- [Narrator] "iQ: smartparent" is made possible by The Grable Foundation.

- Welcome to "iQ: smartparent".

Today we are tackling a very serious topic.

Youth suicide rates have reached their highest point since the year 2000.

We'll tell you what factors are contributing to this heartbreaking trend, and we have advice from experts so you can support teens who are struggling right now.

Stay with us for the next half hour as we talk about teen suicide, getting help, and finding hope.

(upbeat music) Welcome to "iQ: smartparent".

I'm your host, Darieth Chisolm.

Suicide is the second leading cause of death for young people ages 10 to 24, and today we're going to examine the complex set of risk factors and where families can find help.

Our first guests are Patrick and Jackie Kimmel.

They are board members at the Western Pennsylvania Chapter of The American Foundation for Suicide Prevention, and Patrick and Jackie are also parents who lost a child to suicide.

Thank you so much for being here.

- Thank you.

- Glad to be here.

Thank you.

- Yeah, and you're definitely strong advocates and educators as a result of your experience.

Can you start by telling us a little more about Jacob?

- This is always very difficult for me, talking about him, but he was a typical kid, a delightful, just an endearing young child.

He had a command of the language.

At 20 months old he was talking in sentences, and he could charm people.

As he grew older he enjoyed playing with his friends and soccer.

He was kind, he was unkind, but you know his-- - When he was younger his kindergarten teacher referred to him as her sunshine.

He really was a-- - [Darieth] Beautiful.

- Yeah, he was.

And it really, things started to change once he hit the later grades, sixth grade, middle school years.

- What were those changes, the behaviors that you were noticing?

- Actually, looking back, hindsight's always 20/20.

Maybe in fourth and fifth grade he became more quiet than he had been as a younger child.

In middle school he started to, they became a little more apparent.

He would withdraw from his friends, didn't have that social interaction that he had as a younger child.

- But did you think that was just normal teenage behavior?

- That, certainly.

- Yeah, we discussed it thoroughly.

I mean we really did think it was normal teenage angst because we had no reason to think it was anything else but that.

- So what happened when he went to college?

- I think college is a transition period, and someone that is struggling with anxiety disorders, it becomes more stressful.

So when he went away to school he, we really noticed it at that point, when he came home he didn't demonstrate that, what I call freshman euphoria, glad to be home, ready to go back.

He wasn't keeping in contact with us, and it was a concern.

And then later on we found out he wasn't attending class.

- So what we didn't realize, that he started off strong and when he was fizzling out at the end, we really think that that's when depression was just taking hold.

- But you didn't think at some point that he would attempt suicide?

- No.

- No, I don't think any parent wants to think that.

Although our kids do things, it's never going to happen.

You have to realize that and we did too late.

No, we never did until he made an attempt.

He had moved from the first university to a second university closer to home, and in that he had made an attempt on his life at that point.

- In hindsight, we know now that the things that were happening with Jacob was depression taking over.

But back then we just had no idea.

- And I would think most parents would assume that it's a part of the transition.

You're away, it's college, all of the new things.

What advice would you have for parents if they, in fact, begin to see certain signs or behaviors.

- Well certainly they have to address it, that suicide attempts or suicide is always a possibility, wherever you are, and it's part of our life now.

We never thought it would be.

But if you're concerned about your child, certainly you need to address it by talking to them calmly, and a really important part is to listen.

That's a hard skill for a parent because we're parenting, and we don't listen sometimes.

But sometimes or listening to someone that's really struggling, maybe that's that window of opportunity that they can feel that they can reach out and be helped.

Certainly if you feel strongly or you're really concerned you need to notify professionals to address your concerns.

- You wanna talk to as many people as you can.

That's the thing about suicide and suicide prevention, you need to talk to people.

You have to get past the stigma.

You can't rule anything out.

You wanna make sure you cover all the bases.

- Yeah, because you can't afford to just assume that it's just basic struggling and the angst of going away to college.

- Not exactly.

Yeah, and when Jacob was going through that, who talked about suicide?

We didn't.

And that's the whole focus, that's a big focus of AFSP, to talk about things, to get past the stigma, to open up that dialogue.

Once we open up that dialogue then we have a better handle on what we can do.

But back then we just, we didn't have a clue.

- Yeah, and with the American Foundation for Suicide Prevention, of course you've now really thrown your support and your advocacy around it, hoping to educate parents.

What are some of the things that you definitely want to make sure that parents are aware of?

- Our organization and we personally feel that suicide is definitely preventable as long as you open that conversation up.

You can't be afraid to ask those particular questions.

- Right, and you advocate for early screening as well.

- Absolutely.

- Absolutely.

When Jacob was in middle school, you know you started to notice those differences.

But we had no idea what was going on.

Again, we thought it was normal teenage angst, but we've been advocating and working with legislators on trying to develop bills that will screen students at the middle school level, 12, 14 years old, so it can be part of the regular health checkup before every school year.

Now, fortunately what's happening is, although some of the laws have been tough to get through legislators, more and more doctors we see are actually doing this screening on their own.

So I, as a parent, knowing everything we know nowadays, with all the young people we are losing, I would make sure, I would ask my pediatrician, I would ask my doctor, do you do mental health screening.

If not, will you?

Because kids, what they found out is kids are more willing to sometimes talk to their medical people.

They're willing to talk to other people more than they are their parents, simply because they don't wanna disappoint their parents or maybe they don't, maybe their parents aren't as open as they should be.

- But they're parents.

- They're parents, right.

- They're also more willing to talk to their peers if they feel comfortable doing that.

But again, the key is in any screening, is information.

- Right.

- Having a screening done doesn't mean that your child is suffering from a mental illness, but it gives you information if there are some indications that you need to go for further care.

It gives you the opportunity to have information available for the next professional.

So screenings are important.

- Extremely important.

- This topic certainly is not easy, but we do appreciate you.

- [Jackie] Well thank you.

- Talking about it and being, to support others.

- Well thank you.

- The more we talk about it, the more people can be saved.

- Yeah.

We're going to continue our conversation with Patrick and Jackie and learn more about recognizing warning signs.

But first, meet a young woman who survived a suicide attempt and hear her words of advice and comfort for other teens who are struggling.

(upbeat music) (bus engine roars) (tattoo gun buzzes) - I think getting a tattoo was therapy because all that pain and hurt that I've been through is coming out right now through this tattoo.

The tattoo hurts figuratively (gasps) but also it hurt like literally as well.

But it's just like it's over.

There's no more hurt and pain.

The reason I chose the tree was because I felt as though you have to grow from something, and regardless of where you come from and how small you are, you're able to grow.

You can still get something beautiful from it, and that's the butterflies and birds.

And I feel as though I've had to grow from where I was.

I've been thinking about taking my life for a while.

I had a lot going on with my mom, my dad, my family, stuff going on in school, but they didn't wanna help in any way, shape, or form so it's just like I just wanted to give up on life.

I took a whole bunch of pills.

It was November of 2016, Thanksgiving, and the holidays to me are the hardest, especially when you have all your friends around you who are able to go home to happy families and I don't have a happy family that I can go home to.

So it was the last day of classes, it was that Thursday, and I decided to take the pills.

But I remember I regretted it, but then after that I was just like it's whatever.

It's really whatever at this point.

I wanted to be dead.

I wanted to be dead.

In the black community nobody likes to talk about suicide, depression, feelings that are going on within the families because they feel as though that we will be judged.

I was afraid to talk because I'd be thought of as crazy, but it's okay to talk to a doctor, talk to somebody.

I remember there was a lady.

Her name was Miss Sheila at Magee-Womens Hospital, and she was like you are too beautiful to do that.

And nobody's ever said that to me before.

But it was mainly non-family that showed up for me.

They were the ones right here with me, day in and day out.

They were like the best things that's ever happened to me.

How's it look, Lionel?

He not even looking.

- With that type of situation, it's very easy for people to just leave because it feels as though this is too much for me, but that's the time they need people the most.

- Oh no, he just messed up on a line right here.

- Oh yeah, I can fix it.

- Wait, what?

(laughs) Y'all gotta stop.

That was not funny!

- I knew what Ta'Sey needed in order to be well rounded and stay instead of running.

Honestly if I would've ran, where would I be?

Where would she be?

I love you.

- I love you too.

- How does it feel?

- It hurts.

- It's just she has stuff to live for.

She's getting a college degree.

She has people that care and love her, like myself.

It's okay, it's almost done.

It's almost over.

- I'm telling you this to help other people.

There are so many black kids out here who are hurting, who probably right now want to kill themselves, but they need to realize that you can get through it.

Coming from me, you can get through it.

I've been thinking about killing myself since middle school, and now I'm a senior in college and I've still made it.

It wasn't my time to go, and it's not your time to go either.

(somber music) (gasps) It's beautiful!

- Put your head back down.

- Wow!

That's really on my back right now!

I can't believe it.

(laughs) I got the tattoo on my back because I don't wanna see it everyday.

I don't wanna be reminded of the hurt and the pain.

If you think about it, you always wanna put stuff behind you and I put the hurt and the pain behind me, literally and figuratively.

It's on my back.

It's pretty, it's beautiful, I love my tattoo, but I don't wanna look back.

I have those moments still where I don't wanna be here.

I do.

It's better to be sad and alive because you can always get better.

Because eventually you'll be happy and alive eventually.

And you'll have your moments where you're happy and alive.

Often it's the deepest pain which empowers you to grow into your highest self.

(slow, inspirational music) - Patrick and Jackie Kimmel are still with us, and we're joined with Katelyn Lamm, a volunteer with the American Foundation for Suicide Prevention.

Katelyn, thank you so much for being here with us.

- Yes, thank you.

- Let's start with this sobering statistic that says for every suicide that occurs, it's an estimated 100 to 200 suicide attempts.

That is alarming, and who's most at risk?

- So we know that there's a variety of factors that are going to contribute to somebody's suicidal risk.

And those will fall into three different categories.

It's going to be health, history, and environmental factors.

So health is going to be things like their personal mental health history, do they have a physical illness, do they have chronic or acute pain.

History is going to be things like their family's mental health or their family member that has died from suicide, a history of their own suicide attempts, or a history of child abuse.

And environmental factors will be things like loss, rejection, prolonged stress, things that are happening externally to that person.

But we know that it's going to be a variety of factors that are going to come together in a vulnerable individual.

- So let's look at the LGBTQ community.

The youth contemplate suicide three times more than heterosexual youth and are five times more likely to attempt suicide.

- So we know that there's nothing genetic or biological inherent in the LGBTQ population that would contribute to an increased risk.

But we know that their gender or sexual identity status can contribute to a lot of that environmental stress within those original risk categories.

And so that prolonged stress in their environment can contribute to that population having a significant risk so that would be a population we would wanna be looking for those warning signs in a little bit more acutely.

- And what are some of those warning signs?

- So someone can talk about ending their life, talk about being in unbearable pain, anything about methods or ways that somebody could end their own life.

Their behaviors are going to be changes from the baseline of what's normal for that individual, but that can include things like increased drug and alcohol use, giving away possessions, withdrawing from their friends and family, and their mood, again, is going to be a significant change from their baseline but increased depression, increased anger, increased anxiety.

But again, it's going to be whatever is a change from that individual, so what might be a significant increase in depression for one person could look drastically different than what it looks like in another.

- And let's bring the Kimmels back into this conversation.

And so when you were talking with other parents, and maybe they recognized some of the warning signs, what would be some of the first things that you would encourage them to do?

- Well if they recognize some of the warning signs I think one thing you want them to do, again, is to open up that dialogue with their children.

- I can't even imagine how difficult this could be for parents who need to have this conversation, but what would be the first things they should say or maybe the dialogue that they should begin with?

- I think the first thing is you say to a person that you're trying to have this communications with is I've noticed things.

I've noticed you haven't been yourself.

I've noticed there's something wrong.

- [Katelyn] The warning signs, - The warning signs.

- the change from the baseline.

You know, you've been different in X or Y.

- Right.

- And then how, what would suggest would be some first conversations that they could have?

- Well if you can get them to open up about what's troubling them, the first thing you have to do is to listen.

Let them tell their story.

You can't make judgments about it.

You have to let them talk.

They need to talk.

Most of the time they want to talk.

- Do you say directly are you contemplating suicide?

- You get that.

- Absolutely.

- That's where you get to, yes.

- If you're really concerned, absolutely.

If you're talking to a child, and that's our perspective, talking to a child, and I did have direct conversation with Jacob.

I did ask him these things, although my reaction was probably, was not the recommended approach, but-- - [Patrick] Mine either, though.

- You know, you, as a parent, you ask your children questions.

Your grades aren't so good in school so it's the same kind of conversational approach.

I'm not sure, I noticed that you haven't been in communication with your friends.

Is there a problem?

You know, as a parent you know what's missing.

Honesty, forthright, you just know that there's a problem.

Even something as simple as I feel like there's a problem.

Is there a problem?

Is there something you need to share?

That's what I would do, and that's one recommendation I would have.

- And ask are you, go ahead.

- And again, if you have that gut feeling that there's something wrong, there's nothing wrong with asking about suicide and asking directly have they thought about suicide.

And if yes, have they thought about how.

And these are terrifying questions for parents, but having those answers allows the individual to feel heard, they feel seen, and then you can take the next course of action effectively with the answers.

If you never ask the question you'll never know what is happening-- - Yeah, and on your website you have a tip sheet.

- Absolutely.

- Absolutely.

- A way to start the conversation.

- Absolutely.

- And you know, I did ask Jacob directly, but probably because I wasn't prepared for the answer, I probably didn't react the way that I should've reacted.

So it's important to maintain your calm.

- Well let's talk about that, though.

What would that look like, to prepare yourself as the listener?

- What I did was I asked him if he had ever thought about suicide.

I think this was before his attempt.

He said oh, Mom, everybody does.

And my reaction was no they don't, and that's never a choice.

And whatever I said was not the good way to answer.

It wasn't constructive conversation.

It needed to be all right, well tell me about that.

What are you thinking about?

When have you thought about that?

How are you feeling now?

Those are the better responses to that, rather than my judgmental response about no, that's not the way to answer it.

As a parent it's like you're listening to me.

I'm not listening to you, and so I can't make that point strong enough, that listening is so crucial to conversation.

- And AFSP also has an ad campaign called Seize the Awkward, which is a program, an online video program that is a similar kind of conversation coaching for young people with their friends.

It personifies the awkward silence when somebody might be concerned about the mental health of their friend, and it tells them to seize that moment and that awkwardness by asking their friend if they're okay.

So that's something that people can find online as well.

- And another thing, too, is people aren't sure who to reach out to.

Again, they can reach out to the suicide lifeline.

You don't have to be going through an immediate problem to reach out to them.

They are more than happy to talk to you about here's what I'm seeing, what should I do, what should I look out for.

- And a question that we get from people a lot is well, if I ask someone, aren't I going to be putting that idea in their head.

And we know from research that if somebody is not suicidal, the simple act of asking them the question is not going to put that idea into their head or increase their risk factors, but if we ask somebody that is on the verge of a crisis, that person not only feels seen, they feel acknowledged, they feel that someone else is seeing the pain that they're going through so we wanna encourage people to not be afraid if they have a gut feeling about those warning signs or if somebody in their life has a history of those historical factors.

We want them to ask.

It's not a scary thing.

We know that it will help.

- Yeah, so tell us about the More Than Sad program.

- So the More Than Sad program is one of a variety of the educational programs that the AFSP offers free of charge.

But this is a community-based education program that focuses on mental health and suicidal thinking in young people in a high school setting.

The program has three versions for educators, so teachers, parents, and students, and it focuses on how those individuals might express signs of mental health crisis and then how to get help.

- So let's talk a little bit about social media, especially if you could clarify for us how social media is sometimes a factor.

- Yeah, so the social media itself is evolving, and so the research around it is constantly evolving.

What we do know is that the way that individuals engage in an online platform can be really drastically different from the way that they're engaging in real life.

And so we wanna encourage people to, regardless of the positive or negative experiences they're having online, to really continue to create a community in the real world, to create friends, reach out to family, other civic organizations to really be in the world.

- What would you suggest a parent or someone who sees something that's alarming to do, a post that may be alarming.

- So we want to always encourage both teens and adults, anyone that's engaging on the platform, to look out for the same kind of warning signs that they would be expressing in a physical setting they could also be expressing either through the things that they're posting, so they could talk about ending their life.

Additionally, if someone is really engaged on various platforms and they would suddenly disengage from those completely, that would be one of those sort of changes IN baseline behaviors where we might wanna reach out.

And again, it's just reaching out, touching base, and seeing what kind of help we can get that person if necessary.

- Any final words, Katelyn, you'd like to share with us?

- No, just that AFSP has chapters in all 50 states and all of our programs are offered free of charge, and we would love for people to take advantage of any and all of those opportunities so that we can create a culture that's really educated on mental health.

- Jackie and Patrick, I have to assume this has to feel somewhat good to be able to be in support of other parents and families, doing the work that you're doing now.

- Absolutely.

We want to get the word out.

Part of the problem when Jacob was going through his struggles, we had no idea.

We just had no idea.

That's where you get back to those would have, could have, should haves.

If we knew the things that we know now, we might've been able to make a difference.

We might've been able to save Jacob.

That's why we want families to know, we want everybody to be aware of what the risk signs are, what you can do, what needs to be done.

That's what AFSP is all about.

We firmly believe that suicide is preventable.

- And you have plenty of resources online, and we'll make sure that they are available on our website as well.

- Yes.

- Yeah, definitely.

- Absolutely.

- Thank you all for being here, and thank you so much - No, thank you.

Thank you for having us.

- Thank you very much.

- Again, it's important to talk about it.

- Absolutely, and we appreciate you talking about it.

- Thank you.

- We hope today's guests have helped to erase stigmas that surround mental health so we can all recognize and support young people at risk.

Thank you for joining us, and we'll see you again next time for more "iQ: smartparent".

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