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Suicide is a leading cause of death in Kentucky. It is also preventable.

As the COVID-19 pandemic passes the year mark, many continue to be concerned with mental health, isolation, and substance misuse — all of which are known circumstances to increase the risk of suicide.

Between 2005 and 2017, precipitating suicide circumstances most often included: depressed mood; mental health, intimate partner, and physical health problems; and substance misuse. These known risk factors have intensified as the risk of spreading the virus continues, according to Sabrina Brown, DrPH, principal investigator for Kentucky’s Violent Death Reporting System (KYVDRS).

In the recently published paper titled, “Suicide in the Time of COVID-19: A Perfect Storm” (Journal of Rural Health, January 2021), Brown, along with co-author Donna L. Schuman, PhD (now at the University of Texas), notes that suicide rates historically decrease during the early phase — or honeymoon period — of a crisis, like the Sept. 11, 2001, terrorist attacks. Following the honeymoon period, however, rates increase, Brown said.

Preliminary data showed that suicides in Kentucky during the second and third quarters of 2020 were lower than the average from the same period in years 2016–2019. Established disaster recovery frameworks can be applied to help predict where we find ourselves as the response to and recovery from this pandemic continues, Brown added.

To help, the Kentucky Violence & Injury Prevention Program (KVIPP) — which, like the KYVDRS, operates as part of the Kentucky Injury Prevention and Research Center (KIPRC) — is working with the Kentucky Department for Behavioral Health, Development and Intellectual Disabilities (DBHDID) and the Kentucky Safety Prevention Alignment Network (KSPAN), a state injury and violence prevention coalition, to improve the suicide prevention infrastructure throughout the Commonwealth through a supplemental grant.

“Suicide most likely has affected each and every one of us, and, unfortunately, if it has not, it will in the future,” said Ashley Bush, DrPH, principal investigator of KVIPP. “This is why prevention is so important — suicide is preventable. One of the ways is by identifying and supporting people at-risk through evidence-based programs such as Question, Persuade, Respond (QPR) gatekeeper trainings.”

KSPAN has been providing monthly QPR trainings. QPR has been dubbed the CPR of mental health.

“QPR helps teach folks to know what to say, when to say it, and what to do,” she added. “QPR training helps to provide ordinary people and front-line professionals with knowledge and skills to engage in suicide prevention behaviors.”

These interventions include providing caring/emotional support, listening empathetically and actively, imparting hope, and other steps to reduce risk factors and strengthen protective factors in regards to self-harm/suicide.

“Though it is not intended to serve as a form of counseling or treatment, QPR is intended to offer hope through action,” Bush said. “As JFK once said, ‘There are risks and costs to action, but they are far less than the long-range risks of comfortable inaction.’ This means training as many people as possible to understand the scope of this public health problem to recognize symptoms of distress/despair and warning signs (indirect/direct) and to take action.”

Bush said everyone has the opportunity to be a gatekeeper and prevent suicide, as each of us interacts with friends, families, and our communities.

“In times of need, people in need need to have someone present. The pandemic has certainly affected our ability to interact and be present in the lives of others,” Bush said.

During December, KVIPP and DBHDID held train-the-trainer trainings for 48 individuals throughout the state, across over 37 different zip codes. These 48 certified QPR trainers will work to deliver QPR to their communities and social networks, Bush said.

“Our goal is to identify who is needing QPR training within a specific portion of the state and help locate a QPR trainer to provide the training to their community. The more people trained in QPR, the higher likelihood we (as a community and state) will be able to recognize and link those at-risk to help, helping to reduce the number of Kentuckians who die by suicide,” she added.

KSPAN is sponsoring free QPR training sessions that will be presented by Adam Trosper (DBHDID) and Larry McNabb (Kentucky Office of Vocational Rehabilitation–Blind Services, formerly the Kentucky Office for the Blind).

These sessions are set for Thursday, March 11, 9:30-11:30 a.m. (Register: and Tuesday, March 30, 1-3 p.m. (Register:

KIPRC is a unique partnership between the Kentucky Department for Public Health (DPH) and the University of Kentucky’s College of Public Health. KIPRC serves both as an academic injury prevention research center and as the DPH’s designee or “bona fide agent” for statewide injury prevention and control.