The mantra for Utahns dedicated to finding ways to keep children from killing themselves is: Suicide is not an option.

Yet despite their best efforts, young people will take their own lives.

"I'm an expert in teen suicide," said Doug Gray, a University of Utah child psychiatrist. "Not every suicide is preventable, but most of them are."

Gray is among a handful of people who devote much of their off time looking for answers to the state's suicide riddle.

Utah loses at least three teenagers to suicide every month and one person of any age every 30 hours. The state's suicide rate consistently hovers among the 10 highest in the nation and has exceeded the U.S. rate for two decades.

But prevention efforts are inconsistent at best. Promising programs fall to the wayside for lack of funding. Task forces form with a slew of good ideas that eventually fizzle.

Sherri Wittwer spends her day as an advocate for mentally ill people, one of the most misunderstood segments of society. Many of them have suicidal tendencies.

"People say to me all the time, 'How do you do that?' It's because there is hope. Treatment is available. Recovery is possible. We see it," said the executive director of the Utah chapter of the National Alliance for the Mentally Ill.

"I think hope is the answer."

Those who think about ending their lives often don't see light at the end of the tunnel. And those around them — friends, parents, teachers — don't know the warning signs or how to react if they do.

"It's too late when you're reactive," said Greg Hudnall, executive director of the Hope Task Force. "You're already losing kids."

Some high schools and junior high schools have taken a proactive approach.

The Utah chapter of the National Alliance for the Mentally Ill started a school-based suicide prevention program after what Wittwer called a "rash" of suicides at East High School six years ago.

Called Hope for Tomorrow, the program has reached 55,000 students in 55 junior and senior high schools statewide. Preliminary results of a study to measure its effectiveness show referrals to counselors or other adults is up as a result, Gray said.

One of the biggest problems with past prevention programs is that they didn't link people to help. Programs also need to be aimed at the most at-risk population. "People who are getting help don't suicide," he said.

An alarming suicide rate in Wisconsin prompted its state legislature to require public schools to teach suicide prevention.

Suicide risk is usually underestimated, said John Hisgen, a Wisconsin health and physical activity consultant. "We tend to believe people will not go to that extreme to end their lives," he said

Hisgen and several teachers developed educational strategies that have become a national model. The program teaches students to acknowledge, care and tell an adult when a friend or peer is hurting emotionally.

Only in recent months has there been a renewed interest to address Utah's suicide problem.

Attorney General Mark Shurtleff brought in an out-of-state organization last fall to provide awareness and education. The state Division of Substance Abuse and Mental Health has made suicide prevention a higher priority, which reflects a new emphasis at the federal level.

"Suicide right now seems to be a hot topic," said Ron Stromberg, state mental health director.

Other than a resolution in 1999 that resulted in a youth suicide task force, state lawmakers have done little to address what the health department 10 years ago deemed an epidemic.

A bill in the 2006 Legislature calling for another task force died after unwieldy amendments were added to it.

Those who have worked on prevention and awareness the past decade or so say the time for talking is past.

"It's a waste of time to create another task force," Gray said. "We've talked enough. We need to do."

Yet there will be more talking.

The state Division of Substance Abuse and Mental Health recently contracted with NAMI to coordinate and oversee a task force that will develop a statewide suicide prevention plan.

Despite his desire to do rather than talk, Gray will be part of it as will other longtime advocates for suicide awareness and intervention.

Wittwer says the group will not attempt to reinvent the wheel but use the knowledge it has gained over the years to progress.

"We have that in common. We are impatient, and we need to move on," she said. "We are all about implementation and moving on to focus on solutions."

Mental health division director Stromberg has $33,000 in federal grant money for the task force to work on a plan, but he's not sure if the state will have funds to put it into practice when the plan is completed early next year.

"Will there be money to do this? I don't know," he said.

Money has and will continue to be a hang up.

The Bryner Clinic in Salt Lake City received a private grant to screen children for mental health problems when they come in for checkups or with runny noses. Pediatricians work with psychiatrists and psychologists to assess a child's overall health.

Even though it's a team approach that works, Gray said, it won't last indefinitely. "The difficulty is if the grant runs out, the program disappears," he said.

Hudnall, the Provo School District student services director, organized the Hope Task Force seven years ago because he could no longer bear to see rescue teams pluck stranded youngsters from a mountain, while suicidal teens' cries for help went unheeded.

"We decided to build this statewide program, and we're doing it with nickels and pennies," he said. "It's just a group of people that got together and said, 'How can we help each other?' "

Gray wonders what might happen if those volunteers burn out or get sick. "How many years can you ask someone to use their vacation days to keep a project going?" he said.

"Why not look at government agencies to get them some level of funding to keep them going?"

So far, the Hope Task Force has been one of the most active prevention and awareness groups in Utah. It also has the only "post-vention" team in the state, which helps communities and schools deal with the aftermath of a suicide. It has made presentations throughout Utah and has received calls from Nevada, Wyoming, Colorado and the Dakotas.

The Provo School District goes so far as to compile annual statistics for suicide attempts, hospitalizations and completions. It's the only district in the state that does so.

"We want to monitor concerns (to see) whether the problem is getting larger," Hudnall said. "We want to track exactly what's going on."

Provo schools also take an active role in suicide awareness.

Timpview High School empowers students to help classmates who have contemplated taking their lives.

At the first of the school year, social worker Wendi Christensen and guidance counselor Monte Marshall survey students to see who among their peers they would turn to for advice. The top 25 or 30 names are invited to join the Hope Squad.

"We're just kind of there for the students," said senior Emily Gillespie, a three-year member and president of the squad.

Team members are trained to talk to classmates who struggle emotionally. They also refer them to Christensen or a guidance counselor. They are not afraid to ask students if they have thought about suicide.

"It's usually a relief for them," Christensen said.

Timpview administrators figure the program has headed off at least two or three suicide attempts.

"It helps them to know there are people out there that can assist them. Sometimes they forget that," Christensen said. "(Suicide) is something we can prevent. We just have to let them know there are other options when they want to escape, want a way out."

Principal George Bayles said the school is trying to break down the notion that you can't "narc" on friends who talk about suicide. Two Timpview students have taken their own lives the past three years.

"The reason we do it is to be proactive, not because we're having a real problem with it," Bayles said.

The Hope Squad sponsors a suicide prevention walk, presents an awareness video and sets up an information booth during the school year. The video is part of NAMI's Hope for Tomorrow program.

"It didn't aggrandize suicide," he said. "It didn't promote the thought that this is the way I can get some attention."

Still, he has parents object to talking about suicide in school. When people complain, Bayles says to them, "Why don't you go tell that boy's mother we spent too much time" on suicide prevention.

"One life makes it worth it."

Timpview is one of the few schools in Utah that talks openly about suicide. Bayles said he doesn't understand why schools aren't willing to address it.

"If they haven't had one (suicide), they're going to. I guarantee you they have kids who are thinking about it or who have tried it. . . . I don't know how you can not do anything."

Shurtleff shares the feeling.

The topic of suicide came to his attention during a national attorneys general meeting two years ago. His counterpart in Tennessee talked about the issue and his involvement with a Nashville-based prevention group called the Jason Foundation.

The speech hit him hard because before leaving for the conference his own son said he wanted to kill himself. Shurtleff's response was, "Oh, come on. Don't be silly."

Those words came back to haunt him, and he immediately walked out to call his son. He apologized and promised they would talk when he came home.

"I thought how awful. I can't believe I said those things. They could really be hurting. How could that make him feel?"

The more Shurtleff learned about suicide, the more he became an advocate for prevention and awareness. He doesn't mind using his position to get the word out, even if it's uncomfortable for Utahns.

"It is a taboo subject. They don't want to talk about it. It's an 'all is well in Zion' type of thing," he said. "We need to do something with the stigma."

Last November, Shurtleff brought the Jason Foundation to Utah. Thirty-three attorneys general are now associated with the prevention program.

"A lot of them see it as a charge for the protection of youth in their state," said Clark Flatt, who founded the organization in Hendersonville, Tenn.

There were some raised eyebrows among the state's suicide prevention fraternity when Shurtleff introduced the Jason Foundation. They didn't see the need to bring in an outside organization.

Flatt said it isn't his intent to tread on current efforts in the state because good local and regional resources already exist. He's looking more for collaboration.

"It's too big a problem for one organization," said Flatt, whose 16-year-old son, Jason, shot himself in 1997. "Our main mission is to get people to do something."

One thing the Jason Foundation has going for it is money and national affiliations. The American Football Coaches Association backs the foundation, and local college coaches agreed to do public service announcements about suicide prevention.

The foundation offers free training to teenagers, parents and educators. It has a school-based curriculum for students, in-service presentations for teachers and seminars for parents.

Clear warning signs precede 80 percent of suicides, according to the American Psychiatric Association.

"They key is learning how to recognize those signs and knowing what to do when you see them," Flatt said.

Failing to act can have dire consequences. "Sometimes," he said, "that hesitation is lethal."


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