Chat about suicide prevention with Marcia Epstein

July 16, 2007

This chat has already taken place. Read the transcript below.

Marcia Epstein, director of Headquarters Counseling Center, talks about the recent spate of Lawrence suicides - and how to recognize warning signs.


Good afternoon, folks. I'm Joel Mathis, managing editor for convergence. Marcia Epstein of Headquarters Counseling has joined us, and we're ready to chat. Welcome, Marcia!

Marcia Epstein:

Hello - I'm both glad and saddened to be here, as the reason we are talking about suicide prevention is that we have had recent suicide attempts and deaths reported - and that's very sad news.


Marcia, it seems we've seen an uptick lately in Lawrence suicides. Is that true, and if so, is there any cause that can be pinpointed?

Marcia Epstein:

From my involvement nationally, regionally, and locally with suicide prevention, I am very aware that suicide deaths and suicide attempts happen all too frequently. Recently we have had deaths and attempts reported locally because they happened in public places. And whenever there are reports, it is essential to also inform people about how to recognize risk of suicide, how to help prevent suicide, how to get help if you've lost a loved one to suicide, including where all that help is available locally. While we were working on creating awareness of all that, we also learned that during 2006, 20 people who died in Douglas County died by suicide. That means 20 sets of people left reeling with the impact. And that means almost twice the number of people who had died by suicide in Douglas County in recent years. We must not assume that is a trend, but it certainly is alarming. As for the reason for each of those deaths - there is rarely one cause that leads a person to choose suicide. But we all know that we have some very powerful urges to stay safe, so it takes a person getting to a very, very dark place to be able to die by suicide. So, we need to get help, or help someone get help, when we see ourselves or another person headed into that downward spiral.


I have heard that once someone tries to commit suicide and is unsuccessful, they usually try again. Is this true? My cousin is in rehab and her family and myself are concerned that once she is out, she will try again.

Marcia Epstein:

The quick answer is - no one has to attempt again or die by suicide. If a person has attempted suicide and survived that attempt, getting the right help can make a huge difference. Although many people who die by suicide have attempted before, please be aware that most people who make an attempt do NOT later go on to die by suicide. But it definitely takes finding and using the right sources of help.


Hi Marcia: Thanks for all that Headquarters does for Lawrence! Is it the norm for a community this size not to have an in-patient mental health unit? It seems that Lawrence is in dire need of in-patient services.

Marcia Epstein:

I am very sorry to say that the lack of in-patient mental health services is a national issue, as well as a local issue. My personal opinion is that Douglas County residents would benefit from having a local in-patient unit for kids and adults who need a safe place and some crisis treatment to keep safe during a time of highly disorganized, dangerous thinking (psychosis) or high risk of suicide. Having this safety net, and knowing that such a safety net is available, would be reassuring to all the individuals and families and friends who face these struggles even once, or periodically. I am part of the CHIP (Community Health Improvement Project) committee working on gathering a more complete picture of the need in Douglas County, so that local funders and providers can work together to meet this need in the future.


I appreciate the good work that Headquarters does for the community. I also know that organizations like yours are always having trouble with funding. How is your current funding situation and what does the future look like.

Marcia Epstein:

Thanks for your compliment about our work. Headquarters Counseling Center has been open to help people every minute since the doors first opened in December of 1969. We have a strong commitment to being here and making it easy for people to get the help when they need it. It is also true that in recent years, the number of people (nationally, not just here) who are willing to make the commitment to complete thorough training and dedicate the hours needed to provide the services is declining. Funding is not increasing, and in fact some of our "core funding" decreased recently. We are hoping that as more people learn about the importance of keeping our services for kids and adults available 24/7, free of charge, those who can help us, will help us. We have many people who contribute through our annual membership drive and by participating in our annual Life Support Rally. We have many businesses and organizations choosing to partner with us, most notably Peoples Bank, Lawrence Amateur Golf Association, McDonalds, and The Merc. Our goal is to help people learn about our services so that they feel comfortable using them when needed, and so they feel PROUD to be among our supporters. It takes our whole community to keep these services strong.


Headquarters does a great job. but it seems the weakest link in our local suicide response process is when someone suicidal presents at the E.R. what can we do to fix this? I have advocated taking the %2 for art and making it %2 for stopping suicide locally; what do you think of that?

Marcia Epstein:

Thanks for saying you believe we do great. Sometimes we are so caught up in our work, we feel the stress, and it helps to know people appreaciate us. As I noted in another answer, I definitely hope we will develop additional in-patient services in our community. I appreciate that LMH has the crisis stabilization rooms and the "screening" done there by both LMH and Bert Nash staff, but that's a very short-term local help. You are right about the need for additional funding. I have no doubt that everyone in our community who provides any type of mental health support would agree that funding is needed to add staffing and services - to meet the range of needs in a timely fashion. I will add that I fear that some people will die by suicide even with more services. But the thing is, if even one person's life is saved, it's worth spending the money.


Hi Marcia, I've always thought about suicide as a result of the mind turning against itself - like the brain short circuits to the point that decisions are made based on an alternate reality. How does that fit with the phenomenon of cluster suicides and suicides that are planned over the course of several months?

Marcia Epstein:

I hope that I understand your question, and if so I basically agree. Based on my many years of work providing counseling to people considering suicide, and providing support to people who have lost a loved one to suicide, I believe that most people who die by suicide have lost the ability to accurately consider the impact of his/her death on others. That person believes that life is so unbelievably painful that living is no longer an option, and every other option has been tried. That is her/his perspective in that downward spiral, with all the blinders on. Some recent research about suicide (written about in Why People Die by Suicide, by Thomas Joiner) suggests that a person who is capable of dying by suicide has to feel a lack of belonging, a sense of being a burden, and must be desensitized to violence. (There's a lot to say about what those three mean.) The lack of belonging does not mean that no one cares, it means that the suicidal person can no longer see that s/he fits anywhere or is cared about. That's not the same.

What are truly considered "suicide clusters" generally only happens with young people. And some of those young people may act impulsively, without a lot of previous planning, but in response to some immediate crisis/disappointment. (Note I'm saying some.)

I hope that anyone reading these questions and answers remembers that it is definitely worth looking for help and finding it. But for those of you who have lost a loved one to suicide, it's essential to know that no matter what you did, it was NOT your fault. The only person who has the control over suicide is that person her/him self. But it's still worth trying to help.


If somebody is feeling suicidal, how do they contact your agency? What other resources are there?

Marcia Epstein:

If you or someone you know is at risk of suicide, PLEASE get help.

To reach our center, Headquarters Counseling Center, if you can call Lawrence exchanges toll-free, call us at 841-2345. If you are in Baldwin City, call us at 888/899-2345. If the person you are concerned about is in some other part of the state, s/he can reach us through the national suicide prevention hotline networks that we are part of: the National Hopeline Network, 1/800/SUICIDE, or the National Suicide Prevention Lifeline, 1/800/273-TALK.

If you are seeing a mental health therapist - PLEASE let her/him know that you have thoughts of suicide.

If you want to know where to find counseling services, call us at HQCC and we can tell you about all of the low-cost centers in our community, and if you have insurance coverage, we can tell you about the private providers that you can use.

If someone has already taken some life-threatening action, call 911 and get the emergency help that is needed, or if appropriate go to the Emergency Department of LMH.

And if you are one of the many adults in Douglas County (or nearby) who has lost a loved one to suicide, please know that you are welcome to participate in our Healing After Suicide bereavement support group which meets every other Tuesday evening.

Just remember - there is help available!


Thanks for joining us today, Marcia.


bearded_gnome 10 years, 10 months ago

thanks for the very good work you do.
I hope this publicity improves your volunteer participation. I was concerned to read that the pool is shrinking.

our community's priorities are really messed up and we need a total civic commitment to change the suicide response. maybe we need to do something different than have the person presenting just wait for the screener to get there. maybe our community needs to take art money and invest in providing for the needed personnel. if it is a priority, we certainly can do it!

I've been writing on here about the epidemic of suicides, and now we see the numbers actually increasing. is it perhaps time for HQ to add some high-tech element to its outreach to get better coverage of the 18-34 age range, i.e. text messaging, counseling online, etc.

Commenting has been disabled for this item.