Editor’s note: This story contains mentions of suicide, suicide attempts and self-harm. If you or someone you know is struggling, help is available through the National Suicide and Crisis Lifeline at 988. More resources are listed at the end of this story.
A source in this story was granted anonymity due to the sensitive nature of their experience. They have been identified as “S.”
Data from the Centers for Disease Control and Prevention reports that approximately 1.5 million people in the United States attempted suicide in 2023. It is the 11th leading cause of death in the country.
Suicide also occurs at a higher rate in rural communities, said Dr. Andrea Charles, a therapist and founder at Dragonfly Counseling in Clarkston, Washington.
Part of that is due to a lack of resources, she said. Part is because of cultural stigma around talking about mental health that can lead people to feel isolated.
“ The mentality of farmers and in rural areas is, ‘What happens at home, stays at home.’ We don't talk about it,” Charles said.
The Lewiston-Clarkston Valley and surrounding area was hit particularly hard by suicides recently, including the death of a Winthrop, Idaho visitor who died by suicide in August, and a University of Idaho student who died by suicide in early September.
In Clarkston, several suicide deaths the past few years were among teenagers. Charles said youth can be uniquely vulnerable because of the way their brain processes information.
“They think that everything is happening, that it's happening right now, and that it's the end of the world, and this is how it's always going to be,” Charles said. “They don't realize that things get better, or this is temporary.”
Understanding suicide
Numerous factors can play into a person’s risk of suicide, said Ann Marie Ridinger, crisis program manager at Quality Behavioral Health in Clarkston.
Substance use disorder, a history of mental health disorders, trauma, clusters of suicide in a community and many other factors can increase someone’s risk.
Usually, an accumulation of stressors leads a person to attempt suicide.
One Clarkston woman, 25-year-old *S., said she remembers feelings of deep, persistent sadness starting at a young age. Growing up in a family skeptical of mental health treatment, she had difficulty finding support.
“None of my family could understand why,” she said. “Most of them didn't believe me.”
As a child, S. said, she experienced abuse, watched people close to her deal with substance use problems, and struggled with her identity as a teenager when a family member told her that her bisexuality was "disgusting" and “wrong.”
At some point, S. became friends with another girl who was going through similar challenges, she said.
That girl self-harmed to try to deal with those overwhelming feelings, S. said. Soon, she was doing the same. Cutting herself became a way of “trying to get the pain out,” S. said.
“ I didn't have any good coping skills or have anybody to show me healthy coping skills,” she said. “So I started to self-harm.”
S. was roughly 12 years old the first time she attempted suicide, she said. She went to therapy for a few years, but was pulled out by a family member.
“ I don't really know if they believe in mental health issues,” she said. “They just grew up in a totally different generation where this just wasn't a thing.”
S. was hospitalized at 15 after telling a school counselor about another suicide attempt, she said, and again at 17 after one of her “worst” attempts that resulted in seizures, short-term amnesia and weeks in hospitals.
Years later, she said she still struggles with feelings of shame and guilt related to those attempts.
“People say that, you know, people that kill themselves are weak because they took the fastest route that they could to make their problems go away,” S. said. “It's not that I'm weak. It's that I am tired of being strong.”
Depression and suicidal ideation are an illness, Charles said, and need to be treated like one. When people attempt suicide, she said, it’s because they can’t see any other way out of their pain.
“Suicidal ideation and behavior is like a cancer. It slowly eats away till they are in so much pain, they cannot deal with it,” Charles said. “ It's not a selfish act. It's an act of desperation.”
While the reasons for suicide are wide-ranging, connection with other people can greatly reduce a person’s risk of suicide, Ridinger said.
“Having some sort of community, whether that be online community, faith-based community, (or) support groups (helps),” she said. “I think that isolating and not connecting with people can be one of the most detrimental things that people can do for their mental health.”
Providing support
For S., teachers and counselors in high school provided connection and a lifeline.
“ I just try to show I care,” said Paige Frazier, a former English teacher to S. “If a kid wants me to listen to a song, I make sure I've listened to it so I can visit with 'em the next day. If they want me to read a book, I try to have it read over the weekend so I could then discuss it to create this rapport that I care about them.”
Just talking with someone who is struggling can make a big difference for that person, Charles said.
“If a teenager just goes and sits with a kid who's sitting by themselves, just once, and has a conversation with them so they know they're not alone,” she said, “ that can make a huge impact.”
Normalizing dark thoughts and sharing one’s own experience can also be helpful, she said.
“ Suicidal ideation, anxiety, depression — our brain tricks us,” she said. “It makes us feel like we are alone.”
When there is any concern that a student may be struggling or a risk to themselves, teachers refer them to school counselors as a first line of defense, said Adam Van Vogt, another of S.’s former teachers.
But building a trusting relationship day-to-day can help people feel safe enough to open up about needing help.
“They may not come right out and say they’re thinking about suicide, but they may say, ‘Life’s kind of tough right now,’” Van Vogt said.
Another teacher who helped S. when she was in high school was Dave Weakland. Weakland said he tries to connect with all his students. He might ask them about their outfit, or to tell him more about an interest of theirs.
“ That just kind of opens a little avenue,” he said. “Once the connection's made, then you might say, ‘Hey, you know, you're looking down today … is there something going on?’”
One of the biggest things that helped her, S. said, were friends who showed up willing to help, talk or provide distraction.
“When I am really sad and I don't want to get up and do anything, (one of my friends will) make me get outta bed and go do something. Go for a walk, come over, watch a movie,” S. said. “She’s probably been one of my biggest supporters.”
Help, resources and preventative measures
Ridinger recommends that anyone who struggles with their mental health create a mental health “safety plan.”
A basic safety plan, Ridinger said, might start with a list of three stressors that could negatively impact an individual’s mental health. Then, three coping skills they can use to ground themself.
That could include things like taking a walk, eating a piece of chocolate or holding an ice cube.
“And then having on there three supports. So, it's really good to have a professional support like 988 or Quality Behavioral Health,” she said. “And then like, their support system. So like, two people that are close to them, that they trust, that they can call.”
Reducing access to the means by which a person would kill themself if they reached a low point is also important, said Conny Kirchhoff, associate director at the Washington State University Psychology Clinic.
One example might be a person asking a friend to hold onto excess medication for them if they know they would use medication in a suicide attempt.
“Even just locking it away in a safe space where it just takes some time to get to, and some effort, can be a deterrent,” she said.
Nationally, the 988 Suicide and Crisis Lifeline offers 24/7 crisis support over the phone, by text, and over an online chat.
Some groups that face a range of systemic challenges and discrimination, including Native Americans and LGBTQ+ youth, are at especially high risk of death by suicide.
In Washington state, the “Native and Strong” lifeline, which serves people of Native American descent, can be reached through the 988 hotline.
The Trevor Project also offers a 24/7 crisis and suicide lifeline for LGBTQ+ youth that can be reached through text, an online chat, and by phone at 1-866-488-7386.
