On a chilly January day at Archbishop Spalding High School in Severn, students are dressed in their standard-issue winter uniforms: chino skirts, white shirts, and black vests for the girls; black sweaters, red ties, and chino pants for the boys. Many days, the students also wear a coveted accessory: rubber wristbands—in blue, orange, red, green—bearing the emergency number for Anne Arundel Crisis Response.

“I have a bunch at my house that sit with my jewelry,” says Spalding senior Alexandra Blunk. “Everyone always wears the bracelets—they’re a hit.”

While crisis wristbands might seem an odd hot accessory, the hotline bracelets are as much a necessity as a fashion statement.

Youth suicide was once rare, but among people ages 10 to 24, it’s on the rise—with an increase of 56 percent from 2007 to 2017 in the United States, according to a recent report by the Centers for Disease Control and Prevention.

“One thing that happened is the opioid crisis,” says Dr. Karen Swartz, director of clinical and educational programs at the Johns Hopkins Mood Disorders Center. Opioid use, explains Swartz, “unmasks or worsens mood symptoms in those with mood disorders”—and that can lead to suicide. “The other thing that happened is all of the social media stuff,” continues Swartz. “There’s growing evidence that cyberbullying is linked to suicide risk, so it’s very concerning.”

Nowhere is that concern more pressing than in Anne Arundel County, where several years ago, a string of suicides, known as a “cluster” in social-science parlance, gave the chilling nickname “Suicide High” to an area school just down the road from Spalding.

Nationally, suicide is the second most common cause of death for 10 to 24-year-olds, and between 2007 and 2017, the suicide rate nearly tripled for children aged 10 to 14, according to the CDC report.

These staggering statistics are mirrored in Arundel County, where according to a study by the Anne Arundel County Department of Health, there were 76 suicide attempts and 42 deaths among youth ages 10-24 in the Severna Park area between 2012 and 2016.

Marcie Gibbons is a counselor at Spalding, where, six years ago, the school adopted a suicide awareness and prevention program designed by Swartz and others at the Johns Hopkins Mood Disorders Center as a reaction to what was happening not only nationwide, but in the community.

“Our administration is all about the holistic needs of the child, especially in our health and fitness class,” says Gibbons, a former hospice social worker. “This is just as important as teaching a kid CPR. They need to know the symptoms of mental illness. Mental health awareness has to be at the forefront—it’s just too scary.”

Twenty years ago, after a spate of teen suicides in the Baltimore area, Swartz, along with a small team, developed ADAP, the Adolescent Depression Awareness Program, a forward-thinking high-school curriculum to address an issue that could no longer be ignored.

“In 1998, there were three suicides in the Baltimore area within a few months, which was obviously devastating for the Baltimore community and shook people into thinking that this was a real problem,” says Swartz, sitting in her Wolfe Street office in the heart of Hopkins’ medical campus. “Leaders in the community came to us and said, ‘What are you going to do about it?’”

When Swartz visited one of the impacted schools, she recalls, “I was so struck by their willingness to learn, but by how little they knew—and these were well-educated people who didn’t understand depression and were really confused about how suicide could ever happen. It really underscored for me that we had to improve education.”

Over several years, Swartz, ADAP’s founder and director, and her cohorts, including several other psychiatrists and psychiatric nurses, applied their expert clinical and research skills, visited area schools, and worked with high-school faculty and students to develop and refine the material.

In the high schools that offer ADAP (which includes training for teachers and is completely free of charge), the program—most often a component of health and wellness classes—is taught to students over the course of several days and encompasses an overview of mood disorders, informational videos, and group activities, and identifies resources within the students’ own school. It’s like a mini med-school class, scaled down for high-schoolers.

 

Youth suicide is on the rise among people ages 10-24.

 

“You can find this information, with slightly different content, in my lecture for third-year med students,” says Swartz, who herself traveled across the country to train some 3,000 high-school teachers and counselors on how to teach ADAP.

And while the grassroots program started in four area schools in its infancy, to date, ADAP has now reached more than 116,000 students across 20 states. Swartz is hoping to soon see those numbers grow.

Thanks to a new website, adapeducation.org, high school faculty members will be able to receive their training online, allowing the program to have an even wider reach.

At the outset of the program, clinical art therapist Sharon Strouse, along with her husband, Douglas, helped fund the program to honor their daughter Kristin Rita Strouse, who took her own life at the age of 17 in 2001. Strouse recalls that it was difficult to introduce the program into any schools, in part because of stigma.

“There was a lot of pushback when we wanted to go into the public schools,” recalls Strouse. “They said, ‘If you talk about suicide, it will happen.’ We even tried to offer it to MICA, they had three suicides that year, and they said, ‘No,’” she recalls.

This year, ADAP is set to be included as a component in all Baltimore county public schools, as well as many other area schools.

“I’m often asked what’s different about this program,” says Swartz. “Well, do you know any other high-school health program that’s developed by a doctor?” And the program is getting results: A study of ADAP’s effectiveness noted that, of those who participated in the program, 46 percent of teachers were later approached with concerns from students about themselves or others, an impressive figure when you consider that adolescents and young adults are notoriously private people, especially around adults.

“The way you can best prevent suicide is to recognize depression in young people and get them help, yet what people want you to do is explain how this happened,” says Swartz. “When I get questions about how this could happen to someone who was a good student, or this was someone with a wonderful family…that’s like saying someone who is a wonderful student or has a wonderful family can’t have asthma. Every one of those conversations has an underlying theme of, ‘Please tell me that my child will be protected.’ My message is that no one is immune from depression. And suicide is the most tragic outcome of mental illness that is either not treated—or not being successfully treated.”

Health class, where social media and cyberbullying issues are also discussed, is a far cry from the throwaway health-education classes of yesteryear, when a teacher, or often a coach, who drew the short straw showed the menstruation movie or reviewed the nutrition pyramid—and left it at that.

“I wrote a paper about birth order in my health class in Pittsburgh,” recalls Swartz, laughing. “It was a lot of nonsense.”

But at Spalding, on this gray January day, the Health and Fit Class is the most serious subject of the day. After pleasantries are exchanged and some 20 or so students settle into their seats, Gibbons gets down to business.

“Today, we’re going to talk about depression,” she says. “What you know, what to look for, and treatments. By tomorrow, you’ll know what to do if you’re concerned about yourself or a friend.”

In a roomful of students who would be forgiven for fidgeting—or even for disaffected boredom, given their tender teenage years—everyone sits stock-still. “What comes to mind when you hear the word, ‘depression?’” Gibbons asks the class of 14- and 15-year-olds. Students respond with various words from “sad” to “suffering” to “hopeless.”

“We need to separate, ‘I’m having a crummy day, and then I have lunch with a friend and my day is better—that’s little ‘d’ depression—from ‘Big D’ depression, which is a medical illness with particular symptoms,” says Gibbons.

Gibbons goes on to discuss the symptoms of someone who visits the doctor’s office with a cough, eventually showing the students a chest X-ray of a patient with pneumonia. “Just like high blood pressure or diabetes, depression is an illness,” she says, making the connection for them. “It’s a treatable illness.”

A few minutes later, the students watch a 1999 video, “Day for Night: Recognizing Teenage Depression,” which stresses that depression is a medical disorder and shares testimonials from teens. “What’s the big message?” she asks, as the bell rings and students grab their backpacks. “If you’re concerned about yourself or one of your friends, reach out to one of us or your parents. Don’t go it alone.”

In between classes, Gibbons lets out a sigh. “It’s such a humbling topic,” she says. “I’d like to wrap them all up in bubble wrap.”

A few weeks later, in neighboring Baltimore County at the Park School of Baltimore, a group of some 24 ninth graders are covering the same curriculum with director of middle-and upper-school counseling and wellness Krista Dhruv. Dhruv was hired by Park in 2001 after the school realized that it needed to provide more support for an increasingly vulnerable young community.

At the start of class, Dhruv emphasizes the importance of taking the subject of depression seriously. “I want you to ask questions, take risks, and be curious about this topic,” she says, “but what I also want you to be is incredibly thoughtful. Anecdotally, we know that in this room someone is potentially affected by this condition in their own life. I ask you to be thoughtful, because you may not know who among us is struggling.”

Dhruv asks the students if they have questions. “What part of the brain does it affect?” asks one student before Dhruv throws out a question of her own. “Is depression treatable?” she asks them. A handful of the students raise their hands, though somewhat tentatively. “All of you should have your hands up,” says Dhruv, “because depression is treatable.” “Can depression be cured?” she continues.

 

“MY message is that no one is immune from depression.” —Dr. Karen Swartz, ADAP founder.

 

“I don’t think so,” responds a student. “But it can be reduced so it’s barely there, but it can’t be cured.”

Dhruv gives a reassuring smile and then tells them that they’re going to watch the “Day for Night” video. But before she pushes the play button, she underscores that, “the people in the video are not actors. And the information is up-to-date, though the styles are a little dated,” she says, anticipating some laughter from an audience that could get distracted by that sort of thing. “There’s a mom with big hair—let it go.”

The lights are lowered, and the video begins. The image of a young woman flashes on the screen. “Sometimes it feels like you’re in a box,” she says. “You can’t get out.” “It feels like you’re surrounded by darkness,” says a young man in the next frame. “It’s like an anvil constantly pressing on your head and putting a lot of pressure on you, and it’s very difficult to lift up,” says another young adult.

By the time the mom with big hair comes on camera, no one lets out so much as a snicker. As class ends, the lights go up, and Dhruv tells the students that they’ll finish the video the next time they meet as a class.

Later, several students who stream in for another class share what they learned when they took the class the prior month.

“I definitely learned a lot of ways to help people who are struggling,” says Cate Cochran, a freshman at Park. “Before this program, I had no idea of how to help someone. My friend went through some things last summer, and I’ve been reaching out to her a lot more and asking her to hang out…I’ve also learned how to identify when there’s an issue, like when someone stops turning in their homework or quits a sports team.”

Just north of Park School at Hereford High School, Ellen Fitzkee, department chair of counseling, only wishes the program had been in place back in 2016 when two students took their own lives within three months of each other.

“As the counseling chair, I felt a tremendous responsibility to bring awareness and education to what was happening,” says Fitzkee. “We needed to take some accountability as a school and look for some support in figuring out how to help the community.”

After doing some research, she discovered ADAP, and, by the following fall, the school adopted it as a regular part of their health class curriculum, co-taught by a health teacher and a counselor. “I was delighted to find that we had this tremendous resource in our own backyard,” she says. “Had we had a program like this in place back then, there’s a possibility those deaths could have been prevented.”

And that’s exactly what keeps Swartz going. The gifted scientist wears many hats at Hopkins—from teaching medical students in a renowned psychiatry program to running an inpatient unit and her own clinical practice. Even so, the information that gets delivered in many high-school health and wellness classes across the country is her passion project. “ADAP is 20 percent of my job,” she says, “but it’s where my heart is.”

It was near 2 p.m. on a hot Sunday afternoon, only about four hours until the official opening of the NBA’s free agency signing period—when players not under contract can decide which team they want to head to next. And Rudy Gay, the Baltimore native and 13-year pro basketball veteran due for a new contract, sat on a red plastic chair in an air-conditioned classroom on the tony campus of Park School, the century-old private pre-kindergarten through 12th-grade establishment in the suburban Pikesville hills just north of the city line.

With legs outstretched as one with a six-foot-nine body is inclined to prefer, he was here for one thing. In a gym across the hall, 16 teenage boys were about to play in the championship game of his brainchild, a high school-aged basketball tournament organized through his charitable foundation. But he was distracted, too. The iPhone Gay cradled in his right hand illuminated with text-messages.

“Attached at the hip with my agent,” he said, taking yet another look at the device, “seeing what’s going on.”

By nightfall, he’d agree to a new two-year deal to stay with the San Antonio Spurs, worth $32 million, a life-changing amount for most of us, but just another contract for an established name like himself. He’s made more than $130 million and is considered a locker-room leader in the wild world of pro sports, even to guys who aren’t his teammates, like his friend Kevin Durant. (Gay’s been giving him been there, done that advice on how to recover from a torn Achilles’ tendon.)

“It’s proof that if you do the right things, great things can happen,” Gay said, and that message is really at the heart of why he’s back home today, about to head to the bleachers to watch two teams—one, the Baltimore-based Orange Life club, led by Frederick Douglass High coach Tyree Bizzelle, and the other from Philadelphia— play for a trophy with his name on it.

Now 32 years old, Gay is almost two decades removed from his own high school days when he donned a uniform representing Essex’s Eastern Tech and, after a somewhat controversial transfer, Archbishop Spalding in Severn. From there, he notably starred at the University of Connecticut, where he was a national player of the year finalist as a sophomore and left school early to become the eighth overall pick in the 2006 NBA Draft.

He’s played for four different pro teams averaging 17 points per game, and made the playoffs three times including—after tearing his Achilles’ tendon in January 2017—the last two seasons with the Spurs, regarded as one of the league’s premier franchises. He has a wife and two kids, a house in typically sunny Ft. Lauderdale, Florida, and has seen most major U.S. cities and other far-flung parts of the world in his NBA travels. In fact, just recently, he was in Paris for fashion week (maybe that’s why on Sunday he wore a Dior travel bag over his shoulder in addition to his Flight 22 High School Showcase gray t-shirt).

But Gay hasn’t forgotten his roots. “If you’re in a position to give back to Baltimore, you should,” he says. And so he is.

The son of Rae, a longtime director of a Head Start program in the city, and father Rudy Sr., a landscaper, Gay is behind a series of public and not-so-public charitable initiatives that reflect his modest personality, as well as his own story.

There’s things like this three-day summertime tournament, designed to provide exposure for high school athletes in front of college scouts. (Semi-pro tip: take note of Orange Life’s Onias Outlaw and Wayne Blanchard, a pair of rising juniors.) The event brought together teams representing Gay’s alma mater, Archbishop Spalding, his old AAU club team, Cecil Kirk, as well as other groups from Baltimore, Philadelphia, Connecticut, and North Carolina for hours upon hours of games. Philly’s “Danny Rumph” squad won the title game, 52-47, and Tyrone Williams was the tournament’s MVP.

“The biggest thing is giving kids the opportunity to be seen that might not necessarily be seen, or might not have the best avenues to do so,” Gay says. “It’s tough being a prep athlete. You got to be in the right place at the right time. I’m just trying to create the right place here in Baltimore.”

That desire is rooted in his own path, including the type of mentorship his former AAU coach, Anthony Lewis, provided him during what’s only a more confounding recruiting process today, and Gay’s fruitful decision to head to Spalding after two years playing varsity basketball at Eastern as a freshman and sophomore.

“That was huge for me,” Gay said. “It got me out of me out of my comfort zone, and put me in the right place, in front of the right people. If not, I’d be some 6-9 kid who could play basketball a little bit, who’s from Baltimore, but nobody knows about.”

Now a bonafide star, for several years, Gay has done other behind-the-scenes work through his independent nonprofit foundation, named the Flight 22 Foundation, with a nod to Gay’s jersey number, 22. It’s mission statement is “to provide disadvantaged youth with proper access to resources and opportunities that will increase their self-confidence and leadership skills in order to successfully compete in the 21st-century workforce.”

He speaks about this part of his life with the wisdom of someone with perspective. He mentions the insane nature of the NBA road, often getting into hotels at 2 a.m. and getting up at 10 a.m. and “doing it all over again,” as much the glitz and glamour the lifestyle affords. “An idle mind is the devil’s playground,” he says. “You just want to keep kids in something as much as you can. That’s what it’s all about.”

His family largely runs the day-to-day operations of the foundation. Most of the volunteers on hand Sunday were related, like his mom, sister and cousins, who put the finishing touches on giveaway bags for the participating teams as Gay sat for an interview, or they were close friends.

The charity has donated to youth development programs in city schools for things like entrepreneurship classes, where money raised from this year’s high school showcase will go toward. It’s also funded the renovations of several city playgrounds. And dating back to his time playing for the Memphis Grizzles, Gay gave $22,222 in each of his last three seasons to St. Jude Children’s Research Hospital.

Sometime later this year, Gay also plans to open an indoor basketball facility in Towson in conjunction with California-based fitness company PickUp USA. “Just another chance for kids to get off the streets,” he says. “That’s the biggest thing with the inner-city and Baltimore, we have to get people together and get kids together, doing something positive.”

He says all this while surrounded by the detritus of a typical youth summertime sporting event. There’s empty water bottles, candy wrappers, tournament results scribbled on a whiteboard in the hallway. Gay stands up and, man, he is tall. His phone’s buzzing.

“I am busy, I am tired, but it’s all good,” he says, then plays with his young kids for a few minutes, bopping them on the head with National Basketball Players Association-branded inflatable thundersticks, before heading off to Park School’s gym, the walls dotted by IAAM and MIAA championship banners, the type of stuff he wants everyone here to strive for.

At one point, Outlaw, from Owings Mills and probably the top player on Orange Life, drove inside the free-throw line, sneakers squeaking on the glossy hardwood, and soared to the basket for a dunk. The kid looked over into the stands to see if maybe Gay was watching. He was. “Oooooh!” the old pro had said in response to the play, impressed, inspired, and content. That’s what it’s all about.