Editor's note: If you or a loved one is in crisis, you can call the National Suicide Prevention Lifeline at 1-800-273-8255 (1-800-273-TALK) .
HARVEY, N.D. — Jonathan Franklin was jolted by a grim realization while chatting with a group of 10 high school students after playing a pickup game of basketball in the town’s Armory gymnasium.
It suddenly dawned on him as he scanned the group that parents of four of the 10, all former classmates or acquaintances from his school days, had died by suicide.
Later, he learned that a parent of a fifth of the 10 students also had died by suicide — meaning that half of the group had been touched by the tragedy of suicide.
“That was kind of the defining moment,” Franklin said. He decided, “We need to do something in this town. It was just crazy.”
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That urge to do something resulted in Mosaic Wellness Center, where counseling services are located on the main street in Harvey. Nicole Franklin, Jonathan’s wife, is a licensed clinical social worker and therapist at the center and also provides counseling in the school.
The Franklins, who grew up in Harvey, had been spending summers back home for 18 years so their kids could experience the joys of country living. By 2018, they moved back permanently to be with their families.
Jonathan sold his interest in a computer-related business, and the couple relocated from Kansas City. They bought a vacant building that had fallen into disrepair to house Mosaic Wellness Center.
Nicole is the only therapist in Wells County, a ratio of one to 3,982. The ratio across North Dakota is one to 510; in the United States, it's one to 373. The numbers show how underserved rural areas are for behavioral health care, Jonathan said.
Suicides and alcohol abuse strike rural areas at higher rates than urban areas, according the Rural Policy Research Institute . Children and young adults in rural areas also have higher rates of mental health conditions than those in urban areas.
The lack of behavioral health care is one of the reasons for the high suicide rates in rural areas, Nicole said. Isolation also plays a role. So does the strong sense of independence and attitude of perseverance.
“You just push through it,” she said, summarizing the mindset. “It’s kind of a 'help yourself' culture.”
Outwardly, nothing much had changed in Harvey, a farming town of 1,700 in Wells County in east-central North Dakota, in the 20-plus years since the Franklins had graduated from high school and left town.
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But something had changed, some dark undercurrent that wasn't there before. When the Franklins were growing up, the first suicide of anyone in school that they were aware of happened in 1994.
Since August 2020, by Nicole’s count, 21 adolescents had attempted suicide, a number that likely spiked because of the stresses of the coronavirus pandemic and also reflects that ideas of suicide have become much more prevalent.
While in Kansas City, she worked in an alternative high school. “I saw quite a lot of trauma there and drug abuse,” she said. “I thought after being in that environment that nothing would surprise me.”
But when she got back to Harvey and opened her counseling practice, she said she “was definitely surprised by the level of trauma” and level of despair.
When her husband came home that night in the fall of 2018 and told her of the high incidence of suicide evident from the group of 10 high school basketball players, she wasn’t surprised.
Many of those students were her clients, but she hadn’t told her husband.
There’s something especially stressful and isolating about the online culture that is part of growing up today, Nicole Franklin said.
Today’s teenagers — dubbed Generation Z — are the first who, from their earliest years, have been saturated in social media, with so much socializing occurring online instead of in person.
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In earlier eras, if a student was being bullied at school, home provided a refuge. That’s not the case with social media. Adolescents stay up into the wee hours checking social media to see if they’ve been mentioned, with a watchful eye for any derogatory references.
“These kids, they never unplug,” Nicole Franklin said. “They never get a break.”
Pressure begins to build. They fall behind in their school work. They have busy schedules, with school, work, activities.
Over time, students who are struggling emotionally come to feel that they have no place to go. Suicide starts to seem like an option, Nicole Franklin said.
“I keep hearing the same story over and over,” she said. “It’s eerily similar.”
Often, attempted suicide among adolescents is a cry for help, she said. They often send a message to a friend who is able to contact the parents in time to intervene.
“For many of them, it was a wake-up call,” she said.
Although housed in the Mosaic Wellness Center, in a building the Franklins own and renovated, Nicole Franklin works for Assessment and Therapy Associates based in Grand Forks. The Harvey office is the firm’s first branch office.
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“This is kind of an experiment for them to branch out into a rural area,” she said. The experiment has proven successful.
After less than four years, Nicole Franklin has authorization to hire another therapist. She has clients who travel up to two hours and has a waiting list.
“We need more providers,” Jonathan Franklin said in recent testimony before the North Dakota Legislature’s Acute Psychiatric Treatment Committee. “Just being the one is really hard.”
The area also needs access to a psychiatric treatment bed, he said. When children attempt suicide, they’re taken to a hospital emergency room, which he said isn’t equipped to handle the case. It can take days for a bed to open, he said.
“It’s not a pleasant experience,” said Jonathan Franklin, who assists his wife at Mosaic Wellness Center. “Not having access to this stuff is traumatizing.”
The Franklins hope to recruit other behavioral health professionals to Harvey, even if they visit to provide counseling. The upstairs of the Mosaic Wellness Center has an apartment.
“Our goal would be to have 20 providers in Harvey,” Jonathan told legislators. “It’s a pretty audacious goal.”
But, he added, there are rural communities that are working to provide home-grown services.
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Nicole Franklin, who finds clients are more accepting of seeking help than before, finds her work fulfilling.
"I have one mission, and I'm just going to keep focusing on that," she said. "I know what I'm doing with my life, and this is it. This is our mission together."
