Love Really IS the Answer: Talking Is the First Step

Marcia Epstein, LMSW

Do you talk with people about personal struggles and suicide every day? I do. And I highly recommend it. Because NOT TALKING is what can kill people. In July and August 2018, three of my friends died, none from “old age.” One died by suicide, one by alcoholism, one by cancer. All three were helping professionals, very respected, and with many people who cared about them. Only one of the three received skilled and compassionate care for the condition that led to their death.

The week of June 3, 2018 included national news that the number of people in the USA dying by suicide continues to increase and that celebrities like Kate Spade and Anthony Bourdain are not immune from suicide. One of the reports released that week came from the CDC, Suicide Rising Across The USA: More Than A Mental Health Concern.

Helping people stick around long enough to learn skills that help them get to #LifeWorthLiving is my passion. Some people call that suicide prevention; call September, Suicide Prevention Month; call the week with September 10, (USA’s) National Suicide Prevention Week; and call September 10, World Suicide Prevention Day. However, for many of us, suicide is in our awareness every day of the year.

Many of us have lost loved ones to suicide, live with suicide thoughts, self-harm, and/or attempts, or are close friends-family of people affected by suicide. Many of us have more than one of those experiences. Those of us “living with suicide” are people of all backgrounds by our age, race, gender identity, firearm ownership or not, national origin, religion or not, sexual orientation, ability, veteran status, and other identities or experiences. We may not be like-minded, but we are like-hearted. We do not want people to suffer in shame and silence, and we certainly do not want anyone to feel forced to die by suicide.

Year-round, people share hotline numbers on their social media. I know and respect hotlines. From 1975 through 2013, I served as a volunteer counselor and then as Director of Headquarters Counseling Center in Lawrence, Kansas. After that I helped at Trans Lifeline. Making sure every person has access to support is a kindness. We also need to share additional kindness, often in the form of additional tools. I know that I am not the only person who is not going to use a hotline as my very first support when I feel bad. And being human means sometimes feeling bad, so I need tools in addition to hotline numbers.

Believing that one belongs and believing one is valued are protective factors. Dr. Thomas Joiner's Interpersonal Theory of Suicide, describes that the intersection of three traits means high risk of acting on suicide thoughts:

  • sense of NOT belonging
  • sense of being a burden
  • (acquired) capability to commit violence on oneself.

How we treat each other matters!

Most days we have some time with another person, whether a close friend, a family member, or a not-yet-friend, with whom we cross paths during our activities. Stop, Look, and Listen! Slow down to a Stop and Look at that person’s face, with a smile on yours. Say “Hello.” with the willingness to Listen. Ask “How are you today?” with the patience to hear and learn about this person, not to share your news or advice. That conversation might be life-saving.

Those of us who work as volunteers or paid staff in the broad field of healthcare can learn more each year about what is known to be helpful in decreasing suicide risk, in supporting people who are bereaved by suicide, and in supporting people who are family and friends supporting loved ones affected by suicide. And we must use what we learn.

I highly recommend that helping professionals use the Suicide Safety Plan, by Barbara Stanley and Gregory K. Brown. This is a great model for working collaboratively with people as they create a personal plan for staying safe from any unhealthy behavior. A safety plan is a way to figure out the detours you can take to avoid traveling down a well-worn path that gets where you really do not want to go. Learning to use those detours takes practice until they feel as natural as that old path.

Offer to be the trusted person to sit next to someone with their writing tools (or apps) to create a Safety Plan that the person will really use. The plan must be kept where the person can find it, even in a crisis. Creating the plan takes time, and the plan will be even more helpful when it is updated regularly.

The Suicide Safety Plan from Stanley & Brown includes:

  • Step 1: Warning signs for this person (emotions, thoughts, images, mood, situation, behavior, physical sensations) that a crisis may be developing;
  • Step 2: Internal coping strategies for this person - Things I can do to take my mind off my problems without contacting another person (relaxation technique, physical activity, or other);
  • Step 3: People and social settings that provide distraction for this person (places you can get to, and phone numbers for the people);
  • Step 4: People whom this person can ask for help (with phone numbers for the people);
  • Step 5: Professionals or agencies this person would actually be willing to contact during a crisis (with phone numbers for the people and agencies); the step where all those hotlines and such belong;
  • Step 6: What this person is willing to do to make their environment safe from suicide, self-harm, any of the dangerous behaviors they are trying to avoid; and
  • Reasons for living: The things that are most important to this person, that make this person’s life worth living

Those of us who have a “loud” public presence through Social Media, Print, TV, Radio, Film, and more, can show our love of our community by following suggestions about how our work can be helpful to people who are already vulnerable to suicide. Those who teach the next generation can also include such suggestions. One great starting point is Ohio Suicide Reporting Guidelines, 2017.

All of us must keep learning about emotional wellness, coping skills, and the components of communities where everyone has the opportunity for #LifeWorthLiving. Act on that information. Show compassion toward yourself and other. To those eligible to vote: get registered, get informed, and vote in elections of all levels from local to national. Participate actively, and with love, in your local, state, national, and international community.

As the Americas Association of Suicidology says, “Suicide Prevention is Everyone’s Business.” And as Henry James said, “Three things in human life are important. The first is to be kind. The second is to be kind. And the third is to be kind.” And that, my friends, is something we can each do for ourselves and for others to prevent suicide. Love really is the answer, and talking really is the first step. And when I say that, I also say to every one of us who has lost loved ones to suicide: If love could have saved our loved ones, they would have lived forever.

Free, 24/7 support for a person in the USA

Marcia Epstein, LMSW

Ms. Epstein is a long-time member of the American Association of Suicidology (AAS), a survivor of suicide loss, and a social worker who specializes in suicide prevention and bereavement support. Her home is Lawrence, Kansas, where she served from 1975 through 2013 as a volunteer, then as Director, of Headquarters Counseling Center, which serves Kansas on the National Suicide Prevention Lifeline. She was a member of the various versions of the Kansas suicide prevention committee from the late 1990’s until 2017, when suicide prevention was moved under the umbrella of the Prevention Committee of the Governor’s Behavioral Health Services Planning Council. Ms. Epstein now works privately, specializing in helping people reduce the risk of suicide and providing support for people who have lost loved ones to suicide. In other words, she helps people learn the skills for #LifeWorthLiving. She does this through individual and family work, as well as support groups, retreats, and special events for people affected by suicide. In Lawrence, she has been facilitating Healing After Suicide, a support group for survivors of suicide loss, since the mid-1990's, and has been facilitating Stayin' Alive, a support group for people living with suicide thoughts, self-harm, and/or attempts, since 2015. She is starting a new support group for family-friends of people living with suicide thoughts, self-harm, and/or attempts, Thriving Family-Friends starts September 2018. The groups are open to people from the Kansas City-Lawrence-Topeka area. Ms. Epstein is a member of the Steering Committee for NAMI Douglas County, KS. She is also the host of Talk With ME podcast and events “at the intersection of Art and Mental Health.” Learn more at