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A UMNS photo by Annette Spence, The Call The Rev. Jean Layell looks at an album of old family photos.

Nineteen years ago, the Rev. Jean Layell?s sister was the mother of six-week-old twins. She asked her sister to come over and babysit because she hadn?t slept well the night before.

When Layell arrived, she took the babies in her arms and encouraged her younger sister to ?go and take a hot shower.? Within moments, Layell heard what sounded like an explosion.

She remembers looking out the window, trying to figure out what happened. She remembers calling her sister?s name and hearing the shower running. She remembers hearing her father scream at some point. She doesn?t remember much else about that day.

?They tell me that I found my sister, and that I called my brother,? says Layell, wiping the tears from her eyes.

When the family arrived at her sister?s mobile home, they found Layell just sitting in a chair, holding the babies.

Nineteen years later, the Norton (Va.) United Methodist Church pastor tells her grief-stricken story as if it happened months ago.

?I?m the last person she talked to,? says Layell, age 55. ?Why didn?t I know what she was going to do? What if I could have stopped her??

Haunted by questions like those, Layell and Bill and Phyllis Russell are on a mission to educate people about the warning signs of suicide, as well as intervention and referral. All three live in the Big Stone Gap District of the United Methodist Church?s Holston Annual (regional) Conference in southwest Virginia.

Through the Lenowisco Suicide Prevention and Awareness Coalition, Layell and the Russells are reaching out to schools to educate teachers and youth, since suicide ranks third as a cause of death among Americans ages 15 to 24.

But they?re also trying to educate clergy, who are on the front line when people reach out for help with mental-health issues. Last year, the Russells presented a suicide-prevention program to clergy in the Big Stone Gap District, an area where suicide rates are reportedly two to two and a half times higher than the rest of Virginia.

Bill Russell, who lost his 36-year-old son to suicide in 2001, partially attributes southwest Virginia?s high suicide rate to a cultural stigma of mental illness.

?They call suicide ?the silent epidemic,?? he says. ?In Appalachia, people don?t want to talk about it.?

?People in southwest Virginia are very private,? says Layell. ?They don?t want anyone knowing their business.?

Like Layell?s sister, the Russells? son took his life with a firearm, the most common way of committing suicide. Both Jean Layell and the Russells now realize their loved ones struggled with depression, which has a strong relationship to suicide.

?If we had just recognized the signs and symptoms of depression, there was the possibility of getting him help,? says Phyllis Russell, a member of Pleasant Hill United Methodist Church.

Before he died on Jan. 2, 2001, the Russells? son seemed withdrawn through the Christmas holidays. His weight had changed dramatically, and he suddenly didn?t seem to care about his personal appearance.

Later, the Russells learned that he had thrown his personal belongings in a dumpster, perhaps to keep his family from having to dispose of them after he died. Although increased alcohol and drug use is a suicide warning sign, the Russells say their son did not have a substance abuse problem.

?It was such a shock,? says Phyllis Russell. ?He knew we loved him dearly ? his whole family loved him. It?s something we?ll never get over.?

The Russells began attending the closest suicide survivors? support group in Johnson City, Tenn., until they saw a need to begin a local support group through their pastor, the Rev. Betty Marshall, and Pleasant Hill Church. The Lee County Survivors of Suicide Support Group started in April 2005.

In late 2005, while on the way from a suicide prevention conference in Roanoke, Va., they decided to form a regional coalition after learning that southwest Virginia?s suicide rate is double the state?s and nearly double the nationwide rate.

?We were really alarmed,? says Bill Russell. Since then, the Lenowisco Suicide Prevention and Awareness Coalition has made about 300 presentations to groups in southwest Virginia. Layell is now chairperson of the coalition?s Wise County branch. (Lenowisco stands for Lee, Wise, and Scott Counties and the town of Norton.)

Suicide warning signs include low self-esteem, anger-management problems, irritability, getting into trouble with the law, becoming pregnant early in life, increased physical health problems, abusing alcohol or drugs, significant changes in appetite or weight, feelings of worthlessness or excess guilt, fatigue or loss of energy. People at risk for suicide often threaten to hurt or kill themselves. They may talk or write about suicide or death or look for ways to kill themselves by seeking access to guns, pills, or other means, according to the American Association of Suicidology.

A high-risk group, other than youth, is the elderly. The elderly make up 12.4 percent of the population but account for 16.7 percent of all suicides. Elderly white men are at the highest risk with a rate of about 32 suicides per 100,000. Overall, suicide is the 11th leading cause of death in the country, the AAS reports.

?They get old, have been independent all their lives, and don?t want to go to the nursing home,? Layell says of the elderly. ?So they starve themselves or don?t take their medication. It?s more common than we know.?

If you a think a person is at risk for depression or suicide, the next step is to actively intervene and refer the person to proper help, according to the Virginia Department of Health:

• Take immediate steps to ensure safety, including eliminating access to firearms.
• Explore individual, family, or group therapy.
• Enlist family and community support.
• Involve mental-health professionals trained to recognize and treat depression and related disorders.

Several online resources exist to help clergy and others address suicide prevention. The Suicide Prevention Resource Center, available at www.sprc.org, provides information such as ?The Role of Clergy in Preventing Suicide? and ?After a Suicide: Recommendations for Religious Services and Other Public Memorial Observances.?

Other resources include the American Association of Suicidology (www.suicidology.org) and the American Foundation for Suicide Prevention (www.afsp.org).

Holston?s Outreach/Advocacy Ministry Team also offers ?Caring Congregations? resources for ministering to the mentally ill on the conference Web site (www.holston.org/outreach). In June, the Holston Conference approved a ?Mental Health Awareness? resolution proposed by the Outreach/Advocacy Team. The resolution requests that each Holston congregation use ?Caring Congregations? resources.

Layell says the ministry of suicide prevention is one of ?great passion? for her because she is daily reminded of her family?s loss.

The twin daughters left behind by her sister are 19 years old now. In August, one of the girls was married. Layell attended the wedding.

?My sister should have been there,? Layell says. ?She should have been there.?

*Spence is editor of The Call, the newspaper of the United Methodist Church?s Holston Annual Conference. This story originally appeared in slightly different form in that publication.

News media contact: Tim Tanton, Nashville, Tenn., (615) 742-5470 or newsdesk@umcom.org.

Related Articles

Couple, Coalition Working to End Suicide in Region

Lenowisco Suicide Prevention Network on life-saving mission

Resources

Suicide (UMC.org theme page)

Suicide (Book of Discipline)

Suicide: A Challenge to Ministry

American Association of Suicidology

The American Foundation for Suicide Prevention

Holstons Outreach/Advocacy Team