NEW PORT RICHEY — Efrem Tyree's schoolmates made sympathy cards Tuesday for his family. His mother, father and siblings huddled with their pastor at home in New Port Richey.
This was how they coped with Efrem's death.
The 9-year-old honor roll student was found hanging in his closet Saturday night. His mother, neighbors and paramedics tried to revive him, but he was pronounced dead.
His death is one of the nation's rare suicides by such a young child.
Only a few clues have emerged that may explain why Efrem ended his life.
A report from the Pasco County Sheriff's Office says Efrem had been struggling in school and at home. Deputies wrote in the report that his mother, Jacqueline, "feels that they argue everyday."
Efrem's parents had recently divorced, and the kids moved to New Port Richey with their mother.
The report also says that on the day Efrem died, one of his teachers from the Athenian Academy, a charter school in Pasco County, called his mother about his performance at school.
But more questions remain unanswered, including why such a young child would end his life.
An autopsy is being performed. Pasco County sheriff's officials do not suspect foul play.
Experts estimate depression afflicts about 5 percent of children and adolescents. But they also caution against jumping to the conclusion that depression was the trigger in this case. Anxiety could be an equal factor.
Whatever the cause, deaths like Efrem's are highly unusual, numbering just a handful each year.
"This is not necessarily representative of anything else," said Dr. David Shaffer, a child psychiatrist and professor of psychiatry and pediatrics at Columbia University in New York.
He said similar cases he has studied appeared to be "semiaccidental," meaning it was unclear that the children intended to die.
And often, he said, they were in fear of getting in trouble for something — a sign of anxiety more than depression.
"Most suicides have a psychiatric disorder, but they're not all depression," Shaffer said.
Experts say it's hard to detect serious problems in young kids.
"Your kids are going through so many changes anyway. They're moody, and that's just normal," said Cynthia Ewell Foster, a child clinical psychologist at the University of Michigan. "I think parents really struggle with when to seek professional help."
Jeremy Gaies, a clinical psychologist in Tampa, said being vigilant of behavior changes — in eating, sleeping, school performance, sadness or irritability — is the most important precaution.
Such symptoms individually may not signify trouble. But any new pattern that emerges is reason to have a conversation.
"Children tend not to be as quick to verbalize their feelings, and so some of those feelings are going to come out in behaviors," Gaies said.
Parents also may have a hard time acknowledging depression in their children, Gaies said. They want to think of them as happy and well adjusted.
Just like with any medical condition, mental health problems are easier to treat if caught early.
Efrem's funeral will be Friday in Lehigh Acres, where the family previously lived, his mother said.
"We're doing the best we can under the circumstances," she said.