|An ever-vigiliant school district discovers that a well-funded town effort can keep kids from killing themselves.|
As Richard Lieberman inches his car through traffic in Los Angeles, his beeper and his cell phone buzz in unison. In any given month, Lieberman fields hundreds of calls from teachers, principals, and counselors working for the Los Angeles Unified School District, home to 700 schools. Today, the callers have some disturbing news to report: One student has shown a morbid drawing to a teacher; another slashed her arms; and a third is talking about hearing voices “that are making her do things.” These kinds of calls are not unusual for Lieberman, whose job description is simple: Keep children from killing themselves. “They call me Suicide Man,” says the director of the district’s Suicide Prevention Unit.
Lieberman doesn’t work solo. He’s backed by a district-run mental-health facility, a city teeming with psychological clinics, and a $14 million annual budget. The investment appears to be paying off: The district has seen the number of suicides among its 700,000 students drop from 35 in 1989 to 19 in 1997 (the most recent year for which figures are available).
In contrast, the national suicide rate among teenagers has more than tripled since 1960. It’s so high, in fact, that suicide is a bigger cause of death for people age 19 and younger than cancer, heart disease, AIDS, pneumonia, lung disease, and birth defects combined, according to Tom Simon, a suicide researcher at the U.S. Centers for Disease Control and Prevention in Atlanta. But despite the uphill trend, only one other school district—Florida’s Miami-Dade County system, with 350,000 students—has someone on staff who specifically deals with suicides.
Aside from access to Lieberman, every Los Angeles school has a counselor and a crisis team on site. Though counselors usually are trained to keep therapy sessions confidential, many schools demand that warning signs be reported to educators and parents. Those signs include sudden changes in attitude, drops in grades or attendance, and suicidal notes found in homework or class journals.
Gloria Grenados, a psychiatric social worker at one of the district’s most crime-battered schools, is constantly on alert. “We get two suicide attempts a month. I’ve even had three in a day,” claims Grenados, who is counselor, confessor, and surrogate mother to many of the 4,900 students at Bell High School.
The district strategically deploys social workers, in addition to the crisis teams, in 200 of the system’s neediest schools. Bell High School, which sits in a poor South-Central Los Angeles neighborhood, used to be notorious for suicides, averaging two a year in the early 1990s. Since Grenados arrived in 1993, not one Bell student has committed suicide.
Grenados turns on a laptop computer in her office to display her caseload. With each fresh screen, a collection of student woes appears: a 15-year-old boy who attempted suicide at school by tying a cord from his sweatpants around his neck; a 14-year-old girl who has a 2-year-old child she neglects; a teenage girl who contracted a sexually transmitted disease from her father, who allegedly raped her.
“This is heavy-duty stuff,” Grenados says. “So many of these kids have lost parents to death, substance abuse. . . .They are so glad that someone is willing to listen to the pain they have harbored for so long.”
Grenados’ tells her “hard cases”—students who have expressed suicidal thoughts—to check in with her daily. If they don’t show up, or they cut class, she calls parents or police. Parents who fail to seek psychiatric help for a clearly suicidal teen-ager are often reported to the county’s department of children and family services. “If a kid has a broken leg, and parents say he doesn’t need treatment, that’s neglect,” explains Marlene Wong, the district’s director of mental health. “Mental illness is just as real as epilepsy or diabetes.”
Once she’s identified a suicidal student, Grenados may refer him or her to one of several places for help, including a psychiatric ward and public or private clinics. But she has another option, one that no counterpart in another district has: a child-psychiatric clinic run by the school system.
|Despite the district’s success in reducing the student-suicide rate, more must be done to help children in the earliest grades.|
Housed in a bungalow classroom shaded by eucalyptus trees in Los Angeles’ San Fernando Valley, the clinic is a warren of cozy offices in which 11 psychologists, psychiatrists, and social workers counsel district students five days a week. With the help of 50 interns—all graduate students in psychology—the clinic resembles a university health center. It serves 70 patients a day for problems ranging from post-traumatic stress disorder to difficulties managing anger.
The clinic operates in large part because of a cost-sharing arrangement in which Los Angeles County provides half the clinic’s $1.2 million annual budget. The rest of the funding comes from Medicaid reimbursements; half the clinic’s patients are eligible for the federally subsidized health plan for the poor. But all students are served free of charge, whether they’re homeless or well-heeled. “We take anyone, regardless of money,” says Gil Palacio, one of the clinic’s coordinators.
Despite the district’s success in reducing the student-suicide rate, Wong, the mental-health director, says more must be done to help children in the earliest grades. Psychologists, she explains, are able to detect whether children are at risk emotionally as early as pre-school. “When it’s a very bumpy road,” she says, “we can bring children back to learning more quickly if we start early.”