If Doctors Couldn’t Figure It Out, How Can You?
By Nkechi Conteh https://www.fruitfulmd.com/
Rarely has a case gripped the country as tightly as this one. The national response has been equally intense. With social media and artificial intelligence amplifying the conversation, thousands of people have joined sometimes aggressive debates through memes, podcasts, blogs, reels, and opinion pieces about what happened, what should have happened, and who was right or wrong. Hindsight makes complicated events seem deceptively simple. Once we know the outcome, earlier behaviors can suddenly appear obvious. A comment becomes a warning. A change in behavior becomes a clue. A missed interaction becomes a missed opportunity.
But it is much easier to believe the warning signs were unmistakable when we encounter a person’s life through headlines, clips, documents, and hindsight than when we are sitting across from that person in real time, responsible for deciding what those signs actually mean.
Beneath the public debate lies a much more personal and unsettling question:
If doctors can't prevent it, how can we?
Perhaps that is the wrong question.
The better question may be: Why do we expect any one person to figure it out alone?
No One Sees the Whole Picture
How many family members sit beside people struggling with suicidal thoughts or mental illness without knowing the extent of what they are experiencing?
How many churches and religious organizations offer counseling, resources, or check-ins for vulnerable members, only for those resources to go underused?
How many teachers, coworkers, friends, and neighbors notice that someone seems different but do not know whether—or how—to ask about it?
And how many people experiencing distress encounter care without having the language, trust, or ability to communicate what is happening inside them?
Clinicians are trained to recognize and treat mental illness and assess suicide risk. That expertise matters enormously. But expertise does not equal omniscience.
Suicide-risk assessment has limitations. People may conceal what they are experiencing. Warning signs may be ambiguous. Risk can fluctuate, and circumstances can change quickly. A person may appear very different to a physician during an appointment than they do to a spouse at home, a friend late at night, a teacher at school, or a coworker during the day.
That does not mean clinical training has failed. It means no single person necessarily possesses every piece of information.
The Scale of the Problem
The scale of depression and suicidality makes this reality especially important.
CDC data collected from August 2021 through August 2023 found that 13.1 percent of Americans age 12 and older met the study’s criteria for depression during the preceding two weeks, compared with 8.2 percent approximately a decade earlier. Among those experiencing depression, 87.9 percent reported at least some difficulty with work, home, or social activities because of their symptoms.
In 2024, an estimated:
14.3 million American adults seriously considered suicide
4.6 million made a suicide plan
2.2 million attempted suicide
Suicide does not affect every population equally. In 2024, he suicide rate among males was nearly four times the rate among females.
These numbers do not demonstrate that medical expertise has failed. They demonstrate the scale and complexity of the problem.
Suicide prevention has never been solely a clinical task. Public-health approaches extend beyond the examination room. They include improving access to effective care, strengthening social connections, creating protective environments, identifying and supporting people who may be at risk, and teaching individuals and communities how to respond when someone is struggling. In other words, we should not try to turn everyone into a psychiatrist. We should teach more people how to recognize when someone may need help.
What “See Something, Say Something” Can Teach Us
There is precedent for teaching the public to recognize concerning circumstances and know how to respond. After September 11, “If You See Something, Say Something®” became a nationwide awareness campaign built around a simple idea: professionals cannot be everywhere, and ordinary people sometimes encounter important information first. Suicide prevention is fundamentally different from counterterrorism. People experiencing mental illness should never be treated as suspicious or dangerous. But the public-awareness principle is useful: teach people what to notice and what to do next. Suicide-prevention programs already apply a related approach through gatekeeper training—equipping ordinary people to recognize potential warning signs, ask appropriate questions, listen without judgment, and connect someone with help.
Notice. Ask. Listen. Connect.
A family member does not need to determine whether someone meets the diagnostic criteria for major depressive disorder. A teacher does not need to conduct a formal suicide-risk assessment. A pastor, priest, rabbi, imam, coach, coworker, or friend does not need to become a mental health professional.
But they can recognize when something has changed.
They may notice someone withdrawing from people they ordinarily care about, expressing hopelessness or feeling like a burden, engaging in unusual risk-taking, giving away valued possessions, making unexpected preparations for death, or communicating in ways that raise concern.
More importantly, they can know what to do next:
Notice
Pay attention to significant changes in behavior, mood, relationships, or daily functioning.
Ask
If you are genuinely concerned, ask clearly and directly whether the person is thinking about suicide. Asking the question does not place the idea in someone’s mind.
Listen
Give the person space to speak without judgment, minimizing their experience, immediately offering solutions, or debating whether they “should” feel the way they do.
Connect
Help the person reach an appropriate source of support—a mental health professional, primary care clinician, crisis service, trusted family member, or emergency service when danger is immediate.
Warning signs are not a diagnostic checklist. Their absence does not guarantee that someone is safe, and their presence does not always mean that someone is suicidal. The goal is not to monitor, label, or report people simply because they behave differently but to make it easier to begin a conversation and connect someone with appropriate support.
Prevention Requires a Community—and a Responsive System
Schools, workplaces, law enforcement, religious organizations, health systems, and community groups should make basic suicide-prevention education widely available.
Education should teach people how to have difficult conversations, not merely how to identify concerning behavior. People should know when and how to ask about suicide, how to listen, where to find professional help, and what to do when the danger appears immediate. Institutions should also establish clear and confidential pathways for raising concerns about someone who may be struggling, with safeguards that protect the person’s dignity, privacy, and well-being. It is about developing connection, not surveillance. These efforts must also lead to a well-supported mental health system. Awareness accomplishes little if someone finally asks for help but cannot obtain it.
A physician may see one part of a person’s life. A parent may see another. A spouse may notice something else. A teacher, counselor, friend, coworker, or faith leader may encounter a moment that none of the others witnessed. Each perspective is incomplete. Together, they may tell us more.
We Do Not Have to Figure It Out Alone
Perhaps the lesson from a difficult case is not that ordinary people should second-guess physicians or that physicians should be expected to predict every tragedy.
It is that human beings are complicated, mental illness is complicated, and suicide prevention cannot depend on one appointment, one professional, one family member, or one institution getting everything exactly right. If doctors cannot always see it, neither can families, friends, teachers, clergy, or coworkers. But each may see something the others do not. Together, we can cultivate a culture in which more of us know how to notice, ask, listen, and connect someone with help.
We may never eliminate uncertainty. But we can make sure fewer people face it alone.
Help Is Available
If you or someone you know is experiencing suicidal thoughts or a mental health crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline. If there is an immediate danger to life, call 911 or seek emergency assistance.
This article is intended for education and should not replace individualized medical or mental health care.
Sources
About the Author
Nkechi Conteh, MBBS, MPH, is a board-certified psychiatrist with an interest in women’s mental health, including emotional well-being during perimenopause, pregnancy, and the postpartum period, and the founder of Conteh Psychiatry, a Women’s Mental Health Clinic.
Comments