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On a February evening in 2003, while his dad fixed dinner, 12-year-old Chase Edwards hanged himself in an upstairs bathroom.
His father, Jeff Edwards of Brighton, said no one -- friends, family or teachers -- had realized Chase was not just a moody kid. In hindsight, Edwards said, the artistic boy, who would have turned 19 last Thursday, had left several clues no one connected.
"People were surprised and shocked, thinking it must have been a mistake," he said.
Michigan youths are more likely than the average American youth to attempt suicide, according to the U.S. Centers for Disease Control and Prevention. In its last survey in 2007, 9% of Michigan youths surveyed admitted attempting suicide (compared to a national average of 7%) and 27% said they had been depressed.
The Edwards family fought for a law in their son's name encouraging Michigan schools to teach about depression and suicide awareness, but it's largely unenforced -- even as federal officials say suicide is the third leading killer of teens in the United States.
In March, a federal task force made a landmark recommendation that all youths be screened for depression.
But the Edwards family and others said they believe by the time some kids get help, it's too late. They believe the conversation has to start in schools.
Little funding, few requirements hinder efforts
When Laurie Graf asks a morning health class at Tower High School in Warren Woods to describe people with mental illness, the Michigan School of Professional Psychology student nods as the teens throw out "crazy," "nuts" and "psycho."
The 30-year-old asks if she looks crazy, and two dozen heads shake no.
Then Graf reveals she's struggled with depression and suicide. The mood in the class shifts. The ninth- and tenth-graders start asking questions.
This is the dialogue that Graf, a suicide prevention counselor, is looking for.
The candid conversation at Tower High is what many Michigan mental health advocates want to have in every school, but they aren't getting it, despite what teens have revealed about their mental health in surveys given by the Michigan Department of Education.
Last year, 25% of tri-county high school students admitted that they showed symptoms of depression; 9% said they had tried to kill themselves.
Suicide is predominantly traced to depression, psychiatrists say. But advocates say it is still a struggle to convince parents and educators the subject belongs in classrooms.
"Most schools don't think it's a problem, until it's a problem," said Lanny Berman, executive director of the American Association of Suicidology, based in Washington, D.C.
Michigan's joblessness, homelessness and hopelessness fuels teen depression, and using school time for mental health education might help catch it early, said Dr. David Rosenberg, chairman of psychiatry at Children's Hospital of Michigan.
Otherwise, by the time teens look for help, they're talking about making nooses and holding guns in their mouths, said Dr. Paul Quinlan, a child psychiatrist at Michigan State University.
Only a handful of the teens in the Tower High class said they'd talked about depression and suicide with a parent. And many parents are confused, oblivious or in denial when it comes to the existence of teen depression.
Some fear suicide prevention in schools will trigger an avalanche of teen suicides. Advocates of suicide prevention education are skeptical of such a possibility.
"You can't plant the idea of suicide in somebody if they aren't suicidal," Rosenberg said.
The 2006 Chase Edwards Law encourages Michigan educators to teach suicide prevention in schools, but it doesn't mandate it -- even with school surveys showing that the percentage of depressed and suicidal teens has barely changed in Michigan since 2001.
The law goes unenforced in part because no funding is attached to it. Schools and districts can individually decide whether they'll broach depression, either through state-provided materials or through presentations like Graf's, who works with MINDS: Shining Light on Mental Health, based in Southfield.
In 2000, the Macomb Intermediate School District started working with Yellow Ribbon, a national organization that teaches kids about the signs of suicide and how to get help. Presenters hand out cards that have a plea for help written on them in the hope that teens in need will give the cards to an adult who can help.
Dakota High School in Macomb Township is trying to set up peer-to-peer counseling. Last fall, it also hosted a walk to raise funds and awareness for the American Foundation for Suicide Prevention.
Dawn Hurley, who teaches health classes at Pioneer Middle School in Plymouth, weaves discussions about depression and suicide into classes on death and grief. She talks about how sadness is normal, but prolonged sadness isn't, and how to seek help.
At Tower High, Graf said depression and suicide can be healed, like a broken bone. She rattles off symptoms, including two weeks of bad moods, falling grades, and casting off old friends for new ones.
The impact is immediate. Nearly every student raises their hand when asked whether they now know someone at risk of suicide. Their health teacher, Shannon Tonkin, asks Graf what to do if a suicidal teen tells another to keep that secret.
"You've definitely got to ruin the friendship," Graf said.
Mitchell Jowers, a 15-year-old Tower student, said he wouldn't keep silent.
"People don't want to live with the fact that ... you never see your friend again, and ... you could have prevented it," he said.
Still, kids can get lost.
Days after a seminar on the signs of suicide at Emerson Middle School in Livonia, a student tried to kill himself. Health teacher Lorraine Giorgino said she believes the student, who did not attend the seminar, had talked with friends about hurting himself. If such a conversation had been overheard on campus, she says, he would have been sent to a counselor, where his parents would have been called and a treatment plan developed right away.
The parents "were keeping an eye on him, but you can't watch kids 24/7," she said.
For suicide prevention to succeed in schools, advocates and counselors say they need supportive administrations and uniform reporting of threats.
Livonia Public Schools, for example, report any drawings, writings or jokes that hint at suicide to a state school safety database. That cautious approach is why during the 2007-08 school year, district staff reported 35 threats of suicide at Cooper Upper Elementary School and eight at Johnson Upper Elementary School.
The Free Press analyzed reported suicide threat data for every Michigan school district in 2007-08 and found four of every 1,000 Livonia students threatened to kill themselves on school property. It's the highest rate among the state's 10 largest districts and twice the rate of the next closest district. But without knowing whether other schools are as vigilant, or even report suicide threat data, Livonia schools are likely just better at reporting their data than actually having more students susceptible to depression and suicide.
Administrators can also skew data by choosing to administer a version of the MDE survey that does not include questions about sex and suicide, MDE school health and safety consultant Bob Higgins said.
In addition, the state's health curriculum, which covers everything from nutrition to anger management, has decades-old sections in need of updating, including more guidance on talking about depression, said Michigan Department of Education Safety Coordinator Kyle Guerrant.
But even if school administrations are willing to implement frank mental health discussions, parents have to agree to put aside feelings that depression doesn't exist and their child is not affected, said Rosenberg.
Sometimes, schools have to be aggressive in tackling parents' fears, as seen in Lake City Schools, near Cadillac. After six teens in Wexford and Misaukee counties killed themselves during the 2004-05 school year, Lake City Middle and High School met some resistance from parents on suicide prevention. The schools' counselor, Nicole Richardson, said they called those parents to say that their child may be fine, but if a friend isn't, their child should know how to help.
Permission slips flowed in, and suicide prevention is now part of the schools' curriculum.
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