"I can tell you what I have seen, because I work specifically with young people, most times in Trinidad," said Margaret Johnston, a counselor with the Franciscan Institute for Personal and Family Development, which also operates in Grenada and St. Lucia.

"I've had girls come to me, and they will say they're cutting themselves and, from cutting they will say, 'Well, I really want to kill myself.'"

Caribbean boys are seldom so open but, in the right setting, will tell all, she said.

"Recently, we've seen a lot of depression in boys, teenage boys; that's something that happens all the time," said Johnston, whose work through schools gives her access to adolescents of various religious and economic backgrounds.

"Sometimes, they talk about killing themselves, and boys are doing cutting, as well. So, that's something that's come up repeatedly in our workshops."

With a system of overworked school counselors, disbelieving families or otherwise "good behavior," it is possible to miss a call for help.

"It's always easy in our culture to overlook quiet people, because that's what we consider to be 'good,'" said Johnston, who also has worked with at-risk children and adolescents at St. Dominic's Home, a Dominican-operated orphanage in northwest Trinidad. "If you're quiet and reserved, that's good. If you're acting out, we see that as a problem."

The causes of self-harm and suicidal thoughts among this group do not vary from those in other countries: strained relationships, isolation, despair. Young people are, naturally, affected by all that stresses adults.

Money is one of the major stressors in Trinidad and Tobago today.

This fall, the closure of a state-owned petroleum refinery meant thousands of job losses and the end of government-subsidized fuel for the country. And, over the past few years, thousands more have suffered job losses from both public and private sector, attracting little or no attention.

"We do have a lot of unemployment taking place, and a lot is not being reported," said Anne John, a counselor with Families in Action, a nonprofit organization that specializes in mediating family and work-place conflict. The means additional struggles with debt for many and new opportunities for conflict in the home. Extended families living together, once the norm in Trinidad and Tobago, are now not so common.

"We have shifted everything of the way we have been before," said John, who has been with Families in Action for 17 years. "Life has changed, people have changed.

"There's aggression, kindness has been eroded a lot -- (it) is each man for himself! So, a lot of things have changed in terms of how we used to be Caribbean."

These changes happened within the last 20 years or so, she noted, so today's young people also lack the stability once afforded by that wider family network.

"A lot of young persons are, actually, the ones who have to handle the homes (and) look after younger children, because parents are out there working," said John, who often goes to the homes and workplaces of clients who cannot get to the counseling center.

"You have a lot of single parents, you have parents who are not able to handle it," she explained. "You have the demands being placed on young persons to perform even that parenting role."

Shouldering a responsibility that isn't theirs, they may feel cut off from meaningful contact.

"For a lot of them, it's social isolation," said Johnston, a specialist in child, adolescent and family mental health. "So that they feel they have no friends, they don't have good relationships at home with their family."

A former youth ministry leader, Johnston sees the need for making a more specific suicide ministry available in parishes.

"We have a lot of access to young people. We see them at first Communion, confirmation, and there are a lot of retreats that happen for young people," she said. "We can do more workshops helping people learn how to cope with their feelings."

And, while Catholic parishes and groups may provide pastorally for people considering suicide or the families of those who have, actual psychological help is less common, mainly because it's expensive, said Johnston.

"The people who need help, a lot of times, they can't afford it," said Johnston. "So, if there would be some way to put some money toward it (so) that, if there's someone from my parish, my community, who needs help, we have money and we work with certain services who would give discounts or sliding scale for people."

In small societies like Trinidad and Tobago, the stigma still attached to suicide makes grief sting all the longer. Many families with someone who has committed suicide do not go to the cemetery on All Souls' Day, as is tradition, said Angenie Sydney, a funeral director at Belgrove's Funeral Home, Tobago. "They're still grieving or are embarrassed. We're a small country."

Tobago is a collection of closely connected villages; Trinidad and Tobago's combined population is nearly 1.4 million, but Tobago's is just under 61,000.

"I'm looking at what is going on now in our little island," said John, "and recognize that there is a lot of emotional upheaval.

"You're seeing a lot of young people walking the streets now who are homeless. You are looking at them and you know a lot of them are experiencing mental illness, but there's nobody. Parents and the family have given up on them or have nothing to do with them."