- [Woman] Funding for this program was made possible by the Richard King Mellon Foundation, The Heinz Endowments, The McCune Foundation, The Pittsburgh Foundation, Highmark and the members of WQED.

Thank you.

- [Narrator] This program contains content that may disturb some viewers.

The people featured in this program talk frankly and openly about suicide.

They are sharing their stories in the hope of helping others.

- Yeah, I know, you know me, I'm Lambert Hillman.

(ominous upbeat music) - Oh, he was happy go lucky, class clown.

- Remember these 52,550 inch biceps.

- Football, baseball, hockey, soccer.

- Very personable.

Vice president of the junior class.

- He's a great kid.

Everybody loved him.

- He loved people and I thought he loved life.

- [Narrator] Lambert Hillman spent the final moments of his teenage life here on this bridge, above the Monongahela River, official cause of death, suicide.

The family sentence, a lifetime of grief and regret.

- I was his mother and I should have seen his pain and that's what hurts.

- [Narrator] Lambert's mother, Kathy, would find out she wasn't alone.

- We lost our youngest son, Tom.

He jumped out a 16 story window.

- We lost our son, Jonathan, showed us no signs of anything wrong.

- Not seeing his legs and his feet in the bathroom, say (indistinct) had shot himself in the head.

- [Narrator] Among others, called Survivors of Suicide, Kathy found support and healing.

- So I needed to be able to do something with this.

- [Narrator] She's now helping others and speaking out to erase the stigma.

- The brain is an organ in the body that fails like anything else does.

- And that's what I'm really trying to understand.

(gentle upbeat music) What brain disorder is causing this to happen?

- [Narrator] The answer may come yet in a first of its kind study where Pittsburgh doctors are looking at young brains and finding something very different than those of teenagers with thoughts of suicide.

- My greatest hope for this research is that we are able to find markers for suicide risk so that we can identify children before they ever attempt suicide before we lose them.

- Lambert was a premature infant and I remember praying to God, please let me get to know him.

(movie reel jittering) And that's what God did.

He gave me 16 years to get to know him.

- [Narrator] When Lambert Philip Hillman struggled into life, Kathy and Ricky Hillman welcomed him as their second son.

It was 1978, the Pittsburgh Steelers were in their dynasty years.

The new baby was named for number 58, Jack Lambert, who heard about his little namesake and posed for a family photo.

- He's one of the best players we could ever think of, so we just decided, well, we'll name him Lambert, so we did and he proved to be tough.

- Loved sports, baseball, football, hockey.

He was a loving kid, a very concerned kid.

- [Narrator] He loved his family too but the marriage was troubled.

Kathy and Ricky would divorce when Lambert was three.

The boys stayed with Kathy, she later remarried.

Her sons grew up loving their stepfather, Marty but stayed in touch with their dad too.

(crowd cheering) - (indistinct), and I was just lucky enough to have both my sons on the same team.

It makes you proud.

- [Narrator] Typical teenage years.

- [Kathy] Lambert loved school.

- [Narrator] That's how Kathy describes Lambert's life at Ringgold High School, 25 miles south of Pittsburgh.

- He loved the companionship in school.

He loved the friends and was an honor student.

He was the type of kid that could go to a party, know no one but yet at the end of the party, everybody was his best friend.

I thought he loved life.

- [Narrator] If there were signs of trouble, nobody saw it, even during the trauma of losing Lambert's stepfather, Marty.

- You know, we had just lost Marty.

It was a three-year battle with cancer.

So we were all grieving, you know, and I just thought he was where we were.

- [Narrator] And by all appearances, he was, talking about the future, happy and in love with his girlfriend.

- He had talked about going to the prom.

He had talked about, he wanted to be a DJ and he wanted to go to Point Park College.

- [Narrator] If Lambert had any worries at all, they were about his mom, still grieving her husband's death.

Kathy remembers one of their last moments together.

- The night before he did this, we were coming up on the anniversary date of Marty's death, three months and he knew it was gonna be a bad day for me and he talked me into going blind dancing that night with my friends and he says, "Mom, when you come home," he says, "You can teach me the steps."

I came home that night and we danced.

- [Narrator] The next day, Lambert broke a longstanding routine.

He didn't call his mother at work.

- [Kathy] I didn't get a phone call from him and it bothered me.

- [Narrator] Later the same day, Kathy found out that Lambert had gotten an expensive speeding ticket after school.

When he didn't come home that evening, Kathy started making phone calls.

Then at 9:10 PM, she was thunderstruck by a mother's instinct.

- Then it takes me to that 10 after nine at night, when I know when he died and being in the kitchen and just had that awful feeling in my stomach and you know, fell to the floor and Justin looked at me and he says, "Mom, what's wrong with you?"

And I said, "Honey, this is bad."

I said, "This is bad."

And he says, "what are you talking about?"

And I said, "I don't know, honey."

I says, "But something has happened to your brother."

- [Narrator] Police would find the family car parked in downtown Monongahela, search dogs would find something more disturbing.

- The one detective came over and grabbed me and he said, "We got his scent."

And I says, "where did you get his scent?"

And they said, "Up on the bridge."

And then the search started, just looking for him day and night.

- Police who are investigating say, Lambert's disappearance is totally out of character.

- [Narrator] Lambert's parents went on TV asking for any information.

The assumption, their son might still be alive.

- Even though we felt we knew what he had done.

We looked, I looked at every kid that had the ball hat turned backwards.

- [Narrator] Missing flyers went up, Lambert's friends and teammates joined the effort.

- [Kathy] This town just pulled together like it was unreal.

- And everybody in the whole valley tried to find him and even the kids from like Belle Vernon, and Monessen and Donora, all the kids that played sports around him.

- [Narrator] Kathy went to the high school looking for answers.

- English teacher come in and she says, I have something I think you need to read.

- [Narrator] It was an essay Lambert had turned in just before he disappeared.

The teacher's assignment, compare any two topics.

- [Lambert Voiceover] There are also good qualities in death.

- [Narrator] Lambert compared life and death.

- [Lambert Voiceover] You can be at peace in heaven, which is what I hope for.

You do have the luxury to take your own life, if you stand for hope, then give life a chance but if you do not want it, then maybe death is what should become of you.

- I don't know how he did it, not show his pain and how could so many of us around him that loved him, just, we couldn't see it.

(alarm blaring) - The fire whistle went off and I knew exactly what happened, they found him.

- [Narrator] One month after 16 year-old Lambert Hillman jumped from the bridge in Monongahela, his body was found several miles downstream.

At first, the family felt a sense of relief.

- [Kathy] 'Cause I was so afraid we would never get him back.

Just so afraid that I would go through life never, never knowing.

- [Narrator] Then the reality of suicide set in.

Shame, blame, regret, endless questions.

- Why he did this not to be around me no more?

There's no answer, no answer.

- [Narrator] News reports focused on the speeding ticket as the suicide trigger.

Lambert knew his mother couldn't afford the fine, she'd racked up huge medical bills when Marty was dying of cancer but Kathy didn't blame the speeding ticket.

She blamed herself.

- The suicide that destroyed him was also destroying me.

When they die by suicide, you feel like you've done it all wrong.

You know, I pulled out all his school pictures and I laid them out on the floor, in all the grades and I looked at them, trying to figure out, okay, when did this happen?

When did he get sick?

- In dealing with a suicide loss, people will do that pretty much nonstop.

- And I would say he was two here, he was happy.

He was three here, he was happy.

- You look at the pictures, you keep going back and you keep going back.

- [Kathy] When I would look at him and think he didn't smile in this picture, maybe it was here.

- And people need to do that until they exhaust all the possibilities and then come to the understanding that the ending won't change.

- [Narrator] Kathy was at her lowest point, emotionally and physically.

- You probably would not have ever recognized her then.

She had difficulty even walking.

- [Narrator] And then Kathy met Sue Wesner.

- Oh my God, she's my lifeline.

I don't know where I would be without Sue Wesner.

- Hello, I'm Sue Wesner, I'm a- - [Narrator] Sue, runs the Survivors of Suicide program at the University of Pittsburgh Medical Center for families and friends of suicide victims.

- Peggy, you and Chester talked to Adrian for quite a bit.

- [Narrator] She knows that everyone in this room has asked themselves the same questions.

- Was I really a good parent?

What did I do wrong?

Why can't they share this with me?

I didn't know they were going through this.

The questions just go on and on and on.

- [Narrator] Kathy went reluctantly to her first group meeting back in 1995.

She didn't say a word for three weeks but later opened up because others did too.

- My name is Chester Young, my wife, Peggy.

- [Narrator] All of the mothers and fathers in this group lost sons to suicide.

Here, they share good memories but they also talk about three things that every survivor of suicide faces, the stigma, the grief, the initial shock.

- When this happens to you, you feel like you're the only one that has been going this, you know, the shame that comes along with suicide, you know, you sometimes, I used to think, well, I wish it was an accident, not suicide.

- Adrian Young was 15, a student at North Catholic High School where he was described as a leader, smart, personable, a good athlete.

- That was my pride and joy, just watching him grow and just be a chip off the old block and then since- - [Narrator] The night Adrian died, he'd been unhappy about baseball practice and talked about changing schools.

- We just thought that he was just going through little teenage disappointments.

- [Narrator] The family talked it over and thought Adrian had settled down.

- Before I went to bed, I passed his room and I thought he was doing his homework and I looked at him, gave him a smile and he looked up at me and that was it.

- [Narrator] The next morning, Chester found Adrian's body, he'd shot himself in the head.

Adrian, hadn't been doing his homework, he was writing a final letter.

- [Peggy] And he told us that we were the best parents ever but he was disappointed in his school and he was just going to be with the Lord.

- I know when it first happened, I mean, my wife used to get frustrated because people would avoid her in the grocery store and I don't blame them.

I mean, it's a horrific situation to have to confront and it's not that you don't wanna speak to that person, it's that you don't know what to say, you know, God, what do I say to the person?

They just lost their child.

One of the things he wasn't like your typical teenager was he was open with us.

We tended to know what went on at school, what went on in his life.

- [Narrator] But Jonathan Madigan never said a word about suicide before ending his life in the family's basement.

- He had hung himself from a chin-up bar that he had done 1,000s of chin-ups from.

He was a senior at Central Catholic High School.

Had his life ahead of him.

When it happens in your life, so close to your life that you need to find answers.

- And if it's cancer or a heart attack, you're never questioned.

- [Narrator] What Jack learned here was to get beyond the stereotype, teenagers who died by suicide aren't always visibly troubled or having trouble with friends or doing poorly in school.

- And I believe that before it happened to me and I guess when it happened to me and I look back on it and I think, but he wasn't troubled, he didn't have problems.

He was not a person that you would ever expect that type of behavior from.

I feel like my son died of a mental illness, you know, he took his life, unfortunately and it was undiagnosed.

- I have nine children, seven boys and two girls.

- [Narrator] Elma Fink would lose the youngest of those nine children to an illness that did show itself but was something the family couldn't fight.

Tom was a junior at Sewickley Academy when depression and thoughts of suicide overwhelmed him.

Hospitalization and medication did not help.

- He left a therapy session and let himself in the building across the street and sat on a 16th story window ledge and leaned forward.

So there was a closed casket and I never saw, never said goodbye and never saw him.

- [Narrator] Dealing with the grief of losing Tom was Elma's first and most difficult step.

- The first couple months you're just plain numb and after that, you try to figure out something to do to get over the awfulness of it.

- It's very difficult because grief doesn't come with a page of instructions.

- [Narrator] Finding support was the second step.

- And getting involved in groups where you can actually talk about it with other people who actually understand where you're coming from.

You can't say to somebody, I understand your pain if you've never walked with great pain and ever lost a child.

- [Narrator] Elma says the pain eases with time but never leaves for good and like the others here, she's less concerned about her own pain, but haunted by her sons.

- This is how I like to remember Tom, as laughing Tom.

You know, I miss Tom a lot and I talk to him sometimes, I think about him and I think sometimes he's saying, I'm okay, mom and I'll see you on the flip side.

- We can't fix grief.

We just have to allow people to feel it.

- [Narrator] Sue Wesner has taught that lesson for two decades now here at Survivors of Suicide, where 1,000s of people have sat in these chairs.

Kathy is now a senior member and she's learned that you can't properly grieve for a child until you understand the suicide that killed them.

- I learned that I didn't cause this, that my son didn't die because of something I did or didn't do.

I learned that my son loved me.

(machine blaring) - [Doctor] This is the button glove you're gonna be using in the scanner.

(machine beeping) Can you see the screen back there?

- I see it.

- People's understanding of what causes a suicide may not be accurate and is likely not accurate but in fact, there may be a brain disorder that we're just beginning to understand.

(upbeat music) - [Narrator] Answers and hope for many parents may someday come from this room.

The Brain Imaging Research Center is a joint venture between the University of Pittsburgh Medical Center and Carnegie Mellon University.

Here, in a first of its kind study, researchers are looking into brains of teenagers who've considered or attempted suicide, searching for abnormalities.

Dr. Lisa Pan is finding them.

She's a psychiatrist and clinical researcher at UPMCs Western Psychiatric Institute and Clinic.

- We've known risk factors for suicide for so long, but we still can't tell you who it is that we have to be careful about.

- [Narrator] Among the most common risk factors for suicide in teenagers, those who have a history of depression or bipolar disorder.

- But there are teenagers that have no history of psychiatric disorder that have had an attempt and those are the kids that really made me start thinking about doing research.

- [Narrator] Dr. Pan's research involves Magnetic Resonance Imaging, commonly known as MRI.

She's studying the brains of three groups, healthy children, like the two volunteers you see here, also, children with depression who've never attempted suicide and children with depression who have attempted suicide.

- Are you comfortable?

- Yeah.

- [Narrator] Once the volunteers enter the scanner, they'll respond to a series of tasks and images projected onto a mirror positioned above their eyes.

This test asks the teenagers to press buttons, identifying faces as male or female.

- But what we're really looking at is the brain's response to that emotion that they see in front of you.

- [Narrator] Does the brain see an angry face as potential danger?

Does it properly warn the child?

Another task looks at impulsive behavior.

- There's an issue of impulsivity where we have teenagers that have attempted suicide and they did it before they even processed that they were about to do it.

This is the one where you press for all the letters except the letter V with your index finger, okay?

- [Child] Okay.

- [Narrator] Now the children are asked to press a button for every letter they see, except the letter V, the idea being, it's easy to press the button, more difficult to hold back when the letter V appears.

- Is the child who has a history of suicide attempt unable to stop themselves when they have an impulse?

Do they act before they have the ability to use the brain circuit to say, wait a minute, I need to stop now and this isn't safe, this isn't good.

- [Narrator] What Dr. Pan has been watching all along is brain activity.

Blood oxygen levels indicated here in yellow, when a teenager needs to stop an impulse such as pressing buttons or putting the brakes on certain behavior, the brain requires strong blood flow to activate that portion of the brain.

- And what we found is that when we use this very simple task of inhibiting that impulse, in healthy kids and kids with depression, we have normal activation in that circuit but in children with suicide attempt, we don't have enough activity there.

- [Narrator] Take a look at the green bar.

It shows the activity in parts of the brain that helps a teenager stop an impulse.

It's quite strong in the healthy children.

The same holds true even in depressed children who've never attempted suicide but look at the drop in brain activity for teens with a history of suicide attempts.

- And you can see that the attempters have much less activity in that area of the brain.

- [Narrator] An indication that there's diminished function in parts of the brain that stop impulsive behavior.

The same holds true for the face test.

There's less activity in the prefrontal cortex, the part of the brain that subconsciously appraises emotion, including potential threat.

- What it says to me is that when a child is confronted with a negative emotion, their ability to focus and appraise what that negative emotion means, may be impaired.

- [Narrator] The results are still preliminary.

The study continues through the year 2014 but it's already showing that suicide appears to be an illness in itself.

- It really seems to me to be a different disorder.

The propensity for a suicide attempt is actually separate from any of the other diagnoses.

- [Narrator] Dr. Pan hopes the results will eventually help to better identify children at risk, lead to better medication and break down the stigma surrounding teenage suicide.

- The thing that I've had parents ask me the most is why this happened.

Too often, people attribute it to a stressor or some characteristic of a child or something that wasn't done and what I wanna say is that I think we have another brain disorder here that we did not understand, that any amount of intervention, could not have helped if that person has left.

My greatest hope for this research is that we are able to find markers for suicide risks so that we can identify children before they ever attempt suicide, before we lose them.

- We're not there yet, but hopefully through Lambert and through all the others we have lost to suicide, someday we're gonna be there.

- [Narrator] Since her son's death in 1995, Kathy has become one of the region's best known advocates for Survivors of Suicide.

- And this is just the one chapter.

- [Narrator] She works closely with program head, Sue Wesner and now conducts survivor support groups on her own, reaching out to others who now sit where she once did.

- Kathy means to these families who've lost children, that there is hope, that there is a future.

- A wonderful person and has been gracious and kept that meeting alive once a month so that people like my wife and I can come when we can.

- I can remember Chester coming to me saying, I will never get where you are, I will never get there.

- She just, was there for us, I don't know how we would've lasted this long or existed because we were so much in turmoil.

- Hearing other people's stories, you have so much empathy for them and so much feeling for them that you feel that when you're telling your story, they have that empathy and feeling for you as well.

- A lot of people will say to me, well, how did you get through it?

How did you get over it?

You don't, you do it every day of your life.

Come on, come on, come on, come on.

- [Narrator] It's a life Kathy now describes as having joy in it again, her surviving son, Justin is now married and living in Kentucky.

In 1999, Kathy married Chuck Fowler, who brought his children into her life.

- Come on guys.

- [Narrator] And she chose to stay in Monongahela, close to her roots, close to the place where her son lived and died.

- I hope the Lambert Hillman story changes the way people look at mental illness and suicide.

You know, that's the end of his story, the end of his life but for me, he goes on.

He left me with a tremendous gift.

He left me with this gift to help others.

Now, how longs it been since you had your loss?

- [Narrator] But helping others hasn't been the only reward during Kathy's journey, along the way she got back her memories of Lambert too.

- His pictures aren't damaged by the suicide anymore.

His pictures are who he was.

I see a happy kid and a kid that we shared a very good life with, my fun loving son, my son that loved life, my son that had hope and a bright future.

That's who I see.

- See you later, yeah, have fun.

(gentle upbeat music)