After three student suicides, one Michigan school district fights back

Cedar Springs and other school districts across Michigan are facing rising stress levels among students. One solution pending in Lansing is a bill that would increase the number of school counselors, an area Michigan lags the rest of the country.  (courtesy photo)

What Michigan schools can do to reduce suicide 

  • Arm teachers statewide with mental health training 
    State Sen. Sylvia Santana, D-Detroit, introduced a bill In January that directs the Department of Education and Department of Health and Human Services to develop a course for teachers on “mental health first aid.”  

    The bill remains in the Senate Education and Career Readiness Committee. More than two dozen states already require some form of suicide prevention training for teachers and other school personnel.

  • Educate students
    After West Bloomfield High School north of Detroit endured four student suicides in four years, the school started mandatory mental health training for high school freshmen.

    The five-week program covers issues including anger, anxiety, stress, the pressures of social media and family conflict. It was created by a 1997 graduate of the school who lost his older brother to suicide.

  • Enlist students in prevention efforts 
    After two student suicides in less than a year, teens at a Seattle high school banded together in a bid to prevent suicide among their peers. The Roosevelt High School Suicide Prevention Team – some three  dozen students  – teaches classmates to recognize warning signs of suicide and encourages open discussion on issues related to mental health. It also organizes suicide prevention events and hands out “Crush the Stigma” buttons found on backpacks throughout school. Some students wear the number for a mental health crisis line on their shirts. 

  • Expand awareness of OK2SAY 
    The statewide confidential student tipline launched in 2014 is aimed at K-12 mental health and school safety.  It received 4,605 tips in 2017, an increase of 72 percent compared to 2016. That included more than 1,200 tips on suicide and nearly 1,000 on bullying. According to the state Attorney General’s office, roughly 500,000 public and private school students in Michigan have received OK2SAY presentations.

CEDAR SPRINGS—In the course of a year, the rural Cedar Springs Public Schools district, north of Grand Rapids, came to know the raw pain of suicide and loss all too well.

In August 2015, a 17-year-old rising senior at Cedar Springs High School took his own life. The following May, students on the bus to school watched in horror as they rode past an eighth-grader who had killed himself, the boy’s mother cradling his body near the roadside. Three months later, an incoming freshman committed the same desperate act. 

“It’s an issue we take very seriously,” Cedar Springs Superintendent Scott Smith told Bridge Magazine. “It is at the foundation of the work that we are trying to do in Cedar Springs.”

Since that difficult year, the district has put those sentiments into action.

Related: Michigan mother finds solace in schools' response after son's suicide

At a time when cash-strapped Michigan districts are on short mental health resources, Cedar Springs is investing $400,000 from its $38 million budget to add six mental health professionals to its staff, including three counselors and three other mental health specialists hired in 2018. They’re part of a 13-member team that also includes social workers, other counselors and psychologists that accounts for a total investment of about $1.1 million in salaries and benefits.

Officials in this district of 3,500 students say they plan to add another mental health specialist this fall.

Beyond that, the team has trained 150 teachers and staff how to spot signs of stress or trauma in students, how to support them, and when to sound the alarm for suicide risks. At the high school, additional support comes from “Peer Listeners” ‒ selected student volunteers who can be sounding boards for classmates who may not want to confide in an adult.

“It takes a team,” said Smith, the superintendent. “You can’t just do it with social workers. You can’t just do it with counselors. You need an array of skills, because this such a complex challenge.” 

Smith said investing in additional professional staff was carefully considered in an era of lean education budgets. More counselors meant less money for hiring teachers. In practical terms, investing $400,000 in mental health added roughly two additional students per classroom in the district’s elementary schools. Smith said officials decided the mental health investment was worth it.

“You ask yourself, ‘What’s the negative impact of not adding those [mental health] supports?’” Smith said. 

Rising stress, little help 

Student suicide remains a matter of urgency across Michigan; it’s the second leading cause of death in the state for those ages 15 to 24, a nearly 50 percent jump in less than a decade, state health data show. 

According to Mental Health America, a nonprofit advocacy organization, nearly 11 percent of Michigan youth ages 12 to 17 have a major depressive disorder. And yet more than 60 percent of this group receive no mental health treatment.

Related: Suicide, depression on rise in rural Michigan, but psychiatrists are scarce
Related: Suicides, often linked to opioids, spike in rural Michigan and among young

Adding to the challenge, Michigan schools have the nation’s second-worst ratio of students to school counselors, with 741 students for every counselor, according to the American School Counselor Association, which recommends a 250-to-1 ratio. A bill pending in Lansing is meant to address the shortage. 

“This a tremendously significant problem here in Michigan,” said Kevin Fischer, executive director of the Michigan chapter of the National Alliance on Mental Illness. “We are not doing nearly enough to address it.”

Fischer noted that districts far beyond Cedar Springs have felt the agony of having multiple students take their own lives. 

Three teenage students at Kingsley Area Schools, 15 miles south of Traverse City, died by suicide within eight months, most recently in February. At Grand Haven Area Public Schools, west of Grand Rapids, six students took their lives between 2011 and 2017.

And some 50 miles northwest of Bay City, two Ogemaw Heights High School students killed themselves within days last November; a third student attempted suicide.

Audra Holst

Mental health specialist Audra Holst: “Kids are dealing with higher levels of stress than we have ever seen before.” (Bridge photo by Ted Roelofs)

Fischer said he’s pressed the office of Gov. Gretchen Whitmer for a public service campaign on suicide prevention. In his view, it’s the minimum the state can do. “We need our leadership to step forward to say this is a priority for this state,” he said.

Whitmer spokeswoman Tiffany Brown said there are “ongoing discussions” regarding such a campaign, adding that the administration “understands how serious the impact is on communities and the need to do more to address the serious mental health issue in our state.”

Brown noted the state has a web with links to resources for suicide prevention.

A bill in the Michigan House would require schools to have at least one counselor for every 450 students. But it does not yet provide additional funding to meet that standard and remains stuck in the Education Committee.

With suicide levels rising nationally, other states also are taking steps to try to address the issue. Oregon, for instance, recently passed a measure that allows students to take “mental health days” in addition to regular sick days. 

Going for walks and ‘calm corners’

In the meantime, Fischer said school districts need alternatives to help students. 

Meet Audra Holst, hired by Cedar Springs in 2018 after eight years as a child life specialist with pediatric cancer and emergency room patients and their families in hospitals. The district hired two similar specialists that same year.

Suicides spike among Michigan adolescents and young adults 

Suicide among those age 15 to 24 has jumped nearly 50 percent in Michigan since 2009

2009: 9.5 suicides per 100,000 people

2017: 13.9 suicides per 100,000 people

Source: Michigan Department of Health and Human Services

While hospital and school settings are different, Holst said the psychological threads in stress and trauma are much the same.

She explained her work as we walked through a couple of school buildings just off the main street that bisects this city’s downtown. Most students in the district live in sparsely populated areas outside the city. 

“In the hospital, my job overall was to help with coping, to decrease stress for kids and families,” she said. “In school, kids are dealing with higher levels of stress than we have ever seen before.

“How do we help them navigate this in a healthy way?”

Research points to at least one prominent factor: social media.

The Pew Research Center, a Washington D.C.-based nonpartisan research center, found 95 percent of U.S. teens use a smartphone and 45 percent say they are online “almost constantly.” Nearly a fourth of those surveyed said social media had a “mostly negative effect” on their lives.

That’s reinforced by a 2017 University of San Diego study that found that students who were frequently on their smartphones were twice as likely to be diagnosed with depression or anxiety versus low users of smartphones.

National surveys also find about a fifth of high-schoolers report being bullied, abuse that can take place in school hallway, the bathroom or on the Internet.

“It’s constant,” Holst said. “Students are being bullied all over on social media. Or they might say, ‘My friends posted a party they were at and I wasn’t there.’ They are having a meltdown because someone didn’t snap them back on Snapchat.”

Stress has even filtered down to students too young in most cases to have their own phone. So last year the Cedar Springs district installed more than 20 “calm-down corners” in its K-1 building. They give an agitated child five or 10 minutes to decompress in a beanbag chair, by drawing, squeezing a stress ball or practicing deep breaths, whatever works for them. The middle school has its own calm-down zone, a small room on the second floor.

Holst says she sometimes takes the youngest students on walks. She might pause at a cattail marsh and ask them what they see and what they hear. The goal: to help children slow down, get outside themselves and reset their emotional bearings.

It’s part of a district strategy to give students themselves tools to recognize and manage their stress ‒ before it escalates. “We know the earlier we start, the more likely it is they will succeed at this,” she said.

Some students are dealing with abuse or violence in the home, neglect, divorce, a death in the family, or perhaps imprisonment of a parent. They’re factors known as ACES – Adverse Childhood Experiences – that research has found makes children more likely to be depressed and attempt suicide as an adult

Stacie Voskuil, who leads the district mental health team, recalled a troubled first-grader from this spring. The child’s mother was absent. The father was in and out of the child’s life. A counselor and a child specialist worked with the father, who agreed to seek outside counseling for the child.

By the end of the school year, Voskuil said, that child was stable and appeared much happier.

“I think we are going to see K-to-12 success for that child,” she said. “The parent thanked us.”

Michigan Health Watch is made possible by generous financial support from the Michigan Health Endowment Fund, the Michigan Association of Health Plans, and the Michigan Health and Hospital Association. The monthly mental health special report is made possible by generous financial support of the Ethel & James Flinn Foundation. Please visit the Michigan Health Watch 'About' page for more information.

In 2016, the district began training teachers, staff and fellow students how to identify and address suicide risks. That could be a student blurting out to a teacher, “ ‘I feel like I want to kill myself’,” or a student reporting that a friend was really struggling. 

The district team holds formal meetings twice a month and communicates steadily through texts and emails. It’s a deliberately collaborative practice. They also receive alerts through the state’s K-12 school tipline, OK2SAY, which allows students to report, anonymously if they’d like, suicide threats, bullying, drugs or other concerns. 

In 2017, the tipline received more than 1,200 alerts across the state on suicide and 961 on bullying.

In Cedar Springs, students identified as suicide threats are often assessed through a test that asks four similar questions, including: “In the past few weeks, have you felt that you or your family would be better off if you were dead?”

If they answer yes to any of those, they are asked: “Are you having thoughts of killing yourself right now?”

A “yes” answer to the fifth question triggers formal mental assessment by the mental health team and a possible trip to a Grand Rapids hospital emergency room for evaluation.

In 2016-17, the year following the three suicides, there were 23 ambulance transports of middle or high school students for a mental health evaluation, Voskuil said. That number fell to seven the following year and to zero in 2018-19.

“We are catching it earlier,” said Lynda Rupke, who was hired by the district in 2016 as an at-risk counselor.

“I have seen a real change from when I got here to now. The difference I’m seeing is the response from students, from our staff and from the community. Everyone is just more educated because they have to be.”

Rupke said she sees struggling students in her high school office virtually every day during the school year, some thinking their depressed feelings will never end. She refers some to therapy.

But she also sends students home with concrete steps they can take to deal with their feelings, starting with deep-breathing exercises that research has shown can calm the brain.

She sometimes advises them, “Go for a walk in nature. Get off your phone. Do things you love. I don’t care if it’s fishing, sewing, poetry, writing a letter. Something that’s active.” 

But students can also be part of the solution.

Last year, a bulletin board in the high school cafeteria had a sign noting that the No. 1 reason teens don’t seek mental health treatment is fear it will stigmatize them to their friends.

“If you support them,” the message said, “sign your name here.”

The board was filled with signatures.

Suicide prevention resources 

Call: National Suicide Prevention Lifeline, at 800-273-8255. It’s a network of more than 150 crisis centers that provides a 24-hour hotline to anyone in suicidal crisis or emotional distress.

Text: Crisis Text Line: 741741, is a national service that connects the texter with a live, trained crisis counselor 

Connect: To Michigan suicide hotlines, located in many communities across the state.

Reach out: To OK2SAY, a state-funded student safety program which allows students to confidentially report tips on potential suicide and other risks to student safety. The tips can be reported by phone, at 8-555-OK2SAY (855-565-2729); by text message at 652729 (OK2SAY); or by email, at OK2SAY@mi.gov

Communicate: People can be hesitant to approach someone showing signs of despair. But experts say getting a friend or loved one to talk openly of suicidal thoughts can save a life. 

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Comments

Matt
Tue, 07/23/2019 - 8:09am

Strange that in an age where we spend more time and money on every material thing for our kids no matter how fleeting the interest. Where parents spend uncountable hours and weekends pursuing every activity in some quest for notoriety and even celebrity for their kids(?). Kids are told and shown from the youngest ages how special and incredible they are in some bid to build their self esteem. And this is where we end up, too many aimless purposeless kids with high rates of depression and all time high suicide rates. Maybe it's not about doing more, maybe it's about doing less?

Paul Jordan
Tue, 07/23/2019 - 9:31am

I think you're on to something, Matt.
While the article points out how much time kids now are spending on their phones & social media, the article (and research) may overlook a question that might seem obvious: If they're spending that much time on their phones, what are they NOT spending time doing?
The answer, I think, is that they are directly interacting less with other people. Under those circumstances, feelings of loneliness and isolation are increased at a time of life when people are already struggling to figure out how to fit in socially with others, and trying to rely less on their relationships with parents and family.
The result can be fatal.

Paul Jordan
Tue, 07/23/2019 - 9:38am

The article illustrates how we have a situation in Michigan where school districts have to choose between having enough teachers or having a minimal level of social workers/counselors. This is like a family having to choose between buying food and paying the rent, when the fact is that you need both.
This is not a natural or inevitable situation, and it is not a situation that exists in states with high performing K-12 schools.

This is the result of decades of dominance of Michigan's government by anti-government Republicans, and the responsibility for that lies with the people that we see in the mirror every day.

Fortunately, the people in the mirror also have the power to change that!

Kathi Geukes
Tue, 07/23/2019 - 10:36am

We expect more from our kids than any other generation has...it's not about what they are given Matt...it's about the high demands placed on them from a very young age...they are never left to be just kids anymore...they always have to be better at school, faster in sports, and better looking than all the other kids....I've seen mothers dress their daughters up in outfits at 5 years old than should be thrown on the trash heap and burned!! We ask WAY too much of our kids and just can't let them BE kids. Time to back off and let them show US the way!!!!!

Matt
Tue, 07/23/2019 - 6:32pm

Kathi, I can't disagree with you ... on this. You've mis-understood my point. Is there a correlation between family income/wealth and youth suicide? I'd bet it is positively correlated . And I'd bet that suicide is fairly low on the lower end of that spectrum? But it's not that we do or do not have expectations for kids, it's what the expectations are. It is difficult to say what and how worked for my kids translates to others but we choose not to buy into the sports, fashion and academics frenzies. Just not interested in them. My kids were ... kids, not valedictorians or super jocks. They were responsible at fairly young to buy most extra stuff they wanted (cars and phones were big ones.) so they had jobs and worked and did a lot of different stuff. And didn't buy as much crap as you might think. Today they are all independent reasonably happy, and successful adults and I can't say the same for many others that went all in on this stuff. Did this make a difference? Maybe ... but in retrospect this approach (and never having cable TV or computer games) is something I wouldn't change at all and hope is repeated with grand kids.

James Anderson
Tue, 07/23/2019 - 1:25pm

Young people have always faced intense emotional demands, and many have had to do so with limited resources. Suicide isn't new, although it takes new and better documented forms. I remember a 1950s high school classmate who was killed in a car crash at 110 miles per hour. He was suicidal, and he used a car as a weapon against himself. His crash killed others. His death was not recorded as suicide.

Despite being a searching article, and painful to read, it fails for a simple reason. We need in-depth profiles of those who have taken their own lives. We sometimes get some indication of family circumstances, but we need to know such things as drug and medication usage, and patterns of abuse. A substantial proportion of suicides, as well as acute forms of outward aggression, can be linked to depression induced by the powerful drugs used to treat such problems as ADHD. Hear me clearly, please: Drugs may be part of the problem.

We can waste a lot of scarce money, if we don't reach to the deep roots of acute depression and stress. A profile of a young person who succumbed to suicide would have strengthened the article. Such profiles are scarce, and much, much needed.

Tam
Tue, 07/23/2019 - 10:59pm

"You are what you eat". Depression and nutrition are directly connected - in everyone, including our military personnel who are committing suicide every day. High fructose corn syrup is outlawed in Europe, but not in the corn producing US. Artificial sweeteners likewise. The Functional Medicine professionals, who look to causes instead of treating symptoms with drugs, are making huge headway into treating most chronic conditions including depression. Cleveland Clinic is not that far down the road. It's Institute of Functional Medicine excels at the practice of helping people become healthy instead of supporting Big Pharma. "Let food be your medicine."

Carli
Tue, 07/23/2019 - 3:02pm

Adding more counselors won’t help. Especially, 1 counselor for 450 students. Look at the suicide rates in smaller schools. Also stating suicide as “a desperate act” is poor and ugly word choice for the families and friends that are being affected right now. I understand schools want to help, but this whole article and the legislation push they are doing is in the wrong direction. Schools don’t need more counselors to “talk” to students, cause by the time the “signs” are clear it’s too late. Schools need a welcoming safe environment and support for all students. Making school a safe space because no one knows what happens to a student outside of school. The legislation push should be towards prevention and mental health programs within schools. Daily or at least weekly, not once a trimester or semester. Programs NOT telling students they are wrong to have anxiety or depression because life is so great. Programs NOT just sitting there and being talked at by a teacher. Programs that ARE interactive and explain to students it’s okay to feel that way and it does hurt but there are ways to cope and make things better. These programs can not be all the same like some recess for an hour. There has to be several different types because not all students are the same and are affected the same. If schools want to make a difference start preventing the problem at all ages not just trying to “talk” or “watch” students in high school that are being affected right now. This issue has been going on too long for schools and communities to still be so unenlightened on the discussion let alone still call the victims “desperate.” We are taught from a young age that “actions speak louder than words.” So how many more ACTIONS need to take place before schools and communities realize some counselors WORDS won’t make a difference.

***
Tue, 07/23/2019 - 6:05pm

Kids kill themselves for any number of reasons, two in the Lansing area in the past few years were because they were being picked on and called names in high school, the teasing in one case was happening on a school bus and now the bus company providing the service is in hot water because the driver is blamed for not be on top of the situation and the company accused of not cooperating like they should be in the investigation.