PLATTSBURGH — Malakai Desourdy was falling deeper and deeper into despair.
Zander LaDuke seemed to be loving life, excited about his future in pharmacy school.
Both teens ended their own lives during this school year.
A third Clinton County youth died by suicide recently as well; the 13-year-old girl attended Stafford Middle School.
Suicide is the second-leading cause of death for young people age 15 through 19 in the United States.
That translates to just 10 out of 100,000 kids in that age group, so it does remain rare.
But according to 2017 data from the Center for Disease Control's Youth Risk Behavior Surveillance System, the percentages of high-school students who reported "seriously considering" suicide and completing suicide increased substantially between 2009 and 2017.
In 2009, according to the statistics, 13.8 percent of students in the study said they seriously considered killing themselves; in 2017, that figure had climbed 25 percent, to 17.2 percent.
Suicide deaths increased 33 percent over that time span, the data showed.
It's a nationwide crisis, said Bonnie Black, director of Behavioral Health Services North's Employee Assistance Services.
Clinton, Essex and Franklin counties have a higher suicide rate for all ages than the New York state average.
In Clinton County, it's 12.9 per 100,000 people.
It's even higher in Franklin County, at 17.4. And that number is 10.5 Essex County, according to state records.
As schools have around the United States, driven by growing numbers of children with mental-health issues, North Country organizations and school districts are focusing increasingly on prevention.
"We have become much more aggressive," Black said of the preventive approach.
"Especially in schools."
The concern is warranted.
According to data from the CDC's National Hospital Ambulatory Medical Care Survey, more children and teenagers who have tried to kill themselves or who harbor suicidal thoughts are showing up in hospital emergency departments.
That number, reported CNN in early April, doubled between 2007 and 2015, based on that analysis.
The study, published in JAMA Pediatrics, sampled 300 emergency departments around the country, tracking how many kids age 5 through 18 were diagnosed with suicidal ideation or suicide attempts each year.
In 2007, combined diagnoses was 580,000, according to the study; it climbed to 1.12 million in 2015.
Lead study author Dr. Brett Burstein, a pediatric emergency room physician at Montreal Children's Hospital of McGill University Health Centre, told CNN those numbers "are very alarming.
"Where suicidal behavior among the pediatric population was just 2% of all visits, that's now up to 3.5%."
The biggest risk factors for suicide are depression and a prior suicide attempt, Dr. Gene Beresin, executive director of the Clay Center for Young Healthy Minds at Massachusetts General Hospital and professor of psychiatry at Harvard Medical School, told CNN.
"And with rates of suicide on the rise, it makes sense for risk factors to increase as well," he explained.
AS YOUNG AS 5
The average age of children in the Ambulatory Medical Care Survey was 13, the report said; 43 percent of the ER visits were kids between 5 and 11 years old.
It's not just teens who die by suicide, Black said.
"Oh, my heavens, no. If you look at the data on deaths, they start recording suicides at age 5."
Plattsburgh City Police Department responds to mental-health issues for all ages at local schools, Chief Levi Ritter said.
Some of those calls start with a child who is "out of control," he said.
"(The schools) call us sometimes out of an abundance of caution," he explained, "for an extra set of eyes, an extra set of hands."
As for ER transports for kids, the chief said, "I don't know what's causing it, but it has increased in the last five years."
Again, while researchers have highlighted a trend that raises concern, it's important to note suicide remains rare among younger children as well.
According to the CDC, 1,309 kids age 5 to 12 ended their own lives nationwide between 1999 and 2015.
ONE IS TOO MANY
All the same, school-district leaders and mental-health providers know that the loss of even one life is too many.
What are they doing about it?
Clinton County's Suicide Coalition has been in place for 13 years.
The effort includes a variety of mental- and physical-health providers working to come up with ways to educate the public on how they can be frontline soldiers in the battle to end suicide, especially among youngsters.
In Franklin County, among other initiatives in place for several years, the SOS program instructs students, staff and the community on signs that a young person may be suicidal.
That includes a parents night, when SOS is explained, said Tracy Gravell, a prevention specialist with Citizen Advocates, "and how it will be introduced to the kids, the signs and symptoms to watch for."
The issue of suicide is addressed by programs under a much larger umbrella that covers mental health in general and substance abuse, Gravell explained.
That includes Students Against Destructive Decisions chapters for grades six through 12.
"Students can raise awareness better with their own peers," said Prevention Specialist Lisa Lawrence-Boyer.
While the prevalence of adolescent suicide is on the rise, according to a study published in JAMA Pediatrics in April, "little is known about effective interventions.
"To date, no intervention for suicidal adolescents has been shown to reduce mortality."
But that paper offers hope.
Lead author Cheryl King went back to a clinical trial she and others conducted more than 10 years ago that involved 448 teens who'd been hospitalized for suicidality.
Half of them were asked to choose as many as four adults who would be in their lives after discharge and would be given continuing education on suicide and prevention.
Recently, King checked on both those subjects and the other half of the group.
She found that, 11 to 14 years later, 13 of the participants who were not given extra supports had died (mostly from drug overdoses; it was unclear whether suicide).
But only two subjects had died from among those who had adults looking out for them, the paper says.
"The most conservative interpretation of the data suggests a 50 percent reduction in death among the treatment group," says an article on Vox.com.
“If you can come up with a treatment where you had 50 percent less mortality with a treatment, that is actually huge, if that were to replicate,” King told Vox.
She emphasized further study is needed but said the results hold promise.
And it makes sense, King said.
When teens in crisis are inpatients at the hospital, they get 24/7 care, she explained.
“And suddenly,” when they are discharged, “they are supposed to go back to school and wait for their first weekly appointment."
That's a very tough transition, she said.
“I developed this out of wanting to build a supportive bridge for them.”
That's the direction BHSN, Beekmantown Central and other local schools have taken in their prevention programs, except that it happens before an attempt, before a hospitalization.
Enlisted in the effort are teachers, coaches, custodians and others trained to pay attention, to listen.
"Looking at it forensically," Black said, "there are indicators that say a trusted adult intervening may reduce risk.
"(It) makes a difference."
Suicide rates are rising in the United States while falling elsewhere around the world, Black said, and that's a message that cannot be ignored.
"There's something happening here, and we have to fix it."
— Staff Writer Joe LoTemplio contributed to this report.
Find the National Hospital Ambulatory Medical Care Survey on ER visits: https://tinyurl.com/y2arfuwt
Read Cheryl King's study: ncbi.nlm.nih.gov/pubmed/30725077
Check out the organization Students Against Destructive Decisions: www.sadd.org