Earlier this year when state lawmakers met in Carson City working furiously on education funding, criminal justice reform and gun laws, there was a hearing on one issue that shocked just about everyone.
Suicide for Nevada’s very young people almost doubled in a single year, from 2017 to 2018.
In 2018, 27 children and teens under the age of 18 took their own lives; 15 did so in 2017. Of those 27, 19 were in Clark County.
Misty Vaughn Allen is the suicide prevention coordinator for Nevada's Department of Health and Human Services. She said the final report hasn't been released yet but Clark County and the Child Fatality Review Committee have looked into what might be linking these teenage suicides together.
She said anxiety and depression have increased among young people across the country. Nationwide, youth seeking help in emergency rooms for thoughts of suicide or suicide attempts has doubled recently, she added.
"The challenge with preventing suicide is that it is so complex," Vaughn Allen said, "The whys are very difficult to determine. There are multiple risk factors that go into risk for suicide."
Some of those risk factors include feeling isolated and lonely, academic and family stressors and increased screen time.
"Research has shown the more time someone spends in front of the screen be it a phone, video games or television their risk for suicide increases," she said, "I think part of that is isolation and loneliness but also not feeling connected, we reach out more and more to those screens."
Vaughn Allen said communities need to build connections and improve relationships. She said research shows that strong, trusted relationships between adults and children can increase the sense of community and lower suicide rates.
The times those connections can become even more critical, she said, is during transition moments in a child's life. For instance, between elementary and middle school and middle and high school. Vaughn Allen said adults should be even more watchful.
Often a stigma about talking about suicide can stop adults from talking to children about it.
Theresa Noonan is a family therapist. She said adults underestimate children's ability to communicate.
"Something like killing one's self or suicide, I think you just put it out there to them," she said, "What I do in my practice is I just put it out there to them and ask, 'Are you feeling suicidal or have you ever thought about killing yourself?'"
She said with those blunt questions you can assess the situation and see what is going on. Noonan compared asking the question to releasing the steam from a pressure cooker.
"A lot of times people are bottling up their feelings of whatever suicidal thoughts they're having, wanting to kill themselves or just the thoughts in general," she said, "When you ask someone, 'Are you thinking of killing yourself?' It gives them the opportunity to open up that pressure cooker and say, 'Well, yeah, things have been really tough.'"
Noonan said if a teenager or young person is acting more depressed or angry than a normal teenager it is vital to talk to them and ask them if they are okay.
Vaughn Allen said the state has launched a new program for when people who are struggling with suicidal thoughts do reach out. It's called Zero Suicide.
The state is working with hospitals and healthcare centers so that all workers are trained on how to react to someone with suicidal ideations.
"Ideally, when [a caller] reached out, every person she encountered would be able to ask her about her thoughts of suicide, put her on a pathway to safe care, have a safety plan when she leaves the facility to help manage her ideation of suicide possibly," she said.
Vaugh Allen said the program is important in a state like Nevada that suffers from a shortage of mental health professionals.
And nowhere is that shortage felt more profoundly than in the rural parts of the state.
Gerald Ackerman is the assistant dean in Rural Health at the University of Nevada, Reno. Ackerman noted that while the number of suicides is larger in the state's population centers because more people live there, the rate of suicide is bigger in the state's rural counties.
"If you look at Clark County, we're almost 10 deaths per 100,000 higher than Clark County," he said, "Unfortunately, that trend continues year to year."
One of the biggest hurdles is access to mental health care.
"Almost every county in Nevada has a mental health professional shortage area and that includes psychiatrists, social workers, marriage and family therapists," he said, "One is access. Two is counseling services and intervention services."
He said tele-mental health services can help but even then there is a shortage because mental health professionals in Clark and Washoe County can barely keep up with their own caseload, let alone adding rural counties.
National Suicide Prevention Lifeline
Counseling Services – University of Nevada, Reno
Counseling Center – Truckee Meadows Community College, Reno
Student Wellness Center – University of Nevada, Las Vegas
Mobile Crisis Response Team - Hotline: South: 702-486-7865 or North: 775-688-1670
Crisis Call Center - Text Line - Text - "Listen" to 839863
De Prevencion del Suicido - 1-888-628-9454
Misty Vaughn Allen, suicide prevention coordinator, NV Department of Health and Human Services; Theresa Noonan, Las Vegas therapist; Gerald Ackerman, UNR assistant dean in Rural Health, director of Nevada Area Health Education Center