Friday is World Suicide Prevention Day. How we can all help prevent suicide? If you or someone you know having feelings of hopelessness or distress, just know that help is available: you can call the National Suicide Prevention Line at 800-273-8255, or go to suicidepreventionlifeline.org.

We have a returning guest for Wellness Wednesday. Dr. Kaz Nelson is an associate professor of psychiatry and behavioral sciences at the University of Minnesota Medical School.

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Every Wednesday morning at 8:30 CST, Jill Riley connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health. Subscribe to Wellness Wednesday as a podcast on Spotify, Apple, RSS, Radio Public, Stitcher, or Amazon Music.

Jill Riley: What the goal of having a designated day like this?

Kaz Nelson: The reason there's a day in recognition of the enormous toll of suicide in our country, is because we're really trying to increase awareness of the issue: that there's probably not a single person that's not touched by this kind of loss in some way. Suicide is very common. It's the 10th leading cause of death as of 2019. In the United States, that's 130 suicides per day. We don't know exactly how to prevent deaths like this, but we're sure going to try, because of the devastating toll of this kind of death.

Between 2019 and now, we've been in the global pandemic. I've heard that suicide has increased during the pandemic. Is that true?

That's such a good question. Our high-quality statistics actually come from the Centers for Disease Control, who do a careful analysis of these kinds of statistics, and it always lags behind a couple years. So our high quality statistics come from 2019. We have yet to determine the overall change in populations impacted by suicide and the overall rates. We do know that stress — and in particular, financial stress — is a risk factor for suicide, though. So a lot of us are asking that question: with the enormous stress and financial toll of the pandemic, how is that going to impact these rates? Work is currently being done now to understand that.

What are some of those risks, that affect people that may take their own life?

Well, one of the risks is actually having mental illness. There are certain mental illnesses like major depression, or bipolar disorder, or borderline personality disorder, that are more associated with self-injury and suicidal thoughts and behaviors. So if somebody does indeed have a mental illness, we want to do whatever we can to remove any barriers to them accessing care for that mental illness.

Of course, it's not as simple as that. There are other risk factors, like loss of functioning, or major medical diagnosis or loss of status: losing a job, having financial stress. We know in our agricultural community, drought and other stressors impact farmers and increase the risk of suicide in that population. And so it's always multifactorial. But we know that these risks exist, and we want to do what we can to mitigate them when possible.

What are some of the warning signs to look for in friends and family?

Certainly talking about death: somebody's saying that their life is ruined, or they'd be better off dead. People talking about being a burden on friends or family, or major change in behavior; whether that's isolation, or maybe for somebody who's usually more low-key, all of a sudden becoming very happy or energetic. Certainly giving away of treasured items can sometimes be a risk factor.

But even though these behaviors exist, it's just really important to point out that sometimes we will never, ever be able to predict this or be able to notice the signs. I just worry that sometimes there are people who have lost a loved one to suicide and thought, "Oh, if I had only known or seen the science." It's not an exact science. But if you're worried about somebody, the bottom line is don't be afraid to ask. Don't be afraid to say, "Are you thinking of suicide?" or, "Are you thinking of taking your own life?" That question is always okay, and that's not going to cause somebody to take their life.

Is there a fear of people admitting that they're having suicidal thoughts?

Absolutely, yeah, there's so many barriers to talking about this. One of those barriers being the discrimination that we've had in our society over decades around this taboo topic of thinking about suicide. And sometimes people are worried that they're going to be punished or cause problems by talking about suicide. So we've got to work together to make it okay to talk about. We've got to tell stories. We've got to make it okay to let people know that they're not alone and encourage people to seek help.

What are some of the other barriers?

Well, access to mental health services can certainly be a barrier, we do not have a perfect mental health system. Sometimes people don't have insurance coverage for certain types of mental health care or treatment. And so we've got to encourage our legislature and other systems to build a more effective, more accessible mental health system. And I know the National Alliance on Mental Illness has been central in that work to try to remove these real barriers to care: time, money, willingness to engage in overcoming these barriers. These are all real barriers that we have to work together to solve.

How can we best support our friends and family that may be experiencing the thoughts? You mentioned just reminding people that they're not alone.

That's right. They're not alone, that you care, that you need them, you need them in your life, and that if you were to lose them that that would be devastating. Sometimes when people are in the midst of mental illness or feeling like they're in an unsolvable situation, that they're stuck, sometimes they develop a self-narrative that the world would be better off without them. And whatever we can do to convince people, no, that is absolutely not the case, the world is better off with you in it. That's one way that we can really actively connect with people around this topic.

Can you talk more about resources in the community?

Yes. There are tools in this toolbox that you can access in order to get assistance or support or help in the way that feels most accessible to you. In addition to that hotline that you mentioned earlier, Minnesota does have its own crisis line for people who are having suicidal thoughts — or if you have a loved one who you're worried that they may be experiencing suicide. If you text the letters "MN," like the state of Minnesota, "MN" to 741741, that will put people directly in touch with a crisis response professional who can help in that moment, and also help navigate some of the different clinics or county-based resources, emergency resources, sometimes even help get a therapy appointment or something like that. Because it's not always easy to navigate the tools in the toolkit when you're in the middle of a crisis yourself. And so this crisis response line can play a role in helping to navigate the resources that are available.

World Suicide Prevention Day is coming up Friday. Why is it important to have a designated day? Are there resources available for those that have lost someone to suicide and are going through the grief and having those thoughts of, "What could I have done?"

Yes, I know from knowing countless people who have lost a loved one to suicide that the hole that is left in one's life and the sensation of feeling just haunted by "What could I have done?" is an extreme stressor. People carry some portion of that stress with them probably for the rest of their life. It is this enormous toll of grief and wondering, "What could I have done differently?" So yes, support for somebody who has experienced Just kind of last is absolutely available. And I would point people towards the National Alliance on Mental Illness to learn about resources in that area because they do exist. It's so important to get support because the toll is absolutely enormous.

The bottom line is, when there is a loss of this nature, it is natural for us to want to think, oh, "Here was the reason why," or "It's because I said this," or, "It was because of this exact one circumstance." Well, that is really an oversimplification of what is an extremely complex issue. The word we use is multifactorial; there are a number of factors that go into suicide thoughts and behaviors. We have to resist the urge to think we know why somebody would do this or to construct a narrative that we don't know is true or not, and to understand the complexity.

One of the simplest things somebody can do is actually restrict access to what we call lethal means. Those are things that are likely to result in death if somebody were to access them. So firearms are responsible for half the deaths by suicide in the United States. Locking up firearms or restricting access to toxic medications [is] one way we can reduce the likelihood of somebody actually dying by suicide attempt. It's never simple, [but] there are some key things we can do.

Wellness Wednesday is hosted by Jill Riley, and produced by Christy Taylor and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License. This week's photo is by Orlando Imperatore (CC BY-NC-SA 2.0). The image was altered: it was cropped, filtered to greyscale, and supplemented with a logo.