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Connections are key to preventing youth suicide across La Plata County

Widespread efforts target building relationships

Emma Harmon wasn’t planning to try to take her life when she started driving north on U.S. Highway 550 one February night in a snowstorm.

“I just felt so out of control, at that point. It was like an impulse decision,” Harmon said.

At the top of Coal Bank Pass, she could not get past the snowplows, so she pulled over and tried to kill herself.

When she woke up hours later in the hospital, she was angry she hadn’t succeeded.

“I screamed to God. I was like, ‘You have to help me. If you are not there, fine, let me die. Otherwise, you have to change my life, and you have to change it right now, ’cause I can’t do this anymore.”

A week later, Harmon found out she was pregnant with her son, Kian.

“I was like, ‘That’s it. That’s my answer. I have to get better now. I have to change, and he’s my saving grace. He’s my miracle. He’s almost 4 years old now. He was everything. Without him, I wouldn’t have changed,” she said.

Harmon was 20 years old the night she tried to take her life in February 2014. Since then, she has returned to school at Pueblo Community College and has a job with San Juan Basin Public Health as a SafeCare provider, working with the parents of young children. She is pursuing her associate degree in psychology and plans to get a master’s degree in psychology.

She has depended heavily on friends and family for support in her recovery, and goes to therapy for her borderline personality disorder.

“There is hope. I am living proof of that,” she said.

Improving the relationships young people have with adults and their peers is a key suicide prevention step, according to a Centers for Disease Control and Prevention report.

Created with Highstock 6.1.4Reports of suicidal peopleThe Durango Police Department is responding to an increasing number of reports aboutsuicidal people. These numbers reflect threats of suicide reported by officers and peopleoutside the department.15151414262636362828464621213232373748484141858536364646636384846969131131Under 2525 and overTotal201220132014201520162017050100150Source: Durango Police Department

In La Plata County, numerous suicide prevention efforts are promoting connection at school, in clubs and with behavioral health providers.

This series will explore youth suicide prevention programs and initiatives that have been successful outside the area and that have started in La Plata County. It will also explore new local ideas founded in the last year.

Young adults and adolescents represent a small percentage of those who die by suicide. However, in recent years, as more young people have died, the community has become increasingly concerned.

In May 2017, a community summit on suicide prevention hosted by San Juan Basin Public Health drew about 700 people.

Since then, agencies and nonprofits focused on preventing suicide and other risky behaviors among youths have repeatedly heard the need for greater connection.

Promoting connection requires honest and open communication about tough subjects, such as suicide, said Breeah Kinsella, interim director for Celebrating Healthy Communities.

“Things like suicide are really scary for people. It’s scary for me sometimes, but just being honest about the fact that it’s scary ... allows a young person to feel connected to the truth that you are speaking,” she said.

A local and national problem

Since 2015, 12 people younger than 25 have died by suicide in La Plata County. Five of the deaths happened in the first seven months of this year, according to La Plata County Coroner’s Office records.

Dengler Frey

“What we’re experiencing is sort of a microcosm of what’s really happening across the entire nation,” said Mary Dengler Frey, regional health connector at the Southwestern Colorado Area Health Education Center.

Nationally, suicide is the second leading cause of death for people between 15 and 24, after accidental injuries, according to the CDC.

The Durango Police Department has responded to a growing number of people with suicidal thoughts in recent years, and about 35 percent of those calls in 2017 came from people younger than 25. The youngest suicidal person the police worked with last year was 9 years old.

The La Plata County Sheriff’s Office has responded to 739 suicide-related emergencies from 2012 through July 2018.

Created with Highstock 6.1.4Suicide deathsAs the total number of suicides has risen in La Plata County, the number of those 24 yearsold and younger who have died by suicide has risen sharply in recent years221144558813131111661515151588881313111188161619191313Under 2525 and overTotal201220132014201520162017201802468101214161820Source: San Juan Basin Public Health, La Plata County Coroner's Office

Some of those calls come from Safe2Tell, an anonymous hotline promoted by local school districts that allows students to report suicide threats and other issues, such as child abuse, bullying and drug or alcohol use.

The rise in suicide reports may be attributed in part to greater awareness about the hotline, but there are other causes at play, said Kathy Morris, safety and security coordinator at Durango School District 9-R.

“I think it’s a multilayered issue,” she said.

Mental illness, depression, hopelessness, self-harm and substance abuse can all put someone at risk for suicide, said Cathrine Frank, an architect of a program in Detroit that became the basis for the national Zero Suicide Initiative.

Traumatic brain injury, an inability to sleep, physical and sexual abuse, relationship problems, bullying and a history of suicide in a person’s family are also among the factors that can contribute to a person’s suicide risk, she said.

Anxiety and depression are also on the rise in La Plata County and nationally.

Between 2010 and 2015, 33 percent more teenagers nationally exhibited high levels of depressive symptoms, and 31 percent more died by suicide, according to a 2017 study published in Clinical Psychological Science.

Bayfield counselor Amy Miglinas said she has observed a rise in anxiety and depression among students during the last 11 years. It is likely a mix of factors are contributing to the problem, she said.

“We expect a lot of our young people these days to be able to achieve,” she said. “The competition for college and scholarships, just the pressure that’s out there to be something, I think is a lot bigger than it used to be.”

She also believes social media plays a role in rising depression and anxiety.

The study in Clinical Psychological Science found a clear link between the time teens spend on electronic devices and depression.

Teens who reported spending the most amount of time on social media and the least amount of time in face-to-face social encounters reported the highest levels of depression.

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Those using electronic devices three or more hours per day were 34 percent more likely to experience suicidal thoughts or attempt suicide, the study found.

While mental health needs are on the rise, the region has a shortage of behavioral health care.

For example, those on Medicaid are more likely to face longer wait times for behavioral health care if they are not in crisis, Dengler Frey said.

Prevention efforts

In La Plata County, schools, clubs, primary care doctors, Axis Health System and Mercy Regional Medical Center are all working on suicide prevention in different ways.

Several schools have adopted Sources of Strength, an evidence-based program that focuses on social supports, such as family support, positive friends and mentors, that can help youths lead healthy lives.

Pediatric Partners of the Southwest and other medical practices are integrating behavioral health care into their medical care and screening patients for depression.

On average, about 45 percent of people who die by suicide often have seen their primary care doctor within the month before their death, according to a literature review in the American Journal of Psychiatry.

Axis and Mercy have both adopted a goal of zero suicides among their patients as the number of people in crisis has risen dramatically in the county.

The changes that both health care providers are working on to achieve zero suicides are based on a national model that has seen success elsewhere.

Teens and college students are building relationships through clubs, such as the Four Corners Rainbow Youth Center, the Communities Overcoming Depressed Youth Project and the Wellness Peer Advisory Council at Fort Lewis College.

These clubs can create safe spaces to discuss suicide and other hard topics.

Breeah Kinsella, interim director for Celebrating Healthy Communities, and her daughter, Lily Kinsella, lead a group training for a suicide-prevention guerrilla marketing campaign at the Holiday Inn earlier this month. The campaign offered an opportunity for adults and teens to form connections, she said.

Healthy Kids Colorado survey data from 2016 showed 69 percent of teenagers in La Plata County don’t feel valued by the community. A Communities that Care survey in 2017 found 74 percent of adults in the community say they are connected to teens.

“There’s clearly a gap in our community. People aren’t feeling connected,” Kinsella said.

Journey to stability

Harmon’s struggles started long before her suicide attempt. In middle and high school, she struggled with her unofficial diagnosis of borderline personality disorder. The condition amplifies all emotions, including depression.

“I hated having a mental illness, and everyone in my school knew I did. I was the freak. I was the outcast, which made it worse,” she said.

She tried many different counselors and was told repeatedly to reach out for help. But she had trouble investing in her therapy.

In 2011, Harmon enrolled at Fort Lewis College as a double major in psychology and public health, and at first, she loved it. Then in spring 2013, she fell into depression, stopped going to classes, and by the winter semester, she was dismissed from school.

Emma Harmon plays with her son, Kian, 3, at their home in the Three Springs subdivision. After Harmon found out she was pregnant with Kian, she committed to her behavioral health therapy. “If I wanted to keep him I had to change. I had to get better. I had to get stable and so I did,” she said.
Harmon said she teaches Kian to accept his feelings. She would like adults to model healthy behavior, such as talking about emotions, accepting mental illness and seeking help.
Harmon said when she attempted suicide, she felt there was no way out of her situation, no tomorrow and no more light. “I depended on my family and friends to remind that there is light,” she said.

In January 2014, she suspected she might be pregnant.

An argument with her boyfriend about the possible pregnancy prompted her spontaneous drive north on U.S. Highway 550 that snowy night. On her way up the pass, she texted several people to say that she was sorry but she was planning to kill herself, Harmon said.

“I felt like that day it was the worst day in my life, and I remember feeling so suffocated and it felt like there was no way out. There was no tomorrow. There was no more light,” she said

One of Harmon’s friends got in touch with her mom, who found Harmon on the pass in time to save her. Her mom drove her to the emergency room, where she was treated and received a mental health evaluation and outpatient care the next day at Axis Health System.

She went on to seek out her own therapist, and she felt stable for about three years before she had a relapse into depression.

But this time, she knew to seek help. She was working during the day and therapy can be expensive. So, she searched online for a different option and found Better Help, a counseling service. She pays $65 a week for the online service, and it allows her to video chat with a counselor at times that are more convenient for her. She is also interested in going back to group therapy.

She expects depression will always be part of her reality.

“I am a depressed person. I have a personality disorder, which is part of who I am,” she said.

Harmon advises those who may be struggling with mental illness to be honest with people around them about how they are feeling.

“A lot of people make mental health and mental illness super weird. It’s like they tiptoe around it, and I don’t think it needs to be tiptoed around,” she said. “I would rather people ask me questions about how I’m feeling and the thoughts I’m having.”

During her recovery, she relied on her family to love her back to life, she said.

“They brought me French fries and watched Netflix with me. I wasn’t looking for my family and friends to fix me, and I still don’t. I just I want them to come alongside me,” she said.

•••

Stephanie Allred, a mental health counselor with Axis Health System, says these actions can guide people who may be in a position to help someone struggling with suicidal thoughts or actions.

Don’t be shy: Are you worried about someone? Have you noticed changes that concern you? Tell them what you notice and ask them if they are OK.

Be informed: Counseling and substance-use treatment is health care, and people who use it get better. Know what resources and support are available.

Reduce access to lethal means: Increase the safety of those around you by securing firearms and disposing of old medications.

Instill hope: Problems in life can feel insurmountable. Any problem can be solved with the right support.

Be a role model: Demonstrate the things that keep us strong, such as balanced eating, getting enough sleep, exercising, staying connected with others and minimizing alcohol and drug use.

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