Credit: (Priscilla du Preez via Unsplash)

While a sophomore at Red Bank Regional High School in Little Silver, Iona Leslie said they were shocked when a close friend shared suicidal thoughts.

The friend “had attempted suicide multiple times before and they did not believe they would survive until their next birthday, which was a few weeks away,” said Leslie, now a 17-year-old senior at the high school, who uses the pronoun they for the friend.

“This was one of the most terrifying things that I had ever heard, because I thought I was going to lose someone who was so close to me and that I loved dearly.”

What followed was a series of interventions, Leslie said, including therapy. The episode highlighted steps taken to address suicidal ideation, which the American Psychological Association defines as “thoughts about or a preoccupation with killing oneself.”

Typically, a mix of education and quick responses to warning signs, the interventions were critical and offer a powerful lesson in how to help teens in crisis. Leslie said the interventions saved their friend’s life.

Leslie was one of many advocates, school officials and mental health professionals who testified last week at a Senate Education Committee hearing on teen suicide. The hearing was in response to a tragedy last month at Central Regional High School in Ocean County, in which a teenager who attended the school took her own life.

One common theme was the need to act fast on warning signs of suicidal intent or ideation.

Sobering statistics

A recent report from the Centers for Disease Control and Prevention said that 57% of surveyed high school female students experienced persistent feelings of sadness or hopelessness in 2021, a significant increase from 36% in 2011. Additionally, 30% of surveyed females and 14% of male high school students said they seriously considered suicide during the past year.

But even a decade before the pandemic, high school students were facing significant increases in persistent feelings of sadness or hopelessness, seriously considering suicide and attempting suicide. The pandemic only exacerbated those feelings.

In 2019, 8.9% of high school students nationally attempted suicide, according to the CDC. In New Jersey, 5.9% of high school students attempted suicide during the same period, according to the state Department of Health.

Suicidal ideation is often a symptom of major depressive disorder, said Dr. Stephanie Marcello, the chief psychologist of Rutgers University Behavioral Health Care. Marcello added that younger children, not just teenagers, are also at risk for suicide.

Most important in preventing youth suicide is for teachers and parents — or anyone who spends time with teenagers — to learn the warning signs and the risk factors, according to Marcello. They can include having a mental health disorder, using drugs or alcohol, losing a close friend to suicide, re-experiencing past trauma or abuse or having previously attempted suicide, she said.

Warning signs

As for warning signs of suicide, a teenager will more often show it in his or her behavior rather than explicitly saying it verbally, explained Dr. Jennifer Chuang, the section chief of adolescent medicine at St. Joseph’s University Medical Center in Paterson.

Chuang said warning signs she tends to look for include teenagers becoming more withdrawn, losing interest in hobbies and activities they used to be excited about and changing their sleeping and eating patterns. Other warning signs include a sudden drop in school performance and any signs of self-harm, like cutting.

Chuang said that parents, pediatricians, teachers and other professionals who work with children need to talk to their kids and, more importantly, need to listen to them.

“As adults, we like to keep on talking,” Chuang said. “But it’s really important to have an open space and to have an open ear and allow our (children) to really talk about what’s on their mind without providing our judgment and making them feel like they’re not being heard.”

Chuang added that if parents are worried that their child is at risk for suicide, they need to ask their child if they are thinking about taking their own life. “We have plenty of studies that show that by asking that does not increase a kid’s risk for suicide, but if they are thinking about suicide, then that is an opportunity that they can have intervention,” she said.

Teens talking to teens

Young adults also play an important role in suicide prevention. Teens will often talk to their friends about suicide before they talk to their parents, Marcello noted.

“It’s so important for there to be young people to tell their stories,” said A’Dorian Murray-Thomas, the founder and chief executive officer of SHE Wins Inc. who also testified at the Senate Education Committee hearing last week.

SHE Wins is a Newark-based nonprofit that works with young women in the city and surrounding area who have been affected by violence to prepare them for college, careers and community service.

 As someone who was affected by violence and feeling alone in her community when she was younger, Murray-Thomas said one of the ways she was able to transcend her loneliness was by not only having her mom and teachers in her life, but also having “peer communities” where she heard other young people tell their stories.

Murray-Thomas added that her organization is looking to get more mental health professionals to work with the girls year-round, not just when there’s a crisis.

The need for more mental health professionals statewide and the shortage of providers was also a common point of discussion during the committee hearing.

“The workforce right now, we’re averaging … about a 30% vacancy rate across the board,” said Mary Abrams, a senior health policy analyst at the New Jersey Association of Mental Health and Addiction Agencies.

That includes psychiatrists, licensed clinical social workers and peer residential-care workers, according to Abrams.

In his budget for the coming fiscal year, Gov. Phil Murphy proposed more than $86 million for a state program that will subsidize training and recruitment for mental health, substance-use and developmental-disability service providers. An additional $40 million will also be allocated to mental health providers in the state Department of Children and Families.

Encouraging career choices in mental health

“We need to provide some kind of … tuition credit or tax credit, something to help … those students who want to go into this profession,” said Sen. Vin Gopal (D-Monmouth), the committee’s chair.

“I’d like to look at all the kids that are studying this and want to go into mental health. What can we do to make their tuition easier or maybe even their first-time job here?” Gopal said. “I think that’s one way we might be able to recruit more people into this industry.”

A number of bills have been proposed in the state Legislature aimed at helping mental health professionals stay in the field. They include legislation that would create a student loan redemption program for licensed mental health professionals who provide counseling services in the state and a tuition reimbursement program for advanced practice nurses.

As for Leslie, they found help for their friend through The Source, a school-based youth services program housed within Red Bank Regional High School that provides mental health support to students, among many other services. The Source was able to provide Leslie’s friend with the resources they needed, including therapy.

“My friend didn’t even go to Red Bank Regional High School, but The Source was still able to save their life,” Leslie said.

— Graphics by Genesis Obando