Nevada had one of the highest suicide rates in the country, and that was before the pandemic.
In 2018, the last year for which statistics are available, 657 Nevadans killed themselves. Of that number, nearly 75 percent were male and a majority used a gun to take their lives, according to the Centers for Disease Control and Prevention figures.
Despite those grim statistics, Rick Egan, the state suicide prevention training coordinator, told KNPR's State of Nevada that Nevada is the only state that has seen a downward trend in the number of suicides.
He said over the last decade and a half the state has made a concerted effort to educate people about suicide and how to prevent it.
Now, as National Suicide Prevention Week is marked, the state and the rest of the country are also grappling with COVID-19. The pandemic has sickened or killed thousands, decimated the economy, and left many isolated and afraid.
Egan said mental health professionals and others are predicting a spike in the number of suicides and Nevada could be at the top of that list.
"We probably will based on the fact that the Great Depression had a suicide spike, the Great Recession, the fires in California and after Hurricane Katrina. These major incidences had suicide spikes after them,” he said.
Last week, researchers from Boston University reported that a national survey found the rate of depression has tripled among U.S. adults.
“Persons who were already at risk before COVID-19, with fewer social and economic resources, were more likely to report probable depression,” one of the researchers said.
With those concerns on the horizon, Egan said now is the time for people to reach out.
“What we need to do now is build connectedness. We need to reach out to five of our friends, five of our family members and check in on them and ask the hard questions,” he said.
Those tough questions can include: 'How are you doing?' 'How can we help you find resources?' 'Are things okay?'
Egan said often times just allowing someone to talk openly will help them work through those fears and anxieties and then help them connect to the appropriate resources.
The pandemic is increasing people's isolation along with a strain on finances, he said.
"Those two things, relationship issues and financial, are usually the number one and number two things that might be going on in somebody's life that get them to that point that they think that that's an option," he said.
Egan said that is why it is important for family, friends and community members to understand what might be going on.
Sydney Smith is a therapist with a practice in Las Vegas. She said she is definitely seeing more patients with concerns stemming from the pandemic.
"In my experience, it's been a lot of fear-based, fear of the unknown, fear of the uncertainty," she said, "So much has happened in such a short amount of time."
Smith said clients have been affected by job loss, which can mean loss of health insurance. She has also had clients who have been impacted by the loss of a loved one from the virus.
But she said therapy can help, and many practices, including hers, are offering a sliding scale for those who don't have enough insurance coverage or money to pay for services.
The important thing is to seek out the help you need.
"We're not designed as humans to feel like it's okay to ask people for help," she said, "We feel like we can do it all on our own."
Therapists will help people walk through whatever struggles they may be facing.
Chantal Corcoran learned how important it was to connect to a good mental health professional when her then-16-year-old son threatened suicide.
He is doing well now, but she admits it was a struggle for many years.
"We had a lot of help," she said, "We had a lot of good professional help and I think that is really, really important."
Corcoran explained that her son needed medication, but she was reluctant to put him on medication something she learned was a mistake. Beyond that, through individual therapy sessions and group sessions, they learned to listen and communicate better.
"We learned to listen to him and take him very seriously but at the same time to let him have agency," she said, "To let him know that we couldn't fix it, he had to learn that he had to fix it."
Some of that came in the form of healing from bullying in his past.
A Las Vegas father who knows just how serious the scars from bullying can be is Jason Lamberth. His daughter Hailee died from suicide two days after her 13 birthday, which was in 2013.
Since then, Lamberth has worked to change some of the systems with schools to better deal with bullying. He helped pass Hailee's Law in Nevada, which lays out a number of steps schools must do in bullying cases.
Lamberth did not know his daughter was a victim of bullying. Now, under the law he helped pass, schools must inform parents the same day that a bullying report is filed.
They must also launch an investigation that must be complete in three days.
There is also now an avenue for parents to take if they don't feel a school is taking bullying seriously enough.
The law came about the same time that SafeVoice was launched. It allows students to anonymously report someone who is threatening suicide, talking about harming themselves or bringing a weapon to school.
Lamberth said he had no idea that his daughter was struggling but now they know some of the warning signs that parents should look for.
"Some of the signs that they say to look for can be a loss of appetite in your child, sleeping more, sleeping less than they typically do, withdraw - not showing interest in activities or events like they used to, not socializing with their friends as frequently as they used to, just general lethargy," Lamberth said.
He said it is vital for parents to open and keep open the lines of communication even if the topics are difficult to talk about.
"You just have to have honest conversations with your children," he said, "Don't be afraid to have an honest conversation about a topic that might seem taboo or have a stigma attached to it."
It is that stigma that many mental health professionals say keeps people of all ages from seeking help.
Frank Hawk is the regional vice president of the United Brotherhood of Carpenters and his son took his own life three years ago.
Since then, he has strived to break down the taboos surrounding mental health, depression and anxiety, especially among construction workers. Construction workers have one of the highest rates of suicide of any industry.
"Construction is a tough industry," Hawk said, "You work hard. You beat up your body. You experience layoffs."
He said it is not unusual for workers to work at several different companies in a year. A project ends and they're out of work again. That is a lot of stress.
In addition, they often go to work in pain, Hawk said, because if they don't, they know someone else will take that job.
"I think it puts a lot of stress on people, and plus, there is this stigma in this trade that we don't talk about things that may be going on inside the head," he said, "It's not cool to cry. I think you get this bottled, pent up energy, and then also with the ups and downs of the industry, it can make it tough on an individual that may already be struggling."
Hawk started a committee that is working with unions throughout the Southwest and employers to get ahead of the problem. They're handing out cards with information on mental health services at job sites and talking about it during safety meetings.
Hawk notes that his union and other construction unions have worked diligently to make workplaces safer with all kinds of required equipment from hardhats to safety harnesses -- but they have yet to really address suicide prevention.
"In the construction industry, suicide has taken more lives than all the other fatalities combined," he said.
National Suicide Prevention Lifeline
Counseling Services – University of Nevada, Reno
Counseling Center – Truckee Meadows Community College, Reno
Student Wellness Center – University of Nevada, Las Vegas
Mobile Crisis Response Team - Hotline: South: 702-486-7865 or North: 775-688-1670
Crisis Call Center - Text Line - Text - "Listen" to 839863
De Prevencion del Suicido - 1-888-628-9454
Rick Egan, state suicide prevention expert; Frank Hawk, regional vice president, United Brotherhood of Carpenters; Jason Lamberth, Southern Nevada regional director, International Union of Painters and Allied Trades; Sydney Smith, therapist