Programs are helping communities speak more openly about suicide – at home, at work, in hospitals, and wherever we gather.

News, Your Health | 2 months ago

Creating a Community Conversation About Suicide

Programs are helping communities speak more openly about suicide – at home, at work, in hospitals, and wherever we gather.

An extraordinary moment occurred in a most ordinary place: a store check-out line. A shopper noticed that a cashier seemed upset, then she noticed cut marks on the cashier’s arms. The shopper decided to do the tough thing. She asked – really asked – “Are you OK?” 

The cashier responded that she wasn’t, so the two women stepped aside to talk privately. The shopper encouraged the cashier to seek professional help and to hold onto hope.

The two women saw each other again later. The cashier told the shopper that her simple question and their quiet conversation kept her alive. Three words sparked a change that saved a life.

Suicide as a Community Issue

On the average day in the United States, 129 people will die by suicide. In North Carolina alone, a death by suicide will occur every six hours. American suicide rates have risen about 30 percent over the past 20 years, and they’re now double the homicide rate.

Teammates across Atrium Health are working to ensure that conversations like the one in the check-out line occur much more frequently: between friends, between colleagues, and between doctors and patients. Suicide has become a community issue, says Victor Armstrong, MSW, vice president of Atrium Health Behavioral Health Charlotte. The best tool we have to reverse these trends is to make suicide a community conversation. 

“Once we can get people to understand that suicide impacts all of us, then we can talk about suicide as a community issue,” Armstrong says. “When one in five people is impacted by mental illness, that means we’re talking about people in your workplace and congregations and maybe even your family.”

Armstrong works to normalize conversations about suicide to overcome the stigma that silences so many of us. One tool Atrium Health uses is Mental Health First Aid training. This training – a free, eight-hour course that is open to everyone in the community – teaches attendees, in part, how to recognize and respond to signs of suicide and mental illness. The shopper in the check-out line had taken this training, and she credits it for empowering her to help. 

Armstrong and others work to bring this training to people all around Charlotte: to offices, to faith groups, to community centers, and even to barber shops. Any place where people gather and talk, Armstrong believes, is a place where people should learn how to talk about mental health and suicide.

“There is hope”

Chad Simpson stands as proof of the power of conversations and mental health intervention. He was a frightened child and a depressed teenager, but many of his relatives just urged him to “pull himself up by his bootstraps.” For decades, Chad didn’t get the treatment he needed. “If someone would’ve been kind to me and said, ‘It’s not your fault,’ and ‘You’re trying to your best,’ that would’ve helped me,” he says.

His first suicide attempt came at age 17; his next one was at age 25. During that time, Chad decided to try inpatient treatment at Atrium Health for mental illness.

“I can’t imagine I would’ve had a chance of surviving if I hadn’t gone to an inpatient facility,” he says now, fifteen years later. The treatment made him feel better in a short amount of time, and he hopes that others who experience suicidal thoughts will enter a facility and that those around them will talk openly and encourage treatment. 

“There is hope,” Chad says. “Even if you can’t imagine a scenario when life could be better and life seems like the worse thing, there is hope. I know that because I’m living and breathing it.”

Creating Open Conversations with Patients

Five years ago, Atrium Health began to screen all patients in the emergency department for suicidality, whether or not a behavioral health issue brought them there. More than 80,000 encounters later, Atrium Health earned an award for the innovation of the program and the volume of its screenings.

“We found a lot of people who wouldn’t have told us that they were suicidal. We saved lives by asking the questions,” says Kate Penny, program coordinator of Zero Suicide at Atrium Health.

Penny has expanded upon this idea through her work on Atrium Health’s Zero Suicide initiative. Zero Suicide creates a network around each patient, assessing for suicidality at multiple points and with multiple providers throughout the care process, and collecting and sharing data to ensure proper follow-up with patients.

“As providers, we ask patients if they’ve traveled out of the U.S. or if they’re allergic to latex,” says Jennifer Ziccardi, RN, vice president and chief nurse executive of Behavioral Health at Atrium Health. “Shouldn’t we ask them if they’re suicidal? That should be our top priority.”

Nearly one year after its start at Atrium Health, Zero Suicide has already become embedded throughout the behavioral healthcare department. More than 700 teammates across the continuum of care – doctors, nurses, environmental staff, and more – have completed training. Each person who interacts with patients has learned motivational interviewing techniques that encourage people to open up during conversations, in a style that points them toward a hopeful direction.

“Our vision for Zero Suicide is coming to fruition within behavioral healthcare, and we hope to eventually spread the program throughout Atrium Health,” Penny says. “It’s a great opportunity to make a huge impact.”

Instilling Confidence to Ask the Hard Questions

Normalizing the conversation around suicide will become an important first step in connecting people in crisis to the help that they need. Whether at work, in a doctor’s office, or even in a check-out line, programs are empowering people to ask important questions and listen to answers compassionately and helpfully.

“Mental health can still be a taboo subject,” says Ziccardi. “We’re working to change that, to make it more normal to ask these questions. These programs really work, and we’re instilling hope back into our patients.” 


Atrium Health’s Suicide Prevention Community Event on October 16 will empower and teach you how to become a suicide prevention advocate in your community. The event is free and open to the public. Learn more and RSVP here.

If you or a loved one is attempting suicide, please call 911. Atrium Health’s Behavioral Health Help Line is available 24/7 for crisis assistance at 704-444-2400 or 800-418-2065.

Mental Health First Aid is an evidence-based eight-hour course that teaches attendees how to recognize and respond to signs/symptoms of suicide, mental illness and substance use disorders. Learn more about Atrium Health’s Mental Health First Aid program and register for a class online.