When suicides happen, most respond with discretion and whispers. Because of shock, shame and a desire to avoid speaking ill of the dead, obituaries use euphemisms about unexpected deaths, and family members and friends are understandably reluctant to divulge how their loved one died. There's almost an unwritten cultural pact between mourners and condolers to get through the funeral with as few mentions of the S-word as possible. All of this is understandable and, in a sense, compassionate and noble.

When celebrities take their life, however, it brings the S-word out from under the black veil. Since everyone knows them and how they chose to end their life, and because most interlocutors are not the victim's immediate family and friends, it gives people a chance to talk about suicide out loud -- and to grapple with the question of why.

That's what has happened in the last week after the suicides of fashion designer Kate Spade and of celebrity chef and CNN travel documentarian Anthony Bourdain. On street corners with strangers, dinners with friends, conversations in between meetings at the United Nations, and various pastoral settings, seemingly everyone has been bringing it up with me, in an attempt to understand it.

How, they ask, can people who seem to have everything going for them -- money and material possessions, fame and influence, millions of appreciative fans -- determine that they don't have reason to go on? How can those with lives most would covet decide that life is not worth living? How can such successful people feel like such personal failures? How can those who inspired so many be so hopeless themselves? How can such responsible people who built huge businesses be so irresponsible toward their loved ones left behind?

Talking about the S-word is a little easier when there seems to be a clear cause, like known mental illness, depression, substance abuse, or a catastrophic personal event. It's more straightforward, albeit no less sad, therefore, responding to the deaths of Robin Williams, Philip Seymour Hoffman, Junior Seau, Whitney Houston, Aaron Hernandez, or the many celebrities who have ended their lives through overdoses. But when those who do not give any indications of being suicidal do so -- 54 percent of those who take their own lives have not had any known mental illness -- it forces us to confront deeper questions.

And these are questions that we cannot really duck if we want to avoid many more premature funerals. Suicide is now the tenth leading cause of death in the US, responsible for 45,000 deaths in 2016, one every 12 minutes. In 2016, according to a comprehensive study by the Centers for Disease Control and Prevention (CDC), 9.8 million or four percent of American adults seriously considered suicide, 2.8 million devised a plan to take their life, and 1.3 million attempted it. (The only good news we can find in the data is that 87 percent of those who contemplate suicide don't act on it and 96.5 percent of those who attempt it thankfully fail). Although women are more likely than men to have suicidal thoughts, men comprise 78 percent of suicide victims.

The numbers concerning young people are much more frightening. Suicide is the second leading cause of death for people 10-34. Among high school students, according to a 2013 CDC study, 17 percent (22.4 percent of girls and 11.6 of boys) considered suicide in the previous year, 13.6 percent made a plan about how they would attempt it (16.9 percent of girls, 10.3 percent of males), and 8.0 percent of students attempted suicide at least once in the previous year (10.6 percent of girls and 5.4 of boys), with 2.7 percent of students (3.6 percent of girls, 1.8 percent of boys) requiring medical attention as a result of injury, poisoning or overdose.

How should we respond adequately to this suicidal surge?

First, not only should we not duck the issue but we should commit to address it with resolve, perseverance and honesty.

This involves, second, confronting, exposing, and eradicating the culture that promotes and even extols suicide. There's a growing pro-suicide movement that has now made it legal in eight places in the States -- California, Colorado, District of Columbia, Hawaii, Montana, Oregon, Vermont, and Washington -- and several European countries for people to murder themselves. Euphemisms abound. It's called "Death with dignity," or "Physician-assisted dying," even "Euthanasia" (good death), but it's suicide. There are well-funded movements that glorify deaths like Brittany Maynard's and that are seeking to extend its legalization, as if suicide is a good thing and a marker of cultural "progress." This week they have been lobbying the American Medical Association to eliminate its opposition to physician assisted suicide (PAS) as "fundamentally incompatible with the physician's role as healer." No one should be surprised that physician-assisted suicide has led to a 6.3 percent increase in total suicides in the states where it has been legalized, considerably higher than the general five percent increase since 1999. It's schizophrenic to try to prevent suicide on the one hand and promote it on the other. We must recognize the promotion of suicide for what it is -- and resist it with vigor.

Third, we should know the warning signs and risk factors. Suicide is "cry for help," but one that many hear only after it's too late. We all have to get better at detecting the signs. Experts tell us that, among the signs, are talking about feeling hopeless, wanting to die, feeling like a burden, having no purpose, feeling trapped, being in unbearable pain, feeling isolated, or looking for a way to end one's life; others are withdrawing, showing rage or extreme mood swings, acting anxious, agitated or recklessly, sleeping much too little or too much, heavy use of alcohol and drugs, or seeking revenge. Factors that can increase the risk are familial history of suicide, mistreatment as a child, clinical depression or mental disorders; physical illness; relational, social, work or financial setbacks; barriers or resistance to accessing mental health treatment for suicidal thoughts or substance abuse. Most but not all people who die by suicide exhibit warning signs: 46 percent have a history of mental or emotional illness, and additional 44 percent a history of substance abuse, but that's retrospective, not predictive. It's normally a combination of many factors, triggered by a setback or a sense of hopelessness. When we deem someone suicidal, we should not leave the person alone. Rather we should remove as much as possible the means that one could use to take one's life and then take the person to an emergency room, seek help from a mental health professional, or call the US National Suicide Prevention Lifeline (800.273.TALK).

Fourth, we should promote a culture of resilience that helps people deal adequately with the risk factors. At a macro-level, these involve trying to strengthen family financial security and housing stability, covering mental health conditions and suicide care in health plans, promoting connectedness with peers and the community especially among teens, reducing access to lethal means, and training people in coping and problem-solving skills, especially in the family.

One of the biggest resilience factors is, unsurprisingly, the regular practice of religion. A 2016 study by the Psychiatry Journal of the American Medical Association showed that women who participate in religious services at least once a week are five times less likely to commit suicide than those who never participate. Faithful Catholic women were the least suicidal of all, with not a single suicide among 6,999 women studied over a 15-year period. Why? It's not just that Catholics do an effective job on communicating both that and why taking one's life is contrary to what God's plans for our life. It's also because practicing Catholics, looking at the Crucifix and knowing the stories of the martyrs, can grasp more easily than others the redemptive meaning of suffering. Rather than escape, they pick up their cross and seek to follow the Lord to Calvary and through Calvary to the eternal Jerusalem.

Practicing Catholics, however, and everyone else in our culture, must do a better job in training others to deal with inevitable setbacks, contradictions, shame, sufferings and pain -- not merely with medication but with greater maturity and hope. Concentration-camp survivor Viktor Frankl argued that the only people who survived Auschwitz and Dachau were those who had a reason to live in the midst of so much suffering. They could make sense out of what they were enduring. We have to help people find that meaning. And, as we've seen with Spade and Bourdain, money, fame and worldly success aren't enough.

Part of building this resilience is, fifth and lastly, forming a greater culture of mutual solidarity. We live in a self-centered, self-pitying age that exalts rights to the almost total exclusion of responsibility, and that, while hungering for compassion, often fails to extend it. This general cultural trend is seen in the growth of suicide. There are six to 32 survivors for every suicide, depending upon the definition used -- seven percent of U.S. residents know someone who has committed suicide in the last year -- and it is impossible to express in words the pain survivors endure. Economically, suicides and suicide attempts cost $70 billion annually in work and medical-related consequences. Forming a greater culture of solidarity not only would help everyone better care for those in danger of taking their lives, but also help those who might be vulnerable recognize the lie that suicide leaves no victims, or only one.

Over the past several decades, the Church has changed its practice with regard to funerals for those who commit suicide, because we've recognized that the vast majority who take their life don't seem to do so with deliberate and free consent, but are suffering with mental illness, depression, addiction, hopelessness or many other maladies. But the Church and the culture together must work to do more than entrust the suicide victims posthumously to God's mercy and console grieving family members and friends; we must resolve to do all possible to prevent those funerals, by helping the vulnerable to experience hope and mercy in life.

Those who patiently and compassionately help those tempted to suicide have traditionally been called Samaritans, and for good reason: They don't ignore but respond to the cries of help for those in the various ditches of life. The question for all of us is: Will Kate Spade's, Anthony Bourdain's, and the 45,000 suicides in our country each year, convince us that we all have an important role in that saving work?



- Father Roger J. Landry is a priest of the Diocese of Fall River, Massachusetts, who works for the Holy See’s Permanent Observer Mission to the United Nations.