4, 2017 at 5:46 pm
As I said in the other thread on this issue, why are our schools being forced to deal with serious mental health issues? Our schools are already overburdened, in terms of resources and emotional turmoil (including our teachers).
Ken Dauber and his cohorts need to be ignored or opposed. He is driving our school district into a lost pool which will fail, in the long run.
Our schools should have to deal with a distributed curve which includes only those who do not have serious mental health issue. Those students with such issues need to be addressed by their families and outside resources, including alternative schools. We need to save our schools from the accusations of the mental health zealots.
Los Altos
on Mar 4, 2017 at 6:19 pm
on Mar 4, 2017 at 6:19 pm
Jack- Students who have serious mental health issues qualify for special education services under the law. Here's a good explanation of why school districts must provide mental health services in California: "Assembly Bill (AB) 114 changed the process by which students in Special Education receive mental health services. Previously, under AB 3632, county mental health departments provided services. However, realignment under AB 114 requires all California school districts to be solely responsible for ensuring that students with disabilities, as designated by their Individualized Educational Plan (IEP), receive the mental health services necessary to benefit from a special education program." schoolhealthcenters.org Schools receive extra funding to provide these services. Also, hospitals sometimes provide supplemental funding to schools for mental health services. El Camino Hospital, for example, funds two therapists for the MVLA district. Allowing students who have anxiety disorders, depression etc to remain in school while learning how to manage their illlnesses helps create functional adults who can contribute to society rather than be a burden upon it.
Old Palo Alto
on Mar 4, 2017 at 9:25 pm
on Mar 4, 2017 at 9:25 pm
@Jack - two problems with your "solution"
A) you would, over the course of 4 years, exclude about 25% of the student body. That is roughly the prevalence of mental health issues among teens. This is both impractical, unfair, and deeply prejudice against mental illness . It is an illness, don't make it a life penalty.
B) most of these kids go unnoticed, and are underdiagnosed. In fact, if we could find them, treatment is successful. Far more successful than, say, shunning. Or whatever it is that you are suggesting.
So not only is your suggestion unworkable, it is also unfair. And deeply disturbing.
College Terrace
on Mar 5, 2017 at 10:47 am
on Mar 5, 2017 at 10:47 am
"Assembly Bill (AB) 114 changed the process by which students in Special Education receive mental health services. Previously, under AB 3632, county mental health departments provided services. However, realignment under AB 114 requires all California school districts to be solely responsible for ensuring that students with disabilities, as designated by their Individualized Educational Plan (IEP), receive the mental health services necessary to benefit from a special education program"
This is exactly what I am talking about. Mental health activists lobby Sacramento to mainstream their kids in public schools...and the schools are forced to take on the burden. One of my kids was deaf, and I sent him to a special school for the deaf...I did not demand that his public school provide a sign language interpreter for him in every class...he did well there among other kids who shared his disability and could accept and understand him. Kids with serious mental health issues should be placed in alternative schools with peers who can understand their issues...they should not take away school resources from mentally healthy kids. I know two teachers at Paly, and they are overstressed by the pressure put on them to comply with special efforts for mentally ill kids...they tell me it gets resolved by taking away resources from normal kids.
It is time that our public schools be allowed to focus on the vast majority, not the special minority with a loud lobby.
Los Altos
on Mar 5, 2017 at 11:49 am
on Mar 5, 2017 at 11:49 am
Jack- Deafness is a low-incidence disability while 30% of high-school aged students in California report having depression-related feelings and 10.2 out of every 1,000 15 to 19 year olds in Santa Clara County were hospitalized for a mental health issue in 2015. (kidsdata.org) According to the National Institute of Mental Health, "In 2015, an estimated 16.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year. This number represented 6.7% of all U.S. adults." Serious mental illnesses such as major depressive disorder are treatable conditions. My 20 year old son is a pleasant, responsible college student. His employer last summer said my son was their hardest working employee. He attends church and is actively involved with the young adult group there. He also happens to have major depressive disorder for which he has an active treatment plan. Public schools are schools for the public, which include children who have mental health challenges.
Leland Manor/Garland Drive
on Mar 5, 2017 at 1:57 pm
on Mar 5, 2017 at 1:57 pm
My SON was extremely hard of hearing due to poor medical care during birth and his first four years of life.
He was treatedABOMINALY by the schools where we lived previously.
It was better in PA Elementary Schools, but by middle school, the teachers and special ed staff had NO patience with him. It was WORSE at Paly!
College Terrace
on Mar 5, 2017 at 3:13 pm
on Mar 5, 2017 at 3:13 pm
@ AHEM,
I think your anger at PAUSD is misplaced. Your son needed YOUR special intervention...and those resources are available.
Another thing, to those who want PAUSD to be all things to all kids: One of my sons (I am a father to three sons and two daughters) was impaired by things doing with math/arithmetic. He was slow in that area. I was spoken to by one of his math teachers, and he suggested that I try to get him into special ed., so that he could get extra time for tests, etc. I ignored the advice, and just loved him and told him to try his best and to accept failure, as it comes. He basically did that, and yet developed other aspects of his personality, including his ability to convince people to buy into his business opportunities. He is now quite well off (muli-millionaire), and has become very adept at computer programming and algorithms AND the underlying math!).
Parents: Please tell your kids its OK to fail! It is an opportunity get off the mat and learn something in a different way. I think much of the 'depression' among kids in this area is due to parents who insist upon success by their kids.
Southgate
on Mar 6, 2017 at 11:31 am
on Mar 6, 2017 at 11:31 am
The report is disappointing. It confirms what we already knew, that the teen suicide rate in Palo Alto is far too high and way beyond the national average, but then it attributes the suicides to "mental illness." Does this mean that mental illness among teens in Palo Alto is also well above the national average? And if so, why?Furthermore, the teen suicide metric only measures those who went over the edge, and not how many teens are too near to the edge.
The problem with this narrative is that it lets the community off the hook. The cure is better schools, better train crossings, better mental health facilities. The Price of Privilege by Dr. Levine, a 25 year child psychologist in Marin County, provides a far more complete answer of what a highly materialistic society which prizes success above all else, does to our children and ourselves.
The fruit never falls far from the tree. Now is the time to consider how we can make Palo Alto a healthier, more compassionate, supportive and caring community where every child feels self worth and value regardless of talent, IQ, GPA, or parental net worth, and desires to help one another.
Old Palo Alto
on Mar 6, 2017 at 1:35 pm
on Mar 6, 2017 at 1:35 pm
@AHEM: Students with special needs should be at private schools which are smaller.
@Jack: Obviously, since your son is a multi-millionaire, he was at Gunn decades ago. Things have changed. There is no room for failure because UCs require 3.75+ GPAs. Our students can no longer enjoy life because they have to build their resumes, take a few Advanced Placement classes, and complete large amounts of difficult homework. The athletes? They sacrifice their grades.
I agree that the report is disappointing. They are telling the public not to worry if their child has no mental illness. Suicides can be due to the environment too: parents and the schools are part of the environment. There are hundreds of students on the edge. I wish the parents would wake up, but they are too busy trying to pay the mortgage or rent.
College Terrace
on Mar 6, 2017 at 1:56 pm
on Mar 6, 2017 at 1:56 pm
@ Sarah,
The son I mentioned graduated from Paly in 2004. He played athletics. He took no AP courses. He got a B+ grade point, went to JC for two years then transferred to a UC (4 year college). Graduated with a business economics degree. He started at the bottom in a large firm, and worked his way up to M&A dept. Then he went out on his own to advise start ups on the 'buy' side of the equation (and what they need to do to focus their pitch to VC); he also made the handshakes and introductions and found the sources; he gets paid a percentage when both sides are happy (by agreement in their contracts). He works on his business relationships, and it shows.
Yes, lots of homework at Paly, but not impossible. Our family rule was: Family meal together, then homework; no TV or computer screens until after that.
Old Palo Alto
on Mar 6, 2017 at 2:24 pm
on Mar 6, 2017 at 2:24 pm
@Jack: Thanks for the inspiring story; it's great to read success stories. If it were acceptable for everyone to attend JCs, then there would be no stress here because GPAs don't matter, no need to take AP classes, and no need to study for or take the SAT/ACT, no need to build the resume with volunteer work or extracurriculars. So it's a good, stress-free route.
But why should our students have to take that route when they are ready and anxious to fly from the nest after high school? Those students from across the nation who attend 4-year colleges are not working nearly as hard as are students are. When the students want to attend 4-year colleges (not necessarily top UCs, but names that people have heard of) then it's stressful for our children. Bypass all the stress by staying at home for two more years and attending JC.
Barron Park
on Mar 6, 2017 at 2:40 pm
on Mar 6, 2017 at 2:40 pm
Has the issue of splitting JLS in half - so that half the kids go to Paly and half to Gunn ever been explored as a policy that does not support, and can chip away at, the emotional well-being and safety net of JLS kids? Has the survey data regarding JLS kids been examined to see if there's a statistical difference vis a vis Terman and Jordan kids? In my experience, it was hard for my kids to experience that divorce, as there is true merit to being with the same kids K-12. We all know that, and Jordan and Terman parents and kids get to experience the joy and strength of it. As a solution, I've thought that all JLS kids who had previously gone to El Carmelo and Fairmeadow could go to Paly, and all from Palo Verde and Hoover could go to Gunn. Or some such thing, to be worked out to include Ohlone as well, being a choice school, like Hoover. Yes, new cross-elementary friendships are formed in middle school. But for many kids those earliest friendships are pure mental-health gold.
Old Palo Alto
on Mar 7, 2017 at 7:34 am
on Mar 7, 2017 at 7:34 am
@Jack - you don't explain how this shunning would work.
Most of the mental illness is depression and anxiety which go undetected. So how will you find and deport these students? Answer: you can't.
Also, much of the mental illness is temporary- a depressive episode triggered by the unusual stress of our schools or a personal issue. Often when treated properly becomes manageable. So will you shun students who have a bad quarter? Answer: no. It is actually impossible to find an alternate school and enroll and transfer within this timeframe.
And what jackass would separate their child from their friends during a depressive episode? That just makes things worse.
So your plan remains unworkable, seems even more deeply disturbing, and is still unfair.
another community
on Mar 7, 2017 at 10:01 am
on Mar 7, 2017 at 10:01 am
I agree with Unfathomable. I am a film producer who is using media to help kids figure out their purpose in life. Just yesterday, I saw a kid that I've known for over twelve years. He was sleeping, homeless on a bench in midtown Atlanta. During his high school years, he was an honor student and a great basketball player. Approaching 12th grade, his sister (best friend) was suddenly killed in a car accident; during the same season, his mother went through a divorce. Because of depression, he did not finish school and could not find a job. I was very troubled after seeing him and thought there must be something that I can do to help him. At minimum give food.
I was in Palo Alto last week interviewing leaders for my TV series and I heard about the suicide issue. The hope that comes from an inspirational story can change a child's life. Silicon Valley has a reputation that's moving them further away from upholding humanitarian values. The pressure to perform, excel and create the next piece of great technology could be the problem. Perhaps the answer lies in helping our youth to dream and encourage them to discover/BE themselves.
College Terrace
on Mar 7, 2017 at 10:28 am
on Mar 7, 2017 at 10:28 am
@ Unfathomable: It is not the schools' responsibility to take care of kids unusual emotional or mental health issues. That goes to the parents, outside influences (like friends, coaches, counselors, psychiatrists etc.). It is hard enough for the schools to herd the cats and make the day rational. PAUSD is facing cuts, not gains in property tax revenues...and this means cuts in resources to the students. The mental health activists are piling on, at the expense of the vast majority of our kids. It needs to end.
Old Palo Alto
on Mar 8, 2017 at 7:02 am
on Mar 8, 2017 at 7:02 am
@Jack - in many cases(most) it is the school environment that is causing the anxiety and worsening the depression.
The workloads, loss of sleep, and constant judgment and intimidation by staff MAKE the mental heath crisis.
That is why psych facilities are empty over summer. Schools have been built for the adults running them, not for the students.
I can guess you response, but in my opinion given schools are a major country, they have a responsibility to help solve the problems they create.
Better still if they didn't create the problems in the first case, but that seems pretty remote.
Old Palo Alto
on Mar 8, 2017 at 7:05 am
on Mar 8, 2017 at 7:05 am
Auto fails
*given schools are a major contributor *
(Not country)
College Terrace
on Mar 8, 2017 at 7:30 am
on Mar 8, 2017 at 7:30 am
@ Unfathomable: Perhaps school vouchers are the best way to go. Then parents can choose the style of school that works for them (e.g. no homework allowed, snowflake high, etc.). But normal pubic schools should not be burdened by the demands of the mental health zealots. Oppose Ken Dauber and his overreach.
Kids need to be raised to develop resilience, which means they need to experience failure early on, then their small victories will have meaning to them. Way too many kids in this area are overprotected by their parents.
Southgate
on Mar 8, 2017 at 7:49 am
on Mar 8, 2017 at 7:49 am
The CDC failed to do its job. The report simply confirmed that Palo Alto's teen suicide rate is far above the national average, and it indicated that in many cases "mental illness" was a factor.
Does this mean that "mental illness" among teens in Palo Alto is far above the national average? They did not say, nor did they go the next step to explain why, if this were the case.
At this point shouldn't CDC have called in a team of sociologists to determine the root cause of excessive "mental illness" among teens?
It is a gross leap of assumptions to conjecture that the schools are the root cause of excessive suicide and mental illness among teens in Palo Alto. In my experience extreme academic pressure is the norm in all of the best schools across the country, but these teen suicide rates are not. So, perhaps it is not the pressure, but the emotional and academic support or lack of support our community is giving these kids. Do they have an environment where they can succeed or where the deck is stacked against them? Are their classmates friends, or merely classmates and best case, colleagues? What do we do to give these kids a sense of belonging, and of being a part of something bigger than themselves. Are we encouraging them to look out for each other, or just for themselves?
There is another way. “Everybody can be great. Because anybody can serve. You don’t have to have a college degree to serve…. You only need a heart full of grace. A soul generated by love.” Martin Luther King