The communities of Palo Alto and Woodside have lost two young people in the past few days to suicide. As we grieve, it is important that we come together to support our youth, their families and their broader social circle. We should also remember some basic information about suicide: what we know about its causes, how we can recognize those at risk, and where to get help.

Suicide is very complex and doesn't "just happen" to anyone, but rather tends to be preceded by a number of risk factors. There is usually a gradual progression from suicidal thinking to suicidal behavior to a suicide attempt. Seventy-five percent to 90 percent of completed suicides occur in persons who have had a mental illness or emotional health problem for at least a year.

Suicidal youth may be more attracted to death and less able to generate alternatives to suicide when faced with severe stress. There are usually warning signs that we can all recognize to help those in need. Youth in transition, whether from high school to "what's next," or when switching school settings, can experience unique stressors that our community must understand better. The 18-24 year old age group can be particularly vulnerable in this regard, as the most recent suicides in Bay Area communities remind us.

If someone you know shows some of these warning signs, seek help:

• Talking about wanting to die and ways to attempt suicide

• Showing signs of sadness, hopelessness or feeling without purpose, or of being a burden to others

• Giving away prized possessions

• Increased use of alcohol or drugs

• Sleeping too little or too much

• Loss of interest and withdrawal from usual activities

• Showing signs of severe panic, anxiety, irritability, or talking about seeking revenge

• Displaying extreme mood swings

What to do:

• Don't dismiss the person's talk of suicide or severe depression.

• Do talk openly about your concern with the person, in a sensitive manner: you will not plant the idea of suicide simply by bringing up the topic. Rather, you will make it OK for the distressed person to talk about their feelings and thoughts of suicide. Using phrases like, "I'm worried about you. Are you thinking of harming yourself?" Asking "You're not thinking of suicide, are you?" does not allow the person to express their true feelings.

• Don't leave the person alone

• Remove or secure any objects that could be used in a suicide attempt: firearms, alcohol, prescription drugs, or sharp objects

Where to get local help:

If the person is cooperative and not in imminent danger (has not harmed him/herself), you may call the person's primary care physician, school counselor/psychologist or mental health professional for advice about where to seek evaluation promptly. School staff can help expedite an evaluation and ensure that the student remains safe.

If you have concerns about a person's physical safety or ability to cooperate fully with an evaluation, you should get them to the nearest emergency room. Not all hospitals can admit patients for psychiatric issues, which might require transfer to another facility. For obvious emergencies, call 911.

Here are local clinics that will triage and/or see individuals affected by our local losses:

1. Palo Alto Medical Foundation: Palo Alto Medical Foundation -- 408-730-4370 in Palo Alto or 650-696-4666 in San Mateo

2. Lucile Packard Children's Hospital and Clinics: 650-723-7704 for children and teens; and 650-498-9111 for adults.

3. El Camino Hospital ASPIRE Intensive Outpatient Programs: 650-940-7000 (Mountain View); 408-866-4021 (Los Gatos). Mills Peninsula Intensive Outpatient Programs: 650-696-4666.

Here are other resources:

1. The Santa Clara County Suicide and Crisis Services line: 1-855-278-4204 available 24/7 to provide support for suicidal persons and those around them.

2. California Youth Crisis Line: 1-800-843-5200; youthcrisisline.org

3. Trevor Project Lifeline, specializing in crisis help for GLBTQ youth: 1-866-488-7386

4. EMQ Families First Services has an excellent mobile crisis team who can assess youth at their home or school site throughout Santa Clara County: 877-41-CRISIS (877-412-7474).

5. HEARD Alliance, our local consortium to address teen behavioral health issues, has many useful resources: www.HEARDAlliance.org

6. American Foundation for Suicide Prevention: www.afsp.org

7. PAUSD website: Health and Wellness Program.

8. Finally, ROCK at Gunn is a student-led, faculty-guided peer support group that has helped numerous Palo Alto teens get through tough times, using personal narratives of hope, help and strength. ROCKatGunn

Since losing several teens to suicide in 2009-2010, it is clear that we, as a community, are much more engaged in the civic discourse of mental health: reducing stigma, improving the number of trusted adults that our youth can connect with, reducing barriers to obtaining mental health services, increasing mental health awareness, and developing suicide prevention strategies. We work through several consortiums, including the City of Palo Alto-sponsored Project Safety Net (PSN).

Our schools continue to lead community efforts to provide our youth with the skills they need to become resilient in the face of distress and protect against suicide. Evidence-supported programs are being used at Gunn and Palo Alto High Schools, and new initiatives to educate middle school students about signs of serious distress in their peers are being planned.

Our school district (PAUSD) enacted a suicide prevention policy in 2010 that has been a model for many other districts around the state. National guidelines have promoted the idea that schools have an essential role to play in preventing suicide and in promoting wellness among our youth. A Comprehensive Suicide Prevention Toolkit has been developed to guide district staff, parents and the community in responding to distressed students using known best practices: Toolkit for Schools

Continued depression education and suicide prevention programs in PAUSD schools ensure that our schools participate fully in the broader community effort to not only handle crises when they occur and prevent youth suicide, but also to promote student wellness more broadly.

We will be sharing additional information in the coming weeks about lessons learned over the past five years and further resources.