"They're so caught up in the despair of where they're at, they're not able to feel hopeful or find anything to be hopeful about," Atwell said. "It's not so much that they really want to die. They're just caught up in the pain."
Both the CDC and Atwell say that more awareness is needed, and that mental-health programs and alcohol and substance treatment need to improve, both in quality and availability.
In her 10-plus years helping people who are thinking about suicide and families who are coping with loved ones who have killed themselves, Atwell said she personally knew three people who took their lives, including a 55-year-old Cincinnati elementary school teacher who jumped to her death in 2007 from the Jeremiah Morrow Bridge near Lebanon, the tallest bridge in Ohio at 239 feet.
Atwell had worked with the principal at Summerside Elementary School to help prevent suicides among her students.
"It was just devastating. She knew how to get help," Atwell said. "People feel so hopeless they don't see a way out, and that's where a lot of people who die by suicide are at. We have to catch them long before that, know the warning signs and the risk factors."
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