Welsh sisters share their family's experience in observance of Suicide Prevention Month

Twin sisters Dacia Sommer and Danielle Howe of Waukon hold the plaque commemorating the Andy Welsh Memorial Annual Texas Hold’em Tournament, which is held Thanksgiving weekend each year in honor of their brother, Andy Welsh of Lansing. In honor of the month of September being observed as National Suicide Prevention Month, the sisters are sharing their family's personal experience in an effort to help others who may be impacted in some way by suicide. Photo by Lissa Blake.

by Lissa Blake

“Suicide is a permanent solution to temporary problems.”
That quote from Robin Williams has gone viral since the beloved actor and comedian took his own life early last month.
Dacia Sommer of Waukon said the news of Williams’ death hit her "like a ton of bricks," as it brought back memories of her own brother’s untimely death just five years ago.
“I cried for about four days,” said Sommer. “Robin Williams was the Hollywood version of Andy’s situation. He liked to entertain and he hid it well.”
In honor of September being observed as Suicide Prevention Month, Sommer and her twin sister, Danielle Howe of Waukon, recently reached out to share their story with the public.
“Suicide is way more common than people realize. Talking about it used to be so taboo. We need to be open about it, because the more you bury it, the worse it’s going to get,” said Howe.

Andy Welsh, a 1994 graduate of Kee High School in Lansing, passed away November 24, 2009 at the age of just 33 years old.
According to his sisters, like Williams, he was the life of the party. “He would do anything and everything for a laugh,” said Sommer.
But be that as it may, the sisters said there were signs before his death that something was a little "off". “It was three weeks before he died and he didn’t show up for work one day at our dad’s store in Lansing,” said Sommer.
Sommer, who teaches at St. Patrick School in Waukon, received a call from her sister, Dana Welsh, asking if she had seen Andy. “I could hear the panic in her voice,” remembered Sommer.
The sisters grew even more concerned when they learned of his most recent post on Facebook, which said, “See you on the flipside. Peace. I’m out.”
The family immediately contacted local law enforcement, who put out a statewide APB (all points bulletin) for Andy, which instructed law enforcement to pull him over for a wellness check.
After spending the day searching and worrying, the family located Andy, who had been driving around all day.
“We were totally blindsided. Before this, there was nothing. No indication. We never saw this coming at all,” said Howe.
Later that day, Sommer and Howe had the opportunity to visit with their brother and ask him what was wrong.
“On the ride to his house in Lansing, he admitted he hadn’t been feeling himself, but he didn’t know why. He said he had even stopped at an area hospital in a neighboring county and told them how he was feeling and they prescribed an antidepressant and scheduled a follow-up for four weeks later,” said Sommer.
Sommer said she and Howe told Andy at the time that those pills usually take at least a month to take effect.
“And three weeks later he was gone,” said Sommer.

Hindsight is 20/20, and Sommer now wishes she would have been more proactive in getting Andy the help he obviously needed.
“We just had no idea how serious it was, and just a few days before he died, I asked him how he was doing. He looked me dead in the eye and smiled and said he was fine. He was so convincing. And just a few days later he was gone,” she said.

Later that week, Sommer received a phone call from her sister, Dana, that she will never forget.
“She called and said I needed to go to Lansing,” said Sommer. “I remember thinking, ‘It’s okay. It’s going to be okay.’ I’m the type of person who always thinks everything is going to be okay.”
But Sommer quickly learned things were not okay, as Dana explained that Andy was gone.
“He hadn’t shown up for work, so our brother had asked Dana to go check on Andy, and she had found him… There was no note. Nothing. He had just bought groceries. He had just bought a brand new pair of shoes. He obviously wasn’t planning it. I think it was probably one of those things where he regretted it the second he did it and it’s something you can’t take back,” said Sommer.

Howe said her family is still so grateful for the community support they received following Andy’s death. “We have a huge support system, but the community was amazing. There are no words to describe how much that carried us through,” she said.
Once the initial shock wore off, the sisters decided they would pay it forward and do something to try to help others. They connected with the American Foundation for Suicide Prevention (www.afsp.org) and have participated in a number of “Out of the Darkness” walks, which raise money for suicide education.
“I think the most important thing anyone can do is educate themselves to recognize the signs of any mental illness, whether depression, bipolar disorder or schizophrenia,” said Howe.
“People say it’s a selfish act. It’s a disease. We don’t condemn people who have cancer. Why would we condemn someone who has a mental illness?” said Sommer.
Howe added mental illness is way more common than people realize and society’s approach to dealing with it needs to change. “There is a stigma that comes with a mental illness diagnosis and that alone prevents people from wanting to find the help they need. It’s scary and it’s not easy. People need to feel like it’s okay to ask for help,” said Howe.
Sommer added even though she has always told herself it’s not her fault, she and her family live with the regret they didn’t pursue Andy harder.
“We will never know why, but maybe we can help someone else before they have to go through this,” added Howe.
To remember Andy, the Welsh family has also started the Andy Welsh Memorial Annual Texas Hold’em Tournament that is held each Saturday after the Thanksgiving holiday. Money from the tournament is awarded as a college scholarship to a Kee High School graduating senior.

Andy Welsh was the son of Betty and Lloyd Welsh of Lansing. He also left behind 13 siblings: Dacia Sommer, Danielle Howe, Debbie Welsh of Lansing, Diane Ruth of Plainfield, Denise Pavlovec of Urbana, Jayme Welsh of Champlain, MN, Dawn Kuster of Bunceton, MO, Rick Welsh of Lansing, Danette Jones of Waukon, Dana Welsh of Lansing, Deanna Gerholdt of Plainfield, Lance Welsh of Lansing and Destiny Welsh of West Des Moines.

There are a number of area resources that can help families and persons concerned with mental illness. These include the Survivors of Suicide Support Group at the Franciscan Spirituality Center  in La Crosse, WI, which can be reached by phone at 608-633-3135, and the Northeast Iowa Behavioral Health crisis line, which can be contacted at 800-400-8923.
The American Foundation for Suicide Prevention also has many ways to help. Visit afsp.org or call 800-273-TALK(8255) to seek help for oneself or for a friend or family member.

Protective Factors for Suicide
According to the American Foundation for Suicide Prevention, protective factors for suicide are characteristics or conditions that may help to decrease a person’s suicide risk. While these factors do not eliminate the possibility of suicide, especially in someone with risk factors, they may help to reduce that risk. Protective factors for suicide have not been studied as thoroughly as risk factors, so less is known about them.
Protective factors for suicide include:
• Receiving effective mental health care.
• Positive connections to family, peers, community and social institutions such as marriage and religion that foster resilience.
• The skills and ability to solve problems.
Protective factors may reduce suicide risk by helping people cope with negative life events, even when those events continue over a period of time. The ability to cope or solve problems reduces the chance that a person will become overwhelmed, depressed or anxious. Protective factors do not entirely remove risk, however, especially when there is a personal or family history of depression or other mental disorders.

What To Do When You Suspect Someone May Be at Risk for Suicide
The American Foundation for Suicide Prevention recommends the following actions when an individual suspects a friend or relative may be at risk for suicide:
Take it Seriously
- 50% to 75% of all people who attempt suicide tell someone about their intention.
- If someone you know shows warning signs, the time to act is now.

Ask Questions
- Begin by telling the suicidal person you are concerned about them.
- Tell them specifically what they have said or done that makes you feel concerned about suicide.
- Don't be afraid to ask whether the person is considering suicide, and whether they have a particular plan or method in mind. These questions will not push them toward suicide if they were not considering it.
- Ask if they are seeing a clinician or are taking medication so the treating person can be contacted.
- Do not try to argue someone out of suicide. Instead, let them know that you care, that they are not alone and that they can get help. Avoid pleading and preaching to them with statements such as, “You have so much to live for,” or “Your suicide will hurt your family.”

Encourage Professional Help
- Actively encourage the person to see a physician or mental health professional immediately.
- People considering suicide often believe they cannot be helped. If you can, assist them to identify a professional and schedule an appointment. If they will let you, go to the appointment with them.

Take Action
- If the person is threatening, talking about, or making specific plans for suicide, this is a crisis requiring immediate attention. Do not leave the person alone.
- Remove any firearms, drugs or sharp objects that could be used for suicide.
- Take the person to a walk-in clinic at a psychiatric hospital or hospital emergency room.
- If these options are not available, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for assistance.

Follow-Up on Treatment
- Still skeptical that they can be helped, the suicidal person may need your support to continue with treatment after the first session.
- If medication is prescribed, support the person to take it exactly as prescribed. Be aware of possible side effects, and notify the person who prescribed the medicine if the suicidal person seems to be getting worse, or resists taking the medicine. The doctor can often adjust the medications or dosage to work better for them.
- Help the person understand that it may take time and persistence to find the right medication and the right therapist. Offer your encouragement and support throughout the process, until the suicidal crisis has passed.

Warning Signs for Suicide

In contrast to longer term risk and protective factors, warning signs are indicators of more acute suicide risk, according to the American Foundation for Suicide Prevention.
Thinking about heart disease helps to make this clear. Risk factors for heart disease include smoking, obesity and high cholesterol. Having these factors does not mean that someone is having a heart attack right now, but rather that there is an increased chance that they will have heart attack at some time. Warning signs of a heart attack are chest pain, shortness of breath and nausea. These signs mean that the person may be having a heart attack right now and needs immediate help.
As with heart attacks, people who die by suicide usually show some indication of immediate risk before their deaths. Recognizing the warning signs for suicide can help a person intervene to save a life. A person who is thinking about suicide may say so directly: “I’m going to kill myself.” More commonly, they may say something more indirect: “I just want the pain to end,” or “I can’t see any way out.”
Most of the time, people who kill themselves show one or more of these warning signs before they take action:
• Talking about wanting to kill themselves, or saying they wish they were dead.
• Looking for a way to kill themselves, such as hoarding medicine or buying a gun.
• Talking about a specific suicide plan.
• Feeling hopeless or having no reason to live.
• Feeling trapped, desperate, or needing to escape from an intolerable situation.
• Having the feeling of being a burden to others.
• Feeling humiliated.
• Increasing the use of alcohol or drugs.
• Having intense anxiety and/or panic attacks.
• Losing interest in things, or losing the ability to experience pleasure.
• Insomnia.
• Becoming socially isolated and withdrawn from friends, family and others.
• Acting irritable or agitated.
• Showing rage, or talking about seeking revenge for being victimized or rejected, whether or not the situations the person describes seem real.

Individuals who show such behaviors should be evaluated for possible suicide risk by a medical doctor or mental health professional.

Risk Factors for Suicide
According to the American Foundation for Suicide Prevention, risk factors for suicide are characteristics or conditions that increase the chance that a person may try to take his or her life. Suicide risk tends to be highest when someone has several risk factors at the same time.

Most Frequently Cited Risk Factors for Suicide
• Mental disorders, in particular:
    - Depression or bipolar (manic-depressive) disorder.
    - Alcohol or substance abuse or dependence.
    - Schizophrenia.
    - Borderline or antisocial personality disorder.
    - Conduct disorder (in youth).
    - Psychotic disorders; psychotic symptoms in the context of any disorder.
    - Anxiety disorders.
• Impulsivity and aggression, especially in the context of the above mental disorders.
• Previous suicide attempt.
• Family history of attempted or completed suicide.
• Serious medical condition and/or pain.

It is important to bear in mind that the large majority of people with mental disorders or other suicide risk factors do not engage in suicidal behavior.

Environmental Factors That Increase Suicide Risk
Some people who have one or more of the major risk factors above can become suicidal in the face of factors in their environment, such as:
• A highly stressful life event such as losing someone close, financial loss, or trouble with the law.
• Prolonged stress due to adversities such as unemployment, serious relationship conflict, harassment or bullying.
• Exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide (contagion).
• Access to lethal methods of suicide during a time of increased risk.

Again, though, it is important to remember that these factors do not usually increase suicide risk for people who are not already vulnerable because of a pre-existing mental disorder or other major risk factors. Exposure to extreme or prolonged environmental stress, however, can lead to depression, anxiety, and other disorders that, in turn, can increase risk for suicide.

Coping with a Suicide Loss

Find a Support Group
If you have lost a loved one to suicide, you may find it helpful to connect with others who have also experienced a suicide loss. It can be a relief to talk openly about suicide with people who share a similar experience. Groups provide a “safe place” where those who have been touched by suicide loss can share their thoughts and feelings, and offer one another support. Support groups can be found by visiting afsp.org or calling 800-273-TALK(8255).
• It is natural to feel unsure about going to your first support group meeting. It may take a few meetings before you feel comfortable.
• Some people attend a support group almost immediately after their loss, while others wait for years. Do what you feel is best for you.
• Some survivors attend regularly for a year or two, then continue to go only occasionally.
• If you attend a group and feel it’s not right for you, consider trying a different group. We all cope differently and draw strength from different various kinds of support.
• In addition to the Support Group Directory, there are Online Support Groups and Groups for Children and Teens that can be found by visiting afsp.org or calling 800-273-TALK(8255).

How to Find a Therapist
It is normal to reach out for help as you cope with a suicide loss. The following steps can help you to find a qualified mental health professional for individual counseling:
• Ask your doctor for a recommendation.
• Ask survivors at support groups if they have had a good experience with any local therapists.
• Use the mental health services locator of the U.S. Substance Abuse and Mental Health Services Administration.
• Contact the American Psychological Association and the National Association of Social Workers for a referral.
• Locate a grief counselor through a nearby hospice.
• For low-cost counseling options, visit Mental Health America.
• Search the Association for Death Education and Counseling’s directory of specialists.
• Visit the American Psychiatric Association's website to learn more about the field of psychiatry.
• Therapists have different styles and approaches. If the first therapist you see is not right for you after an appointment or two, consider meeting with another.

For Others Who Want To Help
Someone you know has lost someone to suicide and you want to help. But how? These simple suggestions from the American Foundation for Suicide Prevention are what people grieving a suicide have said helped them most.
• Reach out. Be there. Your very presence will be comforting and reassuring.
• Follow the lead of the person who is grieving. Some survivors of suicide loss find it helpful to talk about the details of the death, share pictures of their loved one, cry, or express their intense emotions. Others prefer not to.
• Listen with your full attention.
• Don't be afraid to ask about their loved one or to say their loved one's name. It hurts so much more when no one talks about the person they lost.
• Offer to help with specific tasks. Instead of saying, “I’m here if you need me” or “Tell me what I can do to help,” ask, “Can I help by…”
...picking your kids up from school; ...walking the dog; ...helping with the grocery shopping; ...helping with funeral arrangements; ...picking someone up at the airport; ...making phone calls; ...organizing your mail?
• Write down a story about their loved one, especially if you have a story they might not have heard. When you know they are ready, share it with them.
• Become more educated about what causes suicide.