Americans have trouble talking about death. Suicide, even more so. But preventing suicide begins with talking about it; knowing what to look for and initiating those tough conversations with loved ones when they're acting strange or seem unusually sad.
When is it time to ask if someone is contemplating killing themselves?
If someone seems depressed. If they frequently complain of physical pain. If they stop participating in things they enjoy. If they are giving away prized possessions.
"Look for significant changes in personality or attitude," says Sabrina Votava, Spokane Area Field Coordinator for the Youth Suicide Prevention Program. "You know the people you care about, and when they're acting weird, investigate what's going on."
Often, we're scared to ask, scared to touch on the taboo topic of suicide, like the mere mention might conjure it into existence. We shouldn't be, though.
"Asking 'Are you having thoughts of suicide?' is not going to put the idea in someone's head," says Votava.
It matters how you ask, however.
"Don't shut down the conversation by using judgmental language," says Frontier Behavioral Health Director of Crisis Response Staci Cornwell.
Asking, "You're not thinking about suicide, are you?" adds judgment and tends to elicit a "no" response.
"Ask openly. You don't have to feel comfortable," says Votava. And if the answer is yes? Then there are professionals available who have experience dealing with this sort of thing. Frontier Behavioral Health's services are free and available 24 hours a day.
As Spokane schools increase counseling resources and host community forums, Canadian mental health researcher Ian Colman says it is important that these efforts continue in coming months and years.
"We followed the kids every two years, and we found that if they had had a suicide in their school, they are more likely to be thinking about suicide two years later," says Colman.
Locking up guns and prescription medications can help, too. Last year, 54 of the 91 suicides in Spokane County involved a firearm, according to the medical examiner's office.
For her part, Votava went to work in suicide prevention after two of her brothers took their own lives over the span of six months.
"Twelve years ago we did not know about 'contagion,'" says Votava. "We just weren't aware. Now we know everyone has a part they can play. By being aware and getting past concerns about not wanting to make it worse, or uncomfortable, or awkward."
Suicide is contagious, especially among teens. Stories spread through high school hallways and shrines, and memorials and social media posts romanticize death, often making the deceased seem larger in death than they were in life. In his research, Colman examined more than 22,000 teens and found that those who had lost a peer to suicide were more likely to experience suicidal thoughts and ideations.
It's not just the students closest to the person who committed suicide who are at risk, either, Colman says. School- and community-wide programs are essential.
In Spokane, schools and mental health workers are echoing this model, striving to reach out to the entire community. It appears to be working — teens are talking. In April, 200 teens called the Frontier Behavioral Health crisis line. That's twice as many as in a typical month. Just one week into May, the line already had received 100 calls. ♦
First Call For Help: 509-838-4428
National Suicide Prevention Line: 1-800-273-8255