Suicide was the first leading cause of death for Utahns between the ages of 10-24 in 2015. National Suicide Prevention Week, held this year from September 11-16, aims to create healthy conversations about the highly stigmatized topic and raise awareness about resources available to those struggling with suicidal ideation.
A Utah Legislature bill signed this year appropriated $145,000 for youth suicide prevention in the 2018 fiscal year. This grant money will be used for suicide prevention programs for elementary school students and children served by the Division of Juvenile Justice Services, according to the bill.
In 2016, Utah was ranked seventh in the nation with 559 suicides that year, according to the 2016 Utah Division of Substance Abuse and Mental Health's Annual Report. The division calls these numbers the tip of the iceberg because they don't even begin to account for suicidal thoughts or attempts, according to the report.
HB346, signed into law in March, creates a psychological autopsy examiner position in the Department of Health and a public education suicide prevention specialist at the State Board of Education. The bill also focuses on implementing suicide prevention programs for youth.
'I think the younger that we can sort of influence folks and their development, the better,' said Kim Myers, Suicide Prevention Coordinator at the Utah Department of Human Services.
Myers said data from state-wide surveys given every two years to students in sixth, eighth, 10th and 12th grade indicate these are the ages of students as they begin reporting more and more mental health issues or suicidal thoughts.
'Waiting for high school to do this kind of work doesn't make sense,' she said.
One focus of the bill is 'peer-to-peer suicide prevention, resiliency and anti-bullying programs in elementary schools,' according to the text.
Suicide at a young age is rare but extremely tragic, Myers said.
Greg Hudnall, the founder and executive director of Hope4Utah, was involved in the creation of HB346. He said the funding for elementary school programs will be directed at creating Hope Squad programs with Hope4Utah curriculum.
Steve Smith, director of the Counseling and Career Center, explains BYU's involvement with Hope4Utah. HB346, passed in March, appropriates money for youth suicide prevention programs like Hope4Utah. (Ari Davis)
The bill appropriates $45,000 to award elementary schools grants for suicide prevention programs like Hope4Utah. It costs $500 each school year to run a Hope Squad, according to Hope4Utah's website. The grants awarded for elementary schools each school year are not to exceed this amount, according to the bill.
Hope Squads are groups of students that are trained to look out for and provide friendship and support to their fellow peers who are at risk, according to the Hope4Utah website.
'It’s all about peer to peer. That is the key right there,' Hudnall said. 'People don’t understand because we’re afraid to talk about suicide, and talking about it may be the best thing that we could do.”
Hope Squad members are chosen by their classmates. School advisors train them to look for warning signs in at-risk peers and to turn to adults for help. Members are not trained to be counselors. Hudnall described them as gatekeepers.
'What the Hope Squads do is they really start to change the culture of that school, of that community, whatever it is they’re involved in,' he said. 'It’s really granting permission to talk about it.'
Hudnall said Hope Squads have been active in Provo elementary schools for 13 years. Hope4Utah began in Provo in 2005 when Provo City School District was averaging one to two suicides a year. Hudnall worked with Provo City School District as a high school principal, student service director and associate superintendent. He implemented Hope Squads in Provo City School District schools to help solve the problem.
Hudnall said the Provo community rallied together to combat the suicide rate in schools.
“While it takes an entire village to raise a child, we believe it takes an entire community to save one,' became his organization's mantra, he said.
HB346 also allocates $100,000 in grant money to suicide prevention programs for children who have been served by the Division of Juvenile Justice Services. The state suicide prevention coordinator is to award these grants, according to the bill.
The bill allocates $85,000 for the appointment of a psychological autopsy examiner in the Department of Health as well, according to the bill's text.
The psychological autopsy examiner will, with permission from the deceased's relatives, gather information about the psychological reasons why the individual took his or her own life. The psychological autopsy examiner is tasked with working with the medical examiner to compile a database with this information that can be shared with University of Utah Department of Psychiatry and other university-based departments studying suicide, according to the bill.
Myers said it isn't clear why suicide is such an issue in Utah. She said issues with access to care because of insurance or geography — especially in rural areas — could play a role. She also said a cultural idea of rugged individualism and valuing the ability of an individual to solve their own problems could be a factor as well.
'We have what a lot of people identify as sort of a culture of perfectionism and an inability to cope with failure or disappointment that might have a role,' Myers said.
Hudnall said research has indicated that Utah's elevation may contribute to the state suicide rate as well.
Myers said it is important to put the issue into context, however.
'We’re in a part of the country that’s always the highest. We’re always in the top ten. That’s not a new phenomenon,' she said.
In the last three years, six BYU students have committed suicide, according to Carri Jenkins, assistant to the president for University Communications.
Steve Smith, the director of the Counseling and Career Center, has worked at BYU for nearly 26 years. He said there have been more suicides recently that make him think BYU is experiencing an uptick.
'We want it to be zero,' Smith said. 'Thankfully, it is a lot lower than other campuses our size.”
Smith is the advisor for the student-run suicide prevention club Circles of Hope. He has worked with Hudnall for about two years on getting Hope4Utah up and running on campus, he said.
The club began Winter Semester 2017. A few BYU students were hired to help make the Hope4Utah curriculum more college specific, Smith said. He said 10 or so students attended Hope Squad trainings each Tuesday during the club's first semester.
Smith, a psychologist, said it is important to know reaching out to people who may be suicidal and doing so has been shown to reduce the risk of an individual following through with suicidal thoughts or attempts.
Smith also said people who are suicidal see their world shrink down, like they're looking through a pinhole.
“But if somebody is there with them, that opens up their world,' Smith said. 'They can see more if somebody’s there willing to help, which is why we want to start Hope4Utah.”
Smith said students who need help can call Counseling and Psychological Services during business hours or Campus Police after business hours. There is a counselor on call 24 hours a day each day of the year.
Emergency services and counseling services are available at BYU Counseling and Psychological Services. Smith said despite long wait times, individuals in an emergency situation can be seen by a therapist immediately.
'Of the six suicides, five of them were not being seen by CAPS (Counseling and Psychological Services) folks, and so we know of them because of the community,' Smith said. 'If somebody’s in being seen by a therapist, they’re much less likely to make a suicide attempt.”
Smith said BYU wants zero suicides.
“We have had years go by with no suicides at BYU. It looked like maybe this academic year was going to be that, and then later in winter semester two folks took their lives,' Smith said. 'There’s no reason that a BYU student should take their life — no reason whatsoever. And we can help. I know the folks that are suffering believe that there is a reason, and they feel so unhappy and so sad that life feels shut down for them, but there isn’t a reason.”
Myers said while college is stressful and some find it hard to cope with expectations, school is worth it in the long run.
'We see much more suicide death in folks without a college education, so college is stressful, but education is also protective,' Myers said.
Myers said it is important counseling centers be staffed and prioritized and colleges have the resources to make sure their students can be successful and graduate.
'People can get through really hard things,' said Myers. 'We need to make sure we’re highlighting that.”