- [Announcer] Live from your public media studios, WVIA presents "Keystone Edition Health," a public affairs program that goes beyond the headlines to address issues in Northeastern and Central Pennsylvania.

This is "Keystone Edition Health."

And now, moderator Tonyehn Verkitus.

- Good evening, and welcome to "Keystone Edition Health."

I'm Tonyehn Verkitus.

Thank you for joining us tonight.

Every year, thousands of young people are constantly dealing with depression or overwhelming emotions caused by circumstances in their life.

As difficult as this is to discuss, it's important to shine a light onto this issue and address it to assist these teens.

We need to help by listening, sharing and learning from one another.

We're going to cover this topic and provide information on different resources from our panel of experts to let you know you're not alone.

But first WVIA's Lydia McFarlane has more.

(transition whooshing) - Teen suicide is a deeply troubling issue that affects countless young lives and families.

It's often the result of a combination of mental health struggles, societal pressures, and a lack of emotional support.

Adolescents face unique challenges, from academic stress to bullying and relationship difficulties, which can sometimes feel overwhelming.

According to an article from the Yale School for Medicine, the CDC identified several factors that have contributed to worsening mental health for teens over the past decade.

These include concerns about violence and safety, persistent sadness or hopelessness, and suicidal thoughts and behaviors.

Female and LGBTQ+ students are disproportionately affected.

It's critical for communities, schools, families and friends to create safe spaces for open dialogue and ensure that teens know that it's okay to ask for help.

Raising awareness, providing resources, and offering emotional guidance are essential steps in preventing teen suicide, and fostering a culture of compassion and understanding.

For WVIA News, I'm Lydia McFarlane.

- Before we get started, if you or someone you may know that is struggling with emotions, help is available through 988 Suicide and Crisis Lifeline.

Just call or text 988 or chat online at 988lifeline.org.

Joining us tonight, we have Bill Poray, owner and executive director of Cross Valley Counseling, Shannon Wells, licensed professional counselor from Riverside School District, and Ginny Rosenkranz, a therapist at Lackawanna County District Attorney's Office Trauma Services Unit.

Thank you all for joining us.

- Thanks for having us.

- Thank you.

- Yeah, Bill, I'd actually like to kick this conversation off with you.

You've been doing this for quite some time, so I'm sure you've had to assess a number of youth and teen who may be coming in with depression.

What are the first things you're looking for?

How are you starting this assessment?

- Well, I think, first off, it's important to develop a safe, comfortable environment for whomever, whether it be a child, adolescent, or an adult, to make them feel more comfortable, not just get right into like, "Why are you here?"

What the problem is.

"What are the symptoms?"

To really start to establish that rapport, so that hopefully at some point in time, they'll feel more comfortable.

And there's many, many different ways over the years that I've found, from asking them what their favorite baseball team is or asking them, "What about the new Taylor Swift album?"

But it's really important, first off, to really develop that safe space where we can talk about whatever they feel like they need to talk about.

- Ginny, how exactly is the District Attorney's Office looking at teen depression, teen suicide, trauma?

- Well, we're looking at it from a variety of perspectives.

Naturally, we deal with a lot of victims of crime and the trauma associated with that.

First responders and all of that.

But we look also at resilience and quality of life and issues with hunger and lack of appropriate housing and mental health services.

So there's a multitude of ways that we're doing that.

And one of the ways that we do that also is to be involved in various coalitions regarding suicide.

And that would be one that Commissioner Chermack started the Lackawanna County coalition on suicide prevention and getting the word out and trying to put out some different means of preventing suicide.

It has always intrigued me that we are the only species that ponder our demise.

And we have formed armies and branches of medicine to forestall the inevitable, and yet there are those that choose to end their life by their own hand.

And we want to take a look at what changes from the thought to the action.

- Shannon, with your work in schools, obviously you're coming in contact with youth quite a bit.

I know that you have some specific programs that we're gonna talk about later.

But what are you hearing from these kids when they come to see you?

- Yeah, so a lot of what I'm hearing from the students I see is they're not totally sure where to turn for help.

And that's something that we're really trying to focus on at Riverside is to just make sure students know who the supports are in their community and kind of post it everywhere so that it's always available for them and they know what to look out for that are warning signs and who to look out for when they need it.

- Do you find that kids are looking out for each other?

Have you ever had a child come tell you that, "Mary doesn't seem like herself today?"

- Yes, definitely.

So especially since we started one of the programs we'll talk about soon, Sources of Strength, we really focus on looking out for those things.

And since we started that program just in February, I've noticed an influx of students coming in and telling me those exact things.

"I noticed that my friend seems off today.

I noticed they're more quiet than usual," or, "They seem a little bit sad today."

And that has been huge.

- Bill, what type of screening tools are you using when children first come into the office?

- Well, I used the ACEs scale, the Adverse Childhood Experience scale.

That'll give me an idea of what's going on in this child's life that they may be dealing with that might trigger them to wanna have thoughts of harming themself.

I think, again, it's important, Ginny was talking about those resiliency factors.

So I can't say enough about really looking at, and there's not any real specific screen, but it's asking, when you're feeling less depressed or when you're feeling okay about yourself, what's going on in your life?

Really looking for those people that, there might be a mentor, a coach, or a guidance counselor, or a specific friend, an activity.

There's so much mileage that I'm able to get by talking about one of those things that they're doing when they're not feeling depressed.

And again, I think that open communication and dialogue, as opposed to just looking at like a screening tool, can be so vital in helping someone to be able to feel more comfortable talking about what's going on with themself.

- Yeah, ACEs, it's such an interesting screening tool, right?

And that goes back to what you were saying about basically social determinants of health.

These are all very closely related.

- Most certainly.

- I would love if you'd talk a little bit about this special training that you had.

- Thank you to another nonprofit organization, Northeast Suicide Prevention Initiative, allowed me to be trained as an investigator in psychological autopsy.

And even though a lot of people think that individuals plan suicide months, years, a period of time prior to actually taking their own life, there is an element of impulsivity.

There's an element of why this day, this method, this hour?

And so what we would do in looking at that and trying to get information to fill gaps in our community that perhaps aren't being filled would be to look at the events of the past, interview people, do an in-depth psychological autopsy of that person's life, read their writings, talk to family members, friends, however, social media posts, whatever information we can get to try and figure out where we can fill a gap with a preventative measure.

- [Tonyehn] And how many of these autopsies have you done?

And not to alarm folks, but what are the youngest ages you are seeing?

- The youngest that I saw of a completed suicide was last year, a female at age 11.

- Wow.

- Yes, yes.

And 13 and 15, yes, we do see that.

I do keep track of suicides in Lackawanna County, and each year, we've had several.

Some years, like 2018, we had six suicides of individuals 21 and younger.

The youngest thus far that has been in our county is 11 that I know of.

But there have been ample 13-year-olds and 14-year-olds and less and such in our county as well.

- And you did bring up social media, I'm sure this is something that you're all seeing.

I'm wondering any of you could address this because I feel like social media can be a detriment, but at times, it feels like it could be a tool as well.

- Exactly.

- So where's that fine line?

- Well, they had mentioned Yale School of Medicine is investing a lot in this research aspect, especially regarding teen suicide.

And I don't think we have a good grip on the complete effects of social media on teens.

It's pretty much most of the studies have focused on the amount of hours someone is attuned to social media.

And without a doubt, I mean, that has an effect because then that decreases your real-life interaction with others and family members and everything you would get from contact with another human.

But they need to study, and what they seem to be doing now is studying what types of social media they are paying attention to.

And certain types of social media would be more of a risk factor than others.

But without a doubt, like you had mentioned, it also can mitigate things, because we can use social media to reach individuals that perhaps we wouldn't.

- Yeah.

- Coming from the substance abuse field, what's really interesting is, and more and more literature is coming out about the amount of screen time that someone is exposed to and the neurobiological effect that takes place dependent upon how much screen time a person is exposed to.

And they compare it to the effect of crack cocaine, methamphetamine, and that the release of dopamine, there's that real spike.

And when anything is spiking that quickly, well, guess what?

- There's a crash.

- The drop is gonna be there.

And then they compare this amount of screen time to that.

And I think it's important to be aware, we're not gonna be able to do away with all iPads and smart phones and all that, but I think we need to at least be aware because adolescents' brains are developing up until the mid-20s.

And I think when you have a stimulant like screen time, it can really negatively affect their ability to think, to make rational sound decisions, and whatnot.

- Oh, you're so, right.

Adolescents have more of an absolutist view than adults have.

They see things in more rigid colors with less gray areas.

So if they're presented with a problem, the problem may seem more overwhelming, with a solution less likely to them with that absolutist thinking.

- Can we also talk, and maybe, Shannon, you can speak to this a little bit about this kind of suicide myth, right?

As parents, we don't wanna necessarily have this conversation with our children, because then maybe that will be what inspires them to take that next step.

- Yeah, absolutely.

So it's interesting, when I have a student in my office who is showing some of those warning signs, maybe they've been a little more quiet the past couple weeks, or not wanting to engage with their peers as much, not seeming so interested in the things they used to be interested in.

If I even bring up the topic of, "Have you been thinking about wanting to hurt yourself?"

it's almost like you could see a weight lifted off their shoulders.

It's like, "Finally somebody said it."

So I think that could be really powerful.

And you're right, it is a myth.

I think a lot of parents are scared to bring up something like that, because it is, it's a scary subject, but I think if it's already there, we need to talk about it.

And yeah, the more we do that, I think the better it is.

- The other myth I think is important is to separate suicidal ideations versus the non-suicidal, self-injurious behaviors, believing that someone that's cutting is suicidal.

And the reality of it is, and kids and young adults that I've talked about, they're either, A, they're trying to escape from some difficult emotion, or oftentimes they're just trying to feel some type of emotion.

And so I think it's important to, again, like Shannon said, to be open to the dialogue, to talk about it.

And I think the child, the adolescent, the adult, will really take their lead from how we are, or they will respond to how we are.

And if we're coming at it from a very, if we're looking nervous or whatever, distracted, then that's gonna really affect how open they're gonna be of talking about what they're thinking about and what they're feeling.

- And Ginny, the other thing we discussed was kind of this availability of means as well, right?

Can you speak to that?

- Yes, in regards to means restriction, a lot of the research came about by happenstance.

And there's two cases that illustrate that perfectly.

And one is the British coal gas theory, in, I believe it was in the '60s and '70s, Britons used coal gas to heat their homes, and that had a high concentration of carbon monoxide.

So they slowly decided to switch over to a more natural gas.

That was a major cause of suicide in Britain.

And when they did that, they noticed that the suicide rate plummeted, that sticking your head in the oven thing.

But one thing that relates to the United States, an example there is in Northwest Washington DC, there are two bridges that are parallel to one another, and they both crossed the same basin of water at the same height.

One is the Ellington Bridge, named for Duke Ellington, and the other is the Taft Bridge.

And they're a stone's throw from each other.

But the Ellington Bridge was known as the suicide bridge.

And it had many, many people attempt suicide from that bridge.

And there was a week back in the 1980s where three people attempted suicide.

So they decided that they would try to erect barriers.

And they met with opposition, with the thinking that they're only gonna go to the Taft Bridge, which is right next door, to do the same thing.

But that didn't happen.

They didn't.

So the rate of suicide from the Ellington Bridge after they erected the barrier plummeted 90%.

The rate at the Taft Bridge didn't increase at all.

- Interesting.

- So they did research into that, and they discovered that the balusters on the Ellington Bridge came up chest high.

- Ah.

- Or I'm sorry, waist high.

And on the Taft Bridge, they came up chest high.

So if we could put as many obstacles into that element of impulsivity, then we can save lives.

And I think that's a very good illustration into means restriction and safeguarding our firearms and our medications in our homes and all of that.

- Thank you.

- Thank you.

- Recently WVIA's Tim Novotney spoke to Teressa and Ashley from the Lou Ruspi Jr. Foundation.

They shared how their foundation began and how it is making a lasting impact on the community.

(transition whooshing) (pensive music) - Sharing my brother's story, which is very profound.

I mean, he was a man of different faces and the person we saw on the outside was not the person he was feeling on the inside.

He definitely struggled with some anxiety, depression and possibly other undiagnosed mistreated mental health illnesses that we didn't know about.

And being a young teenage boy, there was a lot of stigma around that.

And he was a little bit afraid, a little bit where really he did not want to reach out for help.

After we lost my brother, Lou, in 2011, we really just, it was an eye-opening event for our whole entire community, let alone our families.

So much, my sister and I just sat together and we started rewinding back and trying to replay some of Louie's struggles from his early teenage years.

So we thought creating the Lou Ruspi Jr. Foundation with mental health wellness education programs right in the schools, right directly to the health classes to support our health teachers that are teaching mental health in the mental health unit, we can get these kids where they're at and where they need it the most.

- My role at the LRJ Foundation is I am a mental health professional who goes into the schools to talk to the student bodies in which we're assigned to.

And I've seen people in my years of practice go through this, that they are doing pretty okay, and then things just kind of go downhill really quickly and they're not okay anymore.

The biggest impacts that I see happening are the kids raise their hand ready to volunteer, and it just feels good that these adolescents understand that, "This is important and I wanna learn more about it, so I'm going to volunteer to engage in this program."

- Afterwards, we always would allow some time for students to come forward.

And this one student, and she shared with us that the night before, she actually had wrote a suicide note and was planning to take her life.

And the next day, we were at this presentation, able to share ways to cope and get through mental health and struggles and reach out for help, and she's here with us today.

So it just was so amazing to think that lives are saved just because we're there sharing positive ways to take care of our mental health.

- And all it takes is just checking in and making sure that, "Hey, I've noticed this about you, and just checking in to make sure everything's okay."

- You may have experienced some sadness and feelings of hopelessness and you wanted to give up today, and your classmate next to you probably experienced that last week.

If we could just support each other and feel more confident in expressing what we're going through that maybe we all can feel like we are one, because we are all going through something, it just may be at different times.

(transition whooshing) - Shannon, I think this is a great segue to talk about the programs in your school and tell us about their effectiveness.

- Yeah, so at Riverside, we're really trying to put emphasis on preventative measures.

I think that's been a huge help at our district.

So at my elementary level, we just recently started up a Sources of Strength program.

We had a training last month in February with about 20 students, 10 fifth graders and 10 sixth graders where it was a day-long training.

And we just talked about some of those warning signs to look out for in our peers, how to really find different supports in your life, ranging from friends, family, spirituality, physical activities you can join.

There's a wheel that we kind of focus on that has eight sections.

So the students have been really receptive to that program.

We're gonna start some new school-wide campaigns to kind of promote all the sections of the wheel and focus on wellness.

And then at our high school level, we have a program called Avidum, and that is Latin for, "I've got your back."

So we've been doing that for a couple years now.

And same thing, we have some campaigns at this school.

We actually just on Monday this week, we had a program at Lakeland High School where all the Avidum programs from different schools in the area came together, and we talked about our mission and what the different schools are doing to promote that mission.

And it was a really, really amazing experience getting to hear from different students.

So those are the main two that we're doing at Riverside right now.

But they seem to be going well, and the students are very receptive to them.

- It sounds like putting tools and the power in the hands of the students is very effective.

I recently heard about a program called Cope Dealer and another called hip-hop therapy where kids are creating music actually while talking about behavioral health.

Are there any specific tools that you've used in your practice that may be outside of the norm?

- Sure, so what we've noticed is, the huge gap between acute mental health or psychiatric care, the residential inpatient hospitalizations, and what comes next.

In our two counties, there really isn't any inpatient programs for adolescents or children.

And what we're trying to do is we're trying to fill that gap.

Right now, we're starting right now from 18 up, we have a mental health group for people that are getting out of the hospital that need more than just that one-on-one counseling.

And we're hoping to, as time goes on, sooner as opposed to later, to have something similar for adolescents, because as Shannon was alluding to, there's power within the group.

And so we wanna try to be able to fill that gap as much as possible.

- Well, I would think that these children do wanna help each other, right?

- Absolutely.

Yeah, yeah.

- No one wants to have a friend that does not come back to school.

- Absolutely, yeah.

- How are you all working with kids in the school?

Do you at all?

- I don't.

- Okay.

- No, I don't.

- I know that my program that we went to on Monday for Avidum, I think it was the superintendent of Lakeland had made the point that it means a lot coming from your peers when you get support.

It's one thing for a counselor to come to you and talk to you about these things, but when it's a friend or a classmate coming and saying, "Hey, I'm noticing that you're acting a little different than usual, how can I help?"

I think that means a lot to them.

- And I think it's also important too, systemically, to look at the whole family.

And what I found is that the child is only gonna be as open to coming to therapy as the parents are gonna be supportive and willing to talk about depression, anxiety, suicide.

So we really try to focus on the whole family, not just the identified individual.

- Right, so as they say, it takes a village, correct.

- Absolutely, absolutely.

- Thank you to all of our guests for their insights and to all of you for joining us.

Remember, if you or someone you may know that is struggling with emotions, call or text 988 or chat online at 988lifeline.org.

This and every episode of "Keystone Edition" is available on demand on your YouTube channel, and now as a special audio podcast, so you'll never miss an episode.

Visit wvia.org/keystoneeditionhealth to stream episodes or subscribe to the podcast.

For "Keystone Edition Health," I'm 10 Tonyehn Verkitus.

Have a good evening.

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