'We need to open the door,' experts say of suicide outreach

SAN FRANCISCO -- The messages stacked up on Twitter and Facebook: Help is here. You are loved. I am listening.

And over and over again, the phone number for the National Suicide Prevention Lifeline: 800-273-8255.

In a week that saw two celebrities take their own lives, as well as the release of a national report detailing an alarming rise in deaths by self-harm, the need to support people in pain, to offer comfort and care, was palpable across social media and in private interactions.

It's a good instinct.

Experts in suicide prevention said that if there is one thing people can do in the shadow of such tragedy, it's to reach out to anyone who may need help.

Text a friend who's struggled with depression. Call a sibling who has talked about suicide in the past. Open a chat window with someone on Facebook who seems lonely. Ask them: Are you OK? Do you want to talk?

``The lesson really is engagement, it's communication. It's never a bad thing to just ask,'' said Paul Gionfriddo, president of Mental Health America. ``If I haven't checked in on my sibling, my friend, my parents, my child for a while -- maybe today is a good day for that.

''Hopefully tomorrow is a good day to do that, too.``

Just as school shootings can ignite conversations about gun violence, high-profile suicides often spark dialogue around mental health, experts said. Those discussions need to be sensitive -- and can be perilous -- but with care in mind, they can be important tools in suicide prevention.

In the wake of this week's deaths -- designer Kate Spade died Tuesday, chef and author Anthony Bourdain three days later -- some people who are struggling with depression and thoughts of suicide may find the news upsetting, even triggering.

But the deaths of Spade and Bourdain are also an opportunity to draw attention to a topic that is often kept secret, said Don Mordecai, national leader for mental health and wellness at Kaiser Permanente.

''You see these successful people -- Robin Williams, Kurt Cobain, this endless parade -- and that can help people realize that depression is real, that it affects anybody, from any walk of life,`` Mordecai said.

''But you have to match that with: It's treatable. There's hope,`` he added. ''That's maybe where we're turning this tragedy into something hopeful. If you're suffering from this, don't suffer alone. If you're on the other side, reach out.``

Suicide is the 10th leading cause of death in the United States. In 2016, nearly 45,000 people took their lives. And according to a report released Thursday by the Centers for Disease Control and Prevention, the rate of suicide deaths has been climbing since 1999.

Every state but one -- Nevada -- has reported an increase in the death rate. Overall, the suicide rate increased by about 25 percent. In California, it increased 14.8 percent.

Why the rates have been climbing is not entirely clear. Some of the increase may be because of more accurate reporting. But higher rates of poverty may contribute, as can other social and cultural factors, like loneliness.

What frustrates so many mental health experts is that suicide is preventable. People who think about it, who plan it, can get help and move on from it. Studies show that 90 percent of people who survive a suicide attempt do not die from suicide later.

That's the message that Rebecca Bernert, a suicidologist and director of the Suicide Prevention Research Laboratory at Stanford, likes to get out to people when suicide is in the news. There is good reason to ask for help, and to offer it, she said.

Still, suicide and mental health are difficult topics for many people to broach, from either side of the conversation. People who are suffering may be ashamed to reach out. Their friends and loved ones may want to help, but fear saying the wrong thing.

A long-persisting myth is that talking about suicide with someone who is depressed will plant the idea. That's not true at all, experts said. Raising the topic of suicide, even asking a person directly about it, can be a kindness.

''The starting point is, 'Have you been feeling like your life is not worth living?' And that can enable help-seeking and greater discussion with a loved one,`` Bernert said.

Kaiser has created a website, FindYourWords.org, to help people talk about suicide and mental health. It includes specific language people can use, including what they should say -- and do -- if someone reveals they are thinking about suicide.

At the University of California at Berkeley, a program started three years ago gives mental health guides, called ''Gold Folders,`` to staff and faculty to help them stay alert for students who may be struggling. The program is a positive step toward making suicide and mental health approachable topics, said Stephen Hinshaw, a psychology professor at UC Berkeley and a psychiatry professor at UC San Francisco.

''People are so afraid to talk about this,`` Hinshaw said. ''We need to open the door.``