The paper handed to each freshman at Oak Lawn Community High School recently was filled with blunt and uncomfortable questions. Had they lost interest in everything? Did they feel they weren't as smart or good-looking as most other people? Were they thinking about killing themselves?
A squad of counselors stood by to interview those who, based on their answers, might have been struggling with depression or contemplating suicide. By the end of the day, more than 50 teenagers had come to see them.
Not long ago, some educators say, teen suicide was enveloped in silence, a subject too perilous to discuss. But candor has begun to gain strength in area high schools, where a new state law is promoting prevention training for teachers and staff. Some are going further, screening their students for signs of trouble or bringing in consultants for specialized instruction.
"It's like CPR," said Stephanie Weber of Batavia-based Suicide Prevention Services. "You don't take it hoping to save a life. You take it just in case you're faced with the opportunity."
While it's not clear that these initiatives affect suicide rates, some experts say they fight the negative feelings that can lead the vulnerable to desperate acts.
"Most of those who suffer from serious suicidal (thoughts) do not seek help from mental health professionals, and one of the major reasons is stigma," said Philip Rodgers, who evaluates programs for the Suicide Prevention Resource Center. "By decreasing that stigma, we feel that those who are at risk might be more likely to seek help."
For all the community trauma a teen suicide can produce, it is an exceedingly uncommon act. In Illinois, state figures show that about 1 in 17,000 teens of high school age takes his or her own life, a rate that has remained constant over the last decade.
The rarity of completed suicides makes it difficult to figure out how to stop them, Rodgers said. But about 1 in 16 high school students in 2009 reported that they had made an attempt, according to the Centers for Disease Control and Prevention, and some approaches have been shown to reduce the risk factors leading to that step.
Winnetka-based Erika's Lighthouse, formed in memory of a girl who took her life at 14, focuses on teen depression, a mental illness closely tied to suicide. The group has offered a program at 54 middle schools from Antioch to Chicago that aims to help students spot and respond to signs of the illness.
"The number of kids who are going to take their lives is so tiny compared to the number of kids who are struggling with depression," said Executive Director Peggy Kubert. "This helps them realize this (should not be) part of normal teenage development. It gives them a vocabulary to talk about depression, and to know where to go for help or to get help for others."
The group offers instruction to school officials, too, a service that is seeing new demand. Last year, Illinois passed a law encouraging teachers and school staff to update their training on suicide prevention when they are recertified.
One key is making them aware that depression and suicidal thoughts are far more common than people believe, said Rep. Greg Harris, D-Chicago, who co-sponsored the measure after a publicized cluster of suicides captured his attention.
Some schools touched by suicide in recent years have responded with a barrage of programs. Barrington High School, which over the last three years endured the self-inflicted deaths of five students and two staffers, started a community group focused on mental health, updated its health curriculum with the help of Johns Hopkins University and engaged medical researchers to evaluate its efforts.
At St. Charles School District 303, which suffered its own spate of suicides, officials put hotline numbers on the back of student IDs and started a Facebook page for mental health awareness. The district also advocated an open discussion of suicide.
"There were some people who felt that if you talk about it, you might motivate students or put the thought in students' minds," said John Knewitz, the district's assistant superintendent for student services. "The more we studied it, we came to the realization that that was not the case. It was something that needed to be talked about openly."
A sabbatical, not a student's suicide, prompted Oak Lawn Community High School's expansive program. Social worker Carol Gustafson used the break to research the delivery of mental health services, hoping to have help at the ready when a crisis emerged.
Three years ago, the school took it a step further, screening all freshmen for signs of depression or suicidal thinking. In late January, 270 students filled out a short questionnaire in their health classes, and a fifth of them were referred to counselors for follow-up interviews.
About half of those teens were offered free in-school therapy or referrals to outside counselors, Gustafson said. She added that the screenings almost always result in at least one student being hospitalized for a psychiatric emergency.
Parents are kept informed throughout, she said, and although they can excuse their children from the screening, only a handful do.
"I think it's an absolutely wonderful idea," said parent Maria Vanderwarren, who has one child at Oak Lawn and another about to enter. "You're showing the child that you care. If they can write (their problems) down, they know that there's someone there that can help them."
A day after the evaluation, Ariel Mindel of Mental Health America of Illinois, a Chicago-based advocacy group, gave the teens a presentation to help them recognize the hallmarks of a coming suicide attempt, from social withdrawal to a burst of inexplicable happiness.
The students listened attentively, but later some said the program had been unsettling, particularly the screening form. One boy said its questions were intrusive and "not really anyone's business."
Others saw it differently.
"If you don't ask," said 15-year-old Ashley Leidecker, "you're not going to get an answer."