There are signs when your child is struggling with depression and anxiety, Kay Scott told teachers and administrators Monday morning at Immaculate Conception School.
However, even a parent may not fathom how deeply their child's mental anguish goes.
At 19, Scott's daughter, Madison "Maddie" Taylor Scott, died by suicide, Scott told about 30 listeners who had gathered for conferences before the school year starts today.
"The pain that Maddie had inside her that I never even knew. I knew a bit of it," Scott said. "I'm her mom, and we experienced things together. I had no idea she'd ever actually take her life - that she'd get that low.
"It must be a darkness that they get into."
Scott spoke to the school staff members after they had participated in nearly two hours of "Signs of Suicide" training sponsored by the Anne Marie Project and presented by Colleen Pace, a suicide prevention manager for Communities Healing Adolescent Depression and Suicide (CHADS).
"Every year, we've had students struggling with anxiety and depression," Principal Heather Schrimpf said. "One of my teachers said we really should do this."
Anne Marie Project is a coalition that provides resources to help young people find information and guidance on challenges they face. The project received a community support grant of $16,610 from the United Way of Central Missouri late this spring to educate in areas of underage drinking, illegal drugs, mental health and faith to youth.
Julie Gramlich, Cathedral of St. Joseph Parish youth minister and organization founder, said under the application of the grant, the award was intended to inform people about suicide, drug or alcohol dependence, and trauma.
The project has worked with CHADS before to bring informational sessions to central Missouri. CHADS is a St. Louis-based coalition for mental health. The family of Chad McCord established it in early 2005, less than a year after the 18-year-old high school senior's suicide. McCord suffered from depression, anxiety, and obsessive-compulsive and bipolar disorders.
Gramlich said the project is trying to reach all the Catholic schools in the Diocese of Jefferson City - 28 of them.
During four-hour follow-up trainings, selected teachers will receive additional training so they may present the "Signs of Suicide" program to students.
The goal, Gramlich said, is for all students in the schools - from sixth to 12th grade - to be able to identify those signs.
Immaculate Conception already conducts Social, Academic, Emotional Behavior Risk Screeners (SAEBRS) twice yearly, Schrimpf said, to identify at-risk children. The school also maintains a Tier 2 Intervention team that will provide support if any students need boosters in behavioral expectations.
"Most importantly, I think our students know that our teachers are accessible," Schrimpf said. "We've had several incidences in the past year where a kid heard something from a classmate and wasn't afraid to come to a teacher right away. That's key.
"They're not going to come out and tell a teacher themselves. But, they'll tell a friend."
A problem for parents, teachers and other adults is that warning signs of depression or suicide are not unlike typical adolescent behavior, Pace said.
Adolescents may experience anger or irritability, loss of interest in activities they once enjoyed, changes in weight or appetite, physical pain, feelings of sadness, excessive isolation, loss of energy or substance abuse, she said.
It's when those issues become consistent or persistent that adults should take notice. Also, if some of the changes occur when there is no apparent reason for them or the behaviors are consistent across environments - such as at school and at home.
Adults should be aware of specific signs of suicide, such as talking or writing about suicide, feelings of hopelessness, strong feelings of wanting to be dead, risk-taking, the adolescent giving away favorite things or a sudden sense of calm.
"If you care about your students and they come to you, you are probably the only adult that they are talking to about this," Pace said. "So, if you don't say something, if you don't share that information, what will happen to them?"
What's important is the adults recognize what's going on and they do something with the information, she said.
Maddie took her own life in her dorm room at Lindenwood University in St. Charles, Scott said. She was known to have visited a male acquaintance. Surveillance video showed her entering her dorm building at about 12:20 a.m., Scott said.
She was found dead about 20 hours later - having asphyxiated herself with a belt.
"It just sneaks up on you that - all of a sudden - there was a change," Scott said. "For Maddie, it was a sudden change."
Internally, it might have been going on for years, Scott said.
"But, she didn't want to burden Mom. She didn't want to burden her dad," Scott said. "She didn't want to burden her friends. She didn't want her friends to feel she was weak or that there was something different."
It seemed like Maddie had it all going on. And, it's unclear if she shared her sadness with friends.
Maddie had disappointments in life, Scott said, like when she didn't make the volleyball team with her friends at Helias High School. Outside, she showed support for her friends. Inside, it hurt, Scott said.
Unlike her friends who decided to go to the University of Missouri, Maddie chose to go to college in St. Charles.
Everybody else went to MU, she told her mom, and she wanted to go someplace to meet new people, make new relationships and do her own thing.
She called one night her freshman year and said she drove herself to an emergency room in St. Charles and told them she wanted to hurt herself. When she said it, health workers took her to a psychological ward in a hospital in Wentzville.
She did not want her mother to come and see her that way.
Scott visited her and found her in hospital scrubs, like the other patients. Her daughter spent the night at the hospital.
She was discharged the next day.
About a month later, during the Thanksgiving break, she decided not to come home from college. A friend's mother picked her up at the university. Scott went to the friend's house to retrieve her.
Maddie had cut her arms with a steak knife and taken a large amount of acetaminophen and ibuprofen.
Scott took her to St. Mary's Hospital and stayed on a bed next to her daughter that night.
Maddie told her she didn't know why she did it.
"I'm so sorry, Mom. I'm so sorry, Mom. I'm so sorry," Maddie said.
This school year, she returned to the university in August.
Unknown to Scott, Maddie had a serious panic attack about a week before, and spoke to her counselor about it.
"When they're 18, they don't share anything with their parents," Scott said.
It all rolls in together, Scott said.
And, now she's with God, Scott said.
"My girl's in good arms," Scott said. "And I'm not mad at God for taking my girl because he's got her. He's got her in his arms, and I feel her all the time."
The National Suicide Prevention Lifeline is 1-800-273-8255. For the Crisis Text line, text "HOME" to 741741. The National Hopeline Network may be reached at imalive.org or at 1-800-784-2433.