In the backyard of their stylish Scripps Ranch home, Bill and Camille Currier have built a memorial to their son, Brett.
In the midst of palm trees, there's a cement fountain and a seat in the shape of a hand.
"When we went to go get the fountain, we found this hand," Camille Currier said. "And we said, that's something Brett would love."
Camille remembers Brett as a cheerful, playful boy. But as she pointed to a photo of him as a teenager, she paused.
"This is where I saw him change," Camille said, looking at a photo of a somber young man. "You go from a really happy kid to someone who you could tell he was troubled. You know, you could tell. But we tried. We tried, we tried, we tried."
On Thanksgiving Day in 2004, Brett killed himself. He was 22-years-old.
"There were no clues," Camille said. "There were no notes — nothing."
Camille said Brett was a heavy drinker. Looking back, she believed he used alcohol and other drugs to self-medicate.
Suicides On The Rise
Suicides have become a major public health issue in the United States. Each year nationwide, more people die from suicides than from car crashes. And the suicide numbers in San Diego County have been on the rise.
In fact, both the number of suicides and the rate per capita have been steadily increasing since 2010.
In 2013, 441 San Diego County residents took their own life. The number is an all-time high.
Contributing Factors
Stan Collins is on the San Diego County Suicide Prevention Council. He also works on a statewide suicide prevention campaign called Know the Signs.
Collins said the Great Recession may have contributed to the increase in suicides.
"But one thing I'm always trying to get people to understand is that not one thing causes suicide," Collins said. "Bullying doesn't cause suicide, PTSD doesn't cause suicide. And that, suicide is really the result of the inability to deal with the stress caused by situations, and the more situations you pile on top and stack on top of each other, the more risk there is for suicidality."
Clinical depression and drug abuse are also major risk factors.
Deputy County Medical Examiner Jonathan Lucas said the highest number of suicides is typically among men ages 45 to 65.
"However, the highest rate is among elderly men, especially over 75 years old," Lucas said. "Those are the individuals who are at highest risk."
The CDC estimates for every completed suicide, there are 25 attempts. Lucas said that should be a call to action.
"And the opportunity is for us as a county to really intervene and somehow identify those people, and sort of divert their behavior," Lucas said.
That's what a suicide prevention training called QPR is all about.
Question, Persuade And Refer Training
On a recent morning, Bonnie Bear gave Question, Persuade and Refer training to a roomful of high school counselors.
"QPR stands for question, persuade, refer," Bear told the audience. "And it's not therapy, it's only a way to offer hope and to get them in for help."
Bear heads the group Survivors of Suicide Loss. She lost her husband to suicide in 2002.
She told the group that suicide is the third leading cause of death for teenagers.
Tackling the issue is difficult. But Bear pointed out asking someone who appears distraught if they've thought about suicide is actually a good idea.
"If they are in that state, they have a sense of relief, because finally, someone understands, someone will talk to them about it," Bear said.
More than 7,000 San Diegans have taken the training over the last few years.
The training teaches people to recognize some of the warning signs of suicide, and to intervene. The idea is that almost any positive action may save a life.
Trainees are encouraged to question a person about how they're feeling, persuade them to seek help, and refer them to counseling or a crisis line.
Megan Turner, an academic adviser at Lincoln High School, said it's tough having a frank talk with a troubled student.
"It's never an easy conversation, ever, but I would rather have it, and have them be angry with me, than not have it, and get a phone call from their parents saying, you know what, so and so committed suicide," Turner said.
What Were You Thinking?
Camille said since her son Brett took his own life, her faith has helped her cope with the loss. And it also gives her something to look forward to.
"I really do think I'll see Brett again some day," she said. "And I'll ask him, what were you thinking?"
