Roughly 1,100 college students in the U.S. die by suicide each year – about one or two on each campus the size of WSU.

Pete Martin, the coroner for Whitman County, said in an average year he sees one or two such deaths. That number is about half of what it was several years ago, Martin said, but it doesn’t include dozens of unsuccessful suicide attempts.

The Centers for Disease Control and Prevention reports that suicide was the 10th leading cause of death among Americans with 40,600 instances in 2012.

“The very large majority of people with depression are not at high risk for suicide,” said Bruce Wright, the executive director of WSU’s Counseling & Testing Services. “They may have thoughts or ideas about it, but thoughts and ideas are a long way from acting.”

According to the Suicide Prevention Resource Center (SPRC), the suicide rate among college students is about half that of non-students in the same age range. Students at a higher risk include those over 25 years old, graduate students, international students and LGBT students.

For many years, the rate of deaths by suicide has been about four times higher among men than among women.

“In general, if you’re concerned about a person – whether you’re a friend or you’re a doctor or a therapist or whatever – people respond positively overall to being asked about it,” he said, “because it’s a positive gesture of concern.”

Wright encourages people to form strong relationships with their peers because doing so, he said, is among the most impactful ways to combat mental illness, which the SPRC refers to as a national epidemic.

“There’s no evidence that asking about it increases the risk of the behavior,” he added.

Wright said it’s important that peers ask about each other’s well-being, notice the signs of depression and other forms of mental illness, and alert professionals when it seems necessary to do so.

Cassandra Nichols, the director of WSU’s Counseling Services, said too many people are made to feel embarrassed or ashamed of their mental health issues, depression included.

“Anecdotally, what I see as a psychologist is people who are coming in struggling with depression, but they’re trying to be happy – even for me,” Nichols said. “They’re apologizing to me for being sad, they’ve got a smile on their face, and they’re laughing.”

This sort of behavior, Nichols said, can be attributed to the demands of American culture.

“American culture doesn’t like negative emotions,” she said. “Sadness in other parts of the world … is just a normal part of life and is seen as that, but American culture just wants to be happy all the time.”

Nichols explained that depression is more pervasive than short-term sadness, which typically surrounds a particular event or situation in one’s life. Markers for diagnosis include changes in sleep and appetite, tearfulness, low self-esteem and withdrawal from social activities.

“We’re looking at a number of markers, and it happening for at least two weeks,” she said. “And then, after we gauge that, how severe are we talking? Mild, moderate, severe.”

Nichols noted what many researchers call suicide “contagion” – an increased tendency toward suicide among individuals who are severely depressed and hear about incidents through news outlets or social media.

“For folks who are not so depressed, though, or maybe only moderately depressed, I don’t think that’s going to be a risk factor for them,” Nichols said. “I don’t know if I would recommend not reporting on something like that, because we’re talking about a small group of people.”

Suicide contagion has been a concern for many years as “outbreaks” or “clusters” surround the deaths of celebrities and other prominent figures.

According to one study at Wayne State University in Michigan, for example, the national suicide rate was about 12 percent higher after Marilyn Monroe’s death in August 1962 than it was in the same months the year before.

Wright said he sometimes writes prescriptions for patients to “unplug” from negative media.

Anyone who witnesses suicidal behavior is asked to call 911 immediately. Martin said a bystander should intervene if a death is likely to occur.

Those seriously considering suicide should call the 24-hour National Suicide Prevention Lifeline – 1-800-273-TALK (8255) – or seek help from a trusted professional. Counseling Services offers regular walk-in hours and unlimited assistance during crisis situations.

Additional resources for mental health can be found throughout this newspaper.

Additional reporting by Kayla Bonar