Are there more homicides or suicides in the U.S. each year?
It’s a question that Ken Dority, executive director of the National Alliance on Mental Illness of Greenville, poses to many people.
“Ninety percent of the people think it’s homicides yearly. But, in fact, suicides are 2 1/2 times the number,” said Dority. “In 2018, there were over 48,000 suicides in America.
“I think when we start thinking about that, you know, those are numbers that we need to be talking about when it comes to suicide because the numbers are just greater than we think in many places,” he said.
September is designated by mental health advocates and experts as Suicide Prevention Awareness Month. It’s a time to shed light on the resources available to anyone who may be experiencing suicidal thoughts, has a loved one who is struggling or has been affected by suicide and to make known the treatment services that exist in our communities.

Finding resources to help
Many people experiencing suicidal ideation may have an undiagnosed mental health condition that’s causing the experience, said Dority.
For instance, 90% of people who die by suicide have experienced symptoms of a mental health condition, according to research cited by NAMI Greenville. But only 46% of people who die by suicide have a diagnosed mental health condition.
That means there are a vast majority of those who die by suicide who may have had a mental health condition that wasn’t treated appropriately. If you, or someone you know, are having suicidal thoughts, it could be connected to an underlying issue — a mental health condition that needs to be treated.
Dority wants those who may be considering or have considered suicide to know there are legitimate health reasons that you may feel this way. “I would implore them that help is available. Please speak to a trusted advisor. Please speak to your spouse, your best friend, someone, and get the help you need,” Dority said.
“This is not something that is incurable. It may feel that way but it is not. There is help,” he added.
One way to stay healthy is to create a suicide safety plan with a doctor or someone close. That’s something Dennis Gillan, who works with the Office of Suicide Prevention at the South Carolina Department of Mental Health, recommends for everyone, “even if you’re well.”
Gillan’s brother, Mark, died by suicide while Gillan was away at college. Eleven years later, so did his brother Matt. He’s told several friends that they may one day receive a call from him, and they need to prepare to act in case Gillan is thinking of taking his life.
“The pain will subside,” Gillan said, noting the loneliness and darkness that many who experience suicidal thoughts may feel. “There’s a big thing called ambivalence. People think they want to die, but in the end, there’s a part of them that wants to live, and we have to speak to that part,” Gillan explained.

Talk, behavior, mood: Identifying suicidal behavior
Three warning signs that someone may be considering suicide concern talk, behavior and mood. People may say something like, “everyone’s better without me,” or they could be behaving in reckless ways, said Gillan. Or, maybe their mood has changed and they become withdrawn. All of these are examples that someone may be thinking about ending their life.
When you notice these signs, take it seriously, said Susan Haire of Mental Health America of Greenville County. “We know that people who die by suicide usually have displayed a symptom or warning sign [in the week before] they have passed away,” she said.
Some symptoms of suicidal thinking may include:
- Talking about dying or wanting to die
- Talking about feeling hopeless
- Mentioning strong feelings of guilt
- Talking about not having a reason to live
- Social withdrawal and isolation
- Giving away personal items
- Saying goodbye to friends and family
Even if you’re concerned you might anger someone you believe might be having suicidal thoughts, experts say that you should speak to them. Discussing suicide with someone who has suicidal thoughts will not immediately lead to them deciding to take their own life. While there might be a last straw, it’s never just one thing, said Haire.
“We all have a part to play,” she said. “And we all must play it and prevent suicide.”

Help is available, but groups are struggling
South Carolina’s budget for mental health services has been slashed over the years, advocates say. For instance, 15 years ago there were multiple suicide prevention centers. Now the state only has one — Mental Health America of Greenville County.
“It just doesn’t seem to get the attention we need in the budget end,” said Gillan. An investment of $1 toward treating depression and anxiety would have a $4 return in better health and ability to work, he added, citing a World Health Organization-led study.
While Greenville County has the largest population in the Palmetto State, Dority says the Upstate has the fewest psychiatrists compared to other regions of the state. He says he’s heard that it can take 90 days to get an appointment in some parts of Greenville.
However, there are resource networks working across county and state lines. “One of the core things that NAMI tries to accomplish in a community is working on having access to the necessary care for individuals, encouraging them to get that treatment to understand why they need to get it,” Dority said.
It’s something Mental Health America of Greenville County also attempts to accomplish with its crisis hotline that works throughout the state.
Where do we go from here?
We should think about South Carolina’s state motto: Dum Spiro Spero, said Gillan.
While I breathe, I hope.
“You know, sometimes people run out of hope,” he said. “Hope will come back. We just need to stick around.”
If you’ve thought of or are concerned about suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255. You can also call 864-271-8888 for a crisis hotline from Mental Health America of Greenville County. Or, you can text CRISISLINE to 839863 (TEXTME). Find local support through NAMI Greenville by calling 864-331-3300.