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Kristin Murphy, Deseret News
Students high-five Salem Hills High School Principal Bart Peery as they walk by in the high school's hallways on Thursday, May 24, 2018.

SALEM — Most students greet him with an exuberant, “Hey, Mr. Peery!” and a high-five, or a fist-bump.

A few are more reserved. Bart Peery is the principal, after all.

And one student seems to be going through a tough time.

It's the final week of the school year at Salem Hills High School, and Peery asks the boy if he’s picked up his yearbook yet. When he replies that he didn’t order a yearbook, Peery says he’ll give him one at no cost — “because I want to sign it.” But the boy shakes his head no. He doesn’t want to remember this year, he says, because “it’s been the worst year of my entire life.”

Peery nods; he’s aware of the boy and his struggles with mental health. He doesn't press.

“The ones who scare me the most are the ones who struggle silently, and I don’t know what they’re fighting," he says later.

Peery, 59, wears an assortment of colorful wristbands and Skyhawk navy blue sneakers as he roams the hallways before first period. It's his morning routine: He wakes up, prays, and goes out in search for teens in trouble.

Kristin Murphy, Deseret News
Students high-five Salem Hills High School Principal Bart Peery as they walk by in the high school's hallways on Thursday, May 24, 2018.

He keeps a list. Currently, he knows of about 60 students who are struggling with mental illness or suicidal thoughts, and statistics tell Peery he's missing upward of 100 more.

The youth suicide rate nearly quadrupled in Utah between 2007 and 2015, when 44 teens died by suicide, and preliminary state data shows 42 died in 2017 — roughly one out of every 10,000 teens. Salem Hills — a midsize school of about 1,350 students in a pastoral Utah County town — has lost four students to suicide in the past five years.

Youth suicides increased nationwide by 75 percent over the same 2007-2015 period (from 2.4 suicides per 100,000 teens to 4.2), with clusters traumatizing communities in California, Colorado, Ohio and elsewhere. But rates are unusually high in the Intermountain West, where research has shown that access to firearms and high altitude may be contributing factors.

In the most recent annual survey published by the state's Department of Human Services, nearly 1 in 5 of Utah's high school seniors reported they'd seriously considered attempting suicide in the past year. Most of those had planned how they would do it.

And 1 in 15 Utah seniors — or 2 in the average-size classroom — had recently attempted to end their lives. Peery said there have been 20 attempts at Salem Hills this school year alone.

In January 2017, the Department of Health invited the Centers for Disease Control and Prevention to study the suicide increase in Utah between 2011 and 2015, as well as Utah's leading school prevention programs. Federal researchers recommended increasing access to mental health care, reducing access to lethal means, and further vetting school prevention programs.

Later, in August, the medical examiner's office hired a full-time sociologist to examine the circumstances of recent youth suicides using what's known as a psychological autopsy.

And in January of this year, Gov. Gary Herbert created a task force — an assortment of influential legislators, business leaders, health officials and others — to propose solutions. The Legislature acted on their recommendations by bolstering staffing at crisis hotlines, creating mobile crisis outreach teams who can act like paramedics in mental health emergencies, and offering more than $2 million in grants for elementary schools to hire counselors and social workers.

But much of the burden of preventing suicide — and the heartache of failing to do so — still falls to educators like Peery, who says he’s lost more sleep over his student body’s mental health than test scores or class sizes.

Kristin Murphy, Deseret News
Principal Bart Peery high-fives Madison McNaughtan at Salem Hills High School in Salem on Thursday, May 24, 2018.

Salem Hills' mental health resources are fairly typical of those described by experts at schools both locally and nationally. It has four counselors, but Peery says they have a full load of academic responsibilities. The school’s psychologist — shared with another school in the Nebo district — is primarily tied up doing testing and scheduling for disabled students and has little chance to work with the general population.

A social worker visits the school once a week for a couple of hours to meet with students — and Peery is grateful. But the need justifies full-time assistance, he says.

“I have students in crisis here every day, and I’ve got to get some help for them,” he says.

A search for answers

Paul Dymock, a school social worker assigned full-time to Lone Peak High School in Highland, recently logged 14 entries on a single page in his daybook.

First, he met with a student who had been referred by a teacher after a sudden, significant dip in her scholastic performance.

Dymock learned the student had a mental disorder and had attempted suicide multiple times, but received no therapy, no medication, and no support, so he alerted her parents about his concern and emailed her teachers to ask that they cut her some slack on deadlines.

Next came a student stressed about family problems. Then, a teacher showed up to share her lack of progress with a troubled student, and then came a report that another student had described suicidal thoughts on social media.

He had previously been one of four roaming social workers in the 80,000-student Alpine district until he moved into a full-time role at Lone Peak's counseling center 3 1/2 years ago, a move spurred by several teen suicides in the prosperous northern Utah County community.

Nine out of 10 youths who die by suicide have an underlying mental health condition, according to the National Alliance on Mental Illness, and a recent study in the journal Pediatrics found that youths are most likely to die by suicide during the months of the school year.

Dymock's office is decorated to be a getaway from the harsh fluorescence of high school hallways, with warm lighting, dark woods and rich leathers. Dymock tells students in his lulling voice that his walls are “100 miles thick.” What is said there can only be shared with a student's permission — unless students plan to hurt themselves or others. (In those cases, Dymock is required to involve parents and school officials.)

“Tons and tons of depression,” he said. “Tons and tons of anxiety. With this generation, they don’t have a lot of good coping skills, and they’re not real resilient. So, little things will throw them into a tailspin."

Lower-risk students are handled by the school’s seven counselors. Dymock’s charge is the 1 to 5 percent of the student body who have diagnosable mental health problems and may be at risk of harm. After gauging their needs, he'll sometimes schedule a follow-up or refer them to an offsite provider.

Lone Peak has had just one student suicide in the 3 1/2 years since Dymock was assigned full time by Wasatch Mental Health, which contracts with the district. But Dymock said he’s just one piece in the school’s all-out response to crisis.

Students are funneled to his office by a wide web of staff, teachers and students. Lone Peak not only has a Hope Squad, which trains students to recognize warning signs of suicide and to refer peers to care, but also a dedicated Hope Squad class, and a community coalition that includes civic, safety and ecclesiastical leaders.

Districts experiencing a rash of suicides tend to turn to contract social workers like Dymock because school psychologists and counselors often have a full plate meeting their school's academic and disability needs.

The National Association for School Psychlogists recommends a ratio of one psychologist to every 700 students, and a representative of the Utah chapter says that while precise numbers are hard to come by, Utah's ratio is about one psychologist to 1,400 students, which is roughly the national average.

The American School Counselor Association, meanwhile, recommends a counselor for every 250 students. Utah's ratio in secondary schools is one for every 340 students, according to a January report from the State Board of Education.

Kristin Murphy, Deseret News
Beca Knapp participates in a Positive in the Present exercise, which includes writing down three things to be grateful for, during first period at Salem Hills High School in Salem on Thursday, May 24, 2018.

More than 300 Utah schools do benefit from some form of support from local mental health providers, but such resources range widely, from occasional social worker visits to full-time, school-located contract social workers like Dymock.

The Provo City School District has less than one-fourth the number of students as the Alpine district, but after seven suicides between 1999 and 2004 and 4 in the last 5 years (after nine years with no suicides), it now has 14 full-time social workers and 20 social work interns from local universities.

Kim Myers, Utah's suicide prevention coordinator with the state's Department of Human Services, wishes other districts would get on board the school-based mental health bandwagon. “Wouldn’t it be nice if we all didn’t have to experience a crisis to learn from it?”

Cathy Davis, suicide prevention coordinator for the Utah State Board of Education, said by investing in school-based mental health, schools can also improve their test scores and graduation rates, and decrease their discipline problems.

In a recent survey of 111 schools across the state, Davis asked administrators what the state can do to prevent suicide in their schools. The top response, Davis told the state board's Standards and Assessment Committee last Friday, was to provide additional counselors or social workers.

"We need boots on the ground, those that are able to be specially trained in mental health response to just these needs," Davis said.

Kristin Murphy, Deseret News
Rebecca Cromar talks about how Positive in the Present has affected her at Salem Hills High School in Salem on Thursday, May 24, 2018.

'You never think this could happen'

At this time last year, Herriman High School had never lost a student to suicide since opening in fall 2010.

Since then, they’ve lost seven — including one recent graduate.

Principal James Birch spoke to the Deseret News at his office in late May, with packed boxes occupying chairs ahead of his pending rotation northeast to become principal at West Jordan High.

“You never think that this could happen at your school,” he said.

The wounds are still fresh. One of the seven students who died by suicide had high-fived Birch the day prior.

The trauma has been especially pronounced for Herriman’s counselors and school psychologist, Birch said. Day and night, tips have come in through the SafeUT app — which Utah kids can use to confidentially refer peers or be connected to counseling services themselves — and his staff has scrambled to prevent another tragedy.

Kristin Murphy, Deseret News
At Salem Hills High School in Salem on Thursday, May 24, 2018, Principal Bart Peery keeps a ceramics piece on his desk that was given to him by a student who committed suicide.

Of nine counselors, one had retired, two had taken other jobs and two more were looking, Birch said.

“I put my arms around them and tell them that, ‘You’re doing a great job, and you need to understand that I have full confidence in you, and it wasn’t your fault. Do not punish yourself for it.’

“And it’s easier said than done, obviously. I have people do the same thing to me, and you still — you know, inside — wonder what you could have done different.”

It’s been hard on Herriman’s nascent Hope Squad, too. Its members were especially dejected when the seventh student died in early May, Birch said, so he arranged a meeting with counselors so they could hear about the dozen or more crises they had resolved by referring their peers.

“They had no clue,” he said.

Birch printed a handout that describes all the measures Herriman has taken to prevent suicide since the start of the year. It's three pages, single-spaced — everything from decorating the hallways with positive messaging and giving students T-shirts telling them they're "Worth Gold" to free counseling and crisis intervention from the Jordan Family Education Center.

Next year, Herriman will start a full-time Hope Squad class, like the one at Lone Peak, and launch new student groups to both promote student health and inclusivity.

The Jordan School District is also hiring for a new health and wellness specialist who can specifically target suicide prevention, intervention and response, as well as bullying.

“They’re doing everything they possibly can,” said Scott Poland, a former prevention director for the American Association of Suicidology who presented at Herriman in April and plans to return in August.

But Birch, like Peery, has also asked for a full-time social worker to take the pressure off administrators and counselors.

Kristin Murphy, Deseret News
Principal Bart Peery high-fives Jared Sly at Salem Hills High School in Salem on Thursday, May 24, 2018.

Tooele — a vast, mostly desert county west of Salt Lake City — went through a similarly horrific period around 2014, when the school district saw seven suicides, a murder and multiple adult suicides and untimely parent deaths.

"We had never had a year like that," said Marianne Oborn, the district's social services and counseling director.

The district has since benefited from a five-year, $2.5 million federal grant, hiring two "safe school coordinators" to assess and support suicide prevention programs, buying a curriculum of soft skills called Second Step for kindergarten through eighth grades, and paying for up to six visits to a mental health provider for each student (after personal insurance).

Oborn said 10 percent of the local community is trained in recognizing suicide's warning signs and referring people to care, a message spread at venues that include church groups, Scouts and book clubs.

And while Oborn worries what will happen when the extra federal resources go away after 2019, the most recent statewide survey of students in grades six through 12 saw a slight decline in percent of students who had attempted suicide in Tooele, even as the statewide numbers rose.

Kristin Murphy, Deseret News
Ethan Moser participates in a Positive in the Present exercise, which includes writing down three things to be grateful for, during first period at Salem Hills High School in Salem on Thursday, May 24, 2018.

"People just need to know that there's hope, and committing suicide, that's a final act for a temporary problem," Oborn said.

"We tell our students, 'You have so much you can offer, and we'll never get that chance to know if you're not there.'"

Gratitude, kindness and hope

A historic farming town about 15 miles south of Provo on Interstate 15, Salem is still awash in lush greens, despite the recent creep of urban development.

Visitors can fish for rainbow trout and bluegill in a pond off Main Street, backdropped by the majestic Loafer Mountain.

But postcard scenery doesn’t shield its youth from the pressures facing teens.

Salem Hills’ first of four suicides came in January 2014, and Peery said there was “a cloud over the school” in the aftermath.

Kristin Murphy, Deseret News
Principal Bart Peery talks to students as they walk by at Salem Hills High School in Salem on Thursday, May 24, 2018.

“It was brutal. I remember sitting in my office just crying,” he said. “And I didn’t know what to do. … I took it personally.”

They didn't get a federal grant or extra social workers. But Peery and psychology teacher Bart Thompson had discussed TED Talks by happiness guru Shawn Achor, who advocates for taking steps to improve the brain’s positive reinforcement mechanisms, and they decided to try an experiment.

Each day, students would be asked to jot down in their handbooks three things they’re grateful for, as well as an act of kindness they had recently performed. Four years later, those "positivity" exercises are an unofficial part of the curriculum.

“The challenge has been getting kids to buy in,” said Thompson, who spends half a period during the first week of each class telling his kids about the science and psychology behind it. “For the kids who do it, it’s life-changing, for sure.”

A recent school day began with an administrative assistant reading a quote from Maya Angelou over the intercom: “Life truly does give back, many times over, what you put into it.”

Kristin Murphy, Deseret News
Xion Davis participates in a Positive in the Present exercise, which includes writing down three things to be grateful for, during first period at Salem Hills High School in Salem on Thursday, May 24, 2018.

AP calculus teacher Porter Nielsen then asked his students to share a few of the things they were grateful for.

“School’s almost out,” one said, to laughs. “I had to throw that one out there.”

Junior Kayson Christensen said when he first started looking for positives as a sophomore, he was drawing a blank.

“It’s like, ‘I’m grateful for sleep.’”

But it’s a breeze now, he said.

Junior Rebecca Cromar balances school with cross country — she’s the team captain — and works about eight hours a week helping an elderly neighbor.

Still, she now stops to talk to peers who seem distraught, and makes time to help her younger brother with his homework (which her older siblings never did, she said wryly). Cromar now writes her daily three things in a personal journal so she can continue the streak on her own time.

“It kind of changes what I do throughout the day,” she said. “I’m looking more outward.”

Peery believes it's made a difference for many of his students — maybe half. He knows he it will take much more to reach some.

Kristin Murphy, Deseret News
Claire Wride winds up for a high-five with Principal Bart Peery at Salem Hills High School in Salem on Thursday, May 24, 2018.

On his desk sits a yellow fist-sized ceramic smiley face with big green eyes and screws jutting out of its head, with the words “You make me smile :)” carved into the back.

The girl who gave it to him had been part of Salem Hills’ emotionally disabled unit. School officials had met with her psychologists and social workers, and the Division of Child and Family Services. They had a plan, and she was engaged in it, calling in to talk about her bad days over the summer.

Then, at the beginning of the year, she took her life anyway.

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Peery said people told him her case was proof that sometimes, there's nothing to be done. And that may be true, he said. But, he added, “I’m not ever going to believe that.”

Help available

If you or somebody you know is experiencing suicidal thoughts, you can call the 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK or text “HOME” to the Crisis Text Line at 741-741. Utah youths with smartphones can also download the SafeUT app for around-the-clock counseling and crisis intervention.