Alejandra Juarez thinks saving a life is more important than keeping a secret.

Asked point-blank what she would do if a close friend told her that she wanted to die, but swore Juarez to secrecy, the Academy for Technology and the Classics teen said she would lead her friend to the school counselor immediately.

And if the friend felt Juarez had ratted on her? "I'd rather have her mad at me forever than have that secret cost her life," she said.

Juarez is a member of her school's Natural Helpers team, a teen peer group that supports students who feel isolated, depressed, bullied or suicidal.

According to Santa Fe Public Schools' 2011 student health and wellness survey, 27 percent of seventh-graders and 18 percent of ninth-graders said they had seriously considered killing themselves at least once in the past 12 months.

The 2009 New Mexico Youth Risk and Resiliency Survey of grades 9-12 reports that between 2003 and 2009, 12 percent to 18 percent of teens had made a plan to commit suicide in the previous 12 months. Somewhere between 14 percent and 22 percent reported seriously considering suicide; and between 9 percent and 20 percent actually attempted to take their own lives.

Juarez and the Helpers aren't the only ones emphasizing support for alienated or depressed youth. Working in tandem with several local social agencies, the school district's Office of Student Wellness offers a same-day assessment for students who tell someone -- anyone -- that they feel like they want to die.

School counselors are immediately notified. They in turn call both the student's parents and Presbyterian Medical Services, which has a clinical services department that offers a professional assessment of the student that day. Both English-speaking and Spanish-speaking therapists are on hand for these evaluations.

Presbyterian Medical Services' team then decides if the student requires a higher level of intervention. The goal is to put a safety plan in place that almost always includes ongoing counseling.

The Student Wellness team and Presbyterian Medical Services both report that some 25 students received same-day suicide assessments in the autumn of 2011. Tita Gervers, director of the Office of Student Wellness, and Terry Sine, clinical services administrator at PMS, credit the program with decreasing the potential for suicide among teens.

Gervers said there have been two deaths by suicide among public school students in the past three years -- including one in late January.

"I think the same-day suicide [prevention] protocol we have developed with Santa Fe Public Schools is something other school districts should look at," Sine said. "It has an impact. The young lady who recently died by suicide was the first in Santa Fe County of school age in a long time."

Santa Fe Public Schools pays $10,000 annually for the program, Gervers and Sine said. To their knowledge, the only other school district in the state to run a similar program is Albuquerque Public Schools.

"Our students are hurting," Gervers noted -- and the risk may be increasing for pre-adolescents. She recalls a kindergartner who talked about taking his own life about five years back.

Immunization against vulnerability

Apryl Miller believes that many teen suicides can be prevented. The clinical director for the New Mexico Suicide Intervention Project's SKY Center in Santa Fe said parents should perform regular wellness checks.

"You immunize your children against illness and disease, so this is the same approach you would take toward an epidemic of the flu," she said. "Ask tough questions: 'Are you thinking about hurting yourself?' Let them know that you care, that you want to work with them to seek care, and that their life is important to you."

This approach is particularly important if teens are coping with the suicide of one of their own, she said. "Teens see other teens as part of their community, so when one of their community suicides, it impacts. A taboo has been crossed by one of their own -- the option to take one's life as a means of escape."

The SKY Center, a nonprofit established in 1998 and housed in offices behind De Vargas Middle School on Llano Street, offers free after-school counseling services to families with children up to the age of 21.

There, five clinical supervisors and a number of graduate students (who are working on their master's degrees in counseling, social work or psychology) work late into the night dealing with parents and children who are stressing out about any number of issues: Domestic abuse, a separation, a lack of work, too much work, academic pressure, bullying, substance abuse, and so on.

In many cases, familial connections have been strained, making direct communication a challenge. But that barrier must be removed, Miller said.

If parents have any suspicion that their children are having suicidal thoughts, they must act immediately, which is where both the SKY Center and the district's same-day assessment program work.

"A parent worried about their child at 3 p.m. should not have to wait two weeks -- or even 24 hours -- for an appointment. It's important to have immediate availability," Miller said.

Most, but not all, people who die by suicide exhibit warning signs, which may include a preoccupation with death, increased use of drugs and/or alcohol, a breakup with a boyfriend or girlfriend, unusual mood changes or withdrawal from daily life and, of course, a previous suicide attempt. Familial conflict, disciplinary problems and easy access to firearms might also contribute to suicidal thoughts.

Gervers points to other clues such as "references to suicide in writing assignments for English class; imagery of death or dying in an artwork."

Sine and Gervers said that suicide risk increases in the spring. For example, if the district's same-day assessment and correlating clinical examination numbers are about 25 in the autumn, that figure will shoot up to 30 to 35 in the spring.

Gervers said parents should monitor all social-media activities to ensure teens are not feeling undue pressure from negative online energy. "Parents must learn how to use the Internet so they can have a Facebook page to monitor the information their child is exposed to, and make that access a condition of their child's computer use," she said.

Almost always, parents who are initially shocked to learn from a school counselor or professional therapist that their child is harboring suicidal thoughts come around to display support, compassion and love.

"I know one thing about parents," Miller said. "They would rather get the phone call saying you are considering suicide rather than the phone call saying you are dead."

Occasionally, parents remain in denial -- a mistake. Gervers recalls a father's response when she informed him that his 15-year-old daughter was talking about killing herself.

"She does this every year on the anniversary of her mother's death," the man told Gervers. "She always says she will kill herself, just like her mother did."

Hurdles to helping

Help is out there. But at times, it seems difficult to access, especially if teens keep their feelings to themselves. Taking one's life is a very private act, Miller said.

And though Alejandra Juarez, as a Natural Helper, is obliged to bring in adult help, many teens enlist the confidentiality of friends to keep their emotions and plans buried.

"It's time to educate teens about keeping secrets," said Nancy David, the wellness and health counselor at Capshaw Middle School. "Students who are aware of a kid having problems have a hard time revealing that kid's secret. Kids think it's 'ratting.'

"We have to help teens understand the importance of letting an adult know and getting help rather than have them live holding this secret in. And if one teen is sharing their pain with another teen, that's a cry for help."

Gustavo Palomino, a 17-year old Natural Helper at the Academy for Technology and the Classics, agrees. He said he does everything he can to let his peers know that they are not alone, and that they can find a healthy path out of their angst. Asked what advice he would offer another teen who believes that no one is there to help, he said, "Give them my phone number." (He was serious.)

He makes himself available to others at the school, popping into a seventh-grade math class to offer tutoring and serve as a role model. The younger students look up to him; they know he's there to help, said teacher Sadhana Woodman, who co-sponsors the Natural Helpers at that site.

Other challenges seem inconceivable. Gervers and several school counselors within Santa Fe Public Schools note that the perfect venue for discussing depression, bullying and suicide is health class. But Santa Fe Public Schools currently does not offer health classes at the middle-school level.

"This has to change," Gervers said. "It's like supporting art and music: Someone says, 'This is going to be offered in our schools,' and then they find the money to make it happen."

Gervers said such classes are being considered in the Board of Education's new strategic plan.

And as overwhelmed as educators in the schools may feel, they should be advised to consider their own behavior when it comes to communicating with teens who may already feel disenfranchised, according to Alicia Wolfe, a Project Success specialist at De Vargas Middle School.

"How do we address adult behavior? There is a lot of adult bullying going on in the schools," she said. "These kids come to school with so many issues, and then adults don't treat them with proper respect. We need to recognize how adults can contribute to how a teen ends up feeling awful."

Another problem is the lack of Santa Fe-based facilities to care for youth beyond a few days. Though Sine said that over the past three years only about five Santa Fe Public School teens were recommended for long-term hospital care, these cases usually have to be referred to either The University of New Mexico Hospitals group or to Presbyterian Kaseman Hospital in Albuquerque.

Wolfe emphasized that many kids want help. Of her experience once she begins talking to students about suicide at De Vargas, she says, "I don't think most kids want to be successful at killing themselves."

David stresses that the same-day-assessment, while a vital part of prevention, is not enough. "Parents can be deceived by a quick Band-Aid fix. Ongoing counseling is important to teach these kids resiliency skills, and that doesn't happen with just the one assessment." Resiliency, to her, means each youth has at least three adults in his or her life who truly care.

But when the crisis hits -- the threat of suicide -- family members and friends have a role to play in reminding teens that they matter.

"Just saying, 'I don't want you to die. You mean a lot to me,' can make the difference," Miller said.

Contact Robert Nott at 986-3021 or rnott@sfnewmexican.com



SUICIDE PREVENTION RESOURCES

The SKY Center, 473-6191. Call Natural Helpers coordinator Nina Bunker Ruiz at this number to learn more about the program.

Presbyterian Medial Services crisis response hotline is 820-6333 or 1-800-273-TALK

Santa Fe Public School's Office of Student Wellness can be reached at 467-2574

Teen Health Center at Santa Fe High School, 467-2439

Teen Health Center at Capital High School, 467-1081

Gerard's House, 424-1800, provides grief and loss support for adults, teens and children. No cost.

Crisis Response hotline - Santa Fe: 505-820-6333

National Suicide Prevention hotline: 800-273-8255