Crestview Hills mother Karen Ruf speaks about the loss of her son J.C. Ruf to teen suicide in October 2016.
Sam Greene/The Enquirer
J.C.
Ruf, 16, was a Cincinnati-area pitcher who died by suicide in the
laundry room of his house. Tayler Schmid, 17, was an avid pilot and
hiker who chose the family garage in upstate New York. Josh Anderson,
17, of Vienna, Va., was a football player who killed himself the day
before a school disciplinary hearing.
The young
men were as different as the areas of the country where they lived. But
they shared one thing in common: A despair so deep they thought suicide
was the only way out.
The suicide rate for white
children and teens between 10 and 17 was up 70% between 2006 and 2016,
the latest data analysis available from the Centers for Disease Control
and Prevention. Although black children and teens kill themselves less
often than white youth do, the rate of increase was higher — 77%.
A
study of pediatric hospitals released last May found admissions of
patients ages 5 to 17 for suicidal thoughts and actions more than
doubled from 2008 to 2015. The group at highest risk for suicide are
white males between 14 and 21.
Experts and teens
cite myriad reasons, including spotty mental health screening, poor
access to mental health services and resistance among young men and
people of color to admit they have a problem and seek care. Then there's
the host of well-documented and hard to solve societal issues,
including opioid-addicted parents, a polarized political environment and
poverty that persists in many areas despite a near-record-low
unemployment rate.
And while some adults can tune out the constant scroll of depressing social media posts, it is the rare teen who even tries.
Then there's the simple fact they are teens.
"With
this population, it's the perfect storm for life to be extra
difficult," says Lauren Anderson, executive director of the Josh
Anderson Foundation in Vienna, Va., named after her 17-year-old brother
who killed himself in 2009. "Based on the development of the brain, they
are more inclined to risky behavior, to decide in that moment."
That's
very different from how even a depressed adult might weigh the
downsides of a decision like suicide, especially how it will likely
affect those left behind. And sometimes life is so traumatic, suicide
just seems like the best option for a young person.
Carmen
Garner, 40, used to walk across busy streets near his home in
Springfield, Mass. when he was a teen, hoping to get hit by a car to
escape life with drug addicted parents.
"Our
students are dying because they are not equipped to handle situations
created by adults — situations that leave a child feeling abandoned and
with a broken heart," says Garner, now a Washington elementary school art teacher and author. "Our students today face the same obstacles I faced 30 years ago."
After the leaves fall
November
is an especially difficult time in the Adirondack mountains resort town
where her family lives, says Laurie Schmid, Tayler's mother. As the
seasons change, the trees are bare, it's bitter cold and the small
community has shrunk after summer residents leave their lakefront
cottages.
In the weeks before he took his life
the day before Thanksgiving 2014, Tayler seemed sullen but his family
chalked it up to "teenage angst and boredom and laziness." It was likely
"masking his depression he was dealing with the last few years of his
life," she says.
As
her son moved through his teenage years, Schmid says she became less
focused on getting her son in to see his pediatrician annually, because
he didn't need shots and wasn't as comfortable with a female doctor.
Besides, he got annual physicals at school to compete on the school
soccer and track teams. Among the "what ifs" that plague her now is the
question of whether the primary care doctor who had treated Tayler all
his life would have picked up on cues about possible depression a new
doctor missed.
She
had even tried to get Tayler to see a mental health counselor, even
though finding one in their area of upstate New York wasn't easy. Once
Schmid and husband Hans settled on one, Tayler refused to go.
One
positive has risen out of the pain. There are far more resources and
awareness about mental health and the need for counseling in her area
now, thanks in part to the family's advocacy through the "Eskimo Strong"
group it started. A local counseling center even has an office at the
high school now.
Schmid
speaks to schools and parents regarding signs of depression, to
encourage counseling, and provide information for suicide hotlines and
text lines. Her oft-repeated motto is "Say Something" and "Talk to
Someone."
Mental illness also needs to be covered
by insurance at the same level as physical illness, says psychiatrist
Joe Parks, Missouri's former medical director for mental health
services.
There need to be more psychiatrists and
they also need to be part of primary care clinics, Parks said. At his
community health center in Columbia, Mo., he screens those who may be
suicidal and taught others to do it, too. Such "accountable care" was
envisioned, but not fully realized, under the Affordable Care Act.
Children
and teens who aren't covered by their parents' insurance can at least
rely on Medicaid's Children's Health Insurance Program. That's hampered
by low reimbursement rates that mean few psychiatrists accept it,
however.
So, even children who receive mental
health treatment, Parks said, may be in environments dominated by family
members with drug, alcohol or domestic abuse issues.
"Wouldn’t you expect that to increase depression in children?" he says.
Suicide chic?
If
super skinny — or muscular — models aren't enough to depress a teen,
flipping through social media feeds can prove misery loves at least
digital company.
Teens regularly post about hating
their lives and wanting to kill themselves, so much in fact that Parks
says it's almost like a competitive "race to the bottom."
On
one hand social media provides a place to vent and get advice, but on
the other hand, as Anderson said, “if everyone is commiserating over
everyone, is it really helpful?"
Because teens
are interacting in a way that isn't face to face, there’s less of a
connection, so it’s hard to understand what, if anything, to say when
someone says they want to die. Teens say they will see a post about
depression or suicide ideation and sometimes just pass it off as
relatable dark humor.
A recent post in one
Baltimore teen's Facebook feed: "Alright, so I will literally pay anyone
to shoot me in the head. Who wants a go at it? Please."
She included a smiley face emoji.
Blacks do kill themselves
Two African American preteen Washington charter school students killed themselves in the space of about two months recently, drawing attention to something not commonly thought of as a problem.
"There’s
been a lot of discussion about how suicide is potentially thought of as
a white person’s issue," says Craig Martin, global director of mental
health and suicide prevention at the men's health charity Movember
Foundation. "As a result of that, less is being done in black
communities to look at the issue of depression."
More:
There's
also a more pronounced stigma in the African American community
surrounding mental health issues. African American men have fewer mental
health issues but more serious types when they are present. And they are far less likely to seek treatment, says New York City psychiatrist Sidney Hankerson.
Then there's the trauma that comes with living amidst multi-generational poverty and addiction.
A
version of the much-publicized opioid epidemic in often-rural white
communities has plagued inner city black families since long before
Garner was a boy.
Garner
thought "normal" meant watching his mother shoot heroin and his aunts
and uncles smoke crack. "I lived with rapists, murderers and drug
dealers and gangsters," he said.
Now, his students are his motivation. They and his family remind "me I don't have to try to kill myself anymore," Garner says.
On
a Monday night, Karen Ruf went to a Bible study and J.C. took his
grandmother out for unlimited shrimp on a Red Lobster gift card. When he
got home, he talked to some friends at about 7:30 p.m. No one heard
anything different in J.C.’s voice. Karen returned around 9:15 p.m. to a
quiet house. She called for her son, no answer. She came downstairs and
found his body.
Ruf
knew J.C's death wasn’t an accident because her son left his phone
unlocked so she could find his note: “Everything has a time. I decided
not to wait for mine. They say we regret the things we do not do. I
regret it a lot.”
Schmid's son Tayler also left
something on his phone. A video suicide note that talked about the
depressive thoughts he was having.
Hans and Hansen Schmid watched it. Laurie says she hasn't been able to: "That's not how I want to remember him."
Contributing: Marquart Doty, Janiya Battle and Ashanea Parker of the Urban Health Media Project, which O'Donnell co-founded.
HOPELINE offers emotional support and resources - via text message -
in an effort to prevent suicide. Text “HOPELINE” to 741741.
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