A very difficult loss 12 years ago for Dolores and Patrick M. Snell led to an easy decision to be forthright about their son’s death and the disease that claimed his life.

Patrick John “PJ” Snell took his own life on Jan. 13, 2007, while the family was still living in Wisconsin. He was just 22.

“If my son had died of cancer, the obituary would have said he succumbed to cancer … how many times do we read that?,” said Dolores Snell, a physician’s assistant now practicing in Glenwood Springs.

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PJ had lived with severe depression since he became an adolescent. He didn’t do drugs, he was artistic, he was involved in his church, he went on mission trips to Native American reservations …

People remarked at the memorial service that he always seemed to have a smile on his face, his mother recalled.

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But, deep down, he was hurting — bouts of anxiety and depression, visits with counselors, psychiatrists, medications …

“He died of an illness that we couldn’t treat enough to keep him on this earth,” Snell said.

“People told me at the time, you’re so brave to do that,” she said of the decision to spell out in the obituary how PJ died and talk openly about his struggles.

It read: Patrick John “PJ” Snell … was a wonderful son, brother and friend. But unfortunately, the love and support of family and friends could not dissipate the darkness of his long fight against depression … 

“There’s nothing brave about that,” his mother affirms today. “I’m just telling the truth.”

As a mother, and through her expertise and insight as a health practitioner, Snell now takes the opportunity whenever she can to help lift the stigma that surrounds mental illness and the loss of a loved one to suicide.

Their family’s story was told in a front page article in the Wisconsin State Journal a few months after PJ’s death. She’s been an advocate for mental health concerns ever since. 

“It’s a real illness that needs advocacy, it needs treatment and it needs so much more than we have,” Snell said.

The stigma was greater at the time her son was struggling with mental illness than it is now, she said. 

And many strides have been taken over the last decade to bring mental health to the forefront alongside physical health concerns.

But more can still be done, she said.

THE TEEN BRAIN

For PJ, the signs began to appear as he entered adolescence, around 12 or 13, Snell said. That’s when hormones start to change, and the brain is growing.

“The frontal lobe is responsible for reason and accountability,” she said. “And in teenagers, we know that frontal lobe is developing, but not resolved.”

People would often ask after PJ’s death if there were any triggers that might have contributed to his disease.

He was smaller than the other kids, so there was some bullying, Snell said. But, from a medical standpoint, it’s more about the brain chemistry, and in the case of mental illness, an imbalance in that chemistry.

It was particularly hard when PJ turned 18 and became an adult, meaning his parents couldn’t be directly involved in his medical needs.

Jackie Skramstad is clinical operations manager for Mind Springs Health, which provides inpatient and outpatient therapy and psychiatric services on the Western Slope. She said that transition from minor to adulthood is a challenge for someone dealing with mental illness.

“Depression can really start to manifest in high school,” she said. “But that first psychotic break often doesn’t happen until between the ages of 18 and 22.”

Because they are adults, there’s a lot of decision-making around who gets to be involved in that person’s care.

“At Mind Springs, we do value and try to work with clients about how best to support their treatment, whether that’s involving family or others,” she said. “We can’t make it happen, but it’s part of our approach using best practices.”

In general, whether there’s a mental health concern, or not, the transition from teenager to young adulthood is a critical time in a person’s development, Skramstad added.

“Kids are leaving the house and gaining more independence, and one of the things you want to do is help prepare them for that additional choice-making … and to be comfortable making decisions,” she said.

It’s a conversation parents and other adults in that teenager’s life need to start before they turn 18, Skramstad said.

“If you deal with it in the moment, you’ve waited too long,” she said. “You want to build up to that point and set the stage for them to be successful as they move on.”

And, if they’re struggling with something, help them find some support, she said. 

CRISIS RESPONSE

For a teenager or young adult who is struggling and possibly contemplating suicide, it’s important to watch for warning signs and take them seriously, said Michelle Muething, executive director for the Hope Center, which provides crisis response in Garfield County.

“’I’m going to kill myself’ has become kind of a flippant sentence for people to use, and especially teenagers,” Muething said. “However, the response has become different and it is taken very seriously.”

The Hope Center operates a helpline and provides in-person crisis response for people of all ages. They do field a fair number of calls from teenagers who are at a point of crisis.

“Some kids don’t understand the gravity of what those words mean, and the response that comes with it,” Muething said. “But the vast majority of kids we see are stressed, and very well do have a higher level of depression or anxiety.”

If they go to the effort to reach out, it is taken seriously, she said.

“Only a small percentage truly want to die,” Muething said. “There’s so much noise and clutter in today’s society to work through, and part of our job is to work through that.”

It could be clinical depression or anxiety disorder. “Or, maybe it’s just that they’re sad. So, let’s figure out why you’re sad,” Muething said. “Sometimes kids have to say something drastic for people to stop and realize, ‘I’m in pain, and I need someone to pay attention to me.’”

Part of Snell’s message is for parents and others whose families are impacted by mental illness to not feel shame or guilt, or to lay blame.  

“If I can help just one mother or one father not experience this by being honest, that’s a start,” Snell said. “From when PJ started needing help to when he died, that stigma was a huge part of the problem.

“And I said from that point forward, if I could do something to stop that, I would …

“My son, I believe, by my actions in advocating for mental health awareness … it is allowing this awful loss to have a meaning.”

jstroud@postindependent.com