It was a goodbye. And a warning.
"She never recovered from what those boys did to her," Daisy Coleman's mother wrote on Facebook.
Coleman, an activist against sexual violence who at 14 said she was raped at a party in Maryville, Missouri, and later became the subject of the 2016 Netflix documentary "Audrie & Daisy," died by suicide on Tuesday at age 23.
Coleman's mother, Melinda Coleman, revealed her daughter's death on Facebook, writing "I wish I could have taken the pain from her."
Coleman's death underscores how sexual assault is not a one-time event, but a trauma that ripples, sometimes with impacts that last a lifetime. Trauma increases suicide risk, and people who've experienced sexual assault are 10 times more likely to attempt suicide than those who haven’t, according to a study by the National Victim Center and Medical University of South Carolina. For women, the odds of attempting suicide is 3 to 4 times greater when the first reported sexual assault occurs prior to age 16.
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Eight years ago, felony charges were filed against Matthew Barnett, then 17, the grandson of Rex Barnett, a former Republican state representative. Coleman said after raping her, he left her on her porch in a T-shirt and sweats in freezing temperatures. Her mother found her.
Barnett said the sex with Coleman was consensual. Felony charges were eventually dropped and Barnett pleaded guilty in 2014 to a misdemeanor child endangerment charge and was sentenced to two years of probation and a four-month suspended jail term.
Coleman became a fierce advocate for sexual assault survivors and co-founded SafeBAE, an organization that works to raise awareness about sexual assault in middle and high schools.
"It broke my heart," said Farrah Khan, a survivor of sexual violence who does education across North America about sexual assault consent and bystander intervention and is the manager of Consent Comes First at Ryerson University's Office of Sexual Violence Support and Education. "We don't recognize enough what we ask of survivors. ... Here's a young woman who not only was healing from the violence that she was subjected to, but was doing all this activism and work, which is commendable and wonderful, and we hold them up and say, 'Wow, what a hero.' But also we need to hold space for the fact that it's messy, it's difficult, and it's hard to survive. There are so many of us who don't."
I am struggling with the news that Daisy Coleman has died by suicide. She wrote a beautiful essay about her experience for xojane in 2013. Her assault story was similar to mine and I identified with her pain. Sometimes I don’t know how any of us survive what they do to us.
— Emily McCombs (@msemilymccombs) August 5, 2020
Coleman's suicide is deeply felt, especially among the survivors she worked alongside and encouraged, and the young girls who saw her as a role model.
“Daisy, her story, and her advocacy meant so much to advocates and survivors of sexual violence of all ages – but especially to high school students who saw their own stories reflected in hers," said Scott Berkowitz, president of RAINN. "Every survivor, advocate, and organization who fights for justice, supports survivors, and works to end sexual violence will continue her legacy.”
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Why sexual assault 'sticks'
Sexual assault is not episodic. It has long-term impacts, which can ebb and flow.
Survivors of sexual violence are at an increased risk for developing depression, PTSD, substance use disorders, eating disorders and anxiety disorders. Sexual violence can lead to disrupted sleep, an inability to focus, fear of leaving safe spaces and a sustained state of hypervigilance.
“It’s kind of a perfect storm. If you’re trying to design a traumatic experience that would really stick with a person, it’s hard to think of a worse one than sexual violence,” said Seth J. Gillihan, who runs a clinical practice and researched PTSD with the University of Pennsylvania.
"It’s the most potent traumatic event in terms of leading to PTSD and long-term disruptions," Gillihan said. "It has all the ingredients – it’s interpersonal, rather than impersonal (like being in a car accident or fire or natural disaster), and the intimacy means it breaks trust in a major way."
Sexual assault can be particularly traumatic for young people.
"We talk about young adults and high schoolers as if they're adults, but in terms of their brain development, they're still in childhood. So 14 is such a young and vulnerable age and the experiences of trauma that happened in childhood compound someone's mental and physical health needs throughout the lifespan," said Laura Palumbo, communications director at the National Sexual Violence Resource Center. "When an assault happens at this very vulnerable and formative stage, it's likely to really shape the trajectory of a survivor's life."
Compounding the problem is a lack of support beyond the acute crisis period.
"So many of the mental health resources and even recovery resources for survivors are structured around immediate aftermath and crisis needs," Palumbo said. "The reality is that these needs are ongoing. They don't have an expiration date."
Your reaction matters
Sexual violence is also found to cause feelings of shame which may deter survivors from seeking mental health care.
Coleman not only had to survive her rape, but she was subjected to victim-blaming and abuse. People were “calling me a bitch, a whore, and a slut every single day,” she wrote in an essay in Seventeenin 2013, a year before she attempted suicide.
I can’t shake Daisy Coleman’s death today. There needs to be a different word than “suicide” to describe what happened to her and so many other survivors of assaults.
— Soraya Chemaly (@schemaly) August 5, 2020
"It's not just the individual act ... of a sexual assault that happened to Daisy Coleman. I think it's important to recognize the fact that there was a whole group of people around her: her classmates, parents, teachers, law enforcement that let her down," Khan said. "It takes a community to end sexualized violence. It takes a community to uphold it."
In her Seventeen story, Coleman wrote, "I want other girls to understand that there will always be people who won't believe you, but all it takes is one person to listen, and you'll be able to feel heard."
It's an important step but shouldn't end there, advocates say.
"We're talking more and more as a society about how important it is to believe survivors. I think that's not all survivors need from us is to be believed," Palumbo said. "When it comes to these real mental health impacts of sexual assault and harassment, those who want to support survivors need to understand that even though we want to uplift survivors and validate them for sharing their experiences, there's a lot of pain and loss in survivorship. Stigma and shame alone are heavy enough."
Never a single cause of suicide
Experts caution there is never a single cause of suicide. While Coleman's sexual assault put her at higher risk, she experienced other traumas that likely exacerbated it. When she was 9, she and her brother were in a car accident that killed her dad. In 2018, her brother Tristan died in a car crash.
Coleman's death was likely caused by multiple factors, many of which are not known.
Bart Andrews, chief clinical officer at Behavioral Health Response, said it's important to recognize the pain of trauma is treatable.
"[Survivors'] lives are valuable and have meaning and it’s so important we support each other, talk to someone when we are struggling, listen to someone when they reach out and connect them to appropriate care," he said.
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For anyone struggling with this news, RAINN offers support through the National Sexual Assault Hotline (800.656.HOPE & online.rainn.org).
If you or someone you know may be struggling with suicidal thoughts you can call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) any time of day or night or chat online.
Crisis Text Line provides free, 24/7, confidential support when you dial 741741.
Alia E. Dastagir is a recipient of a Rosalynn Carter fellowship for mental health journalism. Follow her on Twitter: @alia_e
This article originally appeared on USA TODAY: Daisy Coleman's death highlights sexual assault, suicide link