Communities taking frank approach after teen suicides

Lila McCain, mother of Karen Douglas, with Mayor Setti Warren (center) and schools chief David Fleishman of Newton.Kayana Szymczak for The Boston Globe/Globe Freelance

When a teenager at Newton South High School took his own life last week, the city’s third high school student to commit suicide since October, school officials addressed the tragedy directly, by sending a letter to parents a day after Roee Grutman, 17, killed himself.

“There were no indications to any of us, or to his family, that Roee was even contemplating suicide,” principal Joel Stembridge wrote.

The forthright letter, followed by an emotional community meeting this week, illustrates a marked shift from the days when suicide was spoken of in hushed tones. Now, more schools are confronting the issue swiftly and explicitly, guided by specialists who say that a frank, open discussion can help comfort and support troubled students.

“I think we know better now,” said Alan Holmlund, director of the state Public Health Department’s suicide prevention program. “We certainly recommend that schools deal with it upfront. Talking about suicide is a whole lot better than keeping it hidden.”

While schools have traditionally feared that discussing suicide could make vulnerable students more likely to consider it themselves, specialists say the concern is misplaced. In the immediate shock and grief over a schoolmate’s death, teenagers need support all the more.

“There’s no evidence that asking about it and talking about it does harm,” said Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, “And it could be critical for certain vulnerable youth.”

Between 1 percent and 5 percent of all reported suicides result from a phenomenon specialists call contagion, or copycat, suicides. Adolescents are especially vulnerable, even when they do not know each other, Moutier said.

The role of social media in circulating details about a suicide, accurate or otherwise, has also put pressure on schools to take a more active role.

“Whether or not schools are talking about it, the students are,” said Darcy Haag Granello, project director of the suicide prevention program at Ohio State University.

The influence of a suicide can be magnified when the method is disclosed, media attention is intense, and the victim is romanticized, specialists said.

“For certain groups of vulnerable students, that can become very tempting,” Granello said. “We think the best strategy is to be straightforward, but not go into specifics.”

Following two suicides in the fall, Newton created a suicide prevention coalition, and high school staff members were given mental health training. The schools are also working with a Dedham mental health care group to provide more services, including drop-in counseling for students and parents next week.

David Fleishman, superintendent of the Newton public schools, said he hopes candid discussions about mental health issues, at school and at home, will help students realize they are not alone.

“There is a stigma around suicide and mental health issues, and we believe to have these difficult discussions will begin to take that stigma away,” Fleishman said. “There are options besides suicide, and there are adults here who can help.”

In New Bedford, where four students have committed suicide in recent years, the schools have adopted mental health screening for all students, beginning in sixth grade, and refer at-risk students to counseling services. The broad effort marks a “culture change” from the past, said Heather Larkin, the assistant superintendent.

“It’s no longer taboo,” she said. “It used to be almost that if you don’t talk about it, it won’t happen.”

Larkin said she believes the system’s targeted approach has helped troubled teenagers. “We feel very strongly we’ve averted very dire situations,” she said.

In Needham, where four young people with ties to the community were lost to suicide from 2004 to 2006, the recent Newton tragedies were sadly familiar. Jon Mattleman, who directs Needham Youth Services, said that while contagion suicides are rare, the risk requires community response.

“Once there’s been a completed suicide, someone has stepped over this threshold, and someone at risk now thinks, ‘This is a possibility,’ ” said Mattleman. “When there’s a youth suicide, it’s so tragic. When there’s more than one, it’s terrifying. It’s a call for parents to have a conversation with their kids.”

The shift toward discussing suicide more openly has been gradual. Many say the pivot point was a 1999 US surgeon general report that described suicide as “a serious public health problem.”

Suicide is the third leading cause of death among 15- to 24-year-olds, and specialists say teens with mental illness can experience overwhelming depression and hopelessness.

“It’s not that they want to die,” Mattleman said. “They can’t figure out a way to go on living.”

In Massachusetts, there were 588 suicides in 2011, the most recent available figures. Of those, 73 were age 15 to 24, and five were younger than 15.

Still, many schools remain reluctant to address suicide, and others mistakenly allow students to create memorials and or make other public displays of grief, specialists say.

Massachusetts schools need parents’ permission to disclose a suicide, and many grief-stricken parents are understandably reluctant to do so. But in Newton, parents have not only acknowledged their children’s suicide, but have spoken publicly about the need for intervention.

“We need to make the kids feel safe to come forward,” Lila McCain said at a forum in October, the month her daughter, Karen, killed herself.

McCain said she has “felt a calling” to speak openly about her daughter’s suicide and believes that a candid dialogue with students is crucial.

“We need to call it what it is,” she said. “And we need to give the teenagers more of a voice.”

In the letter sent to Newton parents last week, the school provided a list of suicide prevention groups, with phone numbers, and urged parents to talk to their children.

If handled properly, outreach efforts can help troubled students realize that hope and help are within reach, experts say. “Contagion does not happen because it’s talked about,” said Roberta Hurtig, executive director of Samaritans Inc., a suicide prevention group in Boston. “Contagion happens when there is no good dialogue.”

At a community meeting in Newton this week, speakers made a point of using the word suicide instead of euphemisms. It was a decision designed to bring about a frank, open discussion, officials said.

“We’re creating an environment where people realize that talking about it is a good thing,” said Dori Zaleznik, Newton’s health commissioner. “We don’t want to glorify what happened, but we want to get people talking and make sure everyone knows that help is available.”