Warning: The following interview contains graphic depictions of suicide. Viewer discretion is advised.
There’s a surprising amount of signs that can precede a suicide attempt. People may experience symptoms of melancholy, rapid moodswings, severe depression, and more. In this follow-up from our previous episode, Rick Hoaglund joins Clark Flatt, President and Founder of the Jason Foundation, to talk about the signs you may be able to spot for suicide prevention and the best ways to communicate with a potential victim in times of crisis.
If you or a loved one are experiencing a crisis, you are not alone. Dial 911, 988, 1-800-273-TALK, or text ‘JASON’ to 741741.
Find out how to get involved at the Jason Foundation at https://www.jasonfoundation.com.
OT Ep. 15 – Transcription.txt
00;00;09;02 – 00;01;27;08
Welcome to OnTopic with Empathia. I’m your host, Rick Hoaglund. Today on the podcast, we’ll continue our conversation started in the last episode with Clark Flatt. In 1997, Clark lost his son to teen suicide. It’s his mission that the epidemic of teen suicide comes to an end. You’ll find part one of this conversation on our website, www.Empathia.com. For Youth Ages 10 through 14, there’s an alarming increase in suicides. The number of suicides for this group has more than doubled since 2006, making it the second leading cause of death for that age group. More teenagers and young adults die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, chronic lung disease, all of those combined. Each day in our nation, there are an average of over 3703 attempts by young people, grades 9 through 12. If these percentages were additionally applied to grades seven and eight, that number would be much higher. Four out of five individuals considering suicide give some signs of their intentions, either verbally or behaviorally. Hello, Clark! Thanks for sitting down with us again!
00;01;27;09 – 00;01;33;22
Glad to be here, Rick. I appreciate you inviting me to come out and talk about this this topic very- very timely now.
00;01;33;25 – 00;01;48;03
So let’s talk a little bit about the behaviors again and about what are we looking for when we believe that someone may be… thinking about suicide? What are what are we looking for there?
00;01;48;05 – 00;07;55;23
What we call the signs of concern, as we talked about on the first half, you know, suicide threats, you know, a biggie. That’s one that we can catch up on Rick, very, very easily. And it doesn’t- can’t be as obvious as I’m going to kill myself. But sometimes a little bit more or less obvious that, oh, that big test next week, I’m not studying for it. Why are you not studying for it? It doesn’t make an impact on my life, if I pass or fail. These are little subtle types of things that I’m thinking about. My life is not worth living. In their way, they’re sharing it to people who are close to them. Hoping that somebody will say, What do you mean it’s not worth it? What do you mean that test is not important? Don’t you know what that’s going to mean for you in college or what? And get them talking. That’s the whole thing there. Get them to. But these are four out of five. It’s been shown by two different studies of young people before they attempt suicide will give clear warning signs or signs of concern. Prior to that, a ten. Four out of five, that means 80% of the time we have a chance that if we know what to look for and how to respond, we have a chance at stopping a suicide attempt. And today, we’re averaging- in our nation today, based on 2021, we’re averaging 137 suicides, documented. 137 per week in our nation from young people. That means 109 of them shouldn’t have died. 80% of them showed warning signs to their friends, family, to their pastors, to their teachers, and we either missed them or misaddressed them. So catching things like a suicide threat, even the less obvious ones, is important. Previous suicide attempts? If you know someone- you were talking about, a lot of young people listen to you. If you know someone who has made a suicide attempt, no matter how minor you might- that might be. Maybe it was, that’s a very small cut. But they were talking about dying. And then if you know of a previous suicide attempt, you go and get somebody, get a responsible adult, get somebody with you, let them know about that individual and don’t let up until a responsible adult either gets with that individual or if it has to do with the parents of that individual and let them know your concern is very, very important, not to give up with some parents. A lot of times we have parents. Oh, that’s nothing. Don’t worry about that, you know. Now, don’t let that happen. You know, tell them about something that you’re concerned. Previous suicide attempt is a big one. Depression, out of character behavior, again, they go together. In my opinion, they go together. And depression has been called one of the leading causes of suicide attempts and suicides, no matter what age group, but out of character behaviors. One I better understand what basically saying someone’s acting in their daily reaction to me and they’re being around me. They’re acting different than I know them. Now, does it mean they’re suicidal? No. Please don’t get, you know, rassle them down and say you’re calling 911. It does mean you should start asking questions and if the questions you don’t get answered correctly, then be concerned enough to take the next step and get a responsible adult involved. Out of character behavior can be such things as their grades dropping, not- not making, completing assignments when they normally were right on the nose every time, maybe even early, giving up things they enjoy, like sports or hunting or shopping. You know, if it- it- when they start doing these things that we call it out of character, then it’s time for your friends, the people around you to start saying, I’m seeing some things. Is there something wrong? And don’t take that, no, nothing’s wrong. And say, well, I asked them! You know, you can tell by the way they’re telling. You know, I always use a lot of description that if you go pick up your girlfriend when you’re dating and they’re 16, 17, that’s a long time ago for me. But I remember pullin’ up and- and go up to the door and you get the girl in and you shut the door or you get in the car, you’re ready to take off. You say, Well, how you doing? And she’s staring straight ahead, not even turning her head. And she says, Fine. If you pull off, you’ve done made a major mistake! And now when I tell you what, you know, I said, well, why didn’t you pull out? She said, Fine! She didn’t mean it. Same way with answering these questions when you ask, How you doing? If you don’t get the right vibe from it, don’t let it slip. Keep on it and find out some help. Then, of course, final arrangements. You talked about young people listening. To guys and girls, please stay on this. You have a friend gives you something. A prized possession. Again, don’t put them in a headlock and say, Get me a counselor. But just simply ask them why they given it to you. It might be because you mean a lot to me as a friend. And this means a lot to me. And I want you to have it. Could be as innocent as that, and that’s fantastic! But you’d be amazed at the times we’ve heard the reports back that when that was asked, Why are you giving it to me now? The person says, Well, I don’t need this anymore. I won’t need this. I’m not going to be around much longer. But really, Rick, I’ve talked to hundreds, if not thousands of young people over 25 years who have attempted suicide. I can tell you, with out of exception in my own heart, not a single one of them wanted to die. Even though I’m talking to them after it, an attempt! They did get to a point in life that they were willing to die to make a pain go away. And- and that’s what we got to work at, helping them see alternatives for that pain going away before it gets to that point of hopelessness. And that’s what this is all about, learning these things so that we can ask and support. You really don’t want to try to let that person get to that- that cliff of suicide, that moment of really doing. You want to back that up as far as you can and get it when it’s just starting to go down that road.
00;07;55;25 – 00;08;10;15
How do you have that conversation? Do you have- is there a- I’m not going to call it a formula, but how do you open a conversation? And maybe it’s a little different if you’re a friend than if you’re an adult that’s observed this. But how do you have that conversation?
00;08;10;18 – 00;10;28;07
I would love to have a formula! If you have somebody that has formula, tell them to send it to me! I think it’s based on your relationship with the person is based on what you’re seeing. You know, if only once you’ve asked them, let’s just take this down to, say, two teenage girls and every time you’ve asked your friend to go shop and she beat you to the car and she’s never won, and then you’ve asked her for the last four times to go shopping. And she says, Now you all go ahead. I’m not interested and I’m just go be in my room. Yeah. You know, I think that would be a perceptive saying maybe not at that moment, but then finding her and saying, listen, I’ve asked you four times, you used to always love to go shopping with me, You know, what’s wrong? Can you talk to me about what’s wrong? But don’t be a counselor. Don’t try to be- once you get them to talk to you, that’s when you can say things like, Listen, you know I want to help you, but I’m not sure I know how. Hey, Coach so-and-so, we think the world that there are past or someone – or your mom! My mom’s really great at talking. Would you come with me and talk to her? She might – could help us with this. Get them talking about why they’re feeling the way they are. Hopefully they’re not saying because I don’t want to kill myself to say after that. Then you go from a point of saying, no, that is not a time of saying I am or get my mom, let’s get somebody to talk to it. You stay with that individual when they say something like that. Don’t leave them no matter what. If you get somebody to call the 911 and get that person help right then and there, you don’t want to say, well, I went away to get help and then it might be too late. I would just say the thing is to be able to ask now, sometimes you dont’ want to have to ask that tough question. I’ve been in this for 26 years almost, and it’s still hard for me to look at somebody and ask them, Are you thinking about killing yourself? You know, it can come to that sometimes because they’re they’re dancing around this thing. I don’t believe this. You got to get to the point, are you thinking about killing yourself? Because you’ve got to see if it’s really an emergency right then and there. I need to get this person help. That’s a tough question because the answer is tough. If that person says, yes, I am, they’ve just put their life in your hands. And if you’re not prepared, that is a scary, scary thing. That’s why things like you’re doing is important.
00;10;28;09 – 00;10;58;07
And you did say just now- you laid it out, but I want to- I want to go into it a little bit deeper. Somebody says, I am thinking about killing myself. The number one thing, don’t leave them alone. Right. And then- and then what are the resources for you as that person that you have confidence? This person has told you something that that they don’t want to tell you. What are your steps? What do you do? And also how do you protect yourself? Because now you’ve been given a shocking news.
00;10;58;09 – 00;15;24;04
Not only soft, shocking news, but a shocking responsibility. That person has just told you that. Yes, I’m thinking about killing myself. That is suspicious, especially if you don’t know what to do. That’s like that- but it’s not that complicated. First of all, remember, don’t be the counselor. Don’t set out so well. Let’s talk about this. Like I said, I’ve been doing this. If that happened to me, Rick, I would get somebody. I would make sure they’re safe. I’d make sure I stay with them. I would make sure then I would start reaching out. As I’m talking, I will share. I will stay with them. They’re not going to even be part of the team because it doesn’t just cure them when they get them and get somebody to help them at that moment, it’s- you don’t get to the point of suicide very seldom all at once, and you don’t get away from it all at once. It takes time to deal with those things that are causing those feelings. So I can be part of the team, but I don’t have to be the leader of the team. Somebody says that to you. Stay with them. First of all, she said, That’s the most important. Do not leave them. I don’t care what they say. I don’t care what you have to do. You stay with them. Second of all, you have to look at how intense it is to a point where they’re getting very emotional stuff. Always that you can lean on is 911. You know, that’s something that you might think is awfully far fetched to do, but it can be the best thing, especially if you don’t know what services are in your community that you could call for Emergency help. Don’t try to go through them all. Call 911. Say I’m here with a friend and they are just now talking about hurting themselves and killing themselves. I don’t know what to do. Can you get someone? A lot of police department, especially metropolitans, now have people that are trained in mental health crises that could ride with an officer that can be there. So 911 is- is a- is a- is one that you can- if you think that it’s an emergency that’s pending, you need to make sure that person is safe right now in getting it. The second one is if they’re just saying, you know, I have been thinking about that some and I don’t- it’s not really an option, but, you know, it bothers me at times. You can call 988. That used to be the old long number that you had to remember. 988 connects you to the to the closest suicide prevention hotline where they’ve been trained. And this is important training not just to help the caller is not that I’m having a crisis. I’m with someone having a crisis. How can I help that person? And you can get that help on 988. They have this the screens in front of them, they have all the resources that are up to date and they can help walk you through. Those are the first two, not one one if it’s an emergency. If you think I’ve got to I’ve got to get out now around this person, I’ve got to make sure they stay safe. Probably the best thing. 988 is if you’re just trying to get information and you want to share with each other. The third one would be even the last where you say, Hey, I don’t know that sure, you’re talking about some things. I’m not. I want to help you, but I don’t know. Can we go talk? And that’s when you go to a responsible adult, whether it be one of the parents, you know, or a good friend, you know, if you’re already an adult or your family doctor. Where I’d hate to say the family doctors are not up to steam yet on- on mental health. And I would- I would take another option for that. But to go and take that person that set out or your high schooler, if it’s a student, your high school, middle school counselors usually have some really good counseling services that they can begin to see how how how much of advice. But one thing I’m concerned with Rick, is not the young people. I’m seeing increase in in young adults that I haven’t seen in 25 years, not just that 18 or 21. We’re talking about that 21 up to 34, 35, 36 years old, and part of it pandemic related, I’m sure economics situations and things like that. And some of the people we talked to says the pandemic direct impact is going to go all the way through 2028, 2029. Now, that’s just a conjunction. But- but we see it’s happening and it’s going to yeah, it’s all important to recognize. But no, you can’t go wrong if you stay with the person, if you have concern and calling 911, you can’t go wrong. You’ve done. I know it’s awfully, I guess, invasive. You might think too. I might have cops showing up. I’m going to have this. But you pretty much could have saved your your your friends life.
00;15;24;06 – 00;15;34;15
What does treatment look like for someone that is suicidal? You know, Is it what we see on TV as far as therapy goes or what? What does that look like?
00;15;34;15 – 00;18;59;03
Now, we’re fortunate. We work with some of the- the nation’s leading providers of mental health in the nation as partners and working with us and communities so we get to see it. We- I’ve visited hundreds of of psych hospitals, as they call them, and they have come a long way from somebody who’s seen them. I’m talking about even when we started working with them in 2004, I’ll be honest with you- some of the location signs were a little scary and I’m going in and out of them and I know I can get out! But they were a little intimidating, especially for our youth. It just- But I have to say, our, our, our mental health leaders today, that has changed completely. The places are very much more- now they have to be safe. So there’s still some you know, some some security there. But but the way they look, the bright colors, the nice looking floors, the counseling sessions, not putting four or five in a room, you know it- we’ve come a long way. So as far as when you go to one now, most of them that we deal with now are more modern. And at least aesthetically, they’re not scary like they used to be. So that’s the first thing. When you have some, or you walk in and as a parent, if you bring a son or daughter there, we have this as our number one complaint. You probably won’t talk to them for the first 48 hours once they’re taken to a psych hospital for observation or help. And- and parents get really upset. You know, my why- why I’m not being talked to and this could differ with different location. I’m just talking about what I have observed. But usually they’ve got to make sure that with that person that’s having this problem, that family or parents are not part of the problem and you surely don’t want the parents involved with them while they’re there. So the first 48 hours is really trying to get to the core of what the problems are, and they want to make sure there’s not- and regretfully, sometimes it is parent related. You know, the parents are some of the least of the way they perceive the problem. So- but then the real help starts. Today, Rick, it is it is phenomenal out there. And now that they have broken it down as far as age and gender, of course, and- and then having your individual counseling while you’re there, plus your group counseling, or you get to talk to other people that are feeling some of the same things you’re doing. The only thing I would say about the the clinical part of it, we haven’t got the insurance companies to- to see this. Like for drugs or alcohol. You can have a drug problem and you have no problem getting 30 days into a into a recovery center. You can do it! You get someone who is suicidal, and that doesn’t come all at once. That’s something that’s usually very complex with some anxiety, depression. And you want them in and out in 72 hours. It’s just Yes, it is. We’ve got to do something about saying that if a doctor needs it, not just carte blanche, but if it’s for an individual that they have more time to stay in these places so that you’re not out in 72 hours and just medicated. And as long as you stay medicated, you’re safe. But if you come off your medications, then- then we have problems again! We have to get our insurance companies in our state to see this long term.
00;18;59;05 – 00;19;06;19
What do you do as a friend or as a parent or some kind of leader in these people’s lives when they come out? How can you support the?
00;19;06;26 – 00;21;48;00
Yeah, the first thing is that not every 5 minutes ask them, are they doing okay? Or put them in a situation where they have to relive it all to tell me what was going on there? That may happen. You know, I think the biggest thing you can do is be supportive. I do say this and I say this. I have a lot of people who are friends, of parents who have a parents who have lost a young person. And we get the friends contacting us and they go, Please help me, help my friend who lost his son or daughter. I don’t know what to say. One of the worst things to do is try to be that overprotective friend who says, I know how tough it is today every time you see them, that’s not good. I always tell him my pad answer, and it would be with that same person. It’s coming back out. So the have a heart to heart say, listen, can we talk just for a minute on this one and we’re going to let this be in the background until you want to talk about it again, especially in losing someone. I say as a friend, say, listen, I don’t know your pain. It has to be tremendous. I don’t know what. I don’t want to know it, you know, But I want, you know, as a friend, I’m here to help you any time, any place I can. I’m not really sure what that means, but, but, Rick, I want you to know I’m here for you. And please, please call me anytime. And then don’t talk about losing that son or daughter again to that person until they bring it up. Go on as much as you can about life. Same way with someone who comes back out. Now be aware that they have been in treatment. And like I say, once you get to that age, especially with the short treatment time we have now, they’re still very much at risk, in my opinion. You know, the- the thing is, is to let them know, hey, I’m glad I’m so proud of you that you got help. That I know that wasn’t an easy thing to do, but I want you to know I am here for you day in and day out. You ever want to talk? You ever need anything? You just let me know. I’m not going to bring it up to you every day, but just know I’m there for you. And then the same way, get back to as normal of a life with that person as you can. And I’m there for you. I think it’s important that they know that someone they consider a friend or a parent. I hope your parent can be a friend, too. I think we we we sort of squash that sometimes together, but- but they they know you’re there for them. I think unequivocally that I’m here for you no matter what you need to talk about or no matter what you need, let- I’ll let you know that I’m there for you. That does more for a person than anything, to know that there’s somebody I encounter.
00;21;48;03 – 00;21;52;08
So in your view, is teen suicide preventable?
00;21;52;10 – 00;23;50;16
Yes. I’ve got in trouble! I’ve had some people, of course, you know, we have we have billboards out. We do a lot on social media that say suicide is preventable. And I understand we have some people who have lost someone to suicide and then they- they- I’ve had it three times in the last six months. Somebody has called and got to me, and said, you shouldn’t say that. You know, my my son or daughter or my my husband or wife didn’t show any signs. It wasn’t. And then I always felt that four out of five shows and what that does mean, though, one out of five doesn’t. 20%! So I guess your son or daughter was one of those 20%. However, at 80%, I’m saying that most suicides are preventable and I believe they are. I think if we know what to look for and if we stay vigilant, if we- if we take action, not just see it, but take action, and then remain supportive that we have a chance of getting someone, especially a young person, through that risk, that this thing of hopelessness that we talked about earlier, it’s really because what we call life lessons, you know, if you have something bad happen to you now, at our age especially, I probably went through something like that four or five times already. I know that given time, I’m gonna make it through it, it’s going to come out. On the other hand, somehow. But I want to make it. When you’re 15 or 16, you haven’t had that life lessons. You haven’t had a long enough life to have it, to know that this this will pass. And I think by just doing enough, I know some of the clinicians get mad at me for saying this. If we can do enough and keep them occupied enough and dealing with it enough, they get that time in their life where there’s life lessons in that. That’s a big thing to overcoming that hopelessness too. They see that other things came up and they dealt with and it went past. So it’s- it’s a big thing, especially because of the youngness.
00;23;50;19 – 00;24;00;02
What can we do on sort of a macro level? Like communities, and federally even. What can we do to help them?
00;24;00;05 – 00;26;23;14
Well the biggest thing is out there is- and I- it’s not a ploy because there’s some other good organizations like ours at the Jason Foundation. There’s some out there that are good. We don’t have the the corner on good programs. There’s some good ones out there, I would say, in your community. First of all, first and foremost, make sure that your school teachers are required, not offered required to make this part of their training annually. You don’t train one time and say, okay, I’m ready for it in five or ten years. I’ll remember that. But, you know, so having teachers go through this training annually, and we’re fortunate, we’ve we passed legislation in 21 states that require teachers to have this training. It doesn’t have to be ours. It just has to be one approved by the Department of Education, making it part of their required training. Training saves lives. It’s no doubt in my mind by providing teachers with the information, tools and resources not to be counselors, but to be better able to recognize when a student might be struggling with suicidal thoughts and then to help their school put together a protocol that they know immediately what to do when they have that student. That saves lives. So check with your schools. Ask your school principals. Do you- do we train our teachers and suicide awareness? If they want more information, they contact us. We don’t- they can say we don’t have a budget. That’s great! We don’t charge anything. And we’re the number one provider in the nation. So it’s- it’s it’s not just some off the wall little problem, you know so the main get your teachers trained second thing make sure the schools that are providing programs for that young people themselves, again not to make them counselors, but to help them know just like the case where my son, when he told two people and they didn’t know what to do. Students see the changes in their friends way before anybody else. They see it. We need to equip them with the same tools to say, I have a friend that might be struggling and I need to know how to help that friend. And so they need a student curriculum. Then I would go to the community of parents and pastors and people that are outside that base, first to the teachers, the students themselves. That’s the most two important in my book. Parents come in third. It’s just that I think parents are at least are not as subjective Sometimes.
00;26;23;17 – 00;26;33;03
If you are equipping the parents, what do they need to know in order to feel like they could recognize the behaviors and that type of thing in their children?
00;26;33;05 – 00;28;53;22
We’re part of what we call the National Council for Suicide Prevention. Just look at our National Council for Suicide Prevention. They have the eight largest nonprofits that deal with suicide. A lot of good information on those. I think as far as a tool kit itself, I don’t know of any. It’s like those things are changing so rapidly, but you can pick up a lot of warning signs. What we talked about on our website, you can look at warning signs. Goes into depth about it, goes into depth about elevated risk factors. I would offer a tool through our company to you guys is called ‘A Friend Ask.’ A Friend Ask. It’s a smartphone app, probably one of the- I think it’s one of the best things The Jason Foundation has. You can download it and the good thing all this stuff we talked about today and more is on that phone is updated annually. Yes, they’re on your side when you need it, you need it listening this but maybe six months ago, you might say, What was that as a warning signs elevated risk factors it has to get help now button if you push that you’re connected to the closest crisis in intervention system that’s been trained for suicide awareness and prevention. And I said this is not just for the person struggling, this is for the person also trying to help the person struggling, all in one little phone app. It’s smart. We have it for iPhone and Android, too. That’s a good tool kit to carry with you. You can have it. You don’t have to worry about where did I put it, where did I file it? If you’re like me, you could see my desk. You know what I’m talking about? Where did I put those papers? You know? But it’s on your phone. It’s very simple. So I would do that or visit the National Council. A lot of good information there. You can text ‘JASON’ – just the word JASON to 741741. And it goes to- we’re partners with a national crisis text line. It’s not our services. We’re just partners with them. It goes to them. They got some really great folks that are really top notch as far as texting. And yes, I’m amazed that at my age I said, no, I wasn’t. So I was actually against the texting crisis thing in its early inception. I said, that’s not you’re removing it, that you need some context. But now I was wrong. Texting has a- has a a good place in there, at least as the initial to get it started. A very good.
00;28;53;24 – 00;28;59;03
So is there anything you’d like to add that we haven’t haven’t discussed in our last two episodes?
00;28;59;05 – 00;29;55;05
Well, the only thing Rick, very quickly I’ll say, that is that if you ever have a concern about a young person who is your son or daughter of one of your sons or daughters friends, take action. Don’t just say, you know, I wonder if anything’s wrong. It might be calling the other child’s parents and say, I’m a little concerned, you know, take action. That’s the one thing that I see, that we lose so many young people that we didn’t have to. Somebody saw something and they didn’t respond. And then we only hear about it after the tragedy. So take action. You can’t go wrong even if it’s not suicide they’re thinking about they’re struggling with something! They’re facing something. If it’s the worst case scenario, they know somebody cares about them. And so you can’t- it doesn’t hurt. You see, something is there like the overt TSA people if you see something, say something that if you- if you feel something, say something and follow it up.
00;29;55;08 – 00;30;55;27
Clark, thank you for joining us today! If you or someone you know is struggling, please reach out to a mental health professional or helpline in your country. If you’re in the United States, dial 988. If you’re thinking of suicide, worried about a friend or a loved one, or if you’d like emotional support, you can also text to 988 or chat on the 988 website. That website is www.988lifeline.org. Or text the word ‘JASON’ – J-A-S-O-N to 741741. There is help available. Please reach out when you’re in a crisis. You will find more information about overcoming challenges on all of our podcasts. To hear more episodes of OnTopic with Empathia, visit our website, www.Empathia.com. Follow us on social media @Empathia, and subscribe to OnTopic with Empathia to hear episodes as soon as they go live. I’m Rick Hoaglund – thanks for listening to OnTopic with Empathia!