But once she started the program, Sophie felt relieved to be among people who battled similar issues. After the third day, she wrote in her journal: “Everyone here is super nice and full of a beautiful, unique mixture of struggles, talent and personality. I hope to cross paths with everyone again, someday. Everyone here deserves nothing but kindness and relief.”

Still, that night she cut her thighs to distract herself from her anguish. But she also downloaded an app that helps users track self-harming behaviors and get support. And every weekday, for almost a month, she returned to the program, where she liked feeling that no one was judging her. When it was over, she resumed her weekly appointments with Binnig. Her progress was jagged for a long time, but with the help of Binnig and the coping strategies she learned, Sophie started to believe her identity extended beyond being a depressed person. She could imagine a future that would have felt impossible two years earlier. (She recently got into college with almost a full ride on tuition.) Her mother, who had become overwhelmed when Sophie wasn’t getting better, learned to stop trying to control parts of daughter’s life. She backed off making what she thought were helpful suggestions for Sophie — meditate, read self-help books, eat more, exercise — which Sophie just batted away.

It’s a difficult balance for worried parents. But as Binnig told me, those who do best by their children take their problems seriously while managing to not hover over them. Ultimately, she said, “getting better has to be the child’s own process.”

There is evidence that less intensive and less expensive therapeutic interventions against suicide might help children, at least those at the highest risk and, by extension, put less pressure on the medical system. For a study published in 2001, more than 800 patients in San Francisco who were hospitalized for suicidality or depression and who declined follow-up care were assigned to two groups: One had no follow-up contact and the other received periodic, typewritten letters from a health care worker who had interviewed them. The letters were brief but expressed concern and a desire to keep in touch. “It has been some time since you were here at the hospital, and we hope things are going well for you,” a typical letter read. “If you wish to drop us a note we would be glad to hear from you.” Patients in the contact group received eight letters the first year, then four letters for several years. Within two years of leaving the hospital — the span of time during which suicidal patients are most likely to kill themselves — the group that received letters was half as likely to die by suicide as the control group. Even several years later, the rate stayed lower. Since then, research has suggested that apps focused on suicide prevention may also help. Studies funded by the National Institute of Mental Health are investigating the efficacy of digital interventions that encourage children and teenagers, upon discharge from the hospital, to gauge their suicidal feelings and gives them strategies to help; another provides support for parents and tips about safety planning.

Better, of course, would be reaching children far earlier. In the last two years, during which the American Academy of Pediatrics and other national children’s organizations declared a “national emergency” in child-and-adolescent mental health, President Biden’s administration began devoting hundreds of millions of dollars to mental health care. Many states have created suicide-prevention programs and efforts to connect students and families to community social services. We already know that schools that teach coping skills and ways for children to receive help when they are depressed or anxious reduce substance abuse, aggression and jail time, along with suicidal thoughts and behaviors.