Suicide rates rise steadily among young people, stigma remains largely unaddressed
Sheridan Hendrix | November 29, 2017
When Adam Doleh heard his younger sister Emily was thinking about studying medicine at either the University of Michigan or Johns Hopkins University, his mission became selling her on Ohio State.
A fourth-year in chemical engineering and Cleveland native, Adam was eager for her to check out the Columbus campus during her senior year of high school. He even got special permission to have Emily visit one of his engineering labs.
During her visit last September, he took Emily to the top floor of Koffolt Laboratories. He pointed out how close Scott Laboratory was and how little walking she would have between her classes. Adam showed his sister the new North Campus residence halls where she could be living in less than a year.
After much deliberation, Emily was convinced. She even changed her major to chemical engineering, just like her big brother.
“It was something he really wanted me to do,” Emily said.
Adam couldn’t wait to show his sister around campus, both as Buckeyes. Only, that day never came.
On Jan. 2, Adam killed himself, seven months before his sister would move to campus.
Adam had been struggling with mental-health issues since October, according to his mother, Dawn Doleh. One night that month, after a relationship with a longtime friend began to sour, she said he threatened to kill himself. His friend called Dawn and the police, who took him to the hospital.
At the hospital, Adam was diagnosed with depression. Dawn was shocked.
He was assigned a counselor on campus and told his mom he was taking his medication regularly. In his last semester at Ohio State, Adam earned straight A’s and had a 3.9 GPA.
After Adam’s episode in October, his family and roommates saw no warning signs of suicidal thoughts, Dawn said. When he went home for Christmas break and appeared to be doing much better, the hospital visit seemed like a distant memory.
The news of Adam’s death devastated the Doleh family — his father, Yaser; younger brother, Zane; Emily and Dawn.
Emily was at quartet practice at North Royalton High School, just outside of Cleveland, when Dawn called her to come home. It was about Adam. She started to get nervous.
Maybe Adam was in a car accident, she thought. Please let it be a car accident.
Adam killed himself in his friend’s backyard that January morning. It was the same friend who had called the police three months earlier.
It’s uncertain why exactly Adam chose to take his own life. It’s uncertain whether he ever attended his counseling sessions or how often he took his medication. The truth was that Adam hid his pain from his family.
Depression, Dawn said, was something Adam thought he could handle alone.
“He didn’t want Emily and Zane knowing how he was sick,” she said. “He still wanted them to look up to him. He didn’t want us to know he was sick. It’s a horrible symptom of this disease.”
The Dolehs were not the only family to experience the loss of an Ohio State student to suicide last year.
A leading cause of death among the young
Adam Doleh was one of six Ohio State students who died by suicide during the 2016-17 academic year, according to public records.
They included a 22-year-old international student, a graduate student in plant pathology, a third-year studying physics, astronomy and math, and a 19-year-old in neuroscience.
The Lantern reached out to the families and friends of the six students. The family and friends of two individuals –– Adam and Cody Sweitzer –– agreed to be interviewed.
Four families did not respond to The Lantern’s request for comment. To respect the families’ privacy, the other deceased individuals are not named.
The 2016-17 academic year was an anomaly for suicides at Ohio State.
In five of the past six years, two Ohio State students died by suicide in each of those years. The only exception was the 2013-14 academic year, during which there was one reported student suicide.
Laura Lewis, the assistant director of Ohio State’s Suicide Prevention Program, said the number of suicides at Ohio State last year is not necessarily off track given national statistics. The fact that Ohio State hasn’t seen enormous spikes in suicide statistics is at least a sign that prevention programs are doing something right, she said.
“That said, there is a national trend we’re following where it is increasing,” Lewis said.
Though last year’s increase in suicides is jarring, nationwide statistics are far more alarming.
In 2011, death by suicide rose from the third- to the second-leading cause of death among 15-to-24-year-olds, behind unintentional injury, according to data tracked by the Centers for Disease Control and Prevention. To this day, it is still the second-leading cause of death for that age group. In the United States, it is the 10th-leading cause of death for all ages.
Nearly 5,500 people ages 15 to 24 died by suicide in 2015, according to a CDC report.
A Lantern review of records supplied by most of the Big Ten universities shows other schools experienced similarly unusual one-year increases in deaths by suicide, but there were no patterns or trends. Those records also show big discrepancies in how schools track and facilitate resources to deal with suicides.
Experts describe suicide as an epidemic that does not discriminate based on sex, race, socioeconomic status, college or major. Though they say 100 percent of suicides are preventable, it remains a central problem among young people.
The issues that confound those looking to prevent these deaths are commonly held misconceptions, or myths, about suicide and the stigma surrounding mental illness.
People want an easy answer to why these deaths keep happening. But the reality is too complex to satisfy that desire.
“The harder answers are always ‘Why?’” said John Ackerman, suicide prevention coordinator and clinical psychologist at Nationwide Children’s Hospital.
“Suicide is very complex and to boil it down to just one answer is not the answer,” he said. “It’s rarely that simple.”
Answering the “why?”
For loved ones, why someone chose to kill himself or herself is often the question that lingers.
It’s common for people to blame an individual’s death on a single cause –– a tension at home, a bad grade in a class or perhaps high expectations from parents.
A number of variables play into a person’s decision to take his or her own life, said Maria Lammy, a doctoral candidate in counselor education and graduate administrative associate at Ohio State’s Suicide Prevention Program.
While it might seem like a single event was the cause of someone’s death, Lammy said there is usually much more beneath the surface.
“Sometimes there will be incidents that have happened leading up to the suicide, like a major breakup or the loss of a job, that seem like the reason that somebody did it, but there’s always underlying issues that have been going on for a long time before that,” Lammy said. “Almost always that’s the case that it’s more complex than what it seems on the surface.”
Ackerman said research points toward a number of precipitating factors that can affect a person’s decision to kill himself or herself.
Some of those habits might include a reduced sense of community, larger social circles but fewer friendships of real depth, and an increasing online presence in young people’s lives.
Lewis said research has found a common cause of suicide in younger generations is a lack of coping skills and increased stressors.
“We’re finding that young people really are struggling to manage day-to-day stressors with healthy strategies,” Lewis said. “Some of that involves parenting, some of that involves changes in environment, some of that involves technology advances and the way that we’re communicating or not communicating with one another as the case may be.”
Lammy said another cause is a lack of strong interpersonal relationships. Without having people in your life to connect and share hardships with, she said it’s easy to feel isolated and withdraw from others.
“It’s not necessarily that you don’t have friends or you don’t have people around you that care, but it’s that sense that you can’t tell people what’s going on,” Lammy said.
And for parents like Dawn Doleh, finding out more about what was going on in their child’s life likely wouldn’t tell the full story.
“The sad thing is you never truly know why,” she said.
Among Big Ten schools
Suicide rates on college campuses have been inching upward in the past decade.
The Lantern reached out to the 14 universities in the Big Ten for all information pertaining to student suicides on their respective campuses since 2011, via public-records requests.
Eight universities returned the request: University of Illinois, University of Iowa, University of Maryland, University of Michigan, Michigan State University, University of Nebraska and Ohio State.
From the 2011-12 to the 2016-17 academic school years, each of the eight schools saw unusual one-year spikes in the number of suicides they experienced, but there were no discernible patterns or trends.
For instance, Illinois saw a two-year increase in student suicides during the 2014-15 and 2015-16 academic years. Minnesota experienced a one-year spike during the 2013-14 academic year, but has seen a steady decline since then.
Northwestern and Penn State were excluded from this analysis because they are exempt from freedom-of-information laws. Three schools — Purdue University, Rutgers University and the University of Wisconsin — denied records requests for various reasons.
Indiana University responded to The Lantern and said it had no documents that include “information about student suicides on Indiana University’s Bloomington campus between the years 2011-2017.”
To some experts, the lack of uniform information and records that schools keep on student suicides is ludicrous.
“Can you imagine a school that keeps records of everything and has all these forms, but can’t tell you if a student has killed themselves?” Ackerman said.
Some school officials agree the discrepancies in how schools report student suicides can be confusing.
Laura Anderson Wright, associate general counsel at the University of Maryland, said a lot of the variation simply comes down to the ways each school operates.
“There are 14 different schools and 14 different ways of doing things,” she said.
Lewis said that although every college faces different challenges, it should be the goal of all universities, not just those in the Big Ten, to consider how they are tackling the issue of suicide.
“We never thought it would happen.”
Cody Sweitzer’s friends could always count on him. Whether someone needed a gym buddy, a shoulder to cry on or a beer after a long week, Cody would be there.
A fourth-year in mechanical engineering and a “red-blooded American” as described by friends, Cody was known for his love of fishing and driving his old and beat-up blue Ford Ranger FX4, the one he once got stuck in a pond.
Brian Bunner met Cody when they pledged the Tau Kappa Epsilon fraternity together in 2013 and the two quickly became best friends. It was shortly after the two moved in together with some friends, in 2015, when Cody’s health problems started.
“Everything was fine until one morning, I woke up to my roommate Alec yelling for me,” Bunner said. “He was yelling that Cody was having a seizure and he didn’t know what to do.”
Bunner rushed to the bedroom to find his best friend in bed, with contracted muscles and completely unconscious. Bunner told his roommate to call an ambulance while he tried to keep Cody from biting through his tongue.
“That was the day that Cody was diagnosed with epilepsy and was what I ultimately believe led to his taking his own life,” he said.
Everything changed after the diagnosis. A once outgoing and hardworking young man, Cody struggled to adjust to his new life. He needed to be on a regular sleep schedule and he had to take medication several times a day. He couldn’t go out drinking with his fraternity brothers anymore because alcohol made the seizures worse.
His seizures were severe and frequent. Doctors regularly switched his medication and dosages to find what would work best. All of this, Bunner said, frustrated Cody and made him feel like he would never be normal again.
“I talked to him about it several times, and myself and the rest of his roommates could tell that it was getting to him,” he said. “We didn’t know what to do. We knew Cody was depressed, but it wasn’t like him to go see someone and we didn’t know how to make him.”
Cody confided in Bunner and a couple of close friends that he was struggling in school and felt helpless. The group assured him that things would get better, that they would always be there for him.
Cody told his friends that had it not been for their support, he would’ve killed himself that year.
Things improved for a while, and then got much worse. Cody had a car accident after seizing behind the wheel, totaling his beloved truck into an overpass. A broken ankle confined him to crutches and made his depression worse, Bunner said.
“He was not himself and we could tell,” he said. “But we didn’t know what to do. We didn’t know who to tell. We never thought it would happen.”
Two weeks before he killed himself, Bunner said he told Cody he needed to get help. Two days before Cody died, Bunner talked to a group of his friends about confronting Cody together, to try and convince him that he needed to go see someone.
“We were all going to do it, but we didn’t do it quickly enough,” Bunner said.
While sitting in the sauna at the RPAC, Bunner received a text from Cody. In his goodbye text, Cody told his friend that he loved him, that he meant the world to him and that he decided to take his own life.
The words on the screen didn’t register to Bunner at first, but once they did, “I dropped my shit and ran.”
Bunner called the police while running up 17th Avenue to meet his friends who Cody also had texted. By then, it was too late.
Bunner said he knows Cody’s decision to kill himself was no one’s fault. He knew the pain his friend felt was unbearable and he doesn’t blame him or anyone else.
If anything, Bunner said he wished he had done more when he could.
“We could have called his parents, we could have gone to a school psychiatrist, we could have drug him to one ourselves,” he said. “All we had to do was say something.”
Ohio State has one of the largest comprehensive suicide prevention centers dedicated to college students in the country. Lammy said she believes suicide is entirely preventable and getting people the help they need is possible. But there are still barriers to prevention.
The greatest of them all? A culture of stigma, Lammy said.
“Stigma is really the big beast without a face,” she said. “It’s everywhere, but nobody really sees it.”
Lewis said trying to make people understand the negative effects of stigma on suicide prevention is one of the biggest challenges.
“The stigma around mental health in general is just something that we need to work on,” she said. “The No. 1 thing that is stigmatized in mental health is suicide.”
Experts agree that commonly held myths about suicide are the biggest reason people don’t intervene sooner.
Believing that talking to someone about suicide will encourage suicide attempts or that suicidal young people will resent the person who tries to help them is damaging to prevention efforts, Lewis said.
Another myth is that a person must assume all responsibility of another when trying to help. Lewis said that’s just not true.
”When we get to a point where we can’t take care of yourself and that’s obvious, then we need to [seek help],” she said, adding once someone initiates a direct conversation with a suicidal person, it’s that person’s job to help them get to the resources needed, not solve the situation entirely.
“I think [a team approach to prevention] alleviates that burden a little bit,” she said. “We want you to react, respond, stay present, engage and then get that person to the resources they need.”
Dawn Doleh wishes someone would’ve called her when her son wasn’t doing well. She wishes someone would’ve told her Adam was depressed earlier, instead of finding out as he lay in a hospital bed. She wishes one of Adam’s friends would’ve sought help earlier.
“When a friend comes and tells you that [they want to die], you don’t leave them alone,” Dawn said. “If someone did that for our son, he would still be here.”
Adam’s sister Emily, now a first-year in chemical engineering and trumpet player in the marching band, said she doesn’t hear college students having real conversations about suicide.
One major problem Emily has noticed is the way people passively talk about suicide.
“People joke — they say ‘I want to die because classes are hard,’” she said. “People don’t want to speak out because it’s just a joke. It’s a figure of speech.”
Lammy said it’s harmful to joke about suicide because when it is the real thing, it’s hard to tell. Instead, Lammy encourages people to turn jokes into opportunities to take things seriously.
“Our words have power and our words communicate how we think about the issue,” she said. “When we can encourage people to consider their language in a new way, to choose how we’re talking about it because it doesn’t align with your values. If you don’t want people to kill themselves, then you probably shouldn’t be joking about that.”
Ackerman compared the current concerns around suicide rates to the rise in concern about cancer diagnoses in the 1970s.
“Much like cancer was in the ‘70s, if we talk about it more, if we create awareness, if we’re having people being asked by doctors and therapists, then it’s an issue that we can do more about,” Ackerman said.
Hope despite loss
It’s been almost a year since Adam Doleh took his own life. For many, the pain and shame that comes with losing a loved one to suicide causes families to shy away from discussing their death.
Not for the Dolehs.
In September, Dawn and Emily participated in Adam’s honor at the “Out of the Darkness” Walk in Columbus. Hosted by the American Foundation for Suicide Prevention, these walks raise money for suicide research, education and advocacy.
The family also started the Adam Doleh Memorial Scholarship, which is awarded to a senior from Adam’s high school who will attend Ohio State and pursue a STEM field.
In the spring, Adam was awarded a posthumous degree from Ohio State. His family walked at commencement in his place.
Dawn, a real estate agent and registered nurse, became a suicide counselor in March. She volunteers with a nonprofit that connects individuals contemplating suicide with resources.
Emily also signed up for a REACH training program to become a suicide awareness advocate.
After Cody’s death, his family and friends started the Cody Sweitzer Memorial Endowment Fund. A scholarship will be given to a student in Greek life at Ohio State who has been diagnosed with epilepsy, is a welding engineering major or is pursuing a career in mental-health management.
Bunner hugs his friends a little longer when they leave now. He takes more pictures of the good times and blasts country music a little louder from the porch when he’s drinking Budweisers with the boys.
He will always remember the day Cody asked him to be the best man at his wedding one day, granted that he would be Bunner’s when the time came. He knows it is a promise his friend will keep from above.
Now in his first year of law school at the University of Pittsburgh, Bunner said he owes it to Cody to carry on his best friend’s legacy.
“He was the happiest, most selfless person I knew, always making sure you were OK,” he said. “Every day I wake up, I do more for him to be remembered. I do it because of him.”