February 23, 2004

Jeff Knutson's suicide prompted creation of a Yellow Ribbon chapter.

The family calls it the perfect suicide. Jeff Knutson had snuck into his father's truck and taken the garage door opener to his grandparent's home nearby. They were vacationing in Germany, so Jeff could easily get access to a hunting gun there and not be disturbed while carrying out his plan in their spare bedroom.

"He must have been thinking about it for a long time," said his father, Brad Knutson of Park View, Iowa. Jeff even called 911 before he shot himself, so no one in the family would have to find him. The preparation for his death mimicked the way he planned out his life—well-organized and thought out. He wrote a good-bye note on the computer. He never mentioned depression or anger, just the love he felt for his family and friends.

Some Warning Signs Abrupt changes in personality. Giving away possessions. Previous suicide attempts. Use of drugs and/or alcohol. Depression. Lack of self-esteem. Withdrawal from people, especially close friends, family and/or favorite activities. Change in eating and sleeping patterns. Chronic pain. Restlessness, inability to concentrate. Source: American Association of Suicidology

A Growing Movement
The death of this 16-year-old Eagle Scout, lifeguard and church youth group member in 1999 shocked everyone in his close-knit community. His parents say they will never understand why Jeff took his own life. But Brad and Dawn Knutson are doing what they can to make sure other teens in their area won't ever feel that they have nowhere to turn when they feel depressed or suicidal.

They have joined a growing movement fueled largely by the volunteer efforts of families devastated by a teenager's suicide, by establishing their own Iowa chapter of the Yellow Ribbon Suicide Prevention Program through the Light of Life Foundation International. They have traveled from school to school, church group to church group, giving presentations and information to thousands of students, parents and community members throughout eastern Iowa and western Illinois.

"We let them know he was an ordinary kid, an average kid," Dawn said. "If we hadn't starting sharing this with others, we would have gone around angry all the time. But now we realize that he's gone but these kids are still here."

How Yellow Ribbon Began
The collaborative, community-based program was created out of another tragedy. In 1994, Dar and Dale Emme of Colorado drove into their driveway seven minutes too late. Their 16-year-old son, Mike, had killed himself with a gun. Mike left a note telling them not to blame themselves and that he loved them.

The night he killed himself, Mike's teenage friends gathered to comfort the family. They asked Dar what they could do to help. "Don't do this. Don't attempt suicide. If you are ever at this point of despair, please ask for help," she told them.

Risk Factors Problems with school or the law. Breakup of a romance or unexpected pregnancy. A stressful family life. (Having parents who are depressed or are substance abusers. A family history of suicide). Loss of security. Fear of authority, peers, group or gang members. Stress due to new situations - beginning at a new school, college or relocating to a new community. Failing in school or failing to pass an important test. Issues concerning sexual orientation and/or identity. Source: American Association of Suicidology

They took her plea to heart and began writing out homemade cards with a simple message, encouraging teens to reach out for help. The card said, "It's OK to Ask4Help." Small, yellow ribbon bows were attached to make the cards stand out. Mike had been well known for giving other teens rides in a bright yellow 1968 Ford Mustang that he and his father had rebuilt, earning the nickname "Mustang Mike."

The idea flourished. Kids in Mike's school sent cards to relatives and friends all over the nation. People began calling the Emmes about starting up a Yellow Ribbon program in their hometowns and schools. In February 1995, the Emmes set up a non-profit organization to foster the growing network of programs. In October of that year, the Emmes’ story was published in the book "Chicken Soup for the Teen Soul". Thousands of letters poured in.

The family knew they had found a way to fill an important role in the lives of adolescents across the country.

What the Cards Do
They soon learned that an abundance of trained professionals with the skills to help depressed teens and an abundance of those who need help weren't finding each other. The family researched every organization that had information on suicide and its prevention. They sought out professional advice from all over the country to come up with their program.

"We came in the middle to become that bridge to get those two sides together," explains Dar.

It starts with education—volunteers speak to groups of young people about depression and suicide, and what their options are when they are feeling alone. Then there are the cards, the same size as an ordinary business card, handed out by the thousands by program volunteers.

The Yellow Ribbon cards have a dual purpose. One side tells teens where to get help and that if they feel overwhelmed or depressed, they should take their card to a counselor, teacher, clergy, doctor, parent or friend, and say, "I need to use my yellow ribbon."

The other side of the card tells those who receive one from a teen what to do: stay with the person, listen to them, take their concerns seriously, and call for help. Each local chapter includes a 24-hour toll-free number on the card.

Dale Emme believes the program has grown so fast because it allows people to take positive action. "If somebody tells you about their issues or problems, you don't have to be a therapist or counselor. All you have to do is be the link."

Passionate Volunteers Fuel Growth
In the past 10 years, the Yellow Ribbon Suicide Prevention Program has grown to reach youth in all 50 states, as well as in Canada and 47 other countries. Ninety-five percent of those who volunteer for the organization are like the Knutsons and Emmes—survivors of the suicide of a loved one.

According to the organization, 42,000 letters asking for help and telling of lives saved have been received, and 5 million yellow ribbon cards distributed. The Emmes get phone calls each day from people who want to help, and from people who say the program saved their lives.

"Because of the nature of the people, this is passionate," Dar said. "They have a reason to get out there and do it. I wouldn't wish this on my worst enemy. What this can do to the human soul is beyond the human soul."

Some days, they still feel the gaping hole of Mike’s absence. "But at the end of each day, our work has given us purpose again," Dar said. "Maybe it was God's will that we were healed to help others."

Youth Suicide Facts Twelve young people between the ages of 15-24 die every day by suicide. Suicide ranks as the third leading cause of death for young people (ages 15-29), only accidents and homicides occur more frequently. Suicide rates for those between the ages of 10-14 increased 99 percent between 1980 and 1997. Research has shown that most adolescent suicides occur in the afternoon or early evening and in the teen's home. Nationwide, nearly one in five high school students have stated on self-report surveys that they have seriously considered attempting suicide during the preceding 12 months. Firearms remain the most commonly used suicide method among youth, regardless of race or gender, accounting for almost three of five completed suicides. Source: American Association of Suicidology

Helping a School Heal
Last fall, a 12-year-old student at the Maquoketa, Iowa Middle School shot and killed himself. Julie Kinrade, counselor at the school, says the school community has been helped by the expertise offered by the Knutsons.

"Our parents need the education that it can happen and what can we do so it doesn't happen again. They need to know what is normal, what isn't normal," she said. "The myth is that if you talk about it, it will happen. But children need to know that there is nothing in this life that they can't talk about with us. We all need to open up communications."

The box of Yellow Ribbon cards and a drop box for notes outside Kinrade's office has helped many of the students express themselves after the tragedy.

One Expert’s View of Yellow Ribbon
When Dr. David Litts first heard about the Yellow Ribbon Suicide Prevention Program, he was intrigued. It seemed to be a well-balanced program that could avoid some of the pitfalls of other programs.

"Over the past decade, there is a lot of controversy surrounding some of these programs, especially those that are awareness alone" said Litts, associate director of Suicide Prevention Resource Center in Washington, D.C. "Some people feel it may stir up angst among teens that have problems rather than build skills and offer students help. Everyone is looking for a simple solution. The fact is, suicide is a complex problem with no simple solutions."

He sees the Emmes' program as very comprehensive, designed to reach faculty, staff, counselors and mental health providers. Yellow Ribbon goes beyond the one-time school assembly by giving students effective ways to deal with the difficulties and stress of life. People are educated at all levels in the community to help.

"They don't want to tell kids that it's normal to think that suicide as the answer," he added. "Suicide is an abnormal reaction. But the real thing to get across is that is it preventable."

Carol Skiljan hears over and over again how grateful people are for the information provided by her San Diego Chapter of Yellow Ribbon, where she serves as executive director.

Skiljan and youth volunteers have recently embarked on a college project. The group is distributing refrigerator magnets that ask, "Are you Concerned about a Friend?" and list signs of depression and where to go for help.

"Being involved in Yellow Ribbon has changed my life in the sense that my involvement is not just about getting the message out there," she said. "I am part of a movement to destigmatize mental illness and to prevent needless deaths because of the myths the general population believes about suicide."

Resources:

• Yellow Ribbon Suicide Prevention Program
• Suicide Awareness Voices of Education or SAVE
• American Foundation for Suicide Prevention
• Youth Suicide Prevention Education Program
• American Academy of Pediatrics— "Some things you should know about preventing teen suicide"

Talk Back

If you’ve got comments or questions about this story, we’d like to hear them. Send your response to Susan Phillips (susan@connectforkids.org).

Lee Nelson is a freelance writer living in DeWitt, Iowa.