Like many high school principals, Mike Warbel had a plan ready when the bad news came. It proved useful, yet of scant consolation after two student sweethearts committed suicide in May.

Grief counselors were deployed at East Knox High School in Howard, Ohio; teachers read a message in their classrooms; students were encouraged to vent their emotions.

In the days following the suicides, Warbel faced some tough decisions. Should the prom be canceled? Should he speak at memorial services?

His choices—the prom was held, he did give a memorial speech—weren’t based on any formal training. “You have a sense of how to react to your kids,” Warbel said. “You can’t be afraid of making a mistake.”

A sadly high number of his peers confront similar dilemmas. About 2,000 American adolescents kill themselves each year.

After accidents and homicides, suicide is the third-leading cause of death for teen-agers. According to federal estimates, one of every five high school students has thought seriously about attempting suicide, and one in 14 has made an actual attempt.

Faced with this toll, school personnel are struggling to find effective ways to prevent suicide and cope with its aftermath.

Many schools lack full-time staff trained to detect mental illness, and experts offer conflicting advice about suicide-prevention strategies. Post-suicide procedures also are a challenge; administrators try to accommodate grief without glamorizing a death in a way that might encourage copycats.

“In our decision-making process, we were keeping two things in mind,” Warbel said. “We wouldn’t do anything to tarnish the images of these two kids, or intensify the grief of their families.”

East Knox High, like many schools, doesn’t have a distinct suicide-prevention course; it addresses suicide in the broader context of mental health. Many experts counsel against overly specific courses, saying they could backfire among students already harboring suicidal thoughts.

“When you’re talking to a big class and saying a lot of things about suicide, different people listen to different words,” said Dr. David Shaffer, a Columbia University psychiatrist who heads the American Foundation for Suicide Prevention.

“In the disturbed kids, you probably reawaken bad thoughts and bad memories and set them off again,” he said. “We recommend teaching teen-agers about depression, how to recognize the symptoms, and give that lesson without mentioning suicide.”

Other experts, while agreeing that caution is warranted, say teachers shouldn’t shy from explicit mention of suicide.

“Adolescents are smarter than we give them credit for. If you’re dancing around something, they know it,” said Lindy Garnette, director of child and family services for the National Mental Health Association.

“People don’t commit suicide because somebody mentioned it. It can be a huge relief to hear the word, and be able to talk about it.”

Some critics say suicide should not be broached at all in school. The Eagle Forum, led by conservative activist Phyllis Schlafly, complains that “death education” pervades U.S. high schools and urges parental skepticism of suicide-awareness programs.

But prevention advocates say such objections often fade when suicide strikes close to home. Programs that increase awareness of depression are widely supported; so are initiatives encouraging young people to advise an adult if a friend reveals suicidal thoughts.

“It’s too often the case that students feel they can deal with this stuff themselves,” said Dr. Alan Berman, executive director of the American Association of Suicidology.

Screening for Mental Health, an organization in Wellesley, Mass., is recruiting 500 high schools nationwide for a program next fall aimed at identifying students prone to depression.

Barbara Kopans, the group’s vice president, outlined how students will complete a questionnaire anonymously and score themselves. The goal: Enabling students to recognize danger signs in themselves and their friends. “We want to empower young people to take action,” Kopans said.

At East Knox High, a 560-student school in central Ohio, Warbel regretted that suicide victims Joseph Hall and Rachel Hanna didn’t seek help.

“They had more lifelines than 95 percent of the kids in this country and didn’t use them,” Warbel said. “The most important message to our kids is don’t be afraid to express yourself. If you think things are so dire that you might consider harming yourself, get up on my desk or your teacher’s desk and stomp your feet until someone hears you.”

If suicide prevention remains an uncertain science, so-called postvention—handling a suicide’s aftermath—is even more improvisational.

After learning that Hall and Hanna killed themselves by setting their car ablaze, Warbel decided against holding a school-wide assembly. He asked teachers to break the news in their classrooms.

“You have the kids in a familiar setting, and then if you drop a bomb in their laps it’s a little easier for them to respond,” Warbel said. “You go through your daily routine … The bells still ring. But the students are free to go anytime to counselors, or just sit around in groups and talk.”

Warbel initially felt anger toward Hall and Hanna—popular Honor Roll students and varsity athletes—because of the pain they caused their schoolmates. By the time he spoke at Hanna’s memorial service, the anger eased.

“We all loved these two kids, we miss them tremendously,” he said. “That should never change, no matter what caused their death.”

Warbel, in his first year as a principal after 28 years as coach and assistant principal, was determined to restore some semblance of normality.

“We went ahead with the prom,” he said. “We encouraged our kids, told them they should come without remorse… They came early, stayed late. It might have helped in the healing process.”

Berman, of the American Association of Suicidology, empathized with administrators facing such traumas.

“It’s a thin line to walk, to be sensitive and responsive to the need to mourn,” he said. “It needs to be done in a downplayed way.”

Mark Kuranz, president-elect of the American School Counselor Association, recalled using a crisis plan after a suicide at Case High School in Racine, Wis.

A girl died in a car crash, he said, and was remembered with a memorial and a tree planting. Soon afterward, a student committed suicide, and the victim’s friends wanted a comparable commemoration

“We struggled to communicate to the kids why that wasn’t appropriate,” Kuranz said. “I felt fortunate to have a well thought-out plan.”

To reduce the risk of copycat suicides, experts recommend stressing that most suicides result from mental illness and inflict deep pain on families.

“Someone may pick up on the notoriety, the attention resulting from a suicide, but they don’t apprehend the downside. The headlines won’t say how the family is devastated,” said David Brent, professor of child psychiatry at the University of Pittsburgh School of Medicine.

Yet, sometimes conflict arises between a school and a grieving family. Mary Margaret Kerr, another University of Pittsburgh professor, recalled an incident where a bereaved father moved a memorial stone onto a campus against school board wishes.

Another recurring dilemma is whether to award a posthumous diploma to seniors who commit suicide.

“I say, ‘Be generous—give the family the diploma,'” Kerr said. “But every now and then, you hear: ‘Why should we give it?'”

As East Knox High’s students dispersed for the summer, Warbel was unsure what legacy the suicides would leave.

“We’re all trying to say it’s over,” he said. “And I’m not sure that’s the right answer either.” n


American Foundation for Suicide Prevention, 120 Wall Street, 22nd Floor, New York, NY 10005; phone (888) 333-AFSP, fax (212) 363-6237, eMail, web

National Mental Health Association, 1021 Prince Street, Alexandria, VA 22314-2971; phone (800) 969-NMHA, web

American Association of Suicidology, 4201 Connecticut Avenue NW, Suite 408, Washington, DC 20008; phone (202) 237-2280, web

Screening for Mental Health, One Washington Street, Suite 304, Wellesley Hills, MA 02481; phone (781) 239-0071, fax (781) 431-7447, web

American School Counselor Association, 801 North Fairfax Street, Suite 310, Alexandria, VA 22314; phone (800) 306-4722, fax (703) 683-1619, web

National Institute of Mental Health, 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663; phone (301) 443-4513, fax (301) 443-4279, web