Powered by over-sweetened coffee and fear of the next case, Trebor Randle traversed Georgia in 2018 to deliver a message: youth suicides can be prevented.

The Georgia Bureau of Investigation special agent built partnerships with other agencies, helped organize community meetings, pushed ad campaigns and trained school workers and cops to recognize warning signs. It was the first full year of forceful efforts by Randle and other officials since youth suicides started climbing in the state in recent history.

But the stats didn’t budge much. Forty-one children died of suicide in Georgia last year, down from 48 in 2017, according to GBI data. The slow progress leads Randle and others to a cold conclusion: Georgia needs to do much more, and the work will be complicated.

Youth suicides, like all suicides, are up nationally. Suicide rates in the general population climbed 21% from 2005 to 2016. Urgency is particularly high to stem the problem with children.

"It's going in the wrong direction – and fast," said Monica H. Swahnan epidemiology and public health professor at Georgia State University.

Like Randle, Swahn sees a few keys threads plaguing many kids today. They need more impulse control. They don’t have — or aren’t aware they have — an outlet to express their troubles. They, like so many adults, are haunted by stigmas against people with mental health issues.

That forces kids to struggle alone, until, in some cases, they become names in a case file sliding across Randle's desk at the GBI. She scours the pages, replete with tales of lonely gunshots and kids as young as 11 hanging. She finds few patterns. While signs were sometimes missed, many of the victims don't "fit the narrative" of kids one might expect to end up in such a file folder, she notes.

That makes Randle think the best solutions are more like blankets than Band-Aids. She wants to reach all children — not just those who fit the narrative. But she hits many roadblocks.

Stalled initiatives

Randle says "prevention" like some people say "um." She wishes that refrain weren't necessary, but it is. She said she's frustrated by the lack of comprehensive statewide policy for how schools handle students who may have suicidal thoughts. Because kids spend so much time at school, Randle figures it's the teachers, coaches and administrators who have perhaps the best opportunity to recognize warning signs.

It’s also easier to train school workers as part of their job than it is to get parents to voluntarily learn to respond to kids in crisis. But without a statewide policy, leaders in each of Georgia 159 counties decide how to identify and help their struggling students. Randle wishes they all would at least post a suicide help line number at middle and high schools.

In some districts, Randle said leaders push back on ideas. For example, she's suggested holding assemblies about mental health resources. But the leaders tell her they fear the assembly could implant the notion of suicide in a kid's mind and cause them to do it. (Swahn of GSU said that's naive, because the assemblies would show students people care and are willing to help.)

To Randle’s disappointment, districts typically only plan such events after a student has died.

Not that soul searching isn’t important after a youth suicide. “We want the entities that were involved in that kid’s life to learn from it and say, ‘Next time, what can I do better?’” Randle said.

September 13, 2018 Decatur: Special agent in charge Trebor Randle, with the Georgia Bureau of Investigation Child Fatality Review Unit, works on multiple suicide cases in her office at the GBI on Thursday, Sept 13, 2018, in Decatur. Curtis Compton/ccompton@ajc.com
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Randle even hit a wall when trying to get local movie theaters to play an anti-suicide public service announcement during the previews for children’s movies. The theaters were willing to show the PSA, but they wanted some $20,000 to do it, Randle said. She doesn’t have the budget.

The good news, officials say, is many agencies, organizations and individuals are joining the efforts.

Slow improvement

At Georgia Tech, students working with the Mental Health Student Coalition train classmates to respond to crisis and to create spaces where everyone feels safe to express themselves. The coalition’s director, biology major Collin Spencer, said students from all over the country arrive at Tech still weighted by the stigma of mental illness and uneducated about how best to get help.

Spencer said he personally can’t remember hearing a word about mental health when he attended North Gwinnett High. At Tech, his new friends saw signs of worsening depression in him. They staged an intervention and walked him to the counselors’ office. “I got better pretty fast,” he said, and he’s since dedicated to preventing suicide on campus.

September 13, 2018 Decatur: Special agent in charge Trebor Randle, with the Georgia Bureau of Investigation Child Fatality Review Unit, works on a suicide case in her office at the GBI on Thursday, Sept 13, 2018, in Decatur. Curtis Compton/ccompton@ajc.com
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Randle said the past few years have been a time of growth for a lot of districts, including in Gwinnett, where leaders now realize they must do more.

The Division of Family and Children Services is also engaged and working in partnership with the GBI, the Georgia Department of Education, the Mental Health Association of Georgia and others. They train teachers to spot signs. They focus on foster kids, who are at greater risk. They push for peer support groups in more schools, but not yet in all schools, as Randle desperately wants to see.

All those involved in the prevention fight are dealing with the reality they’re trying to stop unseen strangers with unseen problems in unseen places from committing suicide by throwing out as many blanket solutions as they can.

A thought motivates Randle and the others: if not for their work, the stats might be even higher.

If you or anyone you know is contemplating suicide, call or text the 24-hour hotline at 800-273-8255. For more information, go to www.suicidepreventionlifeline.org.