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'We should be very worried.' Coroner alarmed by 5 suicides of kids 14 and younger in last year.

Lexington Herald-Leader - 1/18/2019

Jan. 18--Fayette County Coroner Gary Ginn says he's alarmed after his office has investigated five suicides by children 14 and younger in the last year, including the death of a 12-year-old Lexington girl earlier this week.

Ginn said the suicides included a 10-year-old Lexington girl who died in October, the youngest victim Ginn said he could recall in years. The others included an 11-year-old Lexington boy who died in October, a 14-year-old boy from Somerset in December and a 13-year-old girl from Frankfort who died in February 2018. (Ginn investigated the out-of-town cases because the children were brought to hospitals in Fayette County.)

Of the Lexington cases, two of the students attended Winburn Middle School, and one student attended Southern Elementary School.

The five cases are unrelated, said Ginn, although all five children died by suicide from hanging, he said. Ginn said he has not yet confirmed a report that one of the children was bullied.

"It's alarming because of their age and the method, the hanging," Ginn said. He noted that some problems that are minor to adults can be major to children. Local officials are trying to sort out the factors that preceded the deaths. There is no pattern among race and gender, Ginn said.

Physicians, mental health professionals and other local officials said the suicides among younger children point to a community problem and that prevention requires awareness from everyone in the children's lives.

"We should be very worried to have this many cases, but we should not be hopeless," said Susan Pollack, a pediatrician at the University of Kentucky Children's Hospital.

There are resources and programs available, Pollack said, but people in Lexington and other Kentucky cities need to build stronger support systems around youth.

On Friday, Winburn Interim Principal Mike Hale sent families a letter confirming that the student who died January 13, died of suicide. Hale said in the letter that the child's father wanted to share information about the death.

"We feel that it is critical to share the cause of death so that families can have open, honest conversations with their children," Hale wrote. The letter included tips for talking to children about suicide, including assuring them that the death of their classmate was not their fault. Hale's letter also included places to go for help.

Earlier, while not mentioning that suicide was the cause of the deaths, principals at Southern Elementary and Winburn sent letters to families notifying them of the deaths and describing a bit about each child. One child, who was described as a hard worker, had written about kindness in a recent assignment, saying, "if people showed kindness ... it would make them a better person and show empathy for others."

Another child belonged to several clubs, had a love of books and math, a unique sense of humor and an infectious laugh. The third child was known for the joy they "brought to learning everyday," their principal said.

Fayette County Public Schools spokeswoman Lisa Deffendall said district officials "have fully investigated each of these three tragedies and there is absolutely no connection to anything happening at school in any of the cases."

"When a child completes suicide it is natural to look for an underlying cause, but the answer is rarely simple," Deffendall said.

The local cases mirror a state and national trend. In Kentucky in 2015, 25 percent of the suicides of children under 17 were among children 10-14 years old. That's up from 9 percent from 2011, according to the Kentucky Public Health Child Fatality Review Annual Report released in November 2017.

In a statewide survey, the percentage of sixth grade students who said they had attempted suicide, made a plan to attempt suicide or seriously considered suicide in the past 12 months had all increased from 2014 to 2016, that report said.

Nationally, the Centers for Disease Control and Prevention reported in 2016 that suicides among children 10 to 14 had doubled from 2007 to 2014.

What are local officials doing in the aftermath of the child suicides? Ginn said that as in all child deaths, the recent suicides are examined by the Fayette child fatality review team that he heads. If a victim is enrolled in Fayette schools, he notifies district officials so they can provide support to classmates, he said.

The school district's crisis response team typically goes to the affected schools to help with grief counseling. The teams stay as long as necessary.

"Each case is unique," said Deffendall. "Losing a student is one of the worst things that can happen to a school community and our entire district pulls together to help."

In the letters to families, school officials offer guidance from experts about signs that their child may need additional help to process the loss of a classmate. All Fayette County public middle and high school students receive information about suicide and homicide prevention, abuse and bullying annually. The lessons are given in all English classes so that every student hears the information, said Fayette Interim Director of Student Support Services Doug Adams.

Age-appropriate lessons are also given to elementary students. As part of the district's recent Comprehensive 10-Point Safety Investment Plan, every school will soon have a new curriculum focusing on social and emotional development, Deffendall said.

Recently, the district has hired 28 mental health professionals to work with elementary-aged students, so that the student to staff ratio at elementary, middle and high schools is now 350:1. The goal is to have ratios of 250:1 at all three levels. Middle and high schools students will soon receive comprehensive health assessments which recognizes that physical health and mental health are intertwined.

Also, Deffendall said the district is impressed by the results that the University of Kentucky'sDepartment of Adolescent Medicine has had in other communities under Dr. Hatim Omar's leadership. Omar is the chief of the division of Adolescent Medicine at the UK HealthCare.

School officials want to replicate Omar's model in Lexington by adding full-time school nurses in every middle and high school, screening for health and emotional needs and providing follow-up medical and mental health services.

While the district increases services at schools, there must be a commensurate increase of resources in the community, Deffendall said.

"Our families have limited options when their child needs a higher level of care ... local agencies often have a wait list," she said. "We have made referrals and seen it take weeks for children to get the help they need. Where do families turn when their child is in crisis? Who provides care when school is not in session?"

"The need is so great. Resources from schools, community health services and the private sector are all stretched beyond what they can provide," Pollack said.

Randa Bush, regional manager of child services for Bluegrass.org, a mental health organization that provides services in 17 area counties, said after one recent child suicide, she spoke to a community group about the problem to raise awareness.

Increasingly children are under pressure to do well in school, said Pollack who serves on local and state child fatality review teams. LGBTQ students have an even higher risk of suicide, she said.

Local professionals are recommending that families should talk to their children about what they are doing online, especially whether they are playing games or are on sites that make references to suicide. Also, they say that families should make sure that children don't have access to items or materials that they could use in suicides.

Families can provide a support system, assuring children they can tell them anything without fear of punishment, Omar said. He recommends frequent family dinners and time frames at home where phones and electronics are put away so family members can communicate with children.

Omar said children in the 10 to 14 age group often don't understand the finality of suicide.

Lexington child psychiatrist Susan Slade said parents should take "it seriously if their child has a change in behavior." Younger children, she said, tend to be irritable when they are depressed rather than show classic signs of depression.

While mental illness can be a factor in suicide with young children, it is not a contributor in about one quarter of suicides in people under 15. In some cases, something simple happens on a given day, Omar said. "Somebody yells at them or calls them names and they think their world is over."

Moving to a new school or getting suspended for the first time can be a major issue for some children, Pollack said. Omar stressed that for the vast majority of young kids, "if they feel that the parent cares, if they feel that the teacher cares, the counselor cares, the church people care" and their peers care, suicide can be prevented.

Need Help?

If you are experiencing a crisis you can call the bluegrass. org 24-Hour Help Line at 1-800-928-8000.

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