September is suicide prevention month. “Checking in on your friends” or publicly offering to “listen to people who are struggling” are two major ideas I see passed around on the internet during this month every year – these ideas are a good starting point, and not the end point. If you’re sharing posts like these, I know you care about this issue and want to help. This post is about how we can move beyond awareness when it comes to suicide prevention.

I fundamentally believe that suicide is not an individual issue – it is a community issue. Anyone who has known someone who died by suicide has experienced firsthand the shockwaves that can level entire communities in the aftermath.

Suicide prevention is difficult because it is almost entirely dependent on self-reporting. We never truly know what goes on in another person’s mind unless they tell us. As someone who has struggled with suicidal ideation since I was very young, I learned early that this is not something that is typically shared with others. At first, I assumed suicidal ideation was normal- that everyone had suicidal thoughts sometimes and just didn’t discuss it because it didn’t affect them the way it affected me. I assumed that if I shared what I was feeling, I would be seen as weak. Then there was the way people talked about suicide or how it was portrayed in media – it was mocked and seen as cowardly or selfish. Later, when I started talking to doctors, there was the fear that I could be hospitalized or sent away and labeled as ‘crazy’ if I told them.

In addition to the fear of judgment are the lies we tell our support systems and ourselves. At the height of a suicidal crisis, I am totally convinced that dying would be a good thing for everyone in my life – that I am relieving them of a burden, and escaping what feels like endless pain. We don’t want to hurt our loved ones any more than we already have, so we are sparing them that pain by keeping it to ourselves. This is why “checking in on your friends” is a start, but not sufficient. If someone were to ask me how I was doing when I was in that place, I would say I was fine, a lie I saw as an act of kindness to that individual.

So, how can we reach the people who need it?

A big first step is easing our collective discomfort in talking about topics related to suicide. Like any stigmatized idea in our culture that is rarely discussed, we may not know how to talk about it. Something I often hear in my suicide prevention community outreach efforts is “I just don’t want to say the wrong thing.” This is a valid feeling that comes from a real place of not knowing how to talk about something that no one ever talks about. It’s one of the reasons I designed my “Notice, Ask, Listen, Connect” suicide prevention one pager (attached to this post) to help prepare people for these kinds of conversations. It’s also about practice – the more we practice having these conversations, the easier it is to have them. Whether that means seeking out mental health advocates who speak on this topic (in person or online) and learning from how they do it, or finding folks in your community that are willing to practice conversations, experience will help you to feel more prepared if/when these situations arise.

Another step is educating ourselves and others in our community on warning signs, and what to do if we notice them in someone we know. There are many interactions that occur on a semi-regular basis within a community where someone could notice a change in behavior – maybe it’s your hairdresser or barber who you see once a month, your favorite barista or bartender who you see a few times a week, the guy you make small talk with at the service station where you fill up your tank, or the lady who brings the cookies to church every Sunday. In a community where paths cross frequently, there are many opportunities to notice when people act differently. Here are some things we can look for:

• Talking about wanting to die, feeling hopeless or having no reason to live
• Obtaining lethal means such as stockpiling pills or buying a gun
• Talking about feeling trapped, being in unbearable pain, or being a burden to others
• Increased use of alcohol or drugs
• Acting unusually anxious, agitated, or behaving recklessly
• Withdrawing or feeling isolated

If we notice these warning signs in someone, they may be considering suicide. It is important to always ask them directly “Are you having thoughts of suicide?” One of the biggest myths surrounding suicide prevention is that talking about suicide will cause them to do it. In reality, avoiding the subject only perpetuates the taboo around talking about suicide. Asking someone directly can signal that you are willing to discuss this topic and can create a space where they can talk about what they may be feeling. Finding out the seriousness of the situation is more important than escaping a briefly uncomfortable social exchange.

After we ask the question, we must also listen. Let the person share their feelings and thoughts without passing judgment. Make a point to acknowledge their pain as real and valid, even if you do not fully understand it. When in a suicidal crisis, the thoughts and feelings we are experiencing may not be proportionate to the situation or seem grounded in reality, but they feel so real in that moment. Refrain from shaming or trying to guilt the other person out of doing it, they likely already have a plan and adding to their sense of guilt and shame will not deter them. Instead, try saying things like:

• “I can see that you are in a lot of pain right now”
• “That is a lot to be dealing with on your own”
• “Your feelings are real and valid, thank you for trusting me”
• “I’m sorry that you are experiencing this”

You are likely not a mental health professional, and no one expects you to be. After noticing a warning sign, asking directly to understand the severity, and listening non-judgmentally, it is time to connect them to resources that can best help them. 988 is the national suicide prevention hotline and is always a good option to share with people, it is available by call or text. If something more specific comes up while you are listening, here are more targeted resources that you could direct them to:

• Wisconsin Farm Center- 24/7 Farmer Wellness Hotline: 888-901-2558
• National Youth Crisis Hotline: (800) 442-HOPE (4673)
• Trevor Lifeline (LGBTQ+): 1-866-488-7386 or Text START to 678-678
• Solstice House (24/7 peer support non-crisis warmline): (608) 244-5077
• nowmattersnow.org and preventsuicidewi.org/find-help

If suicide prevention depends on self-reporting, then we must build communities where people feel they can share the darkest thoughts in their mind. That is what makes suicide a community issue. We all have a role to play by signaling that we are safe people and creating spaces where people can show up as their authentic selves, and ask for help.