There’s a difficult issue that we must recognize and discuss during this ongoing pandemic. It’s one that many of us may not want to acknowledge because it can have devastating impacts on our families and communities.

However, we as Appalachians must stand strong together, and that means taking care of those who may be severely struggling right now. Therefore, we must talk about suicide.

World Suicide Prevention Day is recognized on Sept. 10, and it is meant to raise awareness that suicide can be prevented. According to the National Institute of Mental Health, suicide does not discriminate, and it can affect anyone of any age, gender, race, ethnicity or socioeconomic status.

In 2018, suicide was the 10th leading cause of death, with 48,344 Americans dying by suicide and about 1.4 million suicide attempts, according to the Centers for Disease Control and Prevention.

There has also been a significant rise in the rate of suicides among young people between 10 and 14 years old. For this age group, suicide is the second leading cause of death, accounting for 425 deaths per year, according to NIMH.

Our veteran populations also suffer from high rates of suicide upon returning home from service. The number of veteran suicides exceeded 6,000 each year from 2008 to 2017, and the suicide rate for veterans was 1.5 times the rate of non-veteran adults in 2017, according to the U.S. Dept. of Veterans Affairs.

It’s now more crucial than ever that we recognize suicide as a public health problem because we are still in the midst of a global health pandemic. There are millions of Americans struggling as a result of it, whether that be physically, mentally, emotionally or financially. The CDC reported that, in late June this year, 40 percent of U.S. adults reported struggling with mental health or substance use.

According to the report, 31 percent of adults reported experiencing depression or anxiety symptoms, and 13 percent of adults reported that they started or increased substance use during the pandemic. 11 percent of them reported that they recently seriously considered suicide.

It can be difficult to know who may be at risk of committing suicide because most people who have risk factors for suicide will not kill themselves. However, there are main risk factors that may make someone more prone to suicide ideation, like a prior suicide attempt, depression and other mental health disorders, substance abuse disorder, family history of a mental health or substance abuse disorder, family history of suicide and family violence like physical or sexual abuse.

Other factors may include having guns or other firearms in the home, being in prison or jail, being exposed to others’ suicidal behavior, medical illness and being between the ages of 15 and 24 years old or over the age of 60, according to NIMH.

While the risk for suicidal behavior is complex, according to NIMH, there are different behaviors that may be warning signs of someone considering attempting suicide. It’s important that we pay attention to these behaviors, rather than dismissing them as means of wanting attention. Suicidal thoughts or actions, according to NIMH, are signs of extreme distress and an alert that someone needs help.

Possible warning signs include:

• Talking about wanting to die or wanting to kill themselves

• Talking about feeling empty, hopeless, or having no reason to live

• Planning or looking for a way to kill themselves, such as searching online, stockpiling pills, or newly acquiring potentially lethal items (e.g., firearms, ropes)

• Talking about great guilt or shame

• Talking about feeling trapped or feeling that there are no solutions

• Feeling unbearable pain, both physical or emotional

• Talking about being a burden to others

• Using alcohol or drugs more often

• Acting anxious or agitated

• Withdrawing from family and friends

• Changing eating and/or sleeping habits

• Showing rage or talking about seeking revenge

• Taking risks that could lead to death, such as reckless driving

• Talking or thinking about death often

• Displaying extreme mood swings, suddenly changing from very sad to very calm or happy

• Giving away important possessions

• Saying goodbye to friends and family

• Putting affairs in order, making a will

If you or someone you know has warning signs or symptoms of suicide, the NIMH recommends to get help as soon as possible. Family and friends are the first to recognize the warning signs of suicide and can take the first steps toward intervening and getting help. Seek help from your local mental health treatment facility, or reach out to a therapist who can help guide you on mental health resources and treatment options.

Based on data from the CDC, we must also increase intervention and prevention efforts at the local, state and federal level in order to address the mental health conditions associated with the COVID-19 pandemic.

If you or someone you know is in emotional distress or struggling with suicidal thoughts or actions or suicide ideation, call the National Suicide Prevention Lifeline at, 1-800-273-8255, or visit its website at,

The NSPL is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. It also provides prevention and crisis resources for you or your loved ones and best practices for professionals.

It’s important to remember that suicide is not the answer. Every life is worth fighting for, including yours, and you matter in this world. Together, we can raise awareness about the risks of suicide, and we can save the lives of our fellow Americans.

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