CUMMING -- As the nurse cleaned around the gunshot wound on Samuel Barrow Jr.'s body, she directed her staff to make the 15-year-old as presentable as possible – she didn’t want the teen’s family to see him bloodstained.

Barrow Jr.’s family had already witnessed too much. His father, Samuel Barrow Sr., had tried to save the boy after he shot himself, but his son didn’t make it to the hospital alive.

“I keep picturing in my head what he did and how low he must have felt and how hopeless,” said Kristen Vaughan, Barrow Jr.’s aunt. “I didn’t know he was hurting – I didn’t know it was that bad. He was just a baby.”

The family of the Centennial High School sophomore is not alone in their loss. In that fatal act, Barrow Jr., who had lived in Forsyth County until the last two years when he moved to Roswell, fell among a growing number of teens who have taken their own lives in recent years.

Like many other hospitals throughout the state and country, Northside Hospital-Forsyth’s emergency room has seen numerous suicides and attempts.

With almost twice as many people dying by suicide than by homicide annually in Georgia, death is frequent for those who work in hospitals.

According to the American Association of Suicidology, 44,193 people died by suicide in 2015, about 2,000 more than the previous year – that was out of 1,104,825 reported attempts.

Northside Forsyth’s emergency department and its behavioral health services work in tandem to provide care to patients and families, with immediate medical help taking precedence, said Chris Munn, director of emergency services at the Cumming hospital.

“Our first point of business is to secure medical stabilization and provide necessary medical treatment before looking into the behavioral health piece of the puzzle,” he said. “During the process of medical stabilization and treatment, we notify Behavioral Health of a need for assessment if the patient is medically stable.”

Treatment methods vary depending on how the suicide was attempted, but the goal is the same: to save lives now and then provide aftercare, which almost always comes in the form of mental health services.

Laws governing health care providers

Title 37 of the Official Code of Georgia Annotated allows medical providers, law enforcement officers, psychologists and other select groups to provide medical and psychological help to individuals, whether a person voluntarily agrees or not.

“After providing [medical] treatment, a behavioral health assessment is completed and appropriate placement of the patient occurs either for inpatient or outpatient treatment,” Munn said. “For patients meeting 1013 criteria, we provide a safe and secure treatment space for the patient to await appropriate placement.

A Form 1013 is a legal document that allows for the involuntary admittance of a patient into a hospital or other designated medical facility.

Physicians, psychologists, licensed social workers, licensed professional counselors, certain nurses and physician’s assistants can fill out the certificate, which is based on criteria outlined in the state law.

“If the patient requires inpatient treatment, we maintain the safe environment until transfer arrangements can be made to an accepting facility,” Munn said.

Despite what many who are involuntary treated may think, being hospitalized is not punishment – health care providers say they there to help patients get better, and that continues on after the emergency room.

Treating beyond the emergency room

Barrow Jr.’s grandmother, Christy Vaughan, said she wishes he knew he could get help.

“I think young people in particular will lie about their feelings because [they feel] there’s no safe place for them to go,” she said. “I wish we could do something to help change that.”

That’s the goal of Northside’s behavioral health department, said Nikeisha Whatley-León, manager – giving patients a safe place.

“Northside offers comprehensive outpatient behavioral health services,” León said. “We have licensed therapist and psychiatrists that offer an array of clinical outpatient services.”

Those services include psychotherapy/counseling, psychiatric evaluation, medication education and management, treatment programs, 24-hour emergency on call care and others.

Even without insurance, patients are cared for.

More people need to know how to recognize when another person needs help and encourage them to do so, said Sheri McGuinness, president and CEO of Suicide Prevention Action Network, Georgia, or SPAN-GA.

“Most people who take their lives don’t ever make it to a mental health professional or they are in mediocre care that treats a symptom rather than the problem,” McGuinness said. “We have to be advocates for those that need resources and get them to the right services.”

“We need communities to take a stand”

In hindsight, Barrow Jr.’s aunt said the family should have watched the teen more closely, especially after his mother’s death, which occurred just two years and two weeks before the boy’s.

“I wish he could have picked up the phone and called one of us that night,” Vaughan said. “What could we have done to prevent it?”

While Vaughan may not have been able to prevent her nephew’s death, and she certainly isn’t to blame, McGuinness said knowing the signs and talking about the subject can help.

“We need to be spreading community education about suicide,” she said. “We need gatekeeper training throughout our communities so that everyone can identify and get those in need to help. We need communities to take a stand. We need them to organize suicide prevention coalitions that would be able to bring prevention, intervention and aftercare strategies to their own community.”

“We can all continue to increase awareness,” León said. “This is a public health issue, and we’re constantly taking a stance to help eliminate the stigma associated with mental health.”