September 21, 2021
Noting increased risks for suicide ideation, behavioral health program director shares warning signs and suggests ways to help

ARLINGTON, Texas — Mental health visits to Texas Health hospitals and behavioral health facilities this year are on the rise and with it, the risk of suicidal ideation — tragically, the signs of which are often missed.

September is National Suicide Prevention & Awareness Month. Texas Health Behavioral Health clinicians say it’s an ideal time to educate yourself and others on the warning signs that a friend or loved one may be contemplating suicide and how to offer support, especially ahead of the winter holidays, a time when death by suicides typically peak.

“The COVID-19 pandemic and the isolation, fear, and economic fallout that has come with it has left many struggling with mental illness and substance use issues,” said Scott Domingue, chief operating officer and chief nursing officer of Behavioral Health Services at Texas Health. “That’s a dire situation that, unfortunately, leads some individuals to contemplate suicide.  The upcoming holidays can often trigger intense feelings that may make things worse.“

At Texas Health hospitals and behavioral facilities, the number of mental health visits increased 25 percent in 2021 (January through August) compared to the same eight-month period in 2020, Domingue said. Inpatient psychiatric admissions of patients arriving at Texas Health emergency departments rose by 11 percent, Domingue said, and emergency departments saw a 12 percent increase in patients with a primary or secondary diagnosis of substance abuse disorder.

Recently, the CDC reported emergency room visits for suspected suicide attempts among adolescent girls aged 12 to 17 years jumped 50.6 percent between February and March 2021 when compared to the same period in 2019.

Catherine Dunham, M.A., LPC, a behavioral health program director at Texas Health Resources, knows too well the pain and questions a loved one’s suicide leaves behind. She lost her 21-year-old cousin to suicide five years ago.

“My family has never been the same. You can still see the pain in everyone’s eyes,” Dunham said. “The grief following a death by suicide is a complicated grief. You are all left wondering, ‘Could I have done something? What didn’t I see?’”

Below, Dunham discusses some of the warning signs that someone might be contemplating suicide and how to help. A Suicide Prevention Q&A video is available here.

  • Verbal cues

While someone may not directly admit they’re contemplating suicide, there could be other verbal cues, Dunham said. “They might say things like, ‘I can’t live with this pain. I can’t live anymore with this sadness. Maybe this family would be better off if I wasn’t here,’” Dunham said.

  • Behavioral changes

A suicidal person may show marked changes in behavior. “Maybe someone who usually is very social and outgoing is isolating more and keeping to themselves,” Dunham said. “Sometimes they might have mood swings, going from really angry to really sad.”

  • Giving away possessions

A suicidal person may began making preparations. “Anytime someone seems like they’re preparing for something, like giving away prized items or making arrangements for their kids, are things to look for,” Dunham said.

  • Experienced major life stressor

A suicidal person may have experienced a recent stressor in their life, such as a divorce, losing their job, an impending trial or something they feel very ashamed about, Dunham said. “Usually situations like that create the mixture for where someone fees really hopeless and helpless, and that usually is what will send someone into a crisis state where they might become suicidal,” she said.

If warning signs are present that someone might be suicidal, Dunham recommends asking the person directly. Once the person begins sharing, be an active listener and don’t show any judgement, she advises.

If a person acknowledges feeling or having felt suicidal, offer them support, Dunham said. If you believe it’s an emergency, call 911 or take the person to the emergency room or a medical facility for immediate help. If there is no immediate danger, help research resources available to help the person, accompany he/she to an appointment with a therapist or behavioral health professional and remove lethal instruments such as firearms from their access, she said.

Texas Health Resources offers free assessments performed by a licensed physician at all our behavioral health facilities. For more information, visit our website or call the Texas Health Behavioral Health Call Center at 682 236-6023 to be connected to appropriate resources.

If you are thinking about suicide, are worried about a friend or loved one, or would like emotional support, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or the Nacional de Prevención del Suicidio at 1-888-628-9454. Services are free and confidential.

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About Texas Health Resources

Texas Health Resources is a faith-based, nonprofit health system that cares for more patients in North Texas than any other provider. With a service area that consists of 16 counties and more than 7 million people, the system is committed to providing quality, coordinated care through its Texas Health Physicians Group and 29 hospital locations under the banners of Texas Health Presbyterian, Texas Health Arlington Memorial, Texas Health Harris Methodist and Texas Health Huguley. Texas Health access points and services, ranging from acute-care hospitals and trauma centers to outpatient facilities and home health and preventive services, provide the full continuum of care for all stages of life. The system has more than 4,100 licensed hospital beds, 6,400 physicians with active staff privileges and more than 26,000 employees. For more information about Texas Health, call 1-877-THR-WELL, or visit  

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