Fifteen year-old Anna lounged on the sofa in Robin Stein’s office, sinking into the cushions with her legs folded beneath her. Though her features remained stoic, the cell phone she cradled shook in the palms of her hand as she rapidly swiped at its surface with her thumbs. “Here,” Anna said, and held the phone out to Stein, a licensed clinical social worker at Jewish Child & Family Services. The screen displayed a somewhat pixelated selfie of a very young girl with a gun pointed at her temple. “She talked about dying all the time.” Anna was in grief therapy with Stein; the girl holding the gun was Anna’s younger sister, Sarah, who had taken her life the year before, ultimately overdosing on a relative’s sleeping pills. Sarah was only 10.