Editor’s note: This is the second of a two-part series examining suicide in rural Colorado.
EDWARDS, Colo. — Walking through the halls of Battle Mountain High School in this small town 14 miles west of Vail, Saphira Klearman stopped and pointed to a flyer on the wall.
“That’s what we’re doing,” she said.
The flyer promoted Project We Care Colorado, which 15-year-old Klearman and several of her classmates launched in August. The program aims to provide education and peer support for students struggling with suicidal thoughts and other mental health issues. Klearman’s typical day doesn’t include a lot of sleep — she squeezed in an interview with a reporter one day this month between her 12-course schedule and a suicide prevention event in the evening.
“This is my passion; this is what makes me happy,” she said.
Klearman knows severe depression first-hand. Last year she was sexually assaulted, and the trauma festered. She started cutting herself, and shortly after Christmas, she made a plan to kill herself.
“I was really close to doing it, and I think I freaked myself out too much,” she said. Occasionally, she pulls her sweatshirt sleeves over her hands, covering the multitude of bracelets around her wrist. Bracelets that cover scars.
But then last spring, after Klearman started interviewing her peers as part of a mental health survey by Eagle County Department of Public Health, her mindset shifted. Instead of feeling overwhelmed by her struggle, she felt driven to help others.
In addition to Project We Care Colorado in her hometown, Klearman is working for change at the state level. She’s part of a wave of Eagle County leaders taking the suicide prevention fight into their own hands, setting an example for the rest of Colorado.
The mountain county, with a year-round population of under 55,000 and an economy based on tourism and service industries, lost five people to suicide in 2016; in 2017, it lost 13. So far in 2018, 17 people have committed suicide, according to the Eagle County Department of Public Health — including 12-year-old, Olivia Ortega, who died in February.
The Roaring Fork Valley around Vail and Aspen has been shaken by suicide for quite a while, “but in Eagle County, it was Olivia,” said Michelle Muething, director of the Aspen Hope Center, a mental health crisis center that serves Eagle County. “They said, ‘No more.’”
Since 2017, the county has passed an innovative marijuana sales tax dedicated to increasing mental health services, created new mental health curricula for schools and is pushing a suicide-prevention agenda at the Colorado General Assembly.
Higher rural suicide rates across all ages
Colorado has the ninth-highest suicide rate in the nation, and rates are disproportionately high in rural and mountain towns, as Part 1 of The Colorado Independent’s rural suicide report outlined. Geographic isolation, loneliness, absence of extended family, economic stress, lack of mental health services, greater access to guns, and a western go-it-alone ethos all contribute.
The rural-urban disparity holds true for youth populations. In the past 15 years, the state’s least populated counties lost young adults aged 15 to 19 at a rate of 20 per 100,000 people, while urban counties lost 14. It was the same for people aged 20 to 24 — rural counties lost 31 people per 100,000 population; urban counties, 21, according to a Colorado Independent analysis of Colorado Department of Public Health and Environment data.
The cause of the increased suicides among youth isn’t clear. Almost a third of Colorado high school students said they consistently felt sad or hopeless in 2017. Seventeen percent said they had considered suicide, and 7 percent reported making at least one suicide attempt in the past year, according to the Office of Suicide Prevention’s 2017-2018 annual report.
Those numbers tripled for youth who identify as lesbian, gay, bisexual, transgender or queer — 63 percent reported feeling hopeless, 45 percent said they had considered suicide and 20 percent said they had attempted suicide, the report said. Transgender youth and teens of Hispanic origin are among the most at risk, reporting suicide attempt rates of 33 percent and 11.3 percent within the last year, respectively.
“If you pull a group of kids together and say, talk to me about what you see amongst your friends, they all talk about anxiety, depression, bullying and wanting to fit in,” Muething said.
Teens and preteens struggle to cope, Muething said. Some cut themselves in the belief it brings temporary relief from anxiety or emotional numbness. The wounds are sometimes superficial, sometimes serious enough for medical attention. They might take a bottle of Tylenol, thinking of it as a painkiller — a way to numb themselves — not realizing how fatal the drug can be over the long term. They might not have support at home or their parents don’t know how to help a struggling teen.
“It takes a tragedy for people to wake up,” she said.
Eagle County funds more mental health care
Last year, Eagle County’s mental health-dedicated marijuana sales tax brought in $400,000, and the Board of County Commissioners provided $500,000 more. The move started a trend — in 2018, 10 more counties approved similar mental health-focused measures.
Some of the money has gone toward establishing a licensed crisis stabilization unit to treat people who need temporary emergency care and 24-hour supervision, operated by the Aspen Hope Center. Money has also been allocated for more mental health counselors in schools.
The Eagle County School District also has been writing a mental health curriculum, starting from scratch, that will be finished in January.
“Schools and districts are definitely understanding that [mental health education] is important work,” said Katie Jarnot, assistant superintendent of curriculum and instruction for the school district. Statewide, “it is definitely getting attention.”
The need seems clear. Youth suicides are climbing in Colorado and nationally. For 10- to 24-year-olds, suicide was the leading cause of death in Colorado in 2016. Nationally, suicide is the second-leading cause of death for that age group.
Eagle County’s mental health curriculum, the first of its kind in the county, will give teachers ready-made ways to integrate mental health education into every class, along with support from counseling staff. The major benefit is that now, teachers will be able to measure outcomes, test curriculum effectiveness and see student progress.
“It’s as important as teaching all of the core subjects, because if kids aren’t mentally healthy, they can’t learn,” Jarnot said.
Action at the state level
Eagle County’s efforts could have statewide impact. State Rep. Dylan Roberts said Klearman came to him and suggested Colorado adopt a mental health education bill modeled after one in New York. The first-of-its-kind legislation makes mental health curriculum mandatory in K-12 health classes.
“When she came to her representative to do a little bit more, you know, there’s absolutely no way I could say no to that,” said Roberts, whose district includes Eagle and Routt counties.
With input from Klearman, Roberts and fellow Rep. Dafna Michaelson Jenet, a long-time youth suicide prevention advocate representing Adams County, plan to introduce their bill in the first two weeks of the legislative session starting Jan. 4.
“It’s unconscionable that our youth could be dying by their own hands,” Michaelson Jenet said. “It’s our job to raise healthy youth.”
Besides adding mental health lessons to school curriculums statewide, the bill will propose two more prevention efforts: lowering the age at which kids can access mental health services without parental permission and encouraging youth-to-youth peer support resources.
Both practices have their supporters and critics.
Lowering the age of parental consent
Currently in Colorado, young people have to be 15 before they can seek mental health treatment without parental consent; this bill would lower the age to 12.
Many parents don’t understand why a 12-year-old needs or should be allowed to talk to a mental health counselor without the parents’ permission.
But by lowering the age of consent, Michaelson Jenet hopes to combat the chilling effect that can occur when a child seeks mental health help and is told that his or her parents need to be notified first. Fear that their parents will punish or criticize them, or that they’ll burden their family, might keep them from seeking help. “The kids then say, never mind, I’ll figure it out on my own,” she said. “Our 12-, 13- and 14-year-olds … are telling us that they need to have a safe space to go.”
Last year, she proposed a bill to lower the consent age to 10, but mental health and school professionals who work with children felt more comfortable with 12. “I’m hoping that we’ll be able to start tackling mental health at a younger age so that we stop losing children.”
Michaelson Jenet’s suicide prevention work started when her son, now 16, attempted suicide when he was 9 while he was at school in Denver.
“I don’t remember walking to my car. I remember the drive from Boulder being very, very long, and coming into the school and not knowing what to expect,” she said.
Her son’s suicide attempt wasn’t out of the blue — he had been depressed. Michaleson Jenet said the doctors told her not to worry, kids his age don’t die by suicide. She trusted the system and listened to them. Now, she sees it differently.
“I wish I would have believed him sooner. I wish I would have heard him better,” she said. She urges parents to advocate for and believe their children.
Klearman agrees that teens and preteens often don’t want their parents to know they are seeking counseling. “When people get their parents involved, sometimes, it makes the situation at home worse,” Klearman said. “We need a way to protect mentally ill kids from situations that are just not good, while still providing them with the ability to get help.”
Klearman knows what it’s like to have that privacy taken away.
After she was sexually assaulted, she didn’t want to tell her parents, afraid they would overreact or drive two hours to Grand Junction for mental health treatment, and she didn’t want everyone to know. But after the holidays, she told a school counselor about the assault. “And then my life blew up.”
The counselor was required by law to report the assault to police, who informed her parents.
“Because they saw my scars and because the police got involved, I had to tell them everything,” she said. “Luckily, they’re supportive, but if they weren’t, I don’t know what would have happened and it’s just … rough. It’s really rough.”
But not everyone thinks it’s a good idea to lower the age of parental consent. Teens commonly won’t confide in adults, Jarnot admitted. They think, “I don’t need help. My friends can help me, but adults can’t help me,” she said. But when adults are left in the dark, they can’t step in and give, at times life-saving, support when they need to, said Jarnot.
All Klearman knows is that teens too often feel like they’re on their own with their mental health struggles.
“It needs to change,” she said. “Something has to change.”
Another key aspect of the Roberts-Michaelson Jenet bill calls for increased peer-to-peer mental health support to combat depression and suicide.
“We are seeing that schools are having positive benefits from peer support, so why not help students along learn how to be better peer supporters?” Michaelson Jenet asked, referring to Sources of Strength, an evidence-based, youth-to-youth program in Colorado schools.
Research indicates peer counseling works at the college level, but for younger populations, it gets riskier, Muething said.
“You’re putting too much burden on young children to try to support someone,” she said. You can’t expect a teenager or even an adult who’s not trained in suicide prevention techniques — such as asking the right questions or removing weapons — “to be someone’s pillar of strength. Because if that person dies, the person who knew about it will have to live with that for the rest of their lives.”
The Aspen Hope Center does work with a junior Hope group at nearby Basalt High School, where students are taught the basics of peer-to-peer crisis work, such as active listening and risk-assessment questions; however, the training stresses bringing in Hope Center counselors as soon as possible.
Michaelson Jenet and Roberts haven’t decided whether to ask for funding for the bill.
“Getting funding for anything in Colorado is very difficult with all of the competing priorities that we have,” Roberts said. “A lot of times, from the state level, we can push departments or schools or things in a certain direction, but without money, it’s hard for us to obligate anybody to do anything.”
Last session, the legislature passed three of seven bills that addressed suicide prevention programs. One funded mental health care in jails, another disbanded a state behavioral health council, and the third set up a grant program that launched during Suicide Prevention Week in September.
The three-year grant, funded by a Senate bill, gives the Office of Suicide Prevention $400,000 to allocate to schools to meet their own suicide prevention needs.
The grant will support 19 Colorado schools and districts, nine of which are in rural areas, “a drop in the bucket in terms of coverage,” said Sarah Brummet, director of the Colorado Office of Suicide Prevention.
Michaelson Jenet and Roberts said that suicide prevention is a priority in the Capitol, but both legislators and Brummet are calling for more attention and funding.
Still, the team feels optimistic about the upcoming legislative session. State politics changed with the last election, with Democrats soon to control the state Senate, House and governor’s office, and Roberts is confident Gov.-elect Jared Polis will support suicide prevention measures.
“I think the voters elected us because this is one of the things that they want to work on,” he said.
Although she still struggles, Klearman has the same goal.
“It’s a literal necessity in my life to make sure that nobody else has to feel isolated, desperate and distraught enough to cut or kill themselves — or to have another parent understand what it’s like to lose a child.”
YOU ARE NOT ALONE
If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline
Deaf and Hard of Hearing
or the Crisis Text Line
by texting 741741