If all goes as planned, six weeks from now, a solemn parade of haggard walkers traipsing through the darkened streets of San Francisco, will carry candle lit paper bags, illuminating the streets, as they participate in the Out of the Darkness Overnight.

The 20-mile walk held from dusk to dawn, on July 22, will raise awareness about depression and suicide, that leaves many affected in the dark.

Every 18 minutes a person in the United States dies by suicide, while an attempt is made once every minute, according to the American Foundation for Suicide Prevention. The AFSP also reports that 20% of American high school students have considered suicide during the past 12 months and 8% of students make a suicide attempt.

"People worry about illness in their child, but the illness that kills the most children is suicide," said Mary Ojakian, a Paly parent who lost her 21-year-old son, Adam, to suicide in December while he was attending UC Davis. "The first disease that kills the most 15- to 24-year-olds is suicide. No other disease kills more children. Suicide is the third leading cause in deaths with auto accidents and homicide before. The next disease, tuberculosis, is way down on the list. Suicide kills more children than war."

In addition to serving on the board of the Northern California Chapter for the ASFP, Ojakian and three other Palo Altans formed, Team Palo Atlo, who will participate in the Overnight.

"The walk brings the topic into the light," Ojakian said. "Through the more awareness raised of the disease and openness."

Sponsored by the AFSP, the Overnight supports clinical research, suicide prevention programs for college campuses, national centers to evaluate suicide prevention treatment, National Survivors [those who have been affected by the death of a loved one] and survivor support groups. The walk also hopes to "raise awareness and end the stigma about the issue of suicide and depression," according to the group’s web site, http://www.theovernight.org/.

"Across all cultures, ages, ethnicities, and religious groups there is a huge stigma," Ojakian said. "Religion used to not accept suicide and wouldn’t let those lost to suicide be buried, as it was considered a mortal sin. The Catholic Church has changed and recognizes the causes of the illness. It takes a lot of publicity to change an attitude ingrained in society. Palo Alto might think they’re different but they aren’t. Every city in the United States has this stigma."

The ASFP also awards research grants all over the nation, one in which includes Stanford MRI studies of a depressed suicidal female brain, and compared to that of depressed, normal brains.

"I hope this walk will affect Palo Alto and the whole Bay Area, and raises awareness of depression and suicide," Ojakian said. "Getting people to say ‘Oh I have an illness and it’s treatable’ is a huge step forward."

In addition to the walk, a Suicide Prevention Bill, that would provide a prevention plan, is currently in the California Assembly.

"Proposition 63 is used to implement suicide prevention strategies," Ojakian said. "We need this strategy, it gives counties guidelines and things to do – the statewide plan is a strategy that all counties can access. Palo Alto can support this bill to establish a suicide prevention strategy in California, Senate Bill 1356, that would provide guidelines."

Within local politics, the Palo Alto Unified School District is working on promoting mental health and preventing suicide.

"We need to not only address suicide but promote wellness as well," Ojakian said. "PAUSD is working on implementing a Wellness Policy and appointing a policy committee to begin work on this. They will begin with nutrition, physical education and health, and creating guidelines that dealt with mental health as one piece."

Yet there is still work to be done, as depression, the main cause of suicide, affects the student’s learning and mental health. According to Dennis S. Charney and Charles B. Nemeroff, the authors of The Peace of Mind Prescription, some of the effects of depression make it harder to clearly think, concentrate, analytical reasoning, and make decisions.

"Paly schools could take a serious evaluation of the stress level of an average student and really look at that and say ‘What can we do to reduce this stress?’" Ojakian said. "The district doesn’t have to decrease academic excellence. There are ways to promote mental health and prevent suicide."

Programs like the UCLA School Mental Health Project and the Youth Suicide Prevention Program (YSSP) focus on promoting mental health in schools. Specifically, the YSSP has been used in Washington, where the suicide rate decreased from 15.4 deaths in 1999 per 100,000 to 10.1 deaths in 2001. YSSP’s public education work to prevent suicide focuses on offering "Gatekeeper Training," workshops for adults who meet with young people regularly, and helping school administrators cope with a suicide and it’s aftermath. The program also assists in student-run campaigns that promote prevention and awareness around suicide, along with teaching a "skills based curriculum" for both middle and high school students. Within Washington, YSSP promotes National Suicide Prevention Week while also distributing posters and other informational documents.

"There’s a request from the staff to get more information on how to support students," Ojakian said. "They want to know how to support students. They want to know how to respond to student who face anxiety and depression. We have the resources, the work is done, it’s simply a matter of accessing and using it."

However, Ojakian sees potential.

"There is tremendous hope because of the type of district we are. The way we function is in the betterment of our students. It’s a very progressive district. They’ve been leaders in the education system, they can easily be a leader in this."

Other efforts to prevent adolescent suicide can be done by youths, according to Ojakian.

"Peer support is key," Ojakian said. "You’re on the frontline, you’re the ones who know what goes on in their brain. The best way is to listen and don’t reassure or say ‘It’s going to be okay’ Rather say ‘Okay, let’s get you help’. "

According to the AFSP some of the symptoms of depression are: a loss of interest or enjoyment of usual activities, change in appetite or weight, fatigue or loss of energy, change in sleep patterns, and thoughts of suicide or death.

"What adolescents can do [to promote suicide awareness], is to take all comments about suicide and hurting oneself serious," Ojakian said. "It’s better to lose a friend than to lose a life, If your friend is upset that you’ve gotten them help, but at least their still alive."

The YSSP’s A Parent’s Guide to Recognizing And Treating Depression in Your Child recommends adolescents to understand what suicide is when helping a depressed friend, along with listening, sharing their concerns, and supporting their friend in seek help. The booklet also encourages adolescents to seek support from trusted adults when helping a depressed friend.

"Suicide is so across the board with blind sight, and effects someone you love," Ojakian said. "It can happen to anyone, and crosses all boundaries- nobody is protected. We think we are- we don’t like to think about sad and horrible things in life, and that’s why people don’t talk about suicide. We assume that it has to be obvious. Suicide is a silent killer, along with depression and mood disorders, which are kept very quiet. We just need to start talking about it. The help needs to come from the outside."

To support the Out of the Darkness Overnight, you can register to volunteer or make a donation at http://www.theovernight.org/.

To learn more about suicide prevention visit http://www.yspp.org/ and http://www.sprc.org/.