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My husband and I first met Trevor Matthews when he and our son, George, started kindergarten together at St. Bernard’s, a private boys’ school on the Upper East Side. Trevor was perhaps the brightest kid in the class. In first grade, he was already reading adult narrative nonfiction. He could be charming, generous, and humane. But he could also turn suddenly violent. At my son’s seventh-birthday party, Trevor bit another boy on the ear so hard that the mark was still visible when that child next went to school. Trevor terrorized the smaller kids in the class, and, if they pushed back, he would try to get them in trouble. He was shrewd in his manipulations. In second grade, he tried extracting cash from other boys by threatening to spread embarrassing rumors. “Trevor was in trouble more than everyone combined,” a classmate recalled. Parents complained, and Trevor was frequently disciplined. “By first grade, he was already awash in a sea of conflict,” one parent said. “I remember seeing his mother’s anguish and just wanting the path for her son to be a little less hard. But it was hard.”
Trevor’s mother, Angela Matthews, a driven intellectual-property lawyer in her early forties, studied ballet and still carries herself like a dancer. Her intelligence and the intensity of her character can make her intimidating, but she is also given to acts of tremendous kindness. Trevor’s father, Billy Matthews, who works in finance, is affable and athletic. They have a daughter, Agnes, three and a half years younger than Trevor; Billy also has two sons, Trey and Tristen, from a previous marriage.
Angela grew up in New York in a Wasp family, and Trevor’s attendance at St. Bernard’s was shadowed by the memory of two uncles who had been pupils there and had both died young. In 1992, Angela’s eight-year-old younger brother, Tristan Colt, fell to his death from the family’s apartment building. Climbing through a window in the apartment, on the twelfth floor, he’d dropped carefully down to a terrace one floor below, from which it was possible to access a neighboring building, go down the stairs, and head out undetected. He was last seen sitting on the terrace ledge, before toppling over backward. He’d thrown a tantrum and been scolded, but the general conclusion was that his death was probably not a suicide. Eleven years later, Angela’s half brother, Trevor Nelson—for whom she named her son—died at thirty-four, when a hospital treating him for viral meningitis inexplicably administered a fatal admixture of drugs. Eleven years older than Angela and a child of her mother’s first marriage, he had been a charismatic presence at St. Bernard’s, athletic and academically brilliant but also a bully. He would gather kids in recess for a game called Kill, where they would chant and then Trevor would announce the name of the person who was going to be attacked. Trevor Nelson went on to be kicked out of multiple prep schools. But eventually he mellowed. He attended U.C. Berkeley, became a top producer at “60 Minutes,” and was a doting husband and father with a wide circle of loyal friends. Hundreds attended his funeral.
When it was Trevor Matthews’s turn to attend St. Bernard’s, he wore Tristan Colt’s blazer, and longtimers at the school often drew comparisons between him and his other uncle, Trevor Nelson. If he acted badly, teachers would say, “Well, Trevor’s like his namesake.” Trevor’s glittering intellect delighted many adults. He was precocious in other ways, too: he was interested in girls and, in fourth grade, brought a date to a school benefit. “It was totally a big deal that he brought her,” Angela told me. “I said, ‘If he wants to have a date, he can have a date.’ They’re not holding hands, it’s O.K.” Trevor was elected class representative that same year, promising to have the recess deck refurbished and to get the boys more involved in helping the neighborhood’s homeless.
Yet his aggression intensified. He pushed one child down some stairs; the mother asked the school to insure physical distance between the boys in the stairwell. Playing paintball, Trevor sneaked up behind a boy and fired close-range into his helmet; the child developed blurry vision. Another boy came home from school with red marks on his neck; the school told his mother that Trevor had choked him. In 2019, toward the end of fourth grade, the school and Trevor’s parents came to an agreement that he’d be better off elsewhere. Many of his classmates were relieved. One mother told me, “I could tell my son didn’t really want Trevor to leave, because they do feel like family. But the tension is gone.” Her son had said, “It was sad that Trevor left, but we can get a lot of work done now.”
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If you are having thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text TALK to 741741.
Last year, over Presidents’ Day weekend, my husband and I took George and one of his sixth-grade friends skiing upstate at Catamount, a popular destination for many families from the school. As we pulled up, we saw Trevor. George and his friend both groaned. We said they didn’t have to ski with Trevor but should try to be polite. As it turned out, they did end up skiing with Trevor and a handful of other St. Bernard’s boys. Trevor, a spectacular skier, skipped the hardest trails to stay with the others. When George and his friend piled into the car at the end of the day, George said, “Trevor has changed. He’s way nicer. We could even be friends.” We were happy to hear it. Perhaps, as others had supposed, Trevor Matthews was on the same redemptive path as Trevor Nelson.
Seven weeks later, on the afternoon of April 6th, Trevor jumped off the roof of his apartment building, on Eighty-sixth Street and Park Avenue, killing himself. He was a few months past his twelfth birthday.
I heard the news from another St. Bernard’s parent while I was buying groceries and rushed home to tell my husband, wondering how we would break the news to our son. George cried on and off all evening. He kept saying, “But why would he do that?,” and then he said, “I wasn’t always that nice to Trevor. Maybe I made his life worse.” I reassured him that nothing he did had caused the tragedy and nothing he could have done would have prevented it. The mother of one of George’s classmates said, “Their childhood ended on Tuesday.”
I asked Angela if we could come by for a condolence call. She said yes, if we were vaccinated. Because vaccines were not yet available to children, she added, “Don’t bring George.” She paused, then explained, “It’s just—because of Agnes. She can’t get vaccinated yet, either. And she’s all I have left.” In the following weeks, Angela told her story over and over to any friend who asked, as though she could contain it through repetition. For Billy, even conversational boilerplate was a struggle.
Angela and Billy had been trying to understand why there are so few therapeutic interventions for children with depression. Trevor, the child of well-off, educated parents, had far better mental-health support than most American children, but was not saved by it. Angela wanted to lobby for legislation to mandate services her son had needed; she considered setting up a center to undertake research and provide clinical treatment. Because I have written about depression, she and Billy encouraged me to address child suicide, and agreed to tell me their story. I talked to those who had known Trevor and began making contact with other bereaved families and with researchers and mental-health workers who are investigating this escalating phenomenon.
Every suicide creates a vacuum. Those left behind fill it with stories that aspire to rationalize their ultimately unfathomable plight. People may blame themselves or others, cling to small crumbs of comfort, or engage in pitiless self-laceration; many do all this and more. In a year of interviewing the people closest to Trevor, I saw all of these reactions and experienced some of them myself. I came to feel a love for Trevor, which I hadn’t felt when he was alive. The more I understood the depths of his vulnerability, the more I wished that I had encouraged my son, whose relationship with Trevor was often antagonistic, to befriend him. As I interviewed Trevor’s parents, my relationship with them changed. The need to write objectively without increasing their suffering made it more fraught—but it also became deeper and more loving. As the April 6th anniversary of Trevor’s death approached, I started to share their hope that this article would be a kind of memorial to him.
Angela was right that a larger issue is at stake. The average age of suicides has been falling for a long time while the rate of youth suicide has been rising. Between 1950 and 1988, the proportion of adolescents aged between fifteen and nineteen who killed themselves quadrupled. Between 2007 and 2017, the number of children aged ten to fourteen who did so more than doubled. It is extremely difficult to generalize about youth suicide, because the available data are so much sparser and more fragmentary than for adult mental illness, let alone in the broader field of developmental psychology. What studies there are have such varied parameters—of age range, sample size, and a host of demographic factors—as to make collating the information all but impossible. The blizzard of conflicting statistics points to our collective ignorance about an area in which more and better studies are urgently needed. Still, in 2020, according to the Centers for Disease Control and Prevention, in the United States suicide claimed the lives of more than five hundred children between the ages of ten and fourteen, and of six thousand young adults between fifteen and twenty-four. In the former group, it was the second leading cause of death (behind unintentional injury). This makes it as common a cause of death as car crashes.
Although it is too early to quantify fully the long-term impact of the pandemic, it has exacerbated the burgeoning crisis. The C.D.C. found that in 2020 mental-health-related visits to hospital emergency departments by people between the ages of twelve and twenty-seven were a third higher than in 2019. The C.D.C. also reported that, during the first seven months of lockdown, U.S. hospitals experienced a twenty-four-per-cent increase in mental-health-related emergency visits for children aged five to eleven, and a thirty-one-per-cent increase for those aged twelve to seventeen. Among the general population, suicides declined, but this change masks a slight increase among younger people and a spike among the country’s Black, Latinx, and Native American populations. Last October, the American Academy of Pediatrics declared that the pandemic had accelerated the worrying trends in child and adolescent mental health, resulting in what it described as a “national emergency.”
The sooner depressed or suicidal children receive treatment, the more likely they are to recover, but children remain radically undertreated. There are too few child psychologists and psychiatrists, and most pediatricians are insufficiently informed about depression. Research suggests that only one out of five American adolescents who end up in a hospital after attempting suicide is transferred to a mental-health facility, and access is predictably worse among the poor and in communities of color. According to the National Institute of Mental Health, of the three million American adolescents who experienced major depression in 2020, almost two-thirds received no treatment.
Scott Rauch, the president of McLean Hospital, near Boston, and a professor of psychiatry at Harvard Medical School, told me, “The convergence between stigma and long-standing traditions of not supporting this kind of care is the shame of our nation.” The authors of a study on the absence of any evidence-based treatment for under-twelves with inclinations toward suicide—“suicidality,” in the psychiatric parlance—wrote, “That so little about this topic exists in the professional literature is baffling. Does it perhaps reflect a collective level of denial that children are simply incapable of such thoughts?”