Bonnie McLelland had just sat down to a Mother's Day dinner with her son Tim when she spotted something shiny on his arm. Show it to me, she said. No, Tim answered. "You're going to fall asleep at some point and I'll just go in and look," she countered. "You might as well show me now."
Tim unveiled his left forearm.
"I am in hell," it said. He had scrawled the words with a hot ballpoint pen.
Eighteen months later, on Jan. 21, 2002, Timothy Michael McLelland would commit suicide in his bedroom in the Seminole house he shared with his mother. He was 17. He was one of 40 people ages 15-24 to take their own lives in Hillsborough, Pinellas and Pasco counties last year. He was among the roughly 1,600 teens to commit suicide in the United States last year.
Tim McLelland's suicide note, barely legible because of his severe dyslexia, ended, "Learn from this and help each other." His death caused a series of aftershocks that left his friends in a black hole of guilt and hopelessness. Some of them also considered suicide, and two actually killed themselves. His mother, meanwhile, was moved to form a suicide awareness organization that would help teach the kids to watch out for each other and foster a collective healing. But she, too, would nearly opt for the permanent solution.
In the face of continuing anguish, Bonnie McLelland leads the Pinellas chapter of the Yellow Ribbon Suicide Prevention Program, which meets twice a month in the showroom of Scott Buick in Pinellas Park. Tim's death is never far from her mind. "It's the only thing I can do for my son," she says. "It was his last request."
Youth suicide is not exactly a hot-button issue. When Gov. Jeb Bush held a news conference for Florida Suicide Prevention Day on March 26, veteran St. Petersburg Times reporter Lucy Morgan opened the Q&A period with a question about the Equal Rights Amendment, effectively squeezing suicide out of the discussion.
"For most people, [suicide] is probably a squeamish topic," says Dan Casseday, whose 16-year-old son killed himself in March 2002. "But it's certainly a huger issue than SARS. If people understood the statistics about suicide, there'd be panic about that."
Suicide ranks as the third leading cause of death for young people, behind accidents and homicide. Suicides account for 1.2 percent of all deaths in the U.S., but they comprise nearly 13 percent of deaths in the 15-24 age group. In 2000, Florida's overall suicide rate ranked 11th among states, the highest in the eastern part of the country.
The death toll tells only part of the story. Recent data released by the Substance Abuse and Mental Health Services Administration showed that approximately 3-million youths ages 12-17 thought about or attempted suicide in 2000. More than a half-million teens a year make suicide attempts requiring medical attention.
Girls are nearly twice as prone as boys to attempt suicide, but boys are more than four times as likely to kill themselves. Girls tend to take pills, while boys resort to more violent means: guns or ropes.
Can there be a worse way than suicide for a child to die? Can there be a more devastating event for a parent? "It's against the nature of things," says Sheryle Baker, director of Life Center of Tampa. "Parents are supposed to keep their kids safe."
Bonnie McLelland walks into the Scott Buick showroom and props a framed photo collage of her late son on a table. She's wearing black pants and a black Yellow Ribbon T-shirt with "Learn from this and help each other" inscribed on the back. She greets 23 people — split about evenly between adults and kids — who sit classroom-style in front of her.
A palpable pain courses through the room. Jan Plum has had six friends and relatives take their own lives. Her daughter, sitting in the row behind her, threatened suicide a couple of months ago. Carol Yaros' husband attempted to kill himself two weeks before her son completed suicide last June. Her husband, she says, is still in bad shape.
A burly 15-year-old we'll call Brendan, with dark features and deep, sad eyes, attempted suicide on Jan. 1 by mixing powerful cold medicine and alcohol. Barely conscious, he staggered into the living room and mumbled, "I don't wanna die." His mother, who sits next to him during the Yellow Ribbon meeting, says she took him to the emergency room, where he stayed five days, followed by a short spell in a mental health facility. Caregivers mistakenly gave him anti-psychotic medication, she says, which caused her son to have severe muscle spasms.
Brendan is withdrawn, speaks in clipped sentences barely above a whisper. Why did he try to end his life?
"I thought my family and friends were better off without me," he murmurs, his hands wringing a piece of paper into a tube. Some five months later, Brendan's mother is still anxious. "After having gone through that, I don't know if I can ever comfortably feel that any of my kids are out of the woods," she says. "I was totally unprepared. I didn't think it would ever happen."
She's not alone. In a recent poll, 90 percent of parents said that they would recognize suicidal tendencies in their child. But such recognition, experts say, is seldom the case. Young people are extremely adroit at masking their feelings; amid the tumult of teenage years they are more inclined to keep suicidal thoughts a secret.
It's all out in the open for Brendan, of course. He says suicide is no longer a solution. "A lot of people want to end their life once in awhile," he says. "And I have those thoughts. But I don't wanna do it."
What separates youngsters who consider suicide and those who actually go through with it is generally a prolonged mental illness, usually depression. A 1995 study showed that 63 percent of people committing suicide had been psychiatrically impaired for 12 months or more.
"Suicide is the lethal result of untreated depression," says Laurie Flynn, director of the Carmel Health Center for Early Diagnosis and Treatment at New York's Columbia University. "Suicide rarely happens in the absence of depression, and depression can be treated."
Tim McLelland was depressed for a long time, says his mother, and he did not benefit from treatment.
His father was rarely around. He was an only child. His dyslexia was chronic. During Tim's pre-teen years, Bonnie placed him in a series of private and alternative schools. She moved to Seminole because she was told that Seminole High School would be a comparatively good environment for a dyslexic child. In her view, it didn't turn out that way. Bonnie says he was humiliated, not helped, by the way school officials handled his special needs during tests.
Despite his problems, Tim grew into a tall, handsome kid with his share of friends. When his mother hit financial straits, he took a job washing dishes at a retirement center to help out. At 16, he landed a gig stocking soda shelves at Publix.
Bonnie tells the story of her son's short life while seated on a sofa in the living room of her modest Seminole home. The ringing of wind chimes outside occasionally wafts through the house. Her eyes well up with tears now and then, but she never breaks down.
Tim was highly sensitive. When Bonnie discovered the "I am in hell" burned into his arm, she asked him why he did it. "He said that when he looked into people's eyes, he could see their souls," she recalls. "And he could see that people were not connected."
Alarmed, Bonnie sought help. She says she called the school guidance counselor, who in turn brought in the school psychiatrist, who then consulted with the assistant principal. Next thing she knew, her son was committed to Pinellas Emergency Mental Health Services under the Baker Act, which allows involuntary psychological evaluation of people if it's deemed they are a danger to themselves or others. "He hated that facility," Bonnie says. "He was there for five days. Kids were screaming. They fed him crap. It was like a little jail."
After his Baker Act ordeal, Tim gradually improved. That summer, he and his mom went whitewater rafting in Tennessee. "He seemed like he was doing great," Bonnie says. "The psychologist's notes said he was getting better."
Not all youth suicide trends are bad. While the number of suicides has tripled since the '50s, it actually began to dip in the mid '90s. Statistics from the Center for Disease Control say that in 1991, 10 of 100,000 people in Florida ages 10-24 committed suicide. By 1999, that number had dropped to six out of 100,000. The decline is accompanied by a major increase in the number of antidepressant prescriptions written for young people.
Columbia's Flynn does not think that's a coincidence. "We feel it's a reflection of better treatment — the increased use of antidepressants like Prozac that are easier to tolerate," she says. "Also, depression seems to be getting a little de-stigmatized. As a result, we think we're seeing more people raising their hand and getting the treatment they need."
But not enough people are getting help. A recent study said that only 36 percent of young people at risk for suicide receive treatment. Most mental health care professionals share the notion that youth suicide could be all but eradicated if the public health system were set up to get kids the care they need.
For his junior year, Tim McLelland began attending Pinellas County Technical Institute part time, studying electronics. As his mother tells it, the teacher instructed the students to bring in a pocketknife to strip wires. Bonnie describes it as a "good-size pocket knife that I bought him at Wal-Mart for Boy Scouts."
One day, she says, Tim missed the bus and decided to skip school. The high school resource officer apprehended him, found the knife and marched him through the school in handcuffs. Tim was charged with a second-degree felony and expelled from school in September. He was sentenced to 10 days public service. "He never recovered from that," Bonnie says. "The pain they put him through — all he had left was his pride and they made him a felon."
Tim joined a program for expelled kids but was not allowed to continue his electronics studies. After a while, he quit school and decided to get a GED. The test had to be read aloud to him. Tim received his failure letter in mid January.
Meanwhile, he wasn't making his psychologist appointments. The office staff left messages, but Tim would come home and erase the answering machine so his mother wouldn't find out.
Tim had three days to live when he gave his best friend Sebastian Urbanczyk a ride to pick up his car. Tim seemed in good spirits. Sebastian now thinks Tim might have already decided to end his life and was relieved to have made up his mind. Sebastian called his friend the two following nights, but Tim didn't feel like getting together.
The evening before Tim died, another friend, Tracy Consoli, looked at the Publix nametag he had given her and thought she should phone and see how he was doing. "I should've called him," she says. "I'm the type of person who tries to make other people happy. Maybe he would've thought, 'Someone was actually thinking about me.'" Her voice drops. "But I didn't."
On Sunday, Jan. 20, Bonnie McLelland went to visit a friend in Tampa. "Tim called me there and asked me if a girl can be pregnant and still have her period," she recounts. "He said a friend of his was having a problem. I said, 'Tell your friend his girlfriend is snowing him.'" Bonnie knew her son was talking about himself but, at the time, thought it better to play along.
Driving home amid thick fog, Bonnie had an eerie feeling. She thought maybe her father, who had terminal cancer, had died. She woke the next morning, read the paper, drank coffee. Tim's car was out front. Bonnie decided to run the vacuum, which they kept in Tim's room.
That's where she found him.
"I think Tim had made the decision to kill himself but didn't know what day," she says. "He did it on a day that the shit just piled up too high."
Most activists think suicide should come off the taboo list. Put it on the table for open discussion, they insist, even among young folk. And the best place for it is in the schools.
But some researchers aren't so sure that's an appropriate strategy. In a 2000 report, the National Institute of Mental Health gave a failing grade to the in-school suicide awareness programs it evaluated. "By describing suicide and its risk factors," the report said, "some curricula may have the unintended effect of suggesting that suicide is an option for many young people who have some of the risk factors and in that sense 'normalize' it — just the opposite of the message intended."
Flynn of Columbia, whose current focus is suicide prevention in schools, essentially concurs. "In case examples, we've seen it stirs up some kids, makes them more anxious, seems to give them permission," she says, adding that while suicide should not be a forbidden topic, it's better taught in context of a "general unit on mental health that covers a lot of material. To dwell on suicide is probably not recommended."
Instead, Flynn advocates screening kids for mental health disorders. She is joined by David Shern, dean and professor at the Louis de la Parte Florida Mental Health Institute at the University of South Florida. "The initiative is to see that every kid in the United States receives [mental health] screening," he says, "just like they do for vision and hearing and scoliosis. It's all about growing up healthfully."
At the leading edge of the screening, or "case-finding," approach is a system developed at Columbia called TeenScreen. After receiving parental permission, students take a 10-15-minute written questionnaire that queries aspects of their mental health. About 40-50 percent of kids move to the next phase: Using a computer and headphones, they enter responses to a series of yes-or-no questions about their mental state. "Do you have trouble staying awake in school?" the computer asks. "Do you have trouble going to sleep at night?" Each yes answer elicits a more specific question ("does it happen every day?"), thus drawing a detailed profile of the disorder. "If a student affirms that he's thought about killing himself," Flynn says, "the computer asks, 'This week?' 'How frequently?' 'Have you made a plan?' 'Have you tried to kill yourself?' What we're finding out is that the kids'll tell ya. They get into it. It's about their favorite subject: them. They're relieved to talk about it."
Columbia TeenScreen offers the technology for free, but a health professional must be on site during testing to assess results and respond accordingly. Thus far, the program has found that about 20 percent of the youngsters tested need counseling; 10-15 percent show some "suicidal ideation."
Local mental health professionals, including representatives from the Hillsborough and Pinellas County school systems, have seen presentations on TeenScreen. They recognize its effectiveness but are concerned with what happens after kids are diagnosed.
Who will treat the new influx of students with mental disorders? Who will pay for it? Most mental health institutions are stretched thin and feeling a budget squeeze, be it from government cutbacks or a drop in donations. Schools, the most obvious venue for such a program, are reluctant to take the lead.
"We felt that we could not set up a system to provide the necessary services for students identified to need treatment," says Linda Jones, Pinellas County's supervisor for Safe and Drug Free Schools. "It's not a good idea to screen unless you can provide care."
Gwen Luney, assistant superintendent for supportive services and federal programs at Hillsborough County Schools, says TeenScreen would cost the school district roughly $200,000 a year — $200K they don't have. Although she's impressed with the screening technique, she said, "We're hesitant to commit to a new program if there's a strong possibility we'll be seeing some [money] shortfalls. Also, are we going to find a place for this [diagnosed] child to go? If so, what if the child doesn't have insurance? Who picks up the cost? Does it get passed on to the county? It can't be passed on to the school district. And the liability factor is greater now that you've identified [the at-risk student]."
Flynn maintains that creative synergy between schools and mental health institutions can save lives. She says TeenScreen pilot programs have not overstressed treatment resources in other communities. "How many are they willing to help?" she asks. "Two, three, five cases a week?"
Nancy Pape is the program manager for Children's Crisis Services at Mental Health Care, Inc., the only facility left in Hillsborough County where young people can get in-patient psychiatric treatment. Last year, her facility did 1,392 psychiatric evaluations of young people. Of these, 909 showed "specific suicidal ideation," or about two-and-a-half per day.
"I think something like TeenScreen would be especially effective in picking up early signs of emotional problems," Pape says. "So in that sense I think it would [have more impact on] outpatient programs. I'm confident that our program could handle the referrals of the most acutely suicidal or depressed."
Bonnie McLelland's father succumbed to cancer on the Easter Sunday following Tim's suicide. She says her three sisters abandoned her. "They can't forgive me for what happened to Tim," she says.
But Bonnie did stay in touch with Tim's friends. And on May 31 of last year, she formed her Yellow Ribbon chapter in Pinellas. The organization was founded nine years ago by a Colorado couple whose son committed suicide.
For a few weeks, Tim's friends stayed locked in a kind of surreal disbelief, even though they knew their friend had been troubled. Guilt made their days darker. "Everybody knew [Tim was at risk]," says Tracy Consoli. "You could see it. We pretended it wasn't there, that he was fine, that he'd be OK. We were afraid to risk our social value, to be the one who actually stood up and did something. Tim was asking for help and we didn't give any."
Meanwhile, Sebastian was sinking lower and lower. He dropped out of school: "It got to the point where I couldn't concentrate."
Sebastian says he had considered killing himself before Tim's death, but "Tim's suicide pushed the idea in front of me."
One of Yellow Ribbon's main tenets is to urge kids to inform a responsible adult if they fear someone they know is contemplating suicide. Bonnie drummed it into the kids' heads.
One day in August, Sebastian was driving around with his friend Jessica. He was speeding and vaguely threatening to end his life that night. Jessica told Tracy. Tracy called 911. The sheriff's department heard, erroneously, that there was a gun involved.
Tracy and some other friends watched as police carted off Sebastian in handcuffs. He'd been Baker Acted. Spent a few days in Windmoor Health Care in Pinellas Park. Sebastian, now 19, says he was never completely serious about killing himself last summer. "One of the reasons I didn't do it was seeing how everyone got hurt by Tim, all the pain it caused," he says.
But that's not a good enough reason, and Sebastian has gradually come to the conclusion that "I'm not gonna kill myself 'cause I wanna live."
At first, he was mad at Tracy for having him Baker Acted, but no longer. "I don't hold nothing against her," he says. "I understand why she did it."
Last December, the shit nearly piled up too high for Bonnie McLelland. Her stepsister died a week after her father. A friend was killed in a motorcycle accident in November; another friend died of a stroke two weeks before Christmas. "I came really close," Bonnie says. "I laid plans out, wrote down what people should have that I left behind. Then I thought, 'If someone has to come and pick my body up like I did Tim's, I don't care if it's an EMT, I can't do that to another human.'"
But that too wasn't a good enough reason, so Bonnie worked on healing herself.
She knew her decision to live had really taken hold in February. While she was riding home from work on I-275 in Tampa, a truck crowded into her lane. She swerved and her car started to spin in traffic. "I was headed toward a concrete embankment," she says. "And I thought, 'I choose to live.' I ended up facing traffic on the Interstate. I felt my son's energy come and save me."
Bonnie knows that her efforts with Yellow Ribbon will always keep the tale of her son's death fresh in her mind and close to her lips. But it's worth it. Besides, she says, "It's therapy. It gives me fire. It keeps me in the game."
Senior Writer Eric Snider can be reached at [email protected] or 813-248-8888 ext. 114.