Children are suffering.
The pain can be seen in failing grades and the number of children seeking counseling services in school. It shows in increased calls to suicide hotlines at younger ages and 911 self-harm emergencies being called in to EMS. Sometimes it ends in suicide.
The S.C. Department of Mental Health doesn’t yet have the numbers of children who killed themselves in the past school year, but school counselors say they know the death toll has risen dramatically.
In one county that does know — Greenville — the number of children who died by suicide increased in one year by 800%. The Department of Mental Health asked that the specific number of suicide deaths in the county not be reported for fear of identifying some of the children and their families.
It would be easy to blame COVID-19’s isolation — school shutdowns, social distancing and mask wearing.
But the reasons go far beyond COVID to the economic downturn, racism and a divisive political climate, said Chris Haines, director of the Greater Greenville Mental Health Center’s School Mental Health Team.
“We have seen record numbers of depression and anxiety in children and adolescents,” he said.
“It’s all piled on,” said Jennifer Butler, program director for the S.C. Department of Mental Health Office of Suicide Prevention. “Children’s worlds were rocked last year.”
She said not only have therapy sessions and suicides increased, but at the same time, the age of children calling helplines has dropped. In 2019, the youngest person to call was 11. Last year it was 7.
Butler said, overwhelmingly, boys kill themselves more often than girls, but more girls attempt suicide. The difference is boys typically use a more lethal method — firearms.
In 2019 — the most recent data Butler has — 851 people in South Carolina killed themselves, and 123 were children. The total number of boys was 109.
The root cause is lost hope
“Suicide is not a one-cause death,” Butler said.
But there is a universal theme. Mental health experts say it stems from lost hope. Just as with adults, despair sets in for children and teens; the future seems dim. Children are particularly susceptible because they have trouble expressing their feelings and often don’t have anyone to talk to.
Meeta Banerjee, an assistant professor of psychology at the University of South Carolina, said children are sponges. They overhear conversations or see things on television. They experience racism in school. They are bullied.
“It used to be, bullying stopped at school,” Banerjee said.
Now it follows them home via social media. And the acid remarks directed at individuals are widely seen. The isolation caused by not going to school heightened social media’s role in children’s lives. That’s how they communicated.
So-called “tea” accounts on Instagram, YouTube and Twitter that were the place for celebrity gossip are increasingly being used by high school students to call people names and accuse them of sex acts and more. They allow anonymous posts yet are often labeled “just for fun.”
It follows that the largest number of callers on the suicide crisis line are 10 to 14 years old, Butler said.
“You never want to feel a small child is in that level of distress,” she said.
Banerjee said she has also seen an increase in bullying toward Asian Americans, who even face criticism for the food they eat, and toward African Americans.
Sometimes adults minimize the feelings, thinking a child could not possibly be feeling that level of despair, Banerjee said.
Mental health services increase
The increase in depression and suicide among young people is not a surprise to those working in mental health. Increasingly, schools have therapists available to students during the school day. For students who have Medicaid, the service is free. Haines said private insurance rarely covers much of the cost.
“Families are informed of the cost of services before starting school mental health for their children. Most will reject services all together due to the cost,” he said.
But, if parents go ahead with the service and cannot pay, therapy does not stop.
“The health and well-being of children is our top priority,” he said.
In the 2019-2020 school year, the Greater Greenville Mental Health Center’s School Mental Health Team provided 7,306 hours of mental health services to children with private insurance and billed $1.4 million. Of that, $186,998 was collected from private insurance companies and families, Haines said.
That is the load in just one school district. The problem is statewide.
Butler, from the state Department of Mental Health, said her agency is battling child suicide in a number of ways. There are various hotlines available, and a new law now requires all school districts to print hotline numbers on student IDs.
State Sen. Katrina Shealy, R-Lexington, who sponsored the bill, said the idea was to have the phone numbers readily available.
“It’s handy when they feel like nobody’s there,” she said.
Shealy expects the issue of mental health funding, especially for children, will be an issue discussed after the Legislature convenes in January.
Among the challenges for crisis hotlines is they are run by nonprofit organizations, not the state. At one time, there were four in South Carolina; now there is one, Butler said. It gets 2,500 calls per month. If someone in Greenville cannot answer, the call is routed across the country to an agency that can.
Butler senses a shift in the conversation about mental health among legislators.
“The next step is funding for the centers,” she said. “It is a wonderful message to children that their life matters.”
Listen to your children
For parents who have a child struggling with mental heath and thoughts of suicide, the answer is simple in principle but not so simple in implementation. It’s about infusing hope, Butler said. Listen to your child. Ask the question: Do you feel like harming yourself?
Conversation is not always easy with a suffering child. It’s hard to get them to talk about their feelings. Butler suggested saying, “I’m worried about you, Can you talk to me?”
And then, most importantly, be quiet and listen. Butler said “listen” has the same letters as “silent.”
If they don’t talk, a parent can say, “I’m just going to be right here. We’re going to get through this.”
Infuse hope, Butler said again. She can’t say it enough.
Banerjee said sometimes it’s best to talk about a movie or something non-threatening to get the child to start talking.
The state has more mental health resources than it’s ever had, Butler said. More therapists and, as important, more training, both for those in the Department of Mental Health and outside, in communities.
The state has an anonymous, online self-check questionnaire that can, if indicated, connect an individual struggling with depression or addiction with a counselor.
The state also has a rapid response team that will send a counselor out to meet with someone in crisis who has called a mental health hotline.
From January to May, 120 faith leaders across the state received training on how to identify and work with people who are considering or may be considering suicide.
A new initiative called Communities of Care identified 10 counties with the most suicides where training will be increased for people working in communities: pastors, teachers, postal workers, neighbors. They are Aiken, Anderson, Berkeley, Charleston, Greenville, Horry, Lexington, Richland, Spartanburg and York.
“We will be able to save more lives,” Butler said.
Here are some resources for support:
Suicide Prevention Lifeline — This line is for anyone in need of crisis help. The Lifeline is available 24/7, toll-free, nationwide, at (800) 273-TALK (8255) – phone call or text.
Crisis Text Line — The Crisis Text Line is for anyone in need of crisis assistance but who is not able or ready to call into a resource line. Earlier this year, South Carolina received its own code for the line. The Crisis Text Line can be reached 24/7, nationwide, toll-free, by texting HOPE4SC to 741741.
SC-HOPES — This statewide, toll-free support line, available to anyone aged 12 years or older, is designed for all South Carolinians impacted by COVID-19 or any other associated stressors. Callers are linked to resources for mental health or substance use treatment or other needs. SC-HOPES is available 24/7, toll-free, at (844) SC-HOPES (724-6737).
Tu Apoyo — This line is a Spanish-language companion line for SC-HOPES. Tu Apoyo is available from 9:30 a.m. to 8:00 p.m. daily, toll-free, at (833) TU-APOYO (882-7696).
Online Mental Health Screener — This recently launched tool is a safe, easy and free service that allows users to anonymously take a Self-Check Questionnaire and connect with a professional counselor who can offer guidance, support and resources to help connect them with mental health and addiction services. https://hope.connectsyou.org/.
S.C. Department of Mental Health — The public mental health system, serving children, adolescents, adults and families through a network of 16 community-based mental health centers, with associated clinics. It serves all counties statewide. To find the location nearest you to learn more, visit scdmh.net or call (803) 898-8581.
S.C. Mobile Crisis — Mobile Crisis is for anyone experiencing a mental health crisis. Local Mobile Crisis Teams assess the crisis and can respond on-site, with law enforcement, if needed. S.C. Mobile Crisis is available 24/7/365, toll-free, statewide, at (833) 364-2274.
SCDMH Deaf Services Hotline — This line is dedicated to folks who are deaf or hard of hearing and in crisis or in need of resources. It is also available to contact for hospital consultation, telepsychiatry interpreter requests, and mental health center referrals. The Deaf Services Hotline is available 24/7, statewide, at (803) 339-3339 (VP) or firstname.lastname@example.org.