September is Suicide Prevention Month

Article written by Dr. Hilda Caquias, Psy.D., Behavioral Health Therapist at Snoqualmie Valley Health.

Every September in the US since 2008, we unite efforts to bring awareness to suicide prevention. As a district hospital, we are joining those affected by talking about suicide loss. Overall, suicide is the 10th leading cause of death in the US. It ranks fourth for people ages 35 to 54, and for 10- to 34-year-olds, it ranks second. Throughout the years, suicide rates have climbed and fallen and climbed again. We cannot say it is due to one factor only. Something constant is the emotional pain.

When an individual dies by suicide, they leave behind their friends and family. Often, friends and families affected by a suicide loss (often called “suicide loss survivors”) are left in the dark. Too often, shame and stigma prevent them from talking openly. The stigma is still there. So many questions remain about why I didn’t see the signs; what if… The hardest part of dealing with suicide is the blame we place upon ourselves. Blame and guilt seem to overwhelm the survivors left behind. At times, the family is in such denial that suicide could happen to them that the scar will be covered up for as long as possible. It is a private matter to lock in the family vault.

When talking to suicide survivors is essential to help them keep in mind that the act of suicide, in the mind of the individual, was the only way to end the pain. That person wasn’t thinking of the devastation they would be leaving behind. Their pain was more significant than their will to live. Suicide is a hard act to accept. As survivors, you may think you could have prevented it. The “if only” thoughts can haunt you. These are just attempts to figure out the “why,” which you may never know. Suicide is unlike any other death. A death caused by cancer, heart disease, stroke, or old age may feel sudden, but at least you feel there was nothing you could have done to prevent it.

Suicide can happen without ever seeing the warning signs. Hurt and loss will never go away. Suicide survivors just must learn how to live differently, to adapt. Please understand that those who have died by suicide did not do this to hurt you. They did it to stop their pain, which they thought would never end, and they shouldn’t be judged. There’s no way to know the demons they faced or how many years it took. The family should also never blame put onto them. Typically, they either didn’t truly see what was happening, or their loved one could not be reached. Dealing with suicide loss is hard enough already, so please, don’t place blame on anyone.


The American Psychological Association gives us some guidelines on how to cope when a friend or loved one dies by suicide:

  • Accept your emotions. You might expect feelings of grief and despair, shock, denial, guilt, shame, anger, confusion, anxiety, loneliness, and even, in some cases, relief. Those feelings are normal and can vary throughout the healing process. Please don’t bottled up your emotions; acknowledge them and embrace them. Feel; that’s what makes you human.
  • Don’t worry about what you “should” feel or do. There’s no standard grieving timeline and no single way to cope. Focus on your needs and accept that others’ paths might differ.
  • Care for yourself. Do your best to get enough sleep and eat regular, healthy meals. Taking care of your physical self can improve your mood and give you the strength to cope.
  • Draw on existing support systems. Accept help from those who have supported you in the past, including your family, friends, or faith-based community members. Social media can help, too, when used appropriately.
  • Talk to someone. There is often a stigma around suicide, and many loss survivors suffer in silence. Speaking about your feelings can help.
  • Join a group. Support groups can help you process your emotions alongside others experiencing similar feelings. People who don’t think of themselves as support group types are often surprised by how helpful such groups can be. Again, social media can help when searching for support groups.
  • Talk to a professional. Psychologists and other mental health professionals can help you express and manage your feelings and find healthy coping tools, like painting, hiking, biking, baking, fishing, and watching TV.


Talking to children and teens about death by suicide is never an easy task. Most adults around them think they won’t understand or feel unprepared. These strategies from The American Psychological Association can help you foster an open dialogue and offer support.

  • Deal with your feelings first. Pause to reflect on and manage your emotions so you can speak calmly to the child or children in your life.
  • Be honest. Please don’t dwell on the details of the act itself, but don’t hide the truth. Use age-appropriate language to discuss death with children.
  • Validate feelings. Help the child put names to their emotions: “It sounds like you’re angry,” or “I hear you blaming yourself, but this is not your fault.” Acknowledge and normalize the child’s feelings. Please share your feelings, too, explaining that while each person’s feelings are different, it’s okay to experience a range of emotions. “I feel lonely too, is okay. And when I feel lonely, I talk to…”. So, you are helping them to cope with their emotions.
  • Avoid rumors. Don’t gossip or speculate about the reasons for the suicide. Instead, when talking to a child or teen, emphasize that the person who died was struggling and thinking differently from most people.
  • Tailor your support. Everyone grieves at their own pace and in their way. Some people might need privacy as they work through their feelings. Please respect their privacy but check in frequently to let them know they don’t have to grieve alone. Other children might want someone to talk to more often. Still, others prefer to process their feelings through art or music. Ask the child how they’d like you to help. Let them know it’s okay just to be together.
  • Extend the conversation. Use this opportunity to reach out to others who might be suffering. Ask children: How can you and your peers help support each other? Who else can you reach out to for help? What can you do if you’re struggling with difficult emotions?


These 6 steps can help you as parents to prevent suicide:

  1. Express your concern. It’s a myth that if you mention suicide, you might plant the idea. You’ll send an important message you care about and understand by honestly and openly expressing your concerns.
  2. Listen. Parents can be tempted to interrupt an upset conversation by saying, “I don’t want to hear those things,” or “I had a hard time as a teen, but I got over it.” Instead, say, “Tell me more about how you’re feeling.” Then listen.
  3. Maintain connection. You might want to safeguard a child or teen by keeping them at home in a protective cocoon, but isolation can increase the risk of suicidal behaviors. Help a struggling child maintain connections with friends and loved ones. As a parent, spend extra time with your child. Even watching TV or playing video games together signals that you’re there.
  4. Be compassionate. Express your love for the child or teen. Tell them you hear their pain, that it can get better, and that you will make sure they get help and support them every step.
  5. Trust your judgment. If a young person denies that he is having suicidal thoughts, but you doubt their honesty, trust your intuition. Take further steps to ensure their safety.
  6. Prioritize safety. Remove weapons from the house, ensure the child or teen is not left alone, and consult a mental health professional immediately.


Again, if you know someone that has suicidal thoughts, follow these steps:

  1. ASK: “Are you thinking about killing yourself?” It’s not easy, but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
  2. KEEP THEM SAFE: Reducing a suicidal person’s access to highly lethal items or places is vital to suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or turning off the lethal means can make a difference.
  3. BE THERE: Listen carefully and learn what they are thinking and feeling. Research suggests acknowledging and discussing suicide may reduce rather than increase suicidal thoughts.
  4. HELP THEM CONNECT: Save the National Suicide Prevention Lifeline’s number on your phone so it’s there when you need it: 9-8-8. You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
  5. STAY CONNECTED: Staying in touch after a crisis or discharge can make a difference. Studies have shown that the number of suicide deaths goes down when someone follows up with the at-risk person.

If you feel concerned about someone is because you should be. Trust your gut feeling. We can help; there are resources in your community.