Linda Diaz, whose daughter, Lauryn Santiago, took her own life in 2013, holds a photo of her daughter and looks at a family photo album. Lauryn's death inspired new legislation in Maryland that will require high school guidance counselors to get mental health training. (Ovetta Wiggins/The Washington Post)

When Lauryn Santiago’s grades started to slip two years ago, her mother, Linda Diaz, suspected something was wrong. Diaz called her daughter’s high school and asked the counselor to meet with Lauryn. But the meeting never happened.

A month later, Diaz found her 15-year-old daughter hanging from the banister of their home. Lauryn, a freshman at Laurel High School in Prince George’s County, had taken her own life.

Diaz told her story to state lawmakers in Annapolis last month as part of a crusade to increase awareness of teen suicide. Her advocacy helped push the General Assembly to approve a bill dubbed “Lauryn’s Law,” which would require that school counselors undergo regular training to recognize signs that students are dealing with mental illness, are in distress or are contemplating suicide.

“There is an epidemic,” Diaz said of teen suicide, the second-leading cause of death among people ages 15 to 24. “This is an issue, almost like a bomb waiting to explode.”

If the bill is signed into law, Maryland would become the 23rd state to require suicide prevention training for school employees, according to the American Foundation for Suicide Prevention. Only nine states had such mandates three years ago, the foundation said, although mental-health advocates have been lobbying for such training for years.

“Regular education and training for school personnel in how to recognize and respond to signs of suicide risk is a crucial step toward reducing the rate of youth suicide,” said Nicole Gibson, senior manager of state advocacy at the organization. “As children and teens spend a significant amount of their young lives in school, the personnel that interact with them on a daily basis are in a prime position to recognize these signs and make the appropriate referrals for help.”

Under the bill, the state’s Professional Standards and Teacher Education Board, which creates standards for teachers and other school personnel, must include mental-health training as a requirement for counselors to maintain their certification. The requirement would take effect in July 2016.

The bill must be signed by Gov. Larry Hogan (R), whose spokeswoman said it is under review.

There were 4,878 suicides by people ages 15 to 24 in the United States in 2013, up from 3,988 a decade earlier, according to the Centers for Disease Control and Prevention. The Youth Risk Behavior Survey, a nationwide survey of students in grades nine to 12, found that 16 percent of students seriously considered suicide in 2013, and 8 percent tried to take their own lives.

Some school systems such as Fairfax County have revamped their mental-health policies in response to a spate of teen suicides. The school district used a grant to expand its mental-health first-aid program, and all middle school and high school teachers enrolled in mental-health awareness training last year.

Linda Diaz, whose daughter, Lauryn Santiago, took her own life in 2013, holds a photo of her daughter and looks at a family photo album. Lauryn's death inspired new legislation in Maryland that will require high school guidance counselors to get mental health training. (Ovetta Wiggins/The Washington Post)

Jeremy Goldman, president of the Maryland School Counselor Association, said his organization did not take a position on the legislation in Annapolis but supports any effort to provide counselors with tools to help their students.

At the same time, he said, current ratios of students to counselors are too high in most schools and the legislation would limit the impact of counselors trained to recognize and respond to suicide risks.

“When school counselors have 500 or 700 students each and are assigned to classroom coverage or hall duty, it makes it more difficult for counselors to intervene,” Goldman said.

Del. Joseline A. Peña-Melnyk (D-Prince George’s), who sponsored the legislation, said she recognizes that counselors are overworked. But “if one child is saved because [the training] is fresh on their minds and they can help the parent, to me it is worth it.”

Counselors must have a master’s degree to work in Maryland schools, and their graduate studies include training in mental health. The bill would require counselors to receive additional suicide prevention training every five years, when they are recertified. There is no cost to the state for the training, Goldman said, because counselors pay for their own recertification.

Peña-Melnyk said the requirement should keep counselors current on new resources and approaches that can be used to identify a child in crisis. During hearings on the bill, she noted nearly a half-dozen instances from the past year in which teenagers from across the state committed suicide.

“This is a problem,” she said. “We cannot ignore it.”

The hearing before the House Ways and Means Committee at which Diaz and others testified was emotional at times. Del. Sheila E. Hixson (D-Montgomery) was visibly moved, wiping tears from her eyes, as University of Maryland graduate Meg Kimmel shared her story about attempting suicide.

Hixson later told the panel that her son took his life. Then Del. Eric G. Luedtke (D-Montgomery) said that his brother attempted suicide at age 22. Hixson and Luedtke praised Diaz and Kimmel for testifying and for trying to remove the stigma associated with suicide.

Diaz began volunteering with a suicide prevention group after her daughter’s death. It was there that she learned how to spot signs that someone is at risk and realized that her daughter was in crisis for months before her death.

The honor roll student was popular but also painfully shy, Diaz said. She loved selfies, motorcycles and spending time with the family dogs. She also was being criticized by some members of her extended family who had started to question her sexuality.

At school, Lauryn was having trouble concentrating. Doctors told Diaz the girl had anemia. They never suggested a therapist, and Diaz didn’t think of it.

She says she never learned why the school counselor and Lauryn did not meet.

Five weeks after Lauryn’s funeral, one of her friends tried to kill himself. Another friend attempted suicide several months later.

Diaz started reading her daughter’s Instagram account and seeing comments from other young people who were considering suicide. She reached out to them.

“These were just kids that I knew,” Diaz said. She figured there were more.

She urged school officials to hold an assembly focused on suicide prevention. They did. She contacted school district officials about training. Things moved slowly, so she turned to state lawmakers.

Diaz said she wants to expand the bill to include training for teachers and other school employees and will try to do so in a future legislative session.

“Suicide is preventable,” she said. “And when the adults interacting with our children are given the knowledge they need to recognize warning signs and act, we can save some of these young lives.”