Editor’s Note: This is the second in a two-part series to raise awareness about suicide as part of Suicide Prevention Week, Sept. 9-15. Yesterday: Suicide bereavement.

Sarah Pembrook, a counselor with Headquarters Counseling Center, 211 E. Eighth St., listens to a local caller who is expressing feelings of depression and being overwhelmed, Tuesday, Aug. 28, 2012. Headquarters, which has been in operation for 43 years, not only takes calls from distressed individuals who sometimes are feeling suicidal, but also offers support for family members who have lost loved ones to suicide. by Nick Krug

Every day, someone dies by suicide in Kansas. Every month, one or two people die by suicide in Douglas County.

Marcia Epstein, director of Headquarters Counseling Center in Lawrence, believes suicide prevention is everyone’s business.

“We all have the opportunity to say a kind word or smile at somebody, and it can make a difference in that person’s day. Those are the kinds of things that we are not going to know the impact necessarily, but that’s a starting point,” she said.

Headquarters has counselors who answer the state’s 24-hour National Suicide Prevention Lifeline and it offers bereavement support for those who have lost a loved one to suicide. Epstein estimated the center gets between 10 and 15 calls a day related to suicide. The center recently received a $480,000 federal grant to help reduce suicide attempts and deaths statewide.

According to the Kansas Department of Health and Environment, there were 385 suicides last year in Kansas, 408 in 2010, and 376 in 2009. In Douglas County, there were seven last year, 21 in 2010, and 12 in 2009.

“We need to be able to talk openly about suicide, and that means if we are the one who is struggling or if we are the one who notices someone who is struggling,” Epstein said.

The warning signs that someone may be suicidal include:

• threatening to hurt or kill oneself.

• looking for ways to kill oneself such as seeking access to pills, weapons or other means.

• talking or writing about death, dying or suicide.

• talking about hopelessness.

• showing rage, anger or seeking revenge.

• acting recklessly or engaging in risky activities such as drinking and driving.

• withdrawing from friends, family or society.

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Eunice Ruttinger, director of adult services at Bert Nash Community Mental Health Center, said if you think someone is at risk for suicide, you should ask him or her matter-of-factly: Are you thinking about killing yourself? Are you having thoughts of suicide? Ruttinger said while some people may think talking about suicide can plant the idea in the person’s mind, it’s not true.

Ruttinger said it’s important to listen and tell that person you want to help them. “We can’t assume that it’s just talk and not action,” she said.

If they have a specific plan on how they are going to kill themselves and the means to do it, seek help immediately by taking them to a community mental health center or hospital emergency room; don’t leave them alone. If the person refuses to get help, you may need to call law enforcement. You also can call the National Suicide Prevention Lifeline at 800-273-8255.

Ruttinger said it’s common for someone to refuse treatment.

“One of the symptoms of depression is you don’t want to do anything. So you are so depressed, you don’t want to engage and you don’t necessarily think anything is going to happen and you feel really helpless,” she said.

If someone has been depressed and then suddenly seems to be doing real well or seems to have turned the corner, think again. That corner may be a commitment to death.

Eunice Ruttinger, adult services director, talks about some of the various forms of therapy used to treat anxiety, depression and psychotic disorders at Bert Nash Community Mental Health Center, 200 Maine, during an interview in 2010. Ruttinger is among the Bert Nash staff members who teach people how to respond to suicidal thoughts and behavior in the center's Mental Health First Aid classes, which are open to anyone. by Nick Krug

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Bert Nash staff members, including Ruttinger, teach people how to respond to suicidal thoughts and behavior in its Mental Health First Aid classes. It also provides counseling and treatment for those at risk.

“They absolutely can get better and that’s the key in talking to people who are having suicidal thoughts. That it is a symptom of a mental health diagnosis and they can get help and recover,” Ruttinger said.

The center performs about 100 screenings per month for suicide. Health Care Access, a clinic that serves uninsured Douglas County residents, sees at least one patient per day who is contemplating suicide or has attempted it.

Across the street, at Lawrence Memorial Hospital, the emergency room had 621 visits last year for suicide, suicidal ideation or self-inflicted injury. In 2010, it had 461 visits and in 2009, there were 655.

Epstein said sometimes there is a need for medical or mental health treatment, but a lot of times when people are thinking about suicide, those thoughts will change once they are reconnected with the people in their lives. She encourages people to call Headquarters Counseling Center at 841-2345 so its trained volunteers and staff can make recommendations for help.

“We get calls every day,” Epstein said. “People say they are worried about my employee, cousin, friend, son, daughter, husband and they let us know what they know and we help in terms of giving some recommendations and we always offer to talk to the person who they believe is at risk.”

Epstein said they are going to help that person move towards the help they need and they are going to use the least invasive methods possible.

“One of our core values is being honest with people. We are not going to do anything without telling you,” Epstein said. “We’ve had people from other communities where the police were immediately dispatched and that can be humiliating and scary and often makes people not want to get help later.”

She said people are more likely to seek help when they’ve been included in the decisions. With someone who is at high risk of suicide, Epstein said, it’s not about doing something against their will, it’s about getting them into agreement to get the help they need.

Headquarters Counseling Center director Marcia Epstein closes her eyes as she listens to a Wichita caller routed through the National Suicide Prevention Lifeline on Thursday, Nov. 12, 2009, at Headquarters. The center recently received a $1.4 million federal grant for statewide suicide prevention efforts. by Nick Krug

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Besides knowing the warning signs and how to get a friend or family member help, there are other ways to promote suicide prevention, Epstein said. One way is to advocate for people who can’t afford to get the physical and mental health care they need. Also, if you see someone being mistreated, do something about it.

“The more we grow up feeling good about ourselves and confident and cared about, the less risk we are going to have getting to the point of life where we are going to feel like suicide,” she said.

SUICIDE PREVENTION

Marcia Epstein, director of Headquarters Counseling Center in Lawrence, says you can make a difference when someone shows signs of feeling suicidal.

Here’s how:

• Listen and show you care.

• Ask the question, “Are you thinking about suicide?”

• For teens, find a trusted adult to help.

• For adults, find someone to be with the person and someone trained in suicide prevention to help.

• Eliminate access to firearms, large amounts of medications and other potential dangers.

• Never keep a secret about suicide.

• Know that suicide is never someone else’s fault.

Where to get help:

• Headquarters Counseling Center’s 24-hour service — 785-841-2345.

• National Suicide Prevention Life-Line — 800-273-8255.

• Bert Nash’s 24-hour service — 785-843-9192.

• Lawrence Memorial Hospital emergency room — 785-505-6100.

• Christian Psychological Services — 843-2429.

SUICIDE PREVENTION WEEK EVENTS

National Suicide Prevention Week is Sept. 9-15. Area events include:

• Life Support Ride. The fifth annual motorcycle Poker Run on Sept. 9 will benefit suicide prevention and suicide bereavement support at Headquarters Counseling Center in Lawrence. Registration starts at 11 a.m. at Johnny’s Tavern, Second and Locust streets, and the ride starts at noon. Cost is $20 per hand. The event includes three stops and ends at Set ’Em Up Jacks in Lawrence. For more information or to register in advance, visit headquarterscounselingcenter.org.

• Remembrance Walk. Suicide Awareness Survivor Support will have its ninth annual walk Sept. 9 at Loose Park in Kansas City, Mo. Registration begins at 8 a.m. and the walk starts at 9 a.m. Cost is $25. Proceeds help with suicide awareness, education, prevention and survivor support. For more information or to register, visit sass-mokan.com/sass-walk.

• Feathers for Cass. Mary Moore, a hair stylist who lost her son to suicide, will be doing feather hair extensions for a $10 donation during the month of September along with hair stylist Emily Willis. The proceeds will benefit Headquarters Counseling Center. To purchase a feather, contact Mary’s Hair and Nail Salon in Baldwin City at 979-7822 or Salon Hawk in Lawrence at 864-1990.