A recent report from the Mesa County Coroner's Office revealed that although the county experienced another high for suicides in 2018, none were reported for anyone 19 or younger.
Mesa County Coroner Victor Yahn called the new five-year low somewhat atypical for the area as there is often at least one or two adolescent suicides a year.
"Look at it over a 10-year stretch and it usually evens out," he said.
In 2017, five suicides were reported for persons 10 to 19 years old in Mesa County. Four were reported for people in the same age group in 2016. Two were reported in 2014 and 2015.
"Always the last thing we want to do is lose a student," Mesa County School District 51 Mental Health and Crisis Coordinator Kati Garner said. "Our goal is to always have a zero."
Garner said in recent years the school district changed its policy to incorporate resiliency training and suicide prevention education at its schools.
Programs like the Crisis Intervention Team responds to schools impacted by the death of a student or staff member while the peer-led Sources of Strength program aims to combat bullying and suicide.
Riding the Waves teaches District 51 fifth-graders about building healthy emotional skills to help combat suicidal ideation early and Signs of Suicide is offered twice a year in all middle and high school grades to help with suicide prevention, according to the district website.
As Garner explained, the suicide prevention courses are more geared towards older middle and high school students while resiliency programs are used for younger students.
She said the goal is to not repeat the curriculum for students and to offer flexible options for each of the schools while ensuring the information and support being offered remains the same.
"It doesn't matter which school you are at, you are getting the same curriculum … it just might be presented at a different time," she explained.
She said it's important to keep that continuity there so if a student transfers schools within the district, they are still getting the same material.
The district also offers yearly training for the staff so they can better identify the warning signs for students.
"We are trying to focus on social emotional learning as a whole for students," Garner explained. "We focus on social, emotional and academic so all that ties together."
According to the National Alliance of Mental Illness, 20% of people between the ages of 13 and 18 live with a mental health condition and 90% of people who die by suicide had an underlying mental illness. Eight to 10 years is the average delay between the onset of symptoms and intervention, NAMI states. While ensuring strong academics is important for each student for the district, ensuring they come to class each day in a good place emotionally can be just as much the district's responsibility.
As far as what happens when a student's behavior becomes concerning, Gardner said the first thing is for the student to meet with the mental health professional at the school they are at.
Tips come from everywhere: concerned teachers and parents, fellow students and anybody else involved in the child's life.
The mental health professional then uses the Columbia-Suicide Severity Rating Scale while assessing the student. Garner said the district switched to the Columbia assessment last year as it is more attuned with best practices.
There is also always a second mental professional being consulted.
From there the assessment lays out next steps, which will always include collaborating with the parents and finding the best place for the student whether that's further assessment, sending them to a crisis center or other mental health resources in the area.
According to Garner, the 2016-2017 school year proved to be an alarming one for the district as several adolescent suicides left the community asking what happened and why.
She said the district moved to being more proactive rather than reactive after that year and put policies in place to better look at mental health.
According to the Colorado Health Institute, Colorado and other mountain states continue to have the highest suicide rates in the country as the southwest corner of Colorado and the state's central mountains had the highest rates of suicide in 2017.
Mental health organizations across the community and region continue to put a greater emphasis on prevention.
Jennifer Daniels, who leads the suicide prevention program at St. Mary's Medical Center, said she looks to coordinate with the district, Mind Springs Health and other organizations to offer mental health first aid and to coordinate implementing various programs like Ending the Silence.
"This isn't just a school district or Mind Springs or St. Mary's problem, it's a community problem and we all need to work together and look out for one another," she added.