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On New Year’s Eve 2013, I lost my sister, Amber, to suicide.

As the 10th leading cause of death in the U.S., suicide claims the lives of over 48,000 of our friends, family members and neighbors each year. Suicides among American youth grew by more than 50% in the last decade. And, among the Black community, the numbers are even more troubling: suicide attempts by Black youth have increased more than 70%, and Black high-school age boys are more likely to attempt suicide than their non-black peers.

Only 25% of African Americans seek mental health care, compared to 40% of the white community. Black people are faced with significant barriers that prevent them from seeking treatment, including the restraints of shame and religious perceptions of mental illness steeped in stigma.

Today, the risk of losing someone we love to suicide is even higher as we face a perfect storm of mental health crises: pandemic-related social distancing and isolation, job loss and economic struggles, social unrest and political and racial tensions at a seemingly all-time high. It’s enough to make anyone struggle with anxiety, depression and thoughts of “is it all worth it?” The recent Black Lives Matter protests validate many of the beliefs that the Black community has that they are not worthy.

With access to mental health care and the stigma of suicide and mental health issues still a pervasive problem for Black Americans, getting help has become an even bigger obstacle. We need to break the silence and subsequently break the chain of depression and internal oppression that’s persisted in our community for generations. By making mental health part of the BLM conversation, we empower a community who are so deeply struggling to have these conversations openly and honestly, without fear of judgement.

Recognizing the warning signs of suicide ideation will allow us to help intervene before it’s too late. Those most vulnerable to suicide tend to display a specific combination of moods and behaviors following the acronym: DEATHWISH. Here’s how to spot the signs of DEATHWISH, which could help you save the life of someone you love.

• Depression: Depression can take a variety of forms, from generally feeling down to frequent crying, not eating or sleeping, to perhaps eating or sleeping too much. Lack of personal hygiene can also be a sign someone is struggling with depression. Even if you can’t see someone due to physical distancing, be on the lookout for troubling social media posts, which can often be a cry for help.
• Extreme mood swings: Drastic mood changes from elated and energetic to sad, tired and lethargic, can be a sign of anxiety, bipolar disorder and other mental illnesses that put someone at risk for suicidal tendencies.
• Anger, agitation, anxiety or aggression: If someone you know is normally mild-mannered and easy-going but suddenly develops uncharacteristic aggression, uncontrollable anger or extreme irritability, it’s time to ask how you can help.
• Trapped: Those dealing with depression and mental illness have a hard time seeing a way out of their situation. They may feel trapped, and this is especially concerning right now, when we’re all “trapped,” in a manner of speaking, unable to go out and socialize with friends. Human connection is vital to our wellbeing and overall health. It’s so important to reach out to those who are vulnerable right now with a phone call, FaceTime or text to let them know that they’re not alone.
• Hopelessness: Feeling that life is a lost cause — that it’s not even worth waking up tomorrow — is a huge red flag. This, along with the sense of feeling trapped, is a recipe for suicide ideation. If someone you know expresses feelings of hopelessness — even in an offhand social media comment — reach out directly and offer to talk.
• Withdrawal: If someone you know has lost interest in activities they once loved, calls off work repeatedly and is isolating from friends and family, these are all clear signs of withdrawal. While it may be hard to know the difference between withdrawal due to depression and suicidal thoughts versus health concerns over COVID risk, when in doubt, reach out.
• Ideation: Talking about suicide, even making casual references on social media is a clear sign of suicidal risk. Off-the-cuff references like “just shoot me now,” “I could jump off the bridge” or subtly celebrating or being envious of those who’ve committed suicide for finding a way to end their misery are warning signs that simply cannot be ignored. Just weeks before taking her own life, This Is Us writer Jas Waters retweeted a message: If people start calling you a hero that means they're about to let you die.
• Substance use: If someone you care about suddenly begins drinking heavily or using drugs, or you notice a marked increase in substance use, please speak up. While substance use itself isn’t necessarily an indicator of suicidal tendencies, any drastic change in behavior is cause for concern. Not to mention, substances cloud judgement and lower inhibitions, which means a person who may have only fleetingly considered suicide may be emboldened by drugs or alcohol into actually doing it.
• History of attempts or gestures. It should be obvious, but anyone who has previously attempted suicide or has a history of self-harm is at increased risk. But this behavior could also be more subtle: intentionally driving under the influence, a car crash that seems unlikely to be accidental, taking unnecessary risks or participating in uncharacteristically dangerous activities. These individuals need our immediate attention and intervention.

Looking for and speaking up when you spot these troubling trends can save someone’s life.

As we come together to recognize Suicide Prevention Awareness Month, and to honor the lives lost to this tragic end, we must raise our voices to let those around us know we care, they’re not alone and they don’t have to suffer in silence. By normalizing mental health conversations, by reaching out to those in need and learning to identify the warning signs of suicidal tendencies, we can reverse this troubling trend and save lives in our community.

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Marlon Rollins is the Chief Executive Officer at Laguna Treatment Hospital, an American Addiction Centers facility. Rollins has more than 15 years of experience in behavioral healthcare. He is a member of the Steering Committee for the National Suicide Prevention Lifeline (1-800-273-TALK).