Youths, first responders and senior citizens can experience unique mental health challenges that can lead to suicidal ideation.

In conjunction with Suicide Prevention Awareness Month, local and regional mental health professionals provided suggestions during the September Partners Community Cafe to meet and overcome these challenges before they progress to suicide attempts.


The National Alliance on Mental Illness (NAMI) -Lake Norman offers free classes, resources and mental health support groups to residents of Iredell County and northern Mecklenburg County, said representative Crystal Hobbs.

Hobbs got involved with NAMI four years ago after her 15-year-old son Tristan took his life. The Mooresville High School sophomore was good at masking and avoiding his feelings and gave no warning of his mental anguish to family or friends, she said.

She learned that Tristan was the second MGSD student in four months to take his life, and a total of six took their lives in the county in 2018.

“I realized we have a problem,” she said.

The first reaction of the high school was to not talk about suicide for fear of sensationalizing it. Hobbs told the principal at the time, “If they are going to do it, they are already thinking about it. You are not going to plant a seed — that’s a myth.”

Hobbs started the T-Man 5K at MHS in 2018 to bring attention to mental heath and suicide and to reduce the stigma around asking for help. The 5th annual race is on Saturday October 8, at 10 a.m. Representatives of the Steve Smith Foundation will be present to talk about the opening of its mental health facility in 2023.

Dell’s Dachshunds for Depression from Cleveland will also be there. The organization is donating two miniature Dachshunds to two teens to serve as their emotional support dogs.

The organization hopes “that our puppies will give a child motivation and a new purpose to keep pushing through the struggles of every day life . . . and give them a comfort in knowing that no matter what the day brings, they will have a friend that will be wagging its tail waiting for them to come back home.”

Hobbs said many in the community are struggling with day-to-day anxiety that can lead to depression.

“We are just trying to break the stigma surrounding mental health disorders. I try to use the T-Man 5K to help people find their voice and ask for help because there are other Tristans out in the world who need help and don’t know how to ask for it.”

“To do better, we have to know better,” added Hobbs.

The free NAMI-LN classes and support groups help educate people about mental health, disorders, diagnosis, and wellness and recovery.

“There is hope — it’s not a hopeless situation,” Hobbs emphasized.

NAMI-LN is starting a new Family Support Group on Wednesday, October 5, at the Mooresville Library from 6:30 to 8 p.m. Contact Hobbs (704-881-2044) or Mike Hoffman (843-245-6189) for more details.

Ongoing mental health groups in Huntersville include the Connections group for those with mental health diagnoses every third Monday of the month at Huntersville United Methodist Church (14005 Stumptown Road) from 6:30 to 8 p.m., with a Family Support group meeting at the same time. Registration is not required.

“You just walk in as you are, where you are,” said Hobbs, who described the groups as a safe place to talk and get help, resources, or access to medications.

Hobbs suggested keeping open, honest, and nonjudgmental communication going with teens and asking them directly about their mental health or any thoughts of self-harm.


Lincoln County EMS Training Coordinator Michelle Paget noted that suicide claims more first responders than line-of-duty deaths. Though general population suicide deaths have decreased, first responders’ suicide rates have not fallen in the same manner.

Only COVID-19 has killed more first responders in the past few years.

The Ruderman Family Foundation reported its research in a white paper, finding that in 2017, 140 law enforcement officers died by suicide, as opposed to 129 in the line of duty.

In 2020, the numbers of suicides was 116, compared to 113 line-of-duty deaths and 182 COVID-19 fatalities. Nearly 62 percent of all officer deaths in 2020 were from COVID-19. Researchers expect the number of suicide deaths to increase as medical examiners complete investigations.

Among EMS and firefighters, 126 died by suicide, with 93 lost in the line of duty. in 2020, 127 took their lives, with 97 lost to suicide in 2021. However, COVID-19 deaths exceeded suicide losses in these years. Since the start of the pandemic, 181 firefighters and 78 EMTs died of COVID-19.

EMS personnel are 1.3 times more likely to die by suicide than the general population.

Marital and relationship issues stemming from trauma or mental health challenges lead the known reasons for firefighter and EMS suicides. Marriages suffer because the spouse does not know how to best support the trauma first responders are experiencing.

The first responder may also be unable to maintain healthy relationships because of health challenges caused by their work experiences. Other reasons are legal or financial problems, medical or physical issues, PTSD, addiction, and depression.

Shame and stigma, which are often associated with the suicide of first responders, lead to secrecy and silence surrounding the event, preventing appropriate processing of it by colleagues of the deceased.

Programs aimed at promoting awareness of first responders’ mental health are needed, and better data collection of suicide deaths is essential, said Paget.

A reluctance to report first responder deaths by suicide means the numbers are most likely much higher. Stigma, fear, or the concern that the death will not be line of duty and affect recognition and family compensation encourage silence about the means of death.

Many first responders also fear a lack of confidentiality when getting mental health services. Most counselors are also not trained to understand the traumas first responders experience on a daily basis.

Mental health injuries are also not easily proven, so claims are often not covered on workman’s compensation. Only four states have laws that cover mental health issues.

To prevent mental health disorders and reduce stress, Paget said her county is encouraging wellness programs and adequate sleep and has used SAMSHA grant funds to provide 3,000 hours of mental health training for staff since November.

A Stress First Aid course teaches stress relief strategies, and mental health counselors are being trained on the special stresses and traumas experienced by first responders. Stress First Aid emotional color charts at all stations remind employees to take their emotional temperature and to check in on fellow staff members as well.

The department members also received Critical Incident Training and Question, Persuade, Refer (QPR) suicide prevention training.

Critical Incident Stress Debriefing Meetings after traumatic incidents also help first responders sort through emotional responses to witnessed trauma. They are taught that it’s okay to ask for help and that “it’s okay not to be okay.”

The department has also purchased computers with secure conferencing for individual virtual counseling sessions when staff members need them.

Paget said the training and programs have created a culture change among her county’s first responders, and she is seeing a difference on the job because of these efforts.


Partners Health Management Geriatric Adult Team member LaQuisha Martin-Hillian said that her group reaches out to different agencies and organizations that work with older adults, including EMS, first responders, churches, and libraries, to enhance their knowledge of dementia, Alzheimer’s, substance abuse, and suicidal ideation among seniors.

Though many older people have happy, fulfilling lives, many face challenges, including family loss, social isolation (lack of support, medical or physical reasons), lack of personal safety (fall risk), transitions (living situations, loss of independence), loss of sense of self or purpose after retirement, financial problems, and physical disability and pain as they age.

Depression affects all ages, but it is not a normal part of the aging process and should be taken seriously and treated.

Seniors also may not seek mental health help for a variety of reasons, including negative stereotypes or stigmas surrounding treatment and counseling, a determination to cope on their own, or a lack of comfort talking about emotions.

Other causes are lack of familiarity with mental health professionals, a belief that nothing will help them, or the costs associated with counseling or mental health care.

To encourage seniors to get help, family, friends, and professionals can honestly share their own experiences with talking it out, acknowledging talking is hard at first but helps to better oneself and learn new coping mechanisms. They can reassure them that all people have problems.

The suicide rate among the elderly is disproportionate. Though they make up 12 percent of the American population, senior citizens account for 18 percent of deaths by suicide. In 2020, those 65 or older accounted for 9,137 of the 46,000 suicides in the United States.

One of of every four older adults who attempt suicide dies because they often use more lethal means.

Caregivers are advised to remove all firearms from the home because of the patients’ possible confusion or the desire to take their lives to avoid putting their families through the stresses of dementia care.

Suicide rates are higher in the senior citizen age group because of a variety of factors, such as loneliness, grief and loss, loss of self-sufficiency, chronic illness and pain, cognitive impairment, and financial troubles.

Seniors can show behavioral or mood signals that indicate suicide ideation, including withdrawal from friends or family, too little or too much sleep, reckless or risky behavior, and increasing alcohol, drug, or medication use.

They may also express feelings of helplessness or being trapped, a lack of sense of purpose or reason for living, or show anxiety or agitation. They may refuse visits, participation in former activities, or assistance with tasks.

If these signs are appearing, caregivers can directly ask about the person’s feelings and listen non-judgmentally to get them to open up. Being there in person to assure and support the person is important.

After the conversation, staying connected and following up to ensure help and treatment is ongoing are important.

Actins that promote emotional wellness for seniors include engaging with physical and emotional health and keeping doctor and counseling appointments, getting involved intellectually and creatively in activities with others, and reaching out to others to create strong social networks.

Martin Hillian recommended the free resource “Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Living Communities” available HERE


Partners Health Management offers a free, 90-minute QPR training to teach anyone how address suspected suicidal ideations in friends, family, or co-workers and to prevent follow through by getting the person to professional help.

Contact Jeanne Patterson at or call her at 704-772-4310 for more information.

Two virtual training sessions are planned for October. The maximum number of people allowed to participate in a virtual QPR training at one time is 30; registration is on a first come, first serve basis.

October 3 at 2 p.m. – Register in advance for this meeting at

After registering, you will receive a confirmation email containing information about joining the meeting.

October 19 at 10 a.m. –  Register in advance for this meeting:

After registering, you will receive a confirmation email containing information about joining the meeting.

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