FRESNO COUNTY, Calif. (KSEE/KGPE) - September is National Suicide Prevention Month. Fresno County school leaders are using it as an opportunity to stay ahead of mental health concerns.  As the Office of the Fresno County Superintendent of Schools Senior Director, Trish Small knows first-hand the importance of reducing stigmas surrounding mental health.   "Taking care of your mental health is just as important as taking care of your physical health," Small said. "I’ve worked in this county a very long time. And to see where we've come in the last 20 years and to see what's available for youth, it just makes me so happy that we're moving in this direction.”  She explained there are several school resources available for students struggling with their mental health, including the Fresno County Suicide Prevention Collaborative, which began serving students in 2016. "It started in response to a cluster of teen suicides that had occurred. And at that time, community leaders came together to form the collaborative," Small said. "The original goal of the collaborative was really to get to a place where we have no suicides. And so, over the years we have done a lot of education. We meet every other month, and we talk about topics that are related to suicide and suicide prevention." School leaders also use different digital resources to help kids with their mental health. One just introduced this school year is called the Soluna app - at least eight school districts in Fresno County are using it.  "The hope is that the Soluna app is going to give them a mechanism to be able to reach out and get help and have somebody to talk to, so that they can get that support without having to go through the formality of getting into treatment of some kind," Small said. According to Dr. Laura Tully with Soluna, the platform provides a safe space for teens with a digital diary, self-guided resources, a peer community forum and one-on-one coaching.   In addition, Soluna targets 13 to 25-year-olds in California and Illinois. Dr. Tully says the app focuses on that demographic because it's a critical developmental phase for young folks. “50% of mental health difficulties start by the age of 14," Tully said. "What this tells us is there is a need for prevention and early intervention. Services and digital tools have a unique opportunity to do that because of that universal access and opportunity to give support where the young person is, rather than waiting for them, waiting for them to come to us.”   Tully says online health platforms play a key role in breaking down barriers for anyone wanting to discuss their mental health.  "We're facing a nationwide shortage of mental health professionals, which increases the wait time for appointments and access to care and availability is even more limited among the uninsured, those individuals in low-income areas or low-income families, people of color, people with disabilities," they explained. "We know that in California, two-thirds of young people that experience depression don't even get treatment. And a lot of that is access issues. If you live in a rural community very far away from a traditional brick-and-mortar clinic, it's going to be really hard for you to access care, even if there wasn't a waiting list. So having digital tools, digital access opens up access to support and can provide universal and equitable access to young people regardless of where they are geographically." Hillary Reid is a school psychologist in Fresno County. She explained part of the job is using different types of resources to help students.  "Students will show that they're having thoughts of suicide in more secretive ways, typically. So, they'll make comments like, I can't do this anymore, or they will start to just withdraw very quietly and look more sad and depressed, or they will draw things on their assignments," she said. "And to them, they don't always realize they are blatantly asking for help from us. But to us, those are indicators that they are asking for help. So, we are trained through various programs to recognize those signs as educators pick up on them and support those students and ask clearly and directly about suicide." That's something Fresno County school psychologist Alex Merrell resonates with.  He says the use of digital platforms could help kids feel more comfortable reaching out with mental health concerns. That includes the Soluna app and the Sandy Hook Promise app, which is currently being onboarded by the Fresno County Superintendent of Schools. "I think in the school setting, like a lot of the time we find out about things way too late. If a student's been struggling like it's often not until things reached a boiling point that it gets to my office or the principal's office," Merrell said. "But the hope is that having like a text-based app like the Sandy Hook app would allow students to report concerns anonymously in a less threatening way that would maybe shorten the timeline of reporting so that we're able to intervene earlier and support them in terms of like reactive approaches." Reid and Merrell both believe any opportunity to have more conversations about depression and suicide makes a huge difference in a child's life.  "When we were younger it was maybe not as openly discussed, and it's been really nice to see how open the dialog has been around suicide and suicide prevention. And it just feels like really authentic work, helping out the kids who need help," Merrell explained.  "Our country has come so far over the last ten years with suicide awareness and prevention. We're seeing students that I think used to just internalize this and suffer. And now they come, and they open up and they have a place of support," Reid said.  Reid adds having open conversations about suicide at home can also help families.  "Speaking directly, [like] 'Are you having thoughts of suicide?' Which I know can be really uncomfortable for a lot of people because the word it's really hard, but we want to make sure we're not using language that could be misinterpreted," he said. "As long as the individual is talking, we can keep them safe. And oftentimes by keeping that dialog open, we can get to learn more about their passions, their interests, hopes for the future. And if there are any passions or hopes for the future, those are connections to life." In the future, Small says they hope to open more wellness centers on school campuses, so students and families can get the support they need.  "The Fresno County Superintendent of Schools Office started a program in 2018 called All for Youth. And the goal of the program was to hire mental health clinicians in case managers. And within five years we've had a clinician or a case manager assigned to every school in our county," she said. "Now we're in over 300 schools. We have over 120 clinicians and we have over 20 case managers. We also have family partners who work with families, not just the youth. We've opened five wellness centers on campuses across the county, and we're going to be opening seven more wellness centers."