(gentle music) - Chris and I got married on a fall September day.

The sun was shining, it was a beautiful, beautiful day.

Aw, look, the baby lambs.

(lambs bleating) The night before he died, he had just finished up with chores.

Such a long conversation.

Never imagined it'd be my last one.

- Suicide is a catastrophe for families and I don't think catastrophe is an exaggeration.

I think it's very apt to call it that because it just shocks and stuns individuals and families.

- The CDC is approaching suicide as a public health crisis because the rate in the United States has been on the rise since about 1999.

- [Narrator] In 2020, almost 46,000 Americans died by suicide.

That's more than the number who died in car crashes and twice the number of homicides.

- We've got 1.4 million attempts.

(marker squeaking) A lot of people, no socioeconomic group, no subculture is immune.

We have about 1.4 million who make attempts so it's just an extraordinary index of misery and despair.

- [Narrator] In the U.S., the highest rates of suicide occur among middle aged and older white men.

But every demographic group is impacted, which means that suicides occur in every community and state.

(tools thudding) Understanding suicide is an important challenge for those who work in public health.

The field of suicide prevention is relatively new, but researchers are making progress in understanding the factors that may influence people to take their own lives.

- It is really important to understand that suicide has multiple risk factors that converge, that come together, and those are things that relate to impulsivity, aggression, experiences from the past, adversity, trauma, abuse, and it's not really ever going to be one issue that causes suicide.

- There are a number of risk factors that are both internal and external.

Family history of suicide, a prior suicide attempt, substance abuse and then there's these other pieces like unemployment, economic problems, financial problems, relationship problems, legal problems.

All of these are risk factors that put you at greater risk of suicide.

Again, it's important to remember that most people can survive and live through those, some can't.

- [Narrator] Although everyone is different, those who die by suicide often have some things in common.

One factor is especially significant.

Most people who take their own lives have some sort of mental health condition, like depression or substance abuse disorder.

- I look at mental health conditions as an almost necessary but insufficient risk factor for suicide.

They are a risk factor, but most people with mental health conditions are learning how to manage those mental health conditions, just like we do our physical health conditions, and so prevention is possible and there are other risk factors as well, not just the mental health condition.

- [Narrator] Scientists are also learning that the brains of those who die by suicide may be different in subtle ways.

The result may be difficulty problem solving, thinking flexibly, coping, or asking for help.

These brain differences can make people more vulnerable to harming themselves, especially in times of personal crisis.

As knowledge grows, so do insights about how to help those at risk, insights that are useful to doctors, therapists, communities, and families.

- [Speaker] The signs of distress begin with worry.

- [Narrator] If you think someone is at risk, experts say ask the question.

- The critical thing is to ask them directly, ask them very clearly, "Are you thinking about suicide?"

- Then there are a series of things that you can inquire about, in terms of, "Have you reached out to anyone else?"

"Is there family or friends or others who can help you?"

"Do I need to walk with you to the emergency department?"

in the extreme.

- [Narrator] And when someone is in crisis, stay with them, help them remove lethal means of suicide, and escort them to mental health services.

Never leave a person in crisis alone.

- We have to develop a stabilization plan.

So you never have to go through an awful night like that again.

(uplifting music) What's compelling to me about being a suicidologist is the idea of saving lives and to really find out what makes life worth living.

(kids cheering) And we've learned so much in the decades of the research that I've been involved with as to why people wanna die and that when you really study that and understand it, you can flip it around and understand a lot about what gives people purpose and meaning.

(boat engine revving) - Chris is still with us in a very big sense.

I never want my kids to forget their dad.

Seeing my kids grow up is what gives me hope.

Hope of a bright future for each one of them.

- [Narrator] If you are considering suicide, or if you or someone you know is in emotional crisis, please call 988, call or text 988 for confidential free crisis support.