By Deborah Jeanne Sergeant
Suicide is the second leading cause of death among adolescents 15-19, behind unintentional injuries and homicide.
It seems incongruent that on the cusp of adulthood at the peak of their health and with their entire lives before them, young people would want to end their own lives.
“A central theme that has come up in our work with people struggling with suicidal thoughts and those who have attempted suicide is feeling stuck alone with overwhelming pain,” said physician Robert J. Gregory, who works at Norton College of Medicine at SUNY Upstate Medical University.
Mental healthcare can make a difference. Because children spend so many hours at school, it’s logical that providing access to mental healthcare at school can help improve mental health. At Rochester City School District schools, licensed, community-based mental health professionals provide services on the school grounds if referred by a school social worker or counselor. The clinic bills the student’s insurance.
Parents can also request a referral from a school nurse or counselor.
“Embedding mental health into the school really helps improve access,” said physician Rebecca Shields, who specializes in psychiatry with Norton College of Medicine at SUNY Upstate Medical University.
Obtaining mental healthcare outside of school may not be easy for some families. Shields said that mental health stigma is a barrier for some.
“Many believe they just need to toughen up or pull themselves up by the bootstraps,” she said.
Not everyone has health insurance that covers mental healthcare. Or some have insurance that covers mental healthcare, but not without paying a hefty deductible every year.
“Some parents are too poor or struggling with too many mental health issues themselves to bring their child to appointments,” Shields said. “They may not have stable housing, may be using substances, or be gone a lot of the time, such as a single mother working to provide for her children, and don’t have enough social or other supports including childcare for other children.”
Living in a rural area may mean driving an hour each way for an hour-long appointment, meaning three hours of childcare for other children in the family, and taking time off from work. Telehealth for mental healthcare can help mitigate this issue; however, some rural areas lack quality internet connections. Some families lack home internet altogether.
“Integrating mental healthcare in schools helps the school and school administration to feel better knowing that they have a place for these kids to go and get help,” Shields said.
Children who have been receiving healthcare at school-based clinics may feel more at ease receiving mental healthcare there as well. It’s also easier for the school administration.
“The school system feels more supported and confident in dealing with these crises instead of having to send them outside for help,” said Sutanaya Pal, MD assistant professor in the Department of Psychiatry and Behavioral Sciences at Norton College of Medicine at SUNY Upstate Medical University. “Further, it helps to have coordination between the mental health care providers and the school to work together to deal with both the social issues and the mental health effects of that along with the crises.”
In addition to providing mental healthcare at school, the entire culture of education is shifting towards improving mental health. In May 2026, the New York State Education Department issued briefs that guide districts about the integration of prevention, early intervention, family and community partnerships, school climate, leadership and targeted support to align with the National Center for School Mental Health. For a decade, state law requires including mental healthcare instruction as a part of K-12 health classes.
Call 988 or 911 if you or someone you know is in crisis or text HOME to 741741.
Suicide Among Young People in Monroe, Ontario Counties
• In 2024, the rate of death by suicide was 2.3 per 100,000 for US children aged 10-14 and 9.4 for aged 15-19, according to the Centers for Disease Control and Prevention (CDC).
• In New York state, the rate was 8.12 deaths per 100,000 with those 15-19 ranked the third highest in the nation, the CDC states.
• The New York State Department of Health stated that suicide is the third leading cause of death among those 15 to 24 as of 2022. More than 18% of students seriously considered suicide in the past year and 10.9% attempted it.
• In Monroe County between 2020 and 2022, the rate of death by suicide was 3.2 per 100,000 for people aged 10-19, and 11.3 for those in Ontario County, according to the New York State Department of Health.