DULUTH - Matthew Campbell could not tell his parents he was depressed.
It was only a little over a year ago that the Duluth East High School senior began treatment for depression, after several years of feeling unhappy, which turned to self-loathing and ultimately, to thoughts of suicide.
The breaking point came during a night when his parents discovered the varsity soccer goalie and student government leader was failing three classes. He broke down crying in front of them, but wasn't able to share his struggles.
"I couldn't get the words out," he said.
He left his house late on that cool September night in a T-shirt and shorts and walked to Brighton Beach. There, he called his older sister, and they talked for a long time.
"My sister impressed upon me that nobody has to feel that bad for that long and struggle alone," he said. "And getting help really truly does help."
His sister did the hard part of explaining to their parents what he was enduring as he walked back home. They were waiting for him, ready with support.
Campbell, who describes depression as "your own mind fighting itself," turned to writing to cope, and his piece on his depression became an award-winning creative speech that he's given as a member of the school's speech team, something which he has begun sharing at assemblies and in classes. He details his love-hate relationship with the medication he takes and the daily realities of depression through his lens, combined with experiences that have been shared with him. He's been approached by several students seeking guidance, or thanking him for sharing a story they could relate to.
"I've seen so many kids go through depression and have that struggle and they don't know who to talk to," said Dani Westholm, an English teacher at East who also leads the student government Executive Board.
Campbell has given his speech to many of Westholm's classes and students are "captivated," she said, and many of them cry.
"Depression," an excerpt of his speech reads. "It's a heavy word, isn't it? It's uncomfortable, it rolls off the tongue and hangs in the air dead center of the room while everyone avoids it. But it's time to stop avoiding it. I avoided it for two years until I reached a breaking point because it demanded to be acknowledged like 'Hello? Yes, it's me depression. Are we still on for our appointment every second of every day? Great. See you then.'"
East's class of 2016 lost two classmates to suicide. Several students in 2015 began working to increase mental health resources at their school. That led to posters hung up around East with appropriate resources, and it also led to the addition of a fourth guidance counselor. While the American School Counselor Association recommends one counselor for every 250 students, its most recent statistics show Minnesota's ratio to be 723 students to one counselor - one of the worst ratios in the country.
The addition of a fourth counselor at East puts the school's ratio at about 375 to one. Students and staff are heartened by that, but they know there is more to do. Last year, the Duluth school district began working with St. Louis County and continued working with Carlton County's Text4Life group. Students at all five of the district's secondary schools have been surveyed about their mental health needs. The data identified who students went to for help, and those staff members were also given a survey, to assess the tools they needed.
A mental health flowchart has been created for school staff, to help employees determine the next move if a student shares a mental health concern, ranging from an emergency situation to something they can handle alone.
"We are here as teachers, but also as people who have relationships with teenagers. It's a volatile, constantly moving day-to-day emotional status for most of our students," said Ordean-East Middle School teacher Holly Bowen-Bailey, who recently attended a relicensure training meant to help staff detect signs of mental health need.
There is a great need for teachers to know what's normal and what isn't for the students in their care, she said, and there is a "wide range of what's normal."
"Do we miss things? Absolutely," she said. "But we get to them fairly well, often."
Each of the secondary schools will hang posters in common areas that show photos of the counselors and how to find them, coping skills offered by fellow students and numbers for area resources.
Catching kids with mental health concerns before things progress to suicidal thoughts is just as crucial as looking for risk factors for potential suicide, said Meghann Levitt, coordinator of Northeast Minnesota's Text4Life organization.
"It's important to have a level of response before it turns into crisis mode," she said, and new state-required trainings and the work of students and staff is helping. "Depression doesn't equal suicide, but those who are depressed have increased risk."
Being explored at East is a possible peer network, with training provided to students who would be able to offer resources and a first line of help, something Campbell said is greatly needed.
Approaching adults "is terrifying," he said. "It's much easier to approach a peer."
According to the Centers for Disease Control, suicide is the second-leading cause of death for those age 15-24. About 20 percent of any student population has a mental health need, said Ron Lake, the Duluth school district's climate coordinator and a social worker.
"Mental health impacts how we think about ourselves, how we relate to other people, how we learn. ... It affects our thoughts and hopes about our future," Lake said.
Campbell's willingness to share his experiences publicly helps reduce mental illness stigma, said Ashley Anderson, a St. Louis County public health nurse who is working with the district on mental health work.
"For him to have the strength and courage to do that is amazing, and it's wonderful for the students to hear that," she said.
Campbell's speech, as startling as it is, is not without hope: "Depression is not your identity," he wrote. "Depression is your mental disorder, but it is far from defining you. Because you are more."
If you need help
National Suicide Prevention Lifeline: (800) 273-8255