Written by: Amanda Ferrat
September is Suicide Prevention Awareness Month. Suicide is not an easy subject to talk about, nor is mental health. Mental health and suicide are often “taboo” subjects as there are religious, societal, and other beliefs that have created myths and misinformation that have made them such. This is partly why the Tillamook County Suicide Prevention Coalition put proclamations before the county commissioners and city council to have September recognized as Suicide Prevention and Action Month. This highlights that we are moving from solely awareness to action as well in Tillamook County. A major start to that action is having the very important, albeit difficult, conversations on mental health and suicide.
We are inspired to change the narrative around suicide as that is what many larger suicide prevention organizations are doing, such as the International Association for Suicide Prevention(IASP). “Changing the Narrative” is their theme for 2024-2026. They state that changing the narrative is about transforming how suicide is perceived; about shifting from silence and lack of comprehension to openness, empathy and support. NAMI, the National Alliance on Mental Illness, has selected the theme of “Start a conversation. Be the Difference.” for September 2025. They want to remind us that silence is what is harmful and can cost lives, not talking about suicide. Like the IASP and NAMI, the Coalition hopes that opening up channels of communication around suicide and mental health that are honest, informed, and transparent will help break barriers, increase awareness, and shift the culture from silence and stigma to understanding and support.
So how/where does one start?
If you would like formal training, a great place to start is by taking a QPR Gatekeeper training. QPR stands for Question, Persuade, and Refer and it teaches ways to ask the difficult question if someone is thinking about suicide, persuade them to stay alive in the moment, and then how to refer them to support services to help them further. It also teaches the clues to watch for that someone may display if they are thinking of suicide. Sarah Ermer, the Prevention Specialist at Tillamook Family Counseling Center and Coalition Co-Chair, is offering a QPR Gatekeeper training on September 10th from 5:30-6:30pm at the Tillamook Main Library. It is free and open to the public. The Coalition has a few certified QPR Gatekeeper trainers that are available to offer QPR Gatekeeper training to your organization or groups, both in person and online. If you would like to know more about QPR or schedule a training, email tcspcinfo@gmail.com.
Another way to start the conversation is to simply ask someone how they are doing if you feel they may be struggling with thoughts of suicide or experiencing a mental health crisis. Then take the time to actively listen, without judgement. How you ask the question is way less important than taking the time to ask and listening openly. Most times, people that are struggling simply need someone to let them know they are not alone and that can be enough to save a life. And you as the person asking do not have to be alone either. There are resources available.
You can call or text the national hotline at 988; you can do this for yourself or with the person who is struggling. You can also chat with the Suicide & Crisis Lifeline at 988lifeline.org. In Tillamook County, you can reach our local Crisis Team with Tillamook Family Counseling Center by calling (503)842-8201, press “0” and ask to be connected to the crisis team. The AgriStress line is also available for folks in the agricultural, fishing, and forestry professions. Their number is 833-897-2474 and you can learn more at https://www.agrisafe.org/agristress-helpline/.
You cannot put the idea of suicide into someone’s mind by asking them if they are struggling and thinking about dying by suicide. That is a myth. Yet if someone is struggling and you show that you care by asking and then listening, you may save their life and they may then get the help needed to address their struggles. Remember, talking about suicide isn’t harmful, staying silent is. Start the conversation. Be the difference. Change the narrative.
How do you know if you should ask someone if they are thinking about suicide or struggling with their mental health?
Some clues to watch for are direct language like “I want to die” or “I am going to kill myself”; or indirect language like “Everyone would be better off without me” or “I just want to go to sleep and never wake up.” There are also behavioral clues like changes in mood, eating, or sleep patterns, increased risk taking or substance use behavior, or things like avoiding hobbies or things they enjoy, withdrawing from friends and loved ones, or even perfectionism (especially in youth). There are also situational clues like the loss of a job, an important relationship ending, or the death of someone they love, especially if that death was by suicide. These are just a few of the clues someone who is thinking about suicide may display. There are many more. Again, if you see changes or clues that make you wonder about how someone is doing, ask them if they are struggling. You can learn more warning signs here: https://www.samhsa.gov/mental-health/suicidal-behavior/warning-signs.
Suicide is the 11th leading cause of death overall in the United States with over 49,000 deaths per year. Suicide was the second leading cause of death among individuals between the ages of 10-14 and 25-34, and the third leading cause of death among individuals between the ages of 15-24. Suicide rates are highest among those 75 and older. Each death by suicide is estimated to impact 135 people as suicide survivors. This is most likely a low estimate, especially for communities like Tillamook County that are smaller and more tightknit.
Oregon ranks 45th out of 50 in the United States for our overall mental health standing. This standing indicates a higher prevalence of mental illness and decreased access to care. Among those who die by suicide, 46% have a diagnosed mental health condition and 90% have experience mental health condition symptoms. Other risk factors are rural setting/isolation, bullying, community violence, discrimination, access to lethal means, and stigma associated with seeking help and mental illness. These statistics highlight the importance of starting the conversations around mental health and suicide in Tillamook County.
If you would like to explore more statistics by state or county, you can visit the CDC, NIMH, World Population Review or Mental Health Association websites. (https://www.cdc.gov/suicide/facts/data.html
https://www.nimh.nih.gov/health/statistics/suicide#part_10459
https://worldpopulationreview.com/state-rankings/mental-health-statistics-by-state https://mhanational.org/data-in-your-community/mha-state-county-data/ )
Thankfully help exists and healing is possible. Hope is often the antidote to suicide. You can help shift the culture in Tillamook County from one of stigma, silence, and high societal risk to a culture of empathy, hope, openness, and honest conversations about mental health and suicide. The Tillamook County Suicide Prevention Coalition invites you to stand together with us in strength, dignity, hope, and purpose so that we can make a difference in our community, so we can help save lives. To learn more about the Coalition or to get involved, you can email Coalition Lead Amanda Ferrat at tcspcinfo@gmail.com.
You are also invited to join us for Hope in Community: a Lunch & Open House with the Coalition on September 18th from 11am-1pm at the Tillamook Main Library in the Hatfield Room. You can meet members of the Coalition, learn about what we are doing, and see how you can get involved all while enjoying some lunch. Come say hello!