Treating Suicide Like a Public Health Crisis

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

Great news this week for the Palo Alto community, as covered by various outlets including ABC News, whose new Nightline segment is seen above:

Following the two clusters of youth suicides in Palo Alto in recent years, the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration have sent a five-person team to conduct an epidemiological assessment, the San Jose Mercury News reports.

More from the Mercury News:

The assessment will survey the extent of the health problem and track trends, as well as identify risk and protective factors, in coming up with recommendations for prevention. [...] Students and other community members have already taken numerous steps to support teens to discourage them from harming themselves. Schools are starting later so that students can get more sleep. Gunn High School students created a student support group. New fencing rims the Caltrain tracks. The school district and city have offered sessions on parenting and mental health issues. And counseling services have been expanded.

The news from the CDC provides a good opportunity to air a few more emails we received from members of the Palo Alto community (our full discussion thread is here):

I am a 2012 Paly graduate, currently studying at Washington University in St. Louis. I’ve read Hanna Rosin’s “The Silicon Valley Suicides” four times now, but it feels like a hundred. The story is honest and true, and Rosin provides a clear overview of what has happened in Palo Alto, but it offers little that is new, at least not for someone who lived it. Rosin’s insights into Suniya Luthar’s research and the parallels between high achieving and underachieving inner-city and affluent kids are interesting and welcome, but ultimately the article provides a bird’s eye view of a community that deserves much more than that.

Here’s more from another reader, Jeremy Neff:

I grew up in Palo Alto, down the street from where the Blanchards live. I graduated from Gunn in 2012 and now I am a senior at George Washington University. Like everyone who went to Gunn when I did, I have powerful memories and emotions pertaining to the suicides of my peers. Below is my personal experience with suicide and a few current thoughts I have on the matter.

One drizzling night in early 2011, I sat in the lonely darkness of my home and wondered why I had to keep living. I was 16. I thought about how easy it would be to not do anymore homework, to not have to worry about whether I was cool, to not have to struggle to succeed in any of my passions, to not have to deal with any conflict, loneliness, or sadness.

It was 1 a.m., past my usual bedtime, and I was exhausted but still I couldn't sleep. I wanted a long rest. I didn’t think about how much my family loved me or about how my friends would cry years later when Facebook said it was my birthday or how everyone that knew me would feel unshakably sad at even the slightest mention of suicide.

Instead, I wondered how J.P. did it. I wondered if I could do it. I wondered if I had the strange courage one needed to walk two blocks to the tracks and let Caltrain sweep them away.

J.P. lived a block down the street from me. When I was 11, he came over for my older brother’s birthday and laughed when I made jokes about how nerdy my brother was. He was absolutely my favorite of my brother’s friends.

His suicide was also part of the reason I opened my front door and walked down to the crossing that night. I don’t know what I would have done if a train had come. Would I have remembered that killing myself would ruin my parents’ lives and hurt so many people? Or would I have made an impulsive leap and given up the mysterious struggle that awaited me in the rest of my life?

I stood in the shadows by the tracks for half an hour before I realized that Caltrain doesn’t run past midnight on weekdays. I didn’t tell anyone for five years, especially not my mother.

Looking back, it is hard to fully understand what drew me so close to tragedy. Certainly I had struggled with depression in the past, and had taken medication until I was 14. But I wasn’t struggling with depression in high school. Perhaps it was the feelings of inadequacy that come from being surrounded by brilliant and impressive people that drove me to consider suicide. But I definitely thought I was at least a little brilliant and impressive to some people, so that couldn’t be it. Mostly, I think I just thought nothing was worth living for.

Years later, at the ripe old age of 21, I look around me and see how I can matter in the world. I see how I can inspire someone, tell a story the world needs to hear, heal a community, bring ease or comfort to people who deserve it, or even just show one person that they are absolutely and without question beautiful and loved. But at the time, everything was just a selfish chore to help me succeed in the future.

For me, high school felt like a time to prepare so I could matter later. But that's wrong and unhealthy. My friends died and I could have too. It is wrong to think that being 16 is any less of a reason to tell a story, to heal a wound, or to make someone feel loved. And it is unhealthy when 2000 students at Gunn are doing great things like that every day, but feel selfish and unfulfilled because at the end of the day their accomplishments are going on a college app where all the beauty of their passions is reduced to a vain attempt to “be the best” and go to a selective college.

If you asked me what should be done, we could talk for hours. But I think most of it comes down to perspective and mental health. If only students fully understood how different the rest of the country was than Palo Alto, I think they would have monumentally less fear about succeeding and monumentally more optimism about how they could use their abilities to matter in the world. And if everyone had the same attitude about mental health as they did about physical health (such as having six-month mental health check-ups and getting easily excused for mental sick days), I think students would both have better mental health in the first place and feel less of a stigma when it came to reaching out for mental health care.

But as the article seems to conclude, it is impossible to be certain what might make a difference or why someone might find so much solace in death. I still don’t know why I walked down to the tracks that night, and I don’t think I ever will.