This column originally appeared in The CT Mirror.

By Dr. James O’Dea
Vice President, Hartford HealthCare Behavioral Health Network

In just a matter of days, two survivors of the Parkland, Fla., shooting and the father of a first-grade girl killed in the Sandy Hook massacre took his own life.

With mass shootings and related suicides on the rise, all of us must play a role in stopping these gut-wrenching tragedies. We need to be open, honest and direct if we suspect anything is awry with our friends, family, loved ones and acquaintances – especially if they have suffered from a traumatic episode in the past.

While the Parkland shooting and the Sandy Hook massacre occurred more than six years apart, time has little to do with how someone is impacted. We must realize that people are going to experience things in different ways and we should stay close in touch with those who have been exposed to this level of heart-breaking trauma — not just immediately when it happens but over the long haul. Inevitably, these events change people forever.

There is no easy solution – it is impossible to predict how someone might react, or make sense of why people do what they do. But unlike some medical conditions, suicide is on the rise. This makes it even more important for us to know the warning signs, including:

  • Feelings of always being unsafe or at risk.
  • Sleep and appetite changes.
  • Preoccupation with past incidents or current events such as the New Zealand mosque murders, which can re-energize or trigger traumatic memories.
  • Survivor’s guilt – wondering why they were not harmed but someone they loved or cared about was.
    Significant changes in behavior.
  • No longer enjoying things like they used to.
  • Pronounced emotional highs and lows.
  • Withdrawal from society or shutting down.

Many people ask me if it is OK to talk to children about mass shootings and suicides. The answer is yes – for both children and adults. While unfortunate, these horrific incidents offer us the opportunity to discuss these difficult topics.

Questions can include: Are there times that you feel your life is not worth living? Are there times you want to go to bed at night and hope you don’t wake up in the morning?

If the answer to either question is yes, then follow up questions may include: Have you had thoughts of ending your life? Have you made attempts to commit suicide? Have you done some things to organize your life around a suicide attempt?

While it might be unsettling, it’s far better to ask the questions than not to.  And the curious approach doesn’t necessarily need to just come from close friends and loved ones. Guidance counselors, teachers, other adults, peers, cafeteria staff and others who know children, adolescents and adults well and notice changes in appearance or behavior should say something to the person or bring it to someone’s attention.

Let’s face it: Tip-toeing around these topics has failed. We are facing a national epidemic. We need to face it head on. Everyone needs to engage. Anything less is not enough.

This needs to be an all-hands-on-deck approach. If we are going to have an impact we must do something differently. Being quiet, respectful and thinking you are being sensitive does not work. Just look around you.

While it’s painstaking to admit, these are tragedies happening across our country and unfortunately we have had to have this conversation far too often.

We need to take the conversation to another level. Please take the time today to check on someone you know. If you notice something, say something. Ask the tough questions. You may just save a life.

If you or someone you know needs help, speak with your primary care provider, pediatrician or visit the Hartford HealthCare Behavioral Health Network here. If you have suicidal thoughts, please call 2-1-1 in Connecticut or the National Suicide Prevention Lifeline at 1.800.273.8255.