Keith Johnson, Deseret Morning News
Kelly Sowell, 17, athlete and poet, Grand County High School, died Nov. 11, 2005
J.J. Serassio, 16, Eagle Scout, Riverton High School, died Nov. 15, 2005.Sierra Dawn Woodward, 15, sophomore, American Fork High School, died March 28, 2006.
Buried in the details of carefully worded obituaries, the tragic clues emerge.
"Sierra chose to leave this life and return to what she believed would be a better place."
Every 11 days, a Utah teenager like Sierra succeeds in taking his or her own life. With teen suicide in a leading role as a killer of Utah young people, state officials could be mounting a full-frontal attack on the problem.
In fact, the opposite is true.
Suicide is clearly a taboo subject. And to talk about youth suicide is to wade into the complicated, mysterious arena of mental health and the delicate world of teenage emotion.
This is a place few want to go.
No one wants to venture into the dark realms where Utah young people with the possibility and potential they represent meet despair and self-destruction. Virtually no one wants to explore factors that contribute to a teenager's private decision to end his life with a gun, pills, carbon monoxide or a rope.
But those who are closest to this issue say we must.
Therapists, educators, "suicidologists" and parents who have lost children to suicide say this community must begin to talk about teenage suicide in a more honest way in order to change the state's infamous reputation.
Utah leads the nation in suicides among men aged 15 to 24.
"We have too much to lose if we don't work together and speak out about this silent epidemic," said Utah first lady Mary Kaye Huntsman, who has turned her attention to the issue in recent months.
Young women are not immune. In fact, females attempt suicide three times as often as males. Males, though, use more lethal means and are four times as likely to wind up dead.
Utah also has the 11th highest suicide rate 14.3 deaths per 100,000 people in the nation over all age groups, according to the most recent data from the American Association of Suicidology.
A former surgeon general who recently spoke in Utah about suicide prevention said he was impressed with the state's warm and friendly people, said Ken Tuttle, director of psychiatry at Utah Valley Regional Medical Center.But he added, "In New York, we kill each other. In Utah, you kill yourselves."
Brandon Cannistraci, 19, big brother, died Sept. 13, 2004.
Blake Eggett, 17, flute soloist, Riverton High marching band, died Oct. 28, 2005.Martika Bate, 15, honor roll student, East High School, died Jan. 27, 2006.
The number of elderly people who take their own lives is still higher than the number of teenagers who do so, but the rate has stayed about the same since 1960, said Dr. Doug Gray, a University of Utah child psychiatrist and expert in teen suicide. Meanwhile, the youth suicide rate here has doubled, tripled and looks like it will quadruple.
"It's one thing to consider an 85-year-old person who suicides because of medical problems," Gray said. "We think of that in a very different way than when a cute 16-year-old girl hangs herself in the basement."
"It is a significant health problem among adolescents, and that's something that has a significant impact on our community," said Todd Grey, Utah's chief medical examiner.
Indeed, a Deseret Morning News investigation into this sensitive issue found suicide among teenagers causes profound repercussions in the families, schools and communities where they occur.
"It's been the toughest thing in my life," said Kerry Bate, whose granddaughter, Martika, was living with him when she took her life in January. Luckily, Bate said, he and his wife are raising three other grandchildren. The little ones are a blessing, he says.
"It gives us a reason to go on; otherwise, it would be really hard to face the future."
Bate knew nothing of his granddaughter's intention.
Neither did George and Darla Serassio of Riverton until a family member found their son in the garage, slumped behind the wheel of his red Camaro and dead from carbon monoxide poisoning.
Mike and Sherilyn Sowell of Moab knew about their daughter's depression and had searched in state and out for the perfect blend of medication, support and therapy that would help. They did not find it before their daughter hanged herself in the closet of the family's home.
"We find this happening in our homes for very different reasons, under very different circumstances," Huntsman said. "What we need to do as a community is put our arms around these kids and ask why."Research shows many more Utah young people than one might guess are hovering on the brink of the decision made by Sierra, Blake and Martika.
- One in six students had seriously considered suicide in the past 12 months, according to a Youth Risk Behavior Survey conducted by the U.S. Centers for Disease Control.
- One in eight students had made a plan to commit suicide in the past 12 months, according to the same survey.
- About 2 percent of Utah young people attempt suicide in a manner that requires medical attention.
- Almost a third of Utah high school girls felt sad or hopeless.
Author and television personality Art Linkletter addressed the issue after his 19-year-old daughter took her life:
"The word suicide is without a doubt one of the most dreadful words in the English language. People wince at the sound of it and avoid using it to describe the tragic death it implies. . . .
"And yet it must be faced squarely and discussed openly because it has become one of the leading causes of death among both the young and the very old in this country," Linkletter said.
So, with all the talk about underage drinking, of illegal drug use, dangerous behavior and car accidents involving teens, parents must be aware of a startling fact, said Michelle Moskos, one of the state's premier experts on this grim subject.
"What parents don't know is that their child is more likely to die by suicide than by all of those other factors," Moskos said. "Parents don't know that."
Blake Eggett recognized his own depression his sophomore year in high school after learning more about mental health in a class. He talked about dying and death to some friends, and one e-mailed his parents.
Larry and Barbra Eggett talked to their youngest son, and all agreed he should see the family doctor. However, the antidepressants the doctor prescribed made Blake more lethargic than he was before, and he stopped taking the medication a few months later. As his parents recall, Blake's moods seemed to get better after that. He had more energy. His ups and downs seemed like normal teenage stuff, though school remained a struggle.
If it weren't for band, where he excelled at the flute, he wouldn't have gone to school at all, according to his mom, Barbra.
But Blake pulled his grades up during the first quarter of his senior year at Riverton High School.
"It seemed to me like things were going pretty well for him," said drum major Jason Weimer, a longtime friend.
His parents often asked him how he was doing. "I'm fine," Blake would say, and Larry and Barbra Eggett wanted to believe him.
Their son ordered a new flute on eBay a week or so before he died. He was planning to go with the band to a competition in California the following week.
In other conversations, Blake talked about a future beyond high school, including a senior trip to Japan and plans for college. "It seemed like he had a purpose and an idea of what he wanted to do," Weimer said.
On Oct. 27, 2005, Blake performed during the band's fall concert. "He was just as happy as could be that night," Larry Eggett said.
But looking back, his father doesn't know if those upbeat moments were real or contrived.
"There were times when he seemed genuinely happy," said Larry Eggett. "I don't know if he really was or if he was just masking his feelings."
The day he died, Blake told his mother, who works in the school cafeteria, that he was going home sick. When she arrived at the house later in the afternoon, she found the van he drove parked outside but no sign of her youngest son. His girlfriend called saying he wasn't answering his cell phone either.
Barbra Eggett woke Blake's older brother Kevin, and the two of them searched the house. They found Blake hanging from a rope in the garage.
"Don't blame yourselves," he had typed on his computer. "I've always been unhappy and depressed. I've learned how to hide it." He closed with, "Goodbye, I'm going to die now."
A single event does not cause suicide not a bad grade, not a fight with parents, not being cut from the team. Suicide is more complicated than that. There are multiple causes. It is usually something internal.
Taking one's life often stems from intense feelings of worthlessness, loneliness and depression. The pain and anguish are too much to bear. People with suicidal thoughts feel trapped in what they perceive as a hopeless situation, and pulling a trigger or swallowing pills ends the unbearable torment.
It is the formidable task of parents and mental health experts to teach teens strategies other than self-destruction.
Deseret Morning News reporters spent three months researching this subject for a series of articles, titled "Teen Suicide: Utah's grim reality," which begins today. This series seeks to educate the public about what the Utah Department of Health calls a teenage suicide epidemic and explore factors that contribute to the phenomenon.
The series also hopes to address the blanket of silence surrounding suicide that all parties agree is at the root of the solution.
The stigma prevents some young people from acknowledging destructive thoughts within themselves. It prevents parents from seeking help for their children and even keeps the state medical examiner from properly classifying such deaths as suicides.
"We have got to do away with this stigma," says Utah Attorney General Mark Shurtleff, whose daughter has struggled with suicidal thoughts. "We need to recognize it as a problem and address it."
Easier said than done.Through dozens of interviews with young people, parents, doctors, counselors and state officials increasingly concerned about the problem, reporters concluded several important points about teen suicide in Utah:
Insurance companies and lawmakers are failing our young people in the context of this problem. Although treatment and medication for mental health concerns associated with suicide have improved, experts say insurance company restrictions have a stranglehold on preventive measures.
Ninety percent of young people who complete suicide have some form of major psychiatric disorder, although the majority are not taking medication at the time they take their lives.
Utah does not have a suicide prevention advocacy network or a crisis center, which would be a critical clearinghouse for worried adults and teenagers.
Local treatment beds for young people who are suicidal have decreased. And there is little, if any, public funding for young people up until the point of absolute crisis.
Research also uncovered some disturbing human behavior that contributes to teen suicide.
It is not known, for example, to what degree high gun ownership in Utah contributes to this issue. What is clear from counselors and psychiatrists though, is that parents are reluctant to remove guns from homes, even when advised how dangerous it is to have firearms around a young person who is depressed, bipolar or suicidal.
And today, in the warming days of April, Utahns should have particular reason for concern:
According to therapists and research, suicide rates are highest in the spring. As child psychiatrist Karen Black says: "We are headed into the manic season."
Already this spring, a Utah girl is forever lost to suicide.
On March 28 one week after the season officially arrived Sierra Dawn Woodward, 15, a sophomore at American Fork High School, died in her family's Pleasant Grove back yard.
Sierra and a friend went to her mother's workplace to use a computer that Tuesday afternoon, according to a police report. They left about 4:30 p.m. for home, and Sierra's friend dropped her off just before 5 p.m. The girl called her mother about that time to say she'd arrived home safely and was starting on her math homework.
But Sierra did not start her studies. As near as police can figure, the girl wearing a black hoodie and a baseball cap wrote three notes of apology and good-bye. In large letters she wrote "I'm sorry," on one note her mom found later in the house and "But I love you all" on another.
She text-messaged three friends with a simple, "I love you."
At some point she got her father's loaded .44 Smith and Wesson handgun from a cabinet in his headboard. Her dad told police later he didn't think Sierra had ever fired the gun or that she knew where it was stored.
Sierra took the weapon but left the soft leather gun cover on her parents' bed, and when Pamela Woodward saw the empty holster 45 minutes later, she started searching for her daughter.
It had been raining, and the ground outside was wet. Rock music was still coming through the girl's headphones when Pamela found her daughter in the corner of the yard. She tried to rouse the girl, then saw the blood and head wound.
After her funeral, someone named "Sissy" wrote a heart-breaking note on Sierra's online memorial page.
"I love you so much. I thought it was enough to save you."The Utah Youth Suicide Study, the state's most careful analysis of this issue, provides the best profile of those young people who "complete" suicide.
- 89 percent were male.
- 58 percent used firearms.
- 93 percent were Caucasian.
- 74 percent killed themselves at home.
- 63 percent had contact with the criminal justice system, and half of those had referrals for substance use, abuse or possession.
- Only 3 percent were using psychotropic medications when they died.
- Only 2 percent were active in public mental health treatment.
Why, parents ask. Why so many teenagers in Utah?
There is tremendous pressure on young people today, mental health experts say. Like the second-grade girl saddled with a bevy of extracurricular activities and 16 pages of nightly homework who recently came to the office of child psychiatrist Karen Black.
"This kid is really bright," she said. "But she looks very unhappy and is feeling pretty pressured."
There is also no question guns are a factor, experts say.
Beyond that, there are only pieces to a complex puzzle and questions.
Studies show 90 percent of young people who take their lives suffer from mental illness. Though some are on medication, most are not. Antidepressants have lowered suicide rates, according to studies in 14 countries.
But what is normal teenage angst and what is depression and suicidal behavior?
Combining mental illness with drug abuse is the deadliest of combinations. "Having both of these raises the risk another level," Gray said.
Teenage suicides are high in all the Rocky Mountain states. Is there some fierce sense of Western independence that contributes to Utah's high ranking?
Utah does rank near the top 10 suicide rates nationally, but it is misleading to say it alone has an epidemic. The Rocky Mountain states have a 30 percent higher rate than the rest of the country, Gray said, and nobody really knows why.
The Eggetts went through a litany of questions. Was it our fault? What could we have done differently?
Larry Eggett has a tinge of regret for not sharing his chocolate milk with his son the night before he died. There was one small bottle left in the refrigerator that Blake wanted to drink. His father wanted it for his lunch the next day.
The Eggetts have since come to know that Blake didn't die over chocolate milk.
"You can't play that 'what if' game," Barbra Eggett said. "If you do, you can't move on."
Margaret Jackson, who lost her son Eddie to suicide, agrees.
"Everybody goes into their little shame corner, and there is no healing for the families," she said. "There is no healing."
A highly motivated honor roll student with an ebullient personality who feeds homeless people on Sunday mornings doesn't end her life hanging in a closet. Not in a perfect world.
But Martika Lynn Canphone Bate didn't live in a perfect world. Despite her loving kindness, her laughter, her academic achievements, her beauty, the 15-year-old East High sophomore suffered inside. No one really knew her pain because she didn't share it.
Kerry and Marilyn Bate didn't hide the fact their granddaughter, for whom they had legal custody, committed suicide. A line in her Jan. 29 obituary reads:
"She hid her own vulnerabilities beneath her need to take care of others and quietly succumbed to depression over fear of failure to achieve her idea of perfection, taking her own life at the age of 15."
The Bates didn't know how much Tika was hurting. She didn't talk about suicide other than to call it something she would never do.
Tika's life began to unravel after a rocky start in a high school class that resulted in a failing grade. Her identity was wrapped up in her grades. To her family it appears that when she lost control of her grades, she lost her grip on life.
But that wasn't all she couldn't control. She couldn't control the strained relationship with her mother. She couldn't control her father's mental illness. She couldn't control the grief that came with the death of a cousin and an uncle.
"If you have several deaths in your family, it makes it look like an acceptable thing," Kerry Bate said.
Her depression really wasn't revealed until she started counseling just a few week before she died. Bate believes had she kept her head above water in therapy, her death could have been prevented.
Instead, her 14-year-old cousin Joshua, who also lived with the family, found her one Friday night. She had hanged herself in her bedroom.
As is the case with most families connected to young people who take their lives, the impact on Tika's family has been profound.
Joshua never slept in his room again. In fact the boy, who goes to therapy and is on a 10-month waiting list for grief counseling, barely slept at all until recently. "I was always thinking about her," he said.
For two months, he fell asleep in the La-Z-Boy in the living room with the television on. Three weeks ago, the family moved to a new house. Springtime. A new start.
Her grandfather is still traumatized. He thinks of the hundreds who came to Martika's funeral, the unfulfilled promise, the happiness in store if she could have just made it through the sadness.
"I don't think kids at that age know how important they are in the larger network of life," Bate said. "She thought she was just a pebble."
The state clearly has not adequately addressed the issue in the past decade. Not much has changed in that time. There is a core of dedicated Utah professionals who continue to study suicide, but money for ongoing research and prevention programs is in short supply.
"I don't think the public understands mental health issues. . . . Because of that, I don't think some kids are getting the support they need," psychiatrist Black said.
Utahns in general remain squeamish about openly discussing the problem and its complex psychological causes.
"I believe if the whole suicide issue wasn't so cloaked in secrecy," said Ray Wahl, administrator of Utah's Juvenile Court System, "then we could deal with some of these kids at the front end, instead of after something bad has happened."
Several doctors associated with the University of Utah School of Medicine participated in an unprecedented study on youth suicide on the barriers to mental health treatment for adolescents.
For the study, officials examined the suicide deaths of 49 Utah young people. They conducted 270 hours of interviews with parents and other survivors to evaluate their access to mental health treatment.The study made clear the role society's attitude plays in this problem and concluded those who died faced the following barriers for adequate mental health care:
- The belief that nothing could help.
- The belief that seeking help is a sign of weakness or failure.
- The reluctance to admit to having mental health problems.
- The denial of problems.
- The embarrassment about seeking help.
The study concluded, "It is suggested that the stigma of mental illness is a considerable barrier to mental health treatment."
Shurtleff saw this dynamic firsthand.
When the state's top law enforcer first spoke publicly and personally about better education and awareness on teen suicide, he got some advice from friends.
"Are you sure you want to be so public about this?" they asked. "This could hurt your career."
"We have this 'All is well in Zion' kind of thing going here," Shurtleff said.
"We'd rather not talk about it at all or maybe to go talk to the bishop about it," he said. "If there really is a mental health issue you need help. It doesn't work to talk to the youth leaders or ecclesiastic leaders."
Teen suicide is an odd issue for an attorney general's time, but Shurtleff has a personal stake in the topic. Her name is Danielle.
His adopted daughter deals with several psychological disorders that induce suicidal thoughts.
Dressed in black jeans, black skater shoes and a Green Day hoodie, Danielle Shurtleff exudes attitude. Her auburn hair falls lazily onto her shoulders. She can be a brawler one minute, a sweetheart the next. But the gleam in her eye suggests more puff than huff.
Thirteen-year-old Danielle says she has contemplated suicide for all kinds of reasons:
When her parents didn't listen. When her parents took a sibling's side. When her parents thought they understood but didn't. When someone was mean to her. When friends turned their backs on her. When something didn't go right.
Those are common occurrences in a teenager's life. Most might be upset or angry for a couple of days. But most aren't born with fetal alcohol spectrum syndrome. They aren't diagnosed with ADHD, depression and oppositional defiant disorder. Danielle deals with all of those. She goes through periods of inconsolable sadness and uncontrollable rage.
Shurtleff held her late one night while she sobbed, "I want to die. I want to die." On another evening, he wrestled a knife away from her during a youth activity at their LDS Church ward. He cut his hand in the process.
Danielle has learned to grapple with suicidal thoughts and come out on top. She's learned to defuse the bad thoughts that come fast and hard some days: "Why am I living? What's the point if my life is so bad? Why am I living?"
Now she can answer herself.
"If I kill myself, I won't be able to ride my dirt bike."
"If I kill myself, I'll hurt the two young neighbor kids who look up to me."
"If I kill myself, maybe my friends will think suicide is the answer."
"Maybe I should wait to see how things come out."
A regimen of antidepressants, antipsychotics and ADHD medication keep her stable. Therapy has taught her coping strategies: Stop. Think. Act. Review.
She shares some of her new techniques with her dad. Recently, the two were driving together, and Shurtleff was struggling with the complexities of his Blackberry. He was mad and ready to heave it out the window."Daddy, stop and think about this," Danielle said. "You have some choices here."
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