Rural communities have a lot to learn when it comes to helping individuals who've lost loved ones to suicide.

The Minnesota Department of Agriculture and Minnesota Department of Health teamed up on Dec. 1 to present a suicide bereavement webinar to help describe what happens to people who are touched by the suicide of someone close to them. All people who live or work in agricultural communities were welcomed to attend.

“I’ve unfortunately known too many farmers who have taken their own life and talked with too many family members or friends who have lost loved ones to suicide,” said Thom Petersen, Minnesota's commissioner of agriculture. “Agriculture is a community, and we all need to know how to help and support people who lose someone they care about along the way.”

Meg Moynihan, senior adviser on strategy and innovation for the MDA, said there were audience members from several states across the country tuning into the webinar, as well as a number of international guests.

Moynihan also talked about the wide "range of people engaged in this kind of work" with agricultural communities, noting there were representatives from county, state and federal agencies on the call.

Dan Reidenberg, executive director of Suicide Awareness Voices of Education, presented the webinar. Moynihan called Reidenberg an "internationally known expert" on suicide prevention.

According to data from the National Alliance On Mental Illness, suicide is the second-leading cause of death in the U.S. among people ages 10-34. Reidenberg said the suicide crisis has hit rural areas particularly hard.

"In the United States and around the world, where it's more rural, we have more death by suicide," Reidenberg said. "That means we have a lot of work to do in those rural areas."

He said it's not limited to the issues around lack of access to care or lack of access to support networks. Farmers became among the most likely to die by suicide compared to other occupations, according to a study done this year by the Centers for Disease Control and Prevention.

"We need to find ways to stay connected to those people in rural communities, just as we are in other communities," he said. "So we can start turning the tide here."

Who are the survivors

Reidenberg gave some history on the "Father of Suicidology, " Edwin Shneidman, who coined the term postvention, which has to do with the process of grief and bereavement. Shneidman referred to survivors of suicide as the "largest mental health casualty area related to suicide," explained Reidenberg.

He said when there is a death by suicide, without intervention or support services, there are serious ripple effects among the people who were close to that person.

"We know that taking of care of people that have been impacted and affected by suicide makes a difference as to whether or not other mental health issues come about, and whether or not other suicides occur," Reidenberg said. "That is the history behind this."

Anyone affected by a suicide is a suicide survivor, he said.

He said for every suicide, 147 people are exposed, and six of those people will experience a major life disruption. He said those people can be found "working in banks, working at co-ops, working in feed mills, at gas stations, lending associations" and more.

"Suicide survivors are all of us and are everywhere," he said.

Suicide survivors face levels of shame, rejection and stigma, said Reidenberg, and feel the "need for really hiding and covering up."

Reidenberg gave an example in rural communities: When there's a barn fire, the community rushes into support the family, save the farm and everything else that's there. But, he said, when there's a death by suicide, "not everybody rushes in."

"People don't know if they should actually go and support them or not," he said. "They are very conflicted about it, and as time goes on they are not sure if they should bring it up again."

Whereas in other types of grief, Reidenberg said someone might bring up an anniversary of a death.

"People don't know the same kinds of rules or guidelines socially around suicide loss," Reidenberg said. "This is magnified in the rural communities, where there is a greater sense of shame and stigma around suicide."

Whether you live in a big city or on a farm, death by suicide of a loved one hurts, he said. But it might hurt more on a farm, where people are often isolated. The sense of blame and guilt can weigh more heavily in rural communities, he said.

"If you live in a city with a million or half a million people, there are places you can go to get away from it for now or two hours," Reidenberg said. "But in a rural community you can't get away, and you're not anonymous, whether you're going to church or the local co-op or going to the bank, everybody knows you and they all know what happened."

Reidenberg gave eight tips to help suicide survivors.

• Give people permission to grieve. Suicide grief may take a lot longer than other kinds of grief, said Reidenberg, and years two and three after a suicide may be the hardest of all for survivors.
• Don't make harmful statements. Sometimes statements get made to suicide survivors that can be incredibly hurtful, said Reidenberg. For example, saying something like, "You're still young, you can have more kids" is very painful for survivors to hear. The same goes for suicide survivor spouses, and saying something like "You can always get remarried" can be harmful to them while grieving.

"It may be true — that they can do that — but losing a child makes it very very hard to hear statements like that," he said.
Instead, make statements like "I'm sorry for your loss," "I'm hurting for you," and ask how you can help.

• Know the facts about suicide and the science behind it. We know that mental health issues are connected to suicide, and that people doing well with their life don't die by suicide, said Reidenberg. Watch for signs, and know some signs can mean that someone is thinking about suicide.
• Be OK with the complex grieving processes. "(Suicide survivors) grieve hard, they grieve during holidays and at different times and in different ways, so allow them that," Reidenberg said.
• Listen, be there. Just sitting in the same room with a person who is grieving can mean the world. "The best way to help someone who is hurting is to just be there," he said.
• Don't judge, don't blame. Try to help suicide survivors understand it wasn't their fault. Help them understand that "if the person's brain was working properly at the time, they wouldn't have done this," said Reidenberg.
• Know about community supports, groups and therapists.
• Help them (and you) be OK with you not knowing why.

Resources

MN Farm Suicide Survivors Support Group

An online group providing support to Minnesota farmers and farm families who have lost a loved one to suicide will be held the third Monday of each month from 8-9:30 p.m. For more information contact: Monica McConkey at monicamariekm@yahoo.com or 218-280-7785. Register here .

To learn MDH's guidelines for safe messaging around suicide, visit here .

A recording of the 90-minute webinar will be replayed on Dec. 14 at 3 p.m. for people who weren't able to attend the live event, in which you can register h ere .

If you or a loved one are having thoughts of suicide, there is help available. Please contact the National Suicide Prevention Lifeline at 1-800-273-8255 or text your state’s two letter abbreviation (like “MN” or “KS”) to 741741.