1N5: Breaking the Silence, Saving Lives

1N5: Breaking the Silence, Saving Lives

Our youth are in crisis.

One in five teens have some form of mental health condition or illness. And suicide is the second leading cause of death in ages 10 to 24.

Nancy Eigel-Miller, founder and executive director of 1N5, a nonprofit dedicated to suicide prevention, has made it her life’s work to make education and discussion about mental health a priority.

“Mental health issues impact the lives of millions of people. But unlike other medical conditions, there is a stigma attached to it that keeps people suffering in silence,” Eigel-Miller says. “At 1N5, our goal is to normalize the conversation about mental health to erase the stigma of mental illness, prevent suicide, and help people live their best, healthiest lives.”

The team works with more than 100 Cincinnati schools. They assess current mental health programs and equip schools with tools to help students, teachers, and staff understand how to have a conversation about mental health and suicide, how to identify those who are at risk for being suicidal, and what to do if they have a friend in crisis.

“All cases of pediatric cancer and heart disease combined do not surpass pediatric suicides. Just think about that and take in the magnitude of it,” says Michael Sorter, M.D., director, Division of Child and Adolescent Psychiatry at Cincinnati Children’s Hospital Medical Center.

“Nancy has taken a grassroots approach to elevating discussions about mental health issues for kids in our community. What she has done is really remarkable.”


For Eigel-Miller, 1N5 is not a job, it is her mission. She lost her husband, Jim, to suicide in 2008.

“When someone you love dies by suicide, it is hard to overcome. It changes how you view the world,” Eigel-Miller says.

She and her daughters, who were teenagers at the time, found themselves grieving while trying to understand how Jim had gotten to the point of taking his own life.

“Jim was an awesome person. He was loud and goofy. Everyone loved him,” she says. “His suicide came as a total shock. He never talked about his internal struggle with anyone.”

Eigel-Miller spent two years learning all she could about mental health, determined to keep others from walking her family’s heartbreaking path.

Her work began in 2010 with the Warrior Run: The Race for Life, a community event to support the suicide prevention program at Cincinnati Children’s, Adapt for Life (previously Surviving the Teens), and the High School and College Challenge.

“We give participating high schools and colleges 100% of the funds they raise so they can educate peers about mental health and suicide prevention. The 1N5 team provides guidance and support,” Eigel-Miller explains.

1N5 opened its doors in 2016 to grow the advocacy, education, and awareness efforts that started with the Warrior Run. 1N5’s five core focus areas are education and programming, stigma reduction, community engagement, advocacy and policy work, and evidence-based data analysis and research.

“Everything we do is evidence based. We use the research and information to gain a deeper understanding and to determine how we can continue to make progress,” Eigel-Miller says

According to Dr. Sorter, the existence of 1N5 is a positive step for the entire community.

“Nancy’s presence in this space and her advocacy continue to break down the barriers that interfere with kids and families getting the care they need,” he says.


Mental illness can start early, but often goes undiagnosed — or even unnoticed — for many years. By age 14, about 50% of symptoms appear; 75% by age 24. It typically takes eight to 10 years for those suffering to get services like medications or therapy.

“Just imagine if you run or play on a broken ankle. It’s going to get worse not better,” says Erin Horn, who heads 1N5’s Youth Programs and Training. “It’s the same with mental health. By the time a person gets services, they usually have found negative ways to cope, which makes it harder to get back on track.”

Horn lost her brother to substance abuse due to undiagnosed anxiety and depression. He started having symptoms at age 12 but did not seek care until he was 20.

“I have a passion for telling people about this work. I want people to talk about it, so they get the help they deserve,” Horn says. “Silence increases the shame. The earlier we talk about it, the better off everyone is.”

Tricia Buchert, director of Student Services for Mariemont City Schools and member of the 1N5 board of directors, agrees. She says we must normalize mental health as a medical condition like diabetes or cancer.

“The brain is an organ. If it is sick, it needs medical care to heal,” Buchert says. “We all need to understand that and realize that there is no shame in having a mental health condition. If you do, you are certainly not alone.”

Buchert has incorporated two 1N5-funded programs in her district:

• Sources of Strength: Students create a campaign to teach peers about ways to stay emotionally healthy.

• Signs of Suicide: An informative, full-day session for students that includes a questionnaire to assess suicide risk for themselves or a friend.

“Kids know things, see things on social media,” Buchert says. “Our main goal is to build a culture where we discuss mental health openly, so kids recognize the signs and feel safe to go to a trusted adult if concerned.”


1N5 has extended its work to reach adults who are feeling the impact of stress, particularly since the COVID-19 pandemic began.

“Before COVID we talked a lot about student wellness, but it became clear that teachers and staff were experiencing extreme stress,” Horn says.

Horn recently led a retreat at Mount Notre Dame High School. Teachers participated in Recharge and Reconnect, an interactive program that provides tools to manage daily stressors and explore ways to foster connection.

“Connection is powerful in addressing mental health concerns,” Horn says. “Participants learn how to keep interpersonal connections strong, even in the most stressful times. And they learn self-care, things to do daily to be our best, physically and emotionally.”

The need does not end with those working in schools.

“Regular life is already stressful. Add to that, two years thinking and talking about COVID. It’s wearing people down, almost like a chronic illness,” Buchert says

Employees are checking out emotionally, calling in sick and quitting. As a result, corporations are requesting 1N5 services.

1N5 tailors programs and messaging to an audience with content based on the needs expressed by each group.

“After every presentation, several people share with me their own experiences and that they wish they had the information sooner,” Horn says.


1N5 has donated $1 million to Cincinnati Children’s, spends more than $450,000 annually for community programming, and has shared its message with thousands in Cincinnati and beyond.

And they are just getting started.

“We want to be in every school in Cincinnati, in corporations, and the community. We want to cover as much of the Cincinnati area as we can,” Eigel-Miller says.

Dr. Sorter says one of the most important things about 1N5 is that it takes the mental health issue out of the realm of health care and brings it to the teachers, parents, and community. “It enables each of us to ask, ‘What can I do?’”

The answer: Make mental health a priority.

“It’s going to take everyone putting the issue at the forefront,” Eigel-Miller says. “We can make it happen, together.”

Want to help? Visit 1n5.org. National Suicide Prevention Lifeline 1-800-273-TALK (8255) Crisis Text Line HELP to 741-741

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