Normally, I write articles about addiction and how it can destroy a family and the person’s life. Suicide can also destroy a family and eliminate any potential that person had to contribute to society. Both are tragedies and both are preventable.

On June 6th, Kate Spade joined the growing number of people who had died by suicide. In 2016, about one person died from suicide every 12 minutes accounting for 44,965 deaths that year. The number of attempts is more than three times that number. Everyone is shocked by the death of a loved one, but it is important to note that suicide is no respecter of age, gender or income.

Family and friends are bewildered by the event, and yet in most cases there were warning signs. But the thought of a loved one killing oneself is so horrifying that a person justifies what they see or hear, as, “They will grow out of it.”, "They are only seeking attention," "They don’t mean what they say,” and think the problem will go away. But for 44,965 people in 2016, it did not go away.

In Indiana, 962 people died by suicide and the numbers are steadily growing. People between the ages of 10 to 14 it is the third leading cause of death and in ages between 15 and 34 it is the second leading cause for death. Indiana has the highest number of people in the nation for contemplating about suicide.

It takes a lot of pain, feelings of hopelessness and not seeing any other option to end the suffering before a person decides to pull the trigger, or swallow that handful of pills. It is important to know that the person who is contemplating suicide is not doing it for attention. Suicide goes against every grain we have embedded in our DNA for survival at all costs and to go against this natural instinct means the person is in an overwhelming emotional distress.

By recognizing who is at risk, and knowing the warning signs that occurs weeks (or hours) before the attempt is crucial to prevent the death of a loved one. Just like an early responder doing CPR can save a person dying from a heart attack. QPR is a program that teaches how anyone can intervene and help a person who is struggling with overwhelming problems in their life that the only option the person can see to ease their pain is by death. This is where a concerned person can intervene and respond to the cry for help and offer hope, and lead them to the help they need.

There are two components to prevention, recognizing those at risk and those who are at eminent danger (showing warning signs) of contemplating suicide. So what are those risk factors?

  1. A person who previously made an attempt is more likely to do it again and die. They have a 40 times increased risk.
  2. Loss survivors (someone who is left behind) they are at high risk of suicide due to grief over the death of loved one, especially middle-aged men.
  3.  A person who has depression/Bipolar has 15 to 20 times increased risk.
  4. Easy ACESS to lethal medications or guns.
  5. Incarceration—loss of freedom. In kids, they perceive taking their phone away, grounded—feel disconnected from friends, loss contact to others, bullying can increase suicide risk.
  6. Certain groups of people that may have social stigma such as LGBT and American Indians are at increased risk
  7. Those who have experienced trauma, sexual abuse, rape victim. Soldiers exposed to combat and police officers with PTSD are all at increased risk.
  8. Diagnosis of a terminal illness or loss of ability to care for oneself.

Risk factors along with clues that suggest acute distress, hopelessness or despair about the future is worth asking the person, "Are you contemplating suicide?" Asking this question does NOT plant the idea in their head, but rather it gets the problem out in the open to be discussed.

  1. Some of the clues and warning signs can be direct. I’ve decided to kill myself, or to end it all. I wish I were dead. I wish I could go to sleep and never wake up.
  2. It can be indirect verbal clues. I’m tired of living. My family would be better off without me. You won't have to worry about me any longer. Giving away cherished possessions -- I won't need it.
  3. Behavioral clues in the form of the person relapsing into drug or alcohol use after a period of recovery, purchasing a gun, or stockpiling pills. Making or changing a will or beneficiaries.
  4. Situational clues of sudden rejection by loved one or unwanted separation or divorce. Death of a spouse, child, friend. Anticipated loss of financial security, or of home. Diagnosis of terminal illness or loss of ability to care for oneself, going into a nursing home.

A person with risk factors along with the clues the person is saying or doing indicates the person may be contemplating suicide and may need to be referred for treatment. But if the person has the following 5 behavioral warning signs—it represents an urgent need for IMMEDIATE intervention, treatment and monitoring. These signs can occur up to 2 weeks (or just hours) before the person actually commits to the act.

  1. Person has severe anxiety, with pacing, wringing of hands, can’t sit still indicating they are suffering from unbearable mental pain.
  2. Constantly going over the same thoughts, worries, fears and can’t be calmed down and redirect their thinking.
  3. Cannot go to sleep or stay asleep and has not slept for several days. This is an indicator of increased chance for suicide
  4. Believing that something terrible and unavoidable is going to happen and they can’t be talked out of these thoughts.
  5. Recent alcohol intoxication, and over drinking to self-medicate and relieve symptoms of insomnia and anxiety.

All these symptoms indicate great psychological pain and if not treated becomes unbearable and leads to doing anything to relieve the pain.

If a person has the risk factors and are giving clues of possible suicide thoughts, the best way to approach the person is to talk to them in private and ask is they are contemplating suicide. 90% of people contemplating suicide will admit they are. This will allow a chance to persuade the person not to do it and guide them to getting the help they need. Sometimes they need someone to hear their suffering, and showing a person a glimmer of hope that things will get better is all they need to reach out and get help.

For QPR (Question, Persuade, and Refer) to work, all of us need to overcome our reluctance to becoming involved. Many times we fail to see the signs, or deny the importance of what the person is saying and minimize it into thinking they are not serious. The person contemplating suicide might see the lack of response as the person doesn’t care what they do, or seen as permission to proceed. Remember, people who die by suicide don’t want to die. They just want to end their pain.

For those interested in getting a QPR program started in their community go to www.qprinstitute.com or call 1-800-273-8255 if you know someone may be thinking of suicide and not sure what to do the National Suicide Prevention Lifeline is available 24/7. Learning about QPR may end up saving one of your loved one's life