September is National Suicide Prevention Month. Here's what to look for.

We all know someone with a bright smile, the one who laughs the loudest in the crowd and the friend you could count on for a pick-me-up. From the outside, they seem invincible - happy, healthy and full of life.

What no one knows is that behind that laughter is a quiet struggle, a battle fought in silence. It's easy to miss the signs when someone appears to be thriving. But the reality is, they carry the heaviest burdens.

In 2022, more than 49,000 people in the United States died by suicide. The United States Centers for Disease Control and Prevention estimated that's one death every 11 minutes.

Suicidal thoughts, much like mental health conditions, can affect anyone regardless of age, gender, race or background. Although common, suicidal thoughts should not be considered normal and often indicate more serious issues.

"We see a lot of different people for a lot of different reasons. And I will be honest, there are a lot of things that children deal with that, I think, adults just in general don't understand," said Tameka Lyles, clinical director for Sumter Behavioral Health Services.

Since the 1970s-80s, Sumter Behavioral Health has specialized in treating clients with substance abuse issues as well as behavioral health issues, including depression, anxiety and adjustment disorders. But with 14 years as a counselor, Lyles said what people feared more than a decade ago is drastically different from what is feared today.

COVID-19 brought to the forefront what people struggle with mentally, the lack of social interaction and the abrupt disruption of day-to-day lives. And while these struggles affect anyone, regardless of age, the pandemic brought awareness to what children - elementary, middle and high-school age - were facing. Lyles said there are children who are more vocal about their struggles who have sat in the office and admitted to having dark thoughts - but only to her.

"We deal with a lot of kids that are just sad [and] depressed about life circumstances where they are currently in life, not being able to get out of the situations that they're in," she said. "As parents, even as teachers, we dropped the ball because we don't have those conversations because I think people fear what [children] are going to say or you have some parents who feel like, 'Man, your only job is to go to school and make good grades. You have no reason to be sad. You have no reason to be worried,' and that's just not true."

On the other hand, Lyles said signs of suicidal thoughts are not always "I'm sad." Some of these struggles are hidden in plain sight, among the bright smiles and infectious humor of some of our favorite people.

"And that's the scary part," Lyles said. "We do a lot of prevention and intervention work to raise awareness on what students may look like at school. If we have students that are having behavioral problems, we screen all students for it. But we do miss the kids that are 'the good kids' because good kids don't always get referred to counseling."

"The kid that goes to school, makes straight A's, never complains about how they feel - those kids are still dealing with suicidal ideations."

Sumter County Coroner Robbie Baker reported a total of 11 suicides in 2024 so far.

The World Health Organization reported that suicide is the third-leading cause of death among 15- to 29-year-olds.

September is Suicide Prevention Month - a time to raise awareness of this "silent epidemic." Organizations and individuals around the world use this month to shift public perception, spread hope and share vital information to people affected by suicide - just as Lyles seeks to do.

When meeting with parents, Lyles always encourages having the conversation about suicide with their children. These conversations don't have to be intimidating; it can be as easy as "How was your day?"

"How are you feeling? What do you need from me? Is there anything that I could do to help you? … I tell parents to have those conversations with your kids; be the voice, be the advocate for your kids," she said. "If your kids are always isolated in their room, even if they're playing a game or always on the phone with their friends, go in there and be like, 'Hey, are you OK? How are you doing?' Most of the time kids do isolate when they are having suicidal ideations, [and] the main thing would be to isolate, be by themselves."

National Institute of Mental Health also said changes in behavior can include making a plan or researching ways to die; withdrawing from friends, saying goodbye, giving away important items or making a will; taking dangerous risks such as driving extremely fast; displaying extreme mood swings; eating or sleeping more or less; and using drugs or alcohol more often.

Sumter Behavioral Health Services also offers school-based counseling services in all middle and high schools in Sumter School District. Referrals can be made through guidance counselors, or parents can visit the Behavioral Health Services office at 755 Electric Drive.

Walk-ins are also welcome from 9 a.m. and 1 p.m. Monday through Thursday. Individual and family therapy is available, as well as telehealth services for those unable to come in.

Trevor Brown, prevention director for Sumter Behavioral Health, also encourages individuals suffering from substance abuse - which can be an onset to depression and other mental health struggles - to reach out to the facility for help. Sumter Behavioral Health Services offers temporary housing, an intensive outpatient program, medicated assistance treatment and intervention services, which include an alcohol and drug safety action program to reinstate lost driving privileges, pre-trial intervention for first time non-violent drug offenders, offender-based intervention to educate those with an alcohol- or substance-related charge other than a DUI and a Probation, Parole and Pardon program which helps those with a criminal record to meet conditions of their probation or parole.

For more information, visit sumterbhs.org or call (803) 905-5100.