Tim Mickelson will never forget the moment that everything he thought was stable and right with his son Nate's life fell away.
It was June 2004. Mickelson saw a photo Nate had e-mailed his ex-girlfriend. His son — captain of his high school football team, honor student, popular guy who had won coveted scholarships to Mizzou — had taken the photo of his own arms, raw slashes up and down them.
That past year had been a rough one for Nate, then a college freshman. But Mickelson, of Affton, said neither he nor Nate's mother had any idea their son was contemplating suicide.
Nate broke down sobbing when his father confronted him about the photo. He pointed to a rafter in his bedroom — the place he had considered hanging a rope.
Mickelson grew numb. He knew this was a crisis. But he had no clue whom he could call for help, right then.
"When you're in that 'Oh, my God' moment, you don't know what to do or who to call or where to go," he said. "You need to talk to somebody quickly who understands the severity of it."
Starting in September, the answer could come through a free, 24-hour crisis hot line that can dispatch trained mental health workers to a St. Louis County home — or even a homeless child on the streets — in less than an hour.
The hot line is one of 90 new programs for children 19 and under made possible through grants from the St. Louis County Children's Service Fund.
In September, the board will begin dispersing nearly $35 million collected through a new quarter-cent sales tax in the county. More than 60 percent of county voters approved the tax in November 2008.
Though the lion's share of the tax money will go to establish $16.8 million in school and home-based mental health counseling and prevention programs across the county, a $554,000 slice of that pie will go to the new crisis response hot line. The service will be available to any county resident seeking immediate mental health crisis assistance for a child.
Kate Tansey, executive director of the fund, said the hot line will be the critical front door for young residents with serious mental or behavioral health issues. Once through that door, they will receive immediate assessments and referrals to newly funded mental health and behavioral services for children like Nate, who did not get the services he needed.
In September 2004, despite visits with a counselor and a pediatrician, the teen wandered away from a college party after leaving a cryptic message on a dry-erase board: "Oh my God, I'm not here."
He hanged himself from a tree outside a dorm room.
"Had there been ... somebody to work alongside of us, to work on this while we fixed it — it could have been different," his father said. "Honestly, we were not doing any of the things we should have."
With the response hot line, Tansey said, the county hopes to catch hundreds of children each year before they hurt themselves or others, fall into trouble with the law or run away from home because of depression, psychological disorders, substance abuse, physical abuse or other issues.
Tansey is so confident about the program and the ensuing web of services — everything from substance abuse counseling and family therapy to homeless beds and emergency shelters — that she is predicting the elimination of homeless teens in the county. About 45 percent of the estimated 5,380 homeless people in St. Louis County are 17 and younger.
One of few countywide programs of its kind in the country, the response hot line will be run by the agencies Youth In Need and Behavioral Health Response. The partnership was an ideal grant match that filled a serious gap in services, Tansey said.
Youth In Need, based in St. Charles, has long provided teen homeless outreach, counseling and emergency youth housing in the region. Behavioral Health Response has been equipped with an emergency hot line for mental health referrals for years. Jim Braun of Youth In Need and Lesley Levin of Behavioral Health Response said the funding enabled them to join forces.
"It's unique because it's not just a hot line," said Levin. "There's a tangible face-to-face service that goes along with it."
Braun noted that the service is meant to appeal directly to teens to seek help. In addition to dialing a simple 800 number, they also will be able to text the hot line.
The two agencies were among 87 that submitted 162 program proposals, totaling $72 million in requests. The Mental Health Board awarded 44 of those agencies grants.
BJC Behavioral Health received the largest grant: $4.3 million. Preferred Family Healthcare, Epworth Children & Family Services Inc. and Catholic Family Services received $3.3 million, $2.2 million and $2 million, respectively. The majority of the remaining recipients got grants of $100,000 to $600,000.
Nearly half of the funding will go to increase the web of professionally trained therapists and prevention workers in county schools. Prevention programs in every school district will address suicide, drug and alcohol abuse, bullying, sexual harassment and other issues.
An additional $5.25 million went to agencies to provide individual, group and family counseling. Other funding will enable area agencies to double capacity for teens at emergency homeless shelters and in transitional living apartments. Last year, agencies provided about 905 teens with shelter. With more than 228,000 children under 18, St. Louis County has the largest population of youths among Missouri counties.
Mickelson now works full time in the suicide prevention field. He said the Children's Service Fund's creation of prevention services in all schools will make a huge difference. He thinks if Nate's friends had been exposed to suicide prevention programs, they might have realized their buddy was in serious trouble.
"It was clear each of them had a piece of the story. They each had seen one warning sign," he said. "They would have known who to talk to and understood how keeping it quiet can kill someone."