Mathew Kayser was a smart kid who loved singing and playing the guitar and piano with family and friends. He was kind, loving and funny. A great soccer player for the Cloquet boys team. He liked to make people laugh.
He was also bright enough to get into medical school at Penn State, where he died by suicide just a week after his "white coat" ceremony 14 months ago. Matt was 23.
Cody Bauer loved to help people. He liked to sit and talk with them, listen to them and learn from them, particularly if they were his elders. He struggled to fit in with kids his own age. His mom, Cassie Diver, joked that he was "an old man in a kid's body." He liked to build and fix things.
Cody was a wildland firefighter and loved traveling across the country, seeing new places, fighting fires.
Cody died by suicide in January. He was 21.
Theirs are only two of the 79 names that Carlton County Public Health Educator Meghann Levitt read at this month's Suicide Awareness Walk.
There is no one face of suicide. There are many.
"Too many," Cloquet resident Chad Mackey said.
Suicide touches everyone: young, old and in between. Veterans. Teenagers and young adults. Women. Grandparents. Parents. Middle-aged males, whose numbers keep rising in Minnesota, from 381 in 2011 to 392 in 2015. Native Americans, who die by suicide at a rate of 20.4 per 100,000 people versus 13.2 for white people. Rich people. Poor people. Famous people. Successful people. Addicts.
As of September, nine people in Carlton County had died by suicide in 2017. Scores more had attempted suicide, but lived to hopefully realize things can get better.
So what can people do to help prevent suicide?
Look out for changes in sleep, routine, mood, activity level. Listen to what they're saying. Are they talking about wanting to die, feeling hopeless, trapped or a burden to others? Are they sleeping too little or too much, or acting anxious, agitated or recklessly? Concussions can also increase risk for suicide and depression, especially repeated concussions.
Although there are certainly clear warning signs of suicide, Levitt stressed that the symptoms or signs can be as unique as the people considering suicide.
"You can have this perfect list of warnings and symptoms, things 'experts' say, but suicide is personal," said Levitt, who sits on the the county's suicide awareness task force and spearheaded the highly successful TXT4Life program. She suggests taking it from the universal to a personal level.
"You have to think: What's going on in that person's life, have they gone through some kind of major event? And is their reaction normal for them and is it healthy?
"People can react so differently," Levitt said.
Not everyone will start talking about wanting to die, or give away their most treasured possessions. Instead, the kid who's normally a straight-A student might be skipping classes. Or the boy who loves football isn't going out for the team, and oh, yes, didn't his parents get divorced this summer?
Ask the obvious question
If you suspect someone is considering suicide, the best thing to do is ask them: "Are you thinking about suicide?"
"There's been this historic stigma that if you ask, they will do it (kill themselves)," Levitt said. "We now know from research that talking about it and asking straight up can actually open up the conversation with somebody. If they say, 'No, I'm not thinking about suicide,' then they're not thinking about it. It's not going to do any harm. But if they're struggling, they will know you're someone it's OK to talk about it with."
Levitt says to put yourself in that person's shoes. Consider how difficult it would be for them to just come up to a friend or family member and say, 'I'm hurting so bad inside that I'm thinking about suicide.'
"It's so much easier just to be asked that question, 'Hey, are you thinking about suicide?' and be able to say 'yes' and have someone understand you could be in that much pain," she said.
And, she noted, not only do people feel more comfortable opening up after they're asked that vital and difficult, awkward question, but ideally talking about the situation will ultimately lead them to get the help they need.
Human Development Center (HDC) psychologist Caroline Phelps stressed that families must be willing to talk openly and freely about feelings and mental health issues, regarding each other, and in their own family history. Families that are very open about talking about feelings and problem solving, that are willing to listen and to talk, are sending a message that "you don't have to keep secrets, that there is nothing you can say that will disappoint me or upset me."
"That's really step 1," she said. "Actually, what I'm suggesting is the radical notion that we don't wait for a problem to emerge. People talk all the time about Aunt Betty's diabetes. We need to be talking about mental health problems that family members have just as easily."
Having suicidal thoughts doesn't always mean a person is mentally ill, either.
Phelps said they often have more to do with the feeling of being trapped in an untenable situation.
"What we want to do is show that person they're not trapped," she said. "If you remove that feeling of being trapped, you take away the suicidal thinking. Nobody likes the feeling of being trapped. That's a desperate place to be."
Phelps said it's important to know that many people have suicidal or morbid - the kind where you simply wish you were dead, versus the kind where you have a detailed plan - thoughts at some point in their lifetime. But of those who have such thoughts, few attempt suicide and even fewer actually die by suicide.
"People should understand those thoughts tend to be transient, meaning they will go away and you will feel differently," Phelps said. "People's perspective in that dark place is so different than when they are out of that dark place."
Of course, such thoughts should be taken seriously, she stressed. The friend or family member should engage, ask the person the nature of the thoughts they're having," and they should validate that person's feelings, acknowledge their despair, and let them know they want to help them.
Making sure they're in safe surroundings is important, she said, and simply being there for them.
"From the time a person first thinks of suicide, if we can give them time and space, even five to 20 minutes, they are less likely to kill themselves," she said.
Time to sober up also helps as suicidal thoughts or impulses are sometimes accompanied by chemical use.
"Suicide is often an impulsive act," Phelps said. "And what alcohol does is decrease a person's inhibition and increase their despair and depression. That's a nasty combination."
For some, substance abuse is a way they self-medicate for ongoing mental health issues. For others, it might be a one-time thing that wasn't a good choice for their frame of mind. Lose job. Get drunk. Panic about the future. Impulsively pick up a weapon.
Gone are the days that a therapist wouldn't help someone with suicidal thoughts until they got sober, Phelps said. They'd rather treat the person and aim to get them to a more stable point where they can also tackle their addiction, she said.
Although he was a fairly happy high school student, Mathew Kayser struggled with depression the last year or two of his life.
Cody, too, started slipping away, his mom wrote in an essay about her oldest son. He was working a job he loved, but he was miserable with the people he worked with, so he quit. He took a job indoors, and it didn't help the depression he was feeling. He wasn't eating or sleeping like he should.
Mathew's mom described his depression as a sickness in his brain, one that wouldn't allow him to love himself. Her sister - his aunt - described it as being like a thick glass wall between Mathew and the many people who loved him. They tried to get in and he tried to get out, but the glass was too thick.
Phelps said one symptom of depression is the inability to see one's worth, the good in life.
"Instead of rose-colored glasses, you have gray glasses," she said. "You can't see the good in the universe, and you particularly can't see the good in yourself. People's perceptions can become very skewed."
Although Mathew sought treatment, he didn't feel he was connecting with the therapist, so he quit going. Always the thinker, he tried to solve his problems on his own.
Stigma about mental illness is also part of the problem. Marie Kayser thinks that's part of what kept Mathew from breaking through that thick wall.
"Fear of being labeled, fear of not feeling 'fixable,' and fear of losing opportunities and dreams, because of the stigma put on a mental illness," she said. "My hope is that society is able to see that something needs to change."
If someone is not comfortable talking about their thoughts or feelings, then they can access TXT4Life by texting the word "LIFE" to 61222 and start a conversation via text, something many young people in today's world find easier.
The phone number for the National Suicide Prevention Lifeline at 800-273-TALK (8255).
The Birch Tree Center operates a mobile crisis line at 844-772-4724. There is a mobile crisis team available to serve anyone in Carlton County who is in crisis. They can meet people at home, or even at a coffee shop, if needed.
HDC always keeps at least one crisis appointment open every day, so call 218-879-4559 for the Cloquet office.
Even calling 911 is fine.
Don't worry about getting an appointment with a counselor if a friend or family member is suicidal or in crisis, Phelps said. They will be able to jump to the front of the hypothetical queue.
"We don't just say, 'That's nice, thank you very much. See you in six weeks,'" she said. "What happens after that call is based on what the individual's situation may be."