Suicides among Georgia’s children and teens set yet another record in 2021, the most poignant sign of the mental health crisis among young people.

An 8-year-old boy hanged himself in a closet in Macon in 2021, the youngest suicide recorded last year. Three 11-year boys from metro Atlanta shot themselves. An 11-year-old girl died by hanging.

The cases multiply among older children, with dozens of suicide deaths of teenagers across Georgia. Many turned to guns to end lives that had barely started. Others used pills, ropes — even a dog leash attached to a clothing rod.

In rural Polk County in Northwest Georgia last year, four teenagers died by suicide.

A 16-year-old girl hanged herself in the middle of the night. A 17-year-old boy who had been reported missing was found days later hanging from a tree in a wooded area. Two other boys, ages 17 and 15, died after shooting themselves at home.

School officials in the county of 43,000 said it has been hard to find mental health care for children. Those who became suicidal were sent to psychiatric hospitals in Atlanta, more than an hour from home. Often, those experiences weren’t good, and follow-up care wasn’t always available, they said.

“The system is broken,” said Lacey Tuck, who coordinates services for the Polk County School District.

It is not just a rural problem, said Dr. Katherine M. Thomas, the district’s superintendent. “The need is everywhere,” she said.

A Georgia Bureau of Investigation review of suicide deaths among children under age 18 between 2016 and 2020 found that less than half of the children who died — 44% — had received mental health services at some point. Only about one in four who died were currently in treatment.

The state must do more to provide the services children need, Thomas said.

“As a state,” she said, “we have got to say it’s a problem, it’s a problem that we recognize and we’re willing to fund.”

Rural district takes action

Her school district couldn’t wait for that to happen. “The way we look at it, these are our kids,” Thomas said.

Students at the county’s two high schools endured the multiple suicides as well as the deaths of several students in accidents. “The kids were traumatized,” said Norman Smith, coroner.

Those who were in 11th grade also had lost a peer back in 7th grade when a 12-year-old Polk County girl live-streamed her suicide. The video of her hanging death was viewed across the country.

Polk school officials wanted every child who might be suffering to have easy access to help. But school counselors who focus on academic schedules and college plans aren’t trained to handle serious mental health issues.

So the district hired five licensed therapists and is currently seeking a sixth. Anyone can make an appointment – even teachers. It’s free and students just need a parent’s consent.

“We told our board and our community, we can act like it doesn’t exist or we can do something about it, and we chose to do something about it,” the superintendent said.

The district, which has 10 schools, now has an average of 350 students seeing therapists at any given time. Depression and anxiety are common, and there’s grief too, officials said.

Knowing that some children might not opt for therapy, the district launched community-wide messaging campaigns, with signs posted everywhere from school hallways to fast-food restaurant signs, telling students over and over: “You Matter " and “You Belong Here.”

It also brought mental health activities and suicide prevention events inside its schools in ways that touch everyone and normalize talking about mental health.

That’s another challenge throughout the state.

GBI found in its review of suicides among young people that there was a warning sign in only about a third of deaths: The child had talked about suicide.

The others who took their own lives hadn’t let on about any struggles.

Two sons lost

Michelle Cleveland’s 18-year-old son, Thomas, is one who never showed obvious signs of a serious mental health crisis. Yet in 2016, he shot himself in the kitchen of their home in Alpharetta.

Cleveland said his journals, discovered after he died, revealed he was struggling. But he kept his issues hidden to the point that his family didn’t pick up on any signs.

“We didn’t know,” Cleveland said. “We didn’t get him the help he needed.”

Less than a month after Thomas’ death, Cleveland got a call from a hospital in Athens about Thomas’ older brother, Nicholas, saying he had just been brought in.

“It doesn’t look good. You better hurry,” the hospital told her.

Nicholas had attempted suicide, too.

Unlike his brother, Nicholas had a long history of serious mental health issues and prior hospitalizations, dating to his high school years.

He went to a hospital ER with suicidal thoughts and shared that his brother had recently died by suicide, records show.

A doctor ordered an involuntary transfer to a local Crisis Stabilization Unit, which is part of the state’s system of psychiatric care to provide short-term treatment, often when someone is at risk of suicide.

Records show he was seen by nurses but never evaluated by a psychiatrist. Two days later, he was hearing voices, records show, but a nurse assessed him as better and arranged for his discharge.

Nicholas was transported to a homeless shelter, which was full when he got there, and his family wasn’t notified. That night, he jumped from a high parking deck and landed on a fence. He died two days later.

“It’s been six years now, and everything we do is colored by it,” his mother said. “Every choice we make, it’s somehow touched by what happened.”

For those left behind, the loss goes beyond devastation, Cleveland said. The best comparison, she said, is a nuclear bomb that leaves people suffering well beyond the initial explosion. “The fallout continues, and after the fallout it’s in the ground, and it continues to poison your life for decades if not forever,” she said

Cleveland said people frequently reach out to her for guidance as they try to find services for their own children who are in the midst of crisis. “They’re desperate. There’s not enough help. They don’t know what to do,” she said.

She said families need better information, especially when it comes to involuntary commitments, and she said the state needs more qualified mental health professionals, including those providing basic care inside psychiatric facilities. Plus, she said decisions about care should be based on what patients need, not on the bottom lines of the hospitals.

Cleveland said she tries to help, too, by being present with those who have lost their children and demonstrating resiliency. But even years in, Cleveland knows she is still finding her way.

“I have been living with it,” she said. “Now it’s time to figure out how to really live with it and come to terms with it.”

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org.