Headquarters Counseling Center director Marcia Epstein closes her eyes as she listens to a Wichita caller routed through the National Suicide Prevention Lifeline on Thursday, Nov. 12, 2009, at Headquarters. The center recently received a .4 million federal grant for statewide suicide prevention efforts.

At the end of a year when suicides increased in Douglas County, local prevention and counseling experts encouraged people to remain keyed in to warning signs and encouraged those affected by suicide to seek help.

It’s available in a wide variety of places in Douglas County. Marcia Epstein, director of Headquarters counseling center, said if anyone calls Headquarters, 24 hours a day, counselors can help direct the caller to assistance.

Douglas County has a higher rate of suicide deaths than the national average, and Kansas ranks 19th among the 50 states.

“Kansas is high, and Douglas County is high,” Epstein said.

Last year, through Dec. 17, 22 people had died by suicide in the county, according to records from the county coroner’s office. That’s up from 11 suicide deaths each in 2008 and 2009.

Dating back to 2006, more men than women died from suicide, and the ages ran the gamut from 13 to 88.

But numbers don’t often tell the whole story, Epstein said. Behind the numbers lie many other people whose lives are deeply affected, including mothers, children and friends.

National statistics, however, show that suicide can affect everyone, Epstein said.

“You can’t just know that kind of demographic information about someone and say that person is safe,” she said.

Epstein provided some tips for people who are concerned about someone who may be contemplating suicide.

One suggestion: Don’t be afraid to ask “Are you thinking about suicide?” if someone appears to be in a bad spot. And show concern by actively listening, she said.

Everyone’s heard of suicide, Epstein said, so it’s very unlikely that a concerned person would plant the idea in someone’s head.

“We have the chance of helping by getting it out in the open,” she said.

If the person says yes, then don’t ignore it and seek help, Epstein said.

Co-workers and friends can watch for other indicators. Look for signs of loss, she said. In older people, that can mean the death of family members or friends, and in younger people, it can mean not making the sports team, or suffering the loss of a relationship.

Other potential signs someone may be in a deep depression or contemplating suicide include:

• Not showering or shaving for days on end.

• Suddenly acting more aggressive than usual.

• Sleeping all the time.

• Being unable or unwilling to eat.

• Long-lasting painful emotions.

• Thoughts about not being capable of handling one’s own emotions or feelings.

Those signs may not always lead to suicide but are good indications that other issues may be present, including depression or anxiety, Epstein said.

And it’s a good idea to limit access to lethal means like firearms, razors or large amounts of medication, too, she said.

Though it’s a myth that more suicides occur during the holidays — summer typically sees more suicides, she said — it’s an issue that the city and the community face all the time.

“Unfortunately, we deal with the issue of suicide every single day,” Epstein said.