Editor's note: This article was first published March 25, 2019.

This story has been updated in light of new information from Andrew Phelps.

Daniel Solomon sat alone in front of the reflection pond at Clemson University as he spoke to his parents on the phone late one night in February 2016. He was in his first year at school and felt isolated, and he was struggling academically as a mechanical engineering major.

He felt his life had come to a "boiling point." He did not know what to do.

He was thinking about killing himself.

But he didn't. He thought about his friends and family and how he could still positively impact the world. He got counseling for his mental health.

Now a junior psychology major, Solomon trains others on campus to recognize the warning signs of suicide: sleeping more than normal, not talking to friends, starting to fail classes. Those were signs he showed as a freshman before he stepped out of the dark of that night toward a new path.

Suicide is the second-leading cause of death for 15- to 34-year-olds in South Carolina and nationally, and on average, 129 Americans die by suicide each day, according to the Centers for Disease Control and Prevention.

As schools such as Clemson and the University of South Carolina work to increase awareness around mental health issues, they are seeing more demand on their services.

University of South Carolina faces lawsuit connected to suicide

From the 2013-14 academic year to 2017-18, the number of triage visits to Clemson's counseling and psychological services increased 25 percent, according to Philip Sikes, Clemson's communications director for student affairs. Triage visits are walk-in visits to the counseling center from 10 a.m. to 2:30 p.m. Monday through Friday each week. Individuals who come in that way are assessed to determine their immediate needs and next steps for treatment.

Over the same time period, the number of individuals accessing counseling services at the University of South Carolina in Columbia increased 37 percent, and the number of psychiatry clients increased by 62 percent, according to USC spokesman Jeff Stensland.

USC is currently being sued by Daniel Strawn, the father of Samantha Strawn, a graduate student who died by suicide in 2016. Samantha and her dad "had a very special father-daughter relationship which cannot be described accurately by mere words," according to her obituary.

Samantha, a human resources master's student from Tennessee, visited the university's counseling department in October 2016 and "acknowledged that for several weeks preceding the visit, that she had a strong desire, wish or intent to kill herself," according to the lawsuit in Richland County.

Samantha's situation was described as manageable and she was scheduled for a follow-up with USC counseling nine days later, according to the suit. Four days after the follow-up appointment, Samantha ended her life.

Daniel Strawn's suit claims a USC doctor provided "inappropriate care" that was "grossly negligent."

The university has denied the allegations and noted that the clinician "reviewed her testing, conducted a clinical assessment and using his clinical judgement determined that she needed to be followed up with him a week later."

Stensland said university officials would not comment on active litigation, but he said the university is "committed to providing comprehensive healthcare services to all students, including those coping with mental illness."

"We have made significant investments over the years in personnel to treat students as well as campus-outreach efforts to destigmatize mental illness," Stensland said.

For Solomon, a temporary change in scenery helped. He took medical leave to go home to Louisville, Kentucky, for a year. He worked at Zaxby’s, took part-time classes at a local university, spent time at his family farm and started a journey to find therapy that was right for him.

It was the toughest year of his life, he said, but he is glad he did it.

"If I hadn't done that, I wouldn't be walking right now," said Solomon, who's returned to Clemson and is a member of the Tigers Together suicide prevention team.

“Caring about mental health is never your problem until you lose somebody,” Solomon said. “It is literally life or death.”

Solomon has seen the student body at Clemson make progress in talking about mental health, but he said there is still a stigma around the topic that he is working to fight. Instead of understanding depression and other mental health issues as illnesses, people instead blame themselves.

For students who do seek help for mental health issues, colleges often have their own on-campus counseling programs.

"No matter what college you are at, there are more resources than you think," Solomon said.

Raquel Contreras, director of Clemson's campus mental-health services, said resources are important now more than ever.

"Being at the university right now places demands on students in this generation that hadn't been there before," Contreras said.

A brother left behind

Thomas Phelps was a college senior studying electrical engineering when he killed himself in September 2018. His brother and Clemson roommate, Andrew, is a senior set to graduate with an accounting degree in May.

Andrew said most people on campus don't talk about suicide "until something happens." He said most students do not necessarily know what they need when it comes to mental health, so he wishes Clemson had more proactive programs in place that "aren't just like situation control or damage repair."

Thomas withdrew from his classes a few days before his death, so the university was not immediately aware that he had been a student and did not send out a notice to campus about his death for a week, Andrew said.

Thomas' obituary does not mention suicide. Andrew had to tell Thomas' friends and his own professors what happened. That was both good and bad.

"I didn't have to deal with people constantly asking me about it, but in another way people would hit against me in the hallway or something and I wanted to yell at them because I was stressed about other stuff — but I was like, yeah, you can't have it both ways," he said. "You either get treated normally or you get treated like you're fragile."

Andrew said the university was accommodating, and he ended up taking the rest of the fall semester off to be at home with his mom in Fort Mill.

Anxiety is the most common diagnosis at Furman and Clemson

In 2017, a federal study by the National Council on Disability found that colleges across the country were struggling to provide mental-health services due to increased numbers of students in need.

"We will not let somebody that is at risk go away," said Contreras, who's worked at the university for 16 years. "We have committed staff. They care, and they want to improve the quality of life of the students."

Contreras said the university now sees more students who were identified as needing services in high school or before.

"When they come to the university, they already have a history, and we just pick them up at that point," Contreras said.

Contreras said the most common diagnosis at Clemson is anxiety, which is reflective of other campuses as well.

At least 20 percent of the Furman University student body uses the school’s counseling services at some point over four years, said Thomas Baez, director of counseling for the private school.

Baez said anxiety also is the No. 1 concern at Furman, which has five full-time counselors and three part-time psychiatrists for a student body of approximately 2,800. There are also developmental issues they see as students adjust with changes from high school to college and a “whole gamut” of mental-health issues ranging from depression to extreme anxiety to bipolar disorder, Baez said.

Clemson needs more space to treat students in need

Contreras said the greatest challenge at Clemson is making sure they serve every student.

Clemson's counseling and psychological services department saw 3,564 patients in the 2017-18 academic year. The staff has 10 licensed psychologists and 10 licensed professional counselors, and they are hiring for two more positions.

The campus population has also grown by more than 30 percent in the last decade to about 24,950 graduate and undergraduate students, according to the Clemson Fact Book.

At USC, there are 22 mental-healthcare providers, including psychologists, counselors and social workers on a campus of about 29,850, according to the university's health services staff directory.

Clemson is also dealing with space limitations at Redfern Health Center.

"Being realistic, we need to increase the number of counselors in proportion to the students to meet the enrollment increases," Contreras said. "Our building is really small, and in order to have more counselors we need to have a space to put them."

The center is planning to move some services off campus, which could make access easier for students in terms of parking but also means services will not be quite as integrated into the campus.

Contreras said treatment plans for students can mean one-on-one sessions, attending group therapy sessions or accessing online services through a platform called Therapist Assisted Online, or TAO.

"A misconception is that we turn everybody away," said Contreras. "We serve a lot of people. But the resources that we have get overwhelmed relative to the demand from time to time."

While they always assess walk-ins to determine immediate needs, when services get overwhelmed, they may refer out to private practices such as Southern Solace in Clemson for treatment and follow-ups. While most of Clemson's counseling services are covered by the student health fee, going off campus can mean paying higher deductibles, depending on a student's insurance.

"We see a lot of students who are struggling with overwhelming worry and anxiety," said Southern Solace counselor Caroline Edwards. "A lot of students are doing well in many areas of their lives, academic, social, work, and sometimes just need extra work on mental health."

Students raise money to bring suicide Out of the Darkness

Earlier this month a group of Clemson staff, students, faculty and community members wound their way through campus from Tillman Hall to the Carillon Garden. They wore beads around their necks.

Solomon wore green, meaning he had struggled with suicide.

Some wore blue, supporting suicide prevention.

Those wearing gold had lost a parent to suicide. Those in purple had lost a relative or friend.

Vanessa Riley, the South Carolina associate area director for the American Foundation for Suicide Prevention, wore white, meaning she lost a child to suicide. Her son died 13 years ago.

"We can't lose any more young people," Riley said.

Riley has channeled her energy into helping coordinate "Out of the Darkness" suicide prevention walks around the state, such as the one at Clemson, which raised more than $16,000. Her goal is to teach young people to talk about suicide and to fight stigmas around getting help for mental-health issues.

She said it feels good to be able to fight for something.

Furman held a walk over the weekend. USC will hold one on April 14.

"This is the crux of what I do and work for," Solomon said of Clemson's walk, which he helped plan with the Tigers Together team. "It is finally a place you can go and talk about mental illness not having to worry about anything."

In 2014, Clemson received an initial $100,000 grant from the Substance Abuse and Mental Health Services Administration, an agency of the U.S. Department of Health and Human Services, to implement a comprehensive suicide-prevention strategy on campus.

Before that grant, there was not much happening on campus in terms of suicide prevention, said Kristi Bussell, assistant director for suicide prevention and mental health initiatives at Clemson.

Bussell said one challenge on campuses is acknowledging that mental-health issues are pervasive in the community.

"If we want our students to thrive socially, physically and academically, if we want them to be excelling scholars, it really is our job and on us to at least learn how to help them get connected to resources they need," Bussell said.

Bussell said movies and television shows often depict mental-health issues in a flippant manner that fuels some of the stigma.

"I wouldn't say, 'I am cancer,'" Bussell said. "But people say, 'I am schizophrenic.'"

Solomon sees a disconnect between mental illnesses and other health issues. While there are clinical settings where it is acceptable to talk about mental health, it is not as easy to discuss outside of therapist offices, he said.

People associate mental illness with personal weakness, Solomon said.

"The reality is it is not your fault and will never be your fault," said Solomon.

He has turned his own experience into action by founding You're Not Alone, a Clemson group dedicated to talking about mental health in a peer-led setting.

He's proud of the work. He's found a number of students and community members who show passion for mental health — for healthy life. He said he was sitting on his bed one night last fall when he was struck by how happy he was to be alive and to be advocating for mental health.

If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741741.