The American Association of Suicidology (AAS) ranks suicide as the 10th leading cause of death in the US.  Suicide ranks as the 2nd leading cause of death for 15-34-year-olds (2018).  Notable rate increases from 2017: 16% increase from 2017 for 10-14 year olds and a 6.3% increase from 2017 for 55-64 year olds.

Important statistics from 2018:

  • 1.2 million suicide attempts
  • One attempt every 26 seconds
  • 25 Attempts for every death by suicide for nation
  • A recent (Cerel, 2019) research-based estimate suggests that for each death by suicide, 135 people are exposed or affected by it.
  • As many as 40-50% of the population have been exposed to suicide in their lifetime (Feigelman, et al., 2017).
  • The number of survivors of suicide loss in the U.S. is more than 5.4 million (1 of every 61 Americans in 2018).

Counseling Associates of the Four States understands that these statistics are difficult to digest. The pain of losing a loved one by suicide is excruciating.   We believe  that suicide is the result of a loss of hope. As a mental health provider, we know that the despair that many feel is temporary and if they can find hope,  they can rise out of that place of deep despair.  Often, the person does not want to die, they just want the pain to stop.  We are here to help anyone who is struggling with or knows someone who is struggling with this deep despair and needs hope that the pain can stop. 

If you, or someone you know are struggling with suicidal thoughts, please reach out to a mental health professional.  It is a myth that talking about suicide to someone will put that idea in their head.  Do not hesitate to be direct.  Discussing suicide in an open and caring way without judgement can give the person the first opportunity they have had to reach out for help.  Ask honest and compassionate questions, such as:

  • “I’ve noticed that you haven’t been yourself lately, is everything ok with you?”
  • “I’m worried about you. I’m wondering if we can talk about what’s troubling you?”
  • “You’ve seemed really (down/sad/angry/unhappy) lately. I’m worried that you might be thinking of hurting yourself or suicide. Can we talk about this?”

Don’t try to deal with this alone.  Encourage the person to get professional help while you support them through this process.  If they don’t agree to seek professional help and you feel the immediate risk is high, you may need to contact emergency services on their behalf regardless of their wishes. 

Please note that Counseling Associates of the Four States, LLC does not provide emergency services at our clinic.  If you or a loved one is acutely suicidal, please go to your nearest emergency department or call 911.  Our office phone is answered Monday-Friday from 8:00 am-5:00 pm by administrative staff and not licensed professionals.  Your counselor may not be available during those hours for emergency calls, as our  providers are often in session and not available during all CAFS business hours. 

***Our social media pages are not monitored by licensed professionals or during non-business hours, so do not utilize these sources during an emergency.

Warning Signs of Acute Suicide Risk (per AAS website)

The following are not always communicated directly or outwardly:

  • Threatening to hurt or kill him or herself, or talking of wanting to hurt or kill him/herself; and or,
  • Looking for ways to kill him/herself by seeking access to firearms, available pills, or other means; and/or,
  • Talking or writing about death, dying or suicide, when these actions are out of the ordinary.
  • Increased substance (alcohol or drug) use
  • No reason for living; no sense of purpose in life
  • Anxiety, agitation, unable to sleep or sleeping all of the time
  • Feeling trapped – like there’s no way out
  • Hopelessness
  • Withdrawal from friends, family and society
  • Rage, uncontrolled anger, seeking revenge
  • Acting reckless or engaging in risky activities, seemingly without thinking
  • Dramatic mood changes
  • Giving away prized possessions or seeking long-term care for pets

Crisis Resources

Local Crisis Services – Ozark Center Joplin, MO

Call 417.347.7720 or 800.247.0661 to speak to a mental health professional.

Ozark Center Crisis Intervention Services offers 24/7 support to people of all ages and backgrounds who are experiencing a personal, emotional or mental health crisis. Individuals can receive private, caring assessments and evaluations through:

  • Brief phone consultation or counseling
  • Messaging service
  • Face-to-face intervention

Translation and TTY/TDD services are available.
For messaging service, text REGISTER to 720-7-TXTOZK (720.789.8695).
Ozark Center Crisis Services include:

  • 24-hour help line, brief phone counseling, education, information and referrals
  • 24-hour messaging service available via text message or web interface
  • Face-to-face mobile response team assessment and evaluation

When you call the crisis services help line, you will always speak with a trained, compassionate and nonjudgmental mental health professional. Ozark Center crisis counselors strive to help you gain immediate emotional relief, discover new life skills and develop solutions.

National Crisis Resources

National Suicide Prevention Lifeline 1-800-273-TALK  (8255)
For online support:
Crisis Text Line (Text Home to 741 741);
The Trevor Project 1-866-488-7386 or
Trans Lifeline 877-565-8860 or

Resources for friends and families

The National Suicide Prevention Lifeline (NSPL)
            1-800-273-TALK (8255)
            24-hour confidential crisis hotline

Statewide Office of Suicide Prevention (SOSP)
            Resources and information

Suicide Prevention Resource Center (SPRC)
            Resources and information

American Association of Suicidology (AAS)
            National non-profit dedicated to the understanding and prevention of suicide

Suicide Prevention Action Network USA (SPAN USA)
            National non-profit that works to increase awareness regarding the toll of suicide on our nation and to
develop political will to ensure that the government effectively addresses suicide.

American Foundation for Suicide Prevention (AFSP)
            Dedicated to advancing out knowledge of suicide and our ability to prevent it.

Suicide Awareness Voices of Education (SAVE)
            Dedicated to educating about suicide and speaking for suicide survivors.

National Strategy for Suicide Prevention (NSPP), 2001
            Our nation’s blueprint for suicide prevention, which was developed through the combined work of advocates, clinicians, researchers, and survivors.


Symptoms of Grief:

Grief symptoms can present as physical, social, and spiritual issues.  Below are some of the most common symptoms associated with grief:

  • Crying
  • Headaches
  • Difficulty Sleeping
  • Questioning the Purpose of Life
  • Questioning Your Spiritual Beliefs (e.g., your belief in God)
  • Feelings of Detachment
  • Isolation from Friends and Family
  • Abnormal Behavior
  • Worry
  • Anxiety
  • Frustration
  • Guilt
  • Fatigue
  • Anger
  • Loss of Appetite
  • Aches and Pains
  • Stress

Treatment of Grief:

There is no right or wrong way to grieve and it is a very personal process.  There is also no specific amount of time that is the “correct” amount to fully grieve a loss.  Losses can come in many forms, such as the death of a loved one or friend, loss of a job/career, end of a relationship/marriage, physical impairment or chronic illness, or financial.  During the recent pandemic, grief losses have also come in the form of loss of independence, security, and “normal life.”  Many individuals have been confined to their homes due to quarantines, furloughed from their jobs suffering loss of income, became home-school teachers for their children, and lost all physical connection to friends and family.  Even social distancing does not provide us the connection we need, as we can’t shake hands, hug one another, or even give a high five.

Counseling in the form of individual, support groups, or bereavement groups can help people work through the grief process. It is a journey and not a destination that can help you work through unresolved grief.  Grief can impact everyday life and counseling will help you deal with grief in an effective way.  However, counseling will not cure your grief or loss, but provide support and coping strategies to help you deal with it most effectively. 

Helpful Websites for Grieving

We value community service and acknowledge that everyone needs different levels of help. Here is a list of grief resources to assist you on your journey:

  1. Undoing isolation for young adults grieving the illness or death of someone close to COVID-19. COVID Grief Network:
  2. Grief support for suicide loss survivors:
  3. You don’t have to grieve alone. What’s Your Grief is a place for sharing, support, resources, & more.
  4. Helping you cope with life after loss using meditation for grief, yoga and journaling. 
  5. Refuge in Grief.  “It’s OK to not be OK. If your life has exploded into a million little bits, you don’t need platitudes. You don’t need cheerleading. You don’t need to be told this all happened for a reason. Some things cannot be fixed. They can only be carried. “
  6. David Kessler who worked alongside Kubler-Ross and her stages of grieving offers help and hope and a new stage of grief, Finding Meaning.
  7. This site aims to offer hope, comfort and support for survivors of suicide loss.
  8. The Tragedy Assistance Program for Survivors offers compassionate care to all those grieving the loss a military loved on.
  9. Will CarryOn is about sharing miscarriage, stillbirth and loss resources, and about sharing hope.
  10. The National Organization of Parents Of Murdered Children makes the difference through on-going emotional support, education, prevention, advocacy, and awareness.