“There are some situations where there’s nothing you can do, there’s nothing you can see. It comes out of nowhere. Sometimes it’s from a breakup that you didn’t think was significant or a job loss, financial issues or an argument with a family member or friend. And it goes from zero to 100, in terms of intensity, for the individual. And there’s no way to predict that.” — Bob Pimlott, a licensed marriage and family therapist
“There are some situations where there’s nothing you can do, there’s nothing you can see. It comes out of nowhere. Sometimes it’s from a breakup that you didn’t think was significant or a job loss, financial issues or an argument with a family member or friend. And it goes from zero to 100, in terms of intensity, for the individual. And there’s no way to predict that.” — Bob Pimlott, a licensed marriage and family therapist
“You can provide the services, you can provide the medication. You can provide the hospitalization. You can provide everything there is to provide, but if a person wants to end their life, you can’t stop them. They have to ask for help and they have to listen.”

It’s one stark reality about the issue of suicide that communities, families and friends, must deal with, said Bob Pimlott, a licensed marriage and family therapist with a private practice in Madison.

Pimlott moved to Madison in 1972 to work as a therapist in the Madison Special Services Unit and then for Madison Consolidated Schools until his retirement in 2002.

He has counseled patients who have had suicidal thoughts or have attempted suicide, and he’s had clients who have died by suicide.

The number of confirmed suicides and fatal drug overdoses in Jefferson County stands at nearly 40 since August 2016, and even mental-health professionals aren’t sure why the situation seems to be escalating here.

“I have no idea why the numbers are so high,” Pimlott admitted. “I have no idea what we can do.”

“There are some situations where there’s nothing you can do, there’s nothing you can see,” he said. “It comes out of nowhere. Sometimes it’s from a breakup that you didn’t think was significant [to the person], or a job loss, financial issues or an argument with a family member or friend. And it goes from zero to 100, in terms of intensity, for the individual. And there’s no way to predict that.”

Just as friends and family members are left with unanswered questions, “as a therapist, you do go over and over your notes. What did I miss? What could I have done differently? What questions could I have asked differently? It’s heart-wrenching.”

He recalls one client who died by suicide, but had given no indication that he was suicidal. “Nothing. He was successful, professional. He had no history [of depression], no indication.”

Pimlott said he pored over his notes from the one session he had had with the man, to no avail.

While the central cause may be unknown, Pimlott said there are plenty of contributing factors, such as the ubiquitous presence of social media and the cyber-bullying that can accompany it.

And that’s not something only teenagers have to deal with.

“It’s across the board,” he said, alluding to a couple of local websites that allow members to post negative comments – in at least one case, anonymously – about government officials, community leaders, and sometimes individuals, programs or other initiatives.

Drug use also exacerbates the situation, he said. “With drug issues, you add the stress of the use of the drugs, you add the stress of getting the money for the drugs; losing jobs, spouses and friends because of drugs. And family. There are a lot of dynamics there.”

Pimlott said he has no insight into why this is a growing problem in Jefferson County, specifically. The community does have mental health services at Centerstone and LifeSpring, and many people in private practice.

“But we need more.”

At the middle schools and high schools in both Southwestern and Madison school corporations, counseling staff have access to online assessments through Bloomington Meadows and Wellstone Regional, two in-patient psychiatric hospitals in southern Indiana. Students at risk can be assessed in the privacy of the counselor’s office and the results are shared with parents.

The emergency room at King’s Daughters’ Health also has the online assessment tool, along with social workers on staff who can assist.

“We talked about, years ago, a local hot line,” Pimlott said. “But that requires intensive training and covering it 24/7. ... I don’t think we have the person-hours.”

He believes the committee working on the issue of suicide as part of the Healthy Communities Initiative, sponsored by KDH and led by Carri Dirksen, is a positive start.

“This community, historically, when they see a need, they start working on it,” he said.

Betsy Sullivan, one of the three counselors at Madison Junior High School, agrees that more services are needed in the area – mental health professionals and in-patient facilities – especially those specializing in working with children and adolescents.

“There just aren’t enough to go around, which is sad,” Sullivan said. “I made a call to Bloomington Meadows today, and they have no beds available. The adolescent floor is full. It happens all the time. There is a great need.”

In the past few years, suicide has moved from being the No. 3 cause of death for young people ages 10 to 24 to the second-leading cause of death for that age group, she said.

At MJHS, she said, “we do suicide assessments with young people on a weekly basis,” she said. “Not everyone is suicidal, and not everyone has a strong plan. But kids are thinking about it as an option. Kids are suggesting it to each other in texts. Most of the time [they don’t mean it], but when someone says something like that, it feels meaningful.”

What’s happening in the schools, however, is not just a school issue. It’s a reflection of what is happening in the community as a whole.

“We are a snapshot of society here in the middle school. There are things that parents are suffering, that families are suffering – all of those things are part of this. Drug and alcohol abuse, disease, domestic violence, poverty, television, divorce, video games.”

One of her goals is to get the Lifelines training program, which she uses to teach students suicide prevention awareness, out into the community – to parents, grandparents, families and friends.

“Talking about it is what will heal,” she said. “We have to start training kids, because they’re dying. And that’s not OK with me.”

While the online assessment tool at the schools is very helpful, Sullivan said, “it happens way too often. And that’s just our school. This is an epidemic and I think it’s a silent epidemic across our country.

“That’s why we have to start talking about it, openly, and not being afraid to ask the question – are you thinking about suicide? People will tell you.”

Talking, raising awareness and learning about prevention is crucial, she said.

It’s been her passion, she said, since she was hired eight years ago as a counselor at Madison Consolidated High School. Soon after, one of the students died by suicide.

“I realized we had no suicide prevention awareness program, so I started teaching it in ninth-grade health classes,” she said, adding that she also uses the Jason Foundation’s Promise for Tomorrow program, which is completely free of charge. “When health moved here to the junior high for high school credit, I started teaching it in eighth grade. … It’s an age-appropriate, developmentally appropriate and a research-based program.”

She also trains all district staff in awareness and prevention and, this month, will offer training to parents directly.

Over time, though, she has come to realize that eighth grade isn’t soon enough for teaching prevention and awareness.

The students tell her “teach it to us sooner,” she said, so the program has now been introduced to the seventh grade.

“I’ll bet when I say to my seventh-graders, am I catching you soon enough, they’ll say, no, we needed this last year. So I’ll teach sixth-graders something this year. I’m not sure how it’s going to work yet, but I will teach them something. They will hear this from me.”

By next year, prevention training will be presented in all four grades – fifth through eighth, she said. The training starts with giving the kids statistics and busting myths that surround the topic – primarily the myth that any discussion about suicide will lead to more deaths.

“We give them information about programs and who to call. What if it’s the middle of the night and a friend is texting, ‘I’m going to kill myself’? You call 9-1-1, you wake your parents up and tell them. And you get law-enforcement” to the friend’s house, she explained.

Sullivan said she has no data to gauge the success of the program yet.

“That’s one of our goals this year, collecting and maintaining data – how many assessments have we done, what have we been teaching. I feel like I save lives. I know I do, and I know we do as a team here. I know at the high school, they do,” she said. “I do know our administration is aware this is an issue we have to talk about. So we just need to get better at data collection to see if it’s doing any good. I hope it is. I have to think it is.”