Hey, it’s Anna. Our episode this week deals with suicide, and we also discuss an attempt. If you or someone you love is at risk of harming themselves, or if you just need some help with mental health, please call the National Suicide Prevention Lifeline. The number is 800-273-8255, or as you’ll hear about in this episode, as of July 16th, you can just dial ‘988’. 

Anna: I imagine, driving a semi, that's a lot of time with your own thoughts.

Jason: Yeah. And sometimes it's rewarding sometimes it's not. It's just thought after thought after thought, it's not healthy. Um, and almost every song on the radio I can twist to where it's a negative song. It's just not good.

This is Death, Sex, and Money.

The show from WNYC about the things we think about a lot…

…And need to talk about more.

I’m Anna Sale.

Jason Whitmire is 37, a husband and father of two little boys, who lives in Casper, Wyoming. Until recently, he made money driving a truck.

Jason: Mostly they’re day trips, but they're long days, you know, the family is asleep when I leave and then the kids are asleep when I get home.

Jason is a suicide attempt survivor and is active in a local suicide prevention group. Wyoming had the highest rate of suicide per capita in the US in 2020. It’s been one of the top states every year since 1990, for most of Jason’s life.

Jason’s mental health struggles started in his mid-20s. He’d make a small mistake or feel guilty about something and couldn’t shake it, and he would end up in a very dark place.

Jason: They put me on an antidepressant and– didn't work. 

Then a few months later, he was heading back from work. This was in 2013.  

Jason: I was, you know, very suicidal, had a plan. I was driving. I was about 45 minutes away from Casper, I was coming back. And then all of a sudden something, something quick– uh, I started calling people to say, Hey, I'm not safe. It was almost as if as soon as the front tires hit the interstate from the on ramp, everything changed.

Anna: Who, who did you call?

Jason: It was probably, my wife is who I called first. And then, then I think I next called my boss, cause I was in a company truck at the time — pickup — and called him. And then after that, the word had gotten around fast enough that people were calling me, and, you know, soon as somebody called that I knew closely and loved dearly, I would just start crying. And so I had to tell people to stop calling me so I could see the road. So, um.

Anna: What, what was, what felt important that you heard from, from somebody on the other side of the phone? What do you remember?

Jason: Uh, well there was a lot of, ‘are you okay?’s and ‘I love you.’ That's pretty much what I heard during the phone conversation. Um, and then ‘drive safe’ because I was 45 minutes away but. That's what it was, it was a lot of emphasis on me. Making sure that I was okay. It was none of like anybody trying to ask questions about ‘how you could do this’ or ‘why would you do this’ or– it was all, everything was positive reinforcement towards me.

Jason knew who to reach out to, but not everyone does. And for people who need support, there’s a new number to call: 988.

This simple three-digit number goes into effect nationwide on July 16th. And along with this new number, local call centers are gearing up for more calls. So when you’re in crisis, you reach someone who knows the community you’re a part of.

Karen: It just became very clear that if we wanted to bring down our, the rate of suicide in Wyoming, we had to start addressing it with Wyoming people.

This is Karen Sylvester. She’s worked in suicide prevention for a long time, 25 years. She’s also raised 8 children in Wyoming, and she’s now the director of training and fundraising for the Wyoming Lifeline, one of two new suicide hotlines that got up and running in 2020 in the state.

Karen: You know, you're supposed to be tough and strong and brave, and all the things that people don't associate with seeking mental health services. We’re very rural. Everybody knows your business. And so when it comes to somebody struggling, the last place that they want to have their car parked is outside the mental health office. So that everybody in town can whisper or try to decide what they think is going on with so-and-so, ‘I saw their car’.

That's why Karen says it’s important that the person at the other end of the line answering the call gets the local community and how to suggest where to find help.  

Karen: Well, you know what? You can drive 50 miles to another town and here's where their office is. And here's their phone number. Most people do not want resources in Wyoming in their own town.

Anna: When you think about the demographics, who, who do you picture calling in?

Karen: Oh, wow. Um, there isn't just one face. We have young people that in Wyoming feel, um, isolated for various reasons. We have a whole, a demographic of farmers and ranchers in a culture all their own that struggle with suicide as a group. Um, I, I see the faces of, the faces of elderly people who think that this is– they don't want to be a burden to their family, and that their only way out is to die by suicide. 

The impact of suicide can be felt throughout Wyoming, across demographics. In one survey, queer young people reported seriously considering suicide at a rate three times higher than straight youth.

According to the most recent data – from 2020 – most deaths by suicide in Wyoming were white men, 25 and older. People like Jason, in Casper.   

Anna: Had you ever thought about calling a, a suicide crisis hotline?

Jason: Um, no.

After his first suicidal crisis in his truck in 2013, Jason was institutionalized. He regularly saw a therapist and a psychiatrist after that, and he thought things might be stabilizing. He told his family and close friends what he would need if he was again in crisis.

Jason: I'd already built my team up so much that I trusted, that knew how to help me and knew what to do to get me to a safer place, both physically and mentally and all that.

The suicidal thoughts didn’t go away though, they came and went like a roller coaster. And in 2017, they intensified. One afternoon, Jason was home alone. He had a plan. So he called his doctors. 

Jason: I was able to reach a receptionist and then they told me that they didn't have an appointment or couldn't squeeze me in.

The despair took over. He texted his friends and family to say goodbye and began to attempt suicide. Moments later, his phone started to light up with replies.  When he closed his eyes and tried to let go, he couldn’t get those messages out of his mind. 

Jason: Not til during the attempt that I had a moment clarity to, to stop.

Anna: Uh-huh. Is that why you think you survived, that you had a, that something caused you to pause. 

Jason: Oh, yeah, that's definitely, um, why I'm still here.

Anna: Do you have the suicide, the national suicide prevention hotline phone number in your phone now?

Jason: No, I don't. I should, but I don't, no.

Anna: What, what, what have you heard about people's experiences when they have tried to dial a hotline and, and seek help in Wyoming?

Jason: Well, prior to the local hotline, I heard some people say they're on hold for up to 20 minutes. Um, and when you're in a crisis situation, 20 minutes is, you know, an eternity, you know? 

Anna: Yeah. 

Jason: But then once they got the local hotlines, um, the people that have, that I have heard or talked about, talked to who called in, say it's much better. They get right in. There's not near as long as a wait.

The two suicide hotlines in Wyoming split the week. The call center in Casper, where Jason lives, answers calls in the evening through the middle of the night. Then the calls are routed to Greybull, a small town in the northern part of Wyoming– it’s less than 2 square miles in area, with a population of 1,600.

Ralph: No call goes unanswered. We do not have the– our phone system cannot return a busy signal.

Ralph Nieder-Westermann runs that call center, the Wyoming Lifeline.  He grew up in Mississippi and spent most of his adult life in San Francisco, but has come to love Wyoming… even its rugged weather… as he showed me when I met him at the front door of the call center in Greybull. 

Ralph: There was a huge gust of wind and this door had not been completely closed. It sheared the door off and the door landed right here.

Anna: That's when you can tell someone's new to Wyoming, they don't know that they can't just like swing open a door, that the wind might take it. 

On the day we met, he was wearing bright red Nike Air Force One’s and his long hair in a ponytail.

Ralph’s been coming to the state since 2015. When I first talked to him, on Zoom, he was out of town, taking care of his husband Jeff’s parents.

Ralph: I think it's important that as a gay couple, that we’re out and proud in Wyoming, in a small town like Greybull. 

Anna: How long have you and Jeff been together? 

Ralph: 40 years.

Anna: Whoa. Wait, how old were you when you met?

Ralph: Two?

Coming up, I talk with Ralph about preparing for the rollout of 988, and whether they’re ready. 

Ralph: The lack of resources is, it's a frustration to everybody who does this work.

This month, I’m guest hosting the NPR show It’s Been a Minute. And we’re talking about the launch of 988 over on that show too this week. I spoke with Hannah Wesolowski to learn more about how this launch is going nationally. Hannah is the Chief Advocacy Officer for the National Alliance on Mental Illness, and I asked how the trained crisis counselors who answer 988 calls are different from the people who answer 911. 

Hannah: The call is the intervention for 988. For about 80 to 98% of calls, they can be deescalated over the phone. So the immediate crisis can be resolved over the phone. And that can reduce the need for in-person response for many of these crisis situations.

And she told me, those crisis situations don’t all have to be about the risk of suicide. This system is designed to answer calls from anyone experiencing any kind of mental health crisis.

Hannah: You know, when I think about who might use it, um, I can think about parents who are worried about their teenage child who's pulled away and has become isolated. Or you know, a mother who recently gave birth who is really struggling. It could be a person who's experiencing some paranoia and doesn't know what is happening and needs help. You know, anyone who's struggling with what's going on in the world and is feeling intense, emotional distress.

So Hannah and her colleagues in the mental health community are expecting, and hoping for, a lot more calls. You can hear the rest of my conversation with Hannah over in the It’s Been a Minute podcast feed on Friday. She was wonderful to talk to, really knowledgeable about this new policy, and also all that still needs to be done to fix our mental health care system. I recommend listening.

This is Death, Sex & Money from WNYC. 

I’m Anna Sale.

When I met Ralph Nieder-Westermann in Greybull, Wyoming, he was just back from Casper pride. He took a bunch of postcards advertising the Lifeline. 

Ralph: This card says ‘it takes courage to open up and heal.’ I call this one hunky cowboy, and this one is just… farmer.

Anna: Yeah.

For most of his working life, Ralph worked for an airline. His husband runs a marketing firm, which is how they got into the call center business to begin with.

Ralph gave me a tour of the center, which was quiet, now that everyone at the Lifeline is mostly working remotely. 

Anna: Here's the break room.

Ralph: The break room, the fridge.

Anna: I’m gonna check the fridge. Is there anything in here? 

Ralph: There’s nothing in there.

Anna: Oh, it's totally, all it has is ketchup and mayo and mustard.

Ralph: Right? We emptied it out because…

Anna: Oh, it's an empty office.

Ralph: We had turned it off. It's an empty office.

It’s empty, but they’ve been busy. The Lifeline only just expanded their hours to cover seven days a week in March, in anticipation of the launch of 988.

Anna: Have you felt a sense of an uptick?

Ralph: I'll show you. I'll show you the graph. Why is it so small? Cause I have a much bigger screen at home. 

Anna: I see, yeah.

Ralph: So here we are. Um. So this shows you what's been going on. We went– in March is when we went, uh, to seven days a week, 12 hours a day. So the spike, January and February, we had 50, 55 calls, 82 calls in March, a dip in April, we had 97 calls in the month of May, through yesterday we’ve had 47...

Then in June, they got the most calls ever. More than double their monthly numbers from the winter.

Ralph: 988 will go into effect on July 16th, come hell or high water. It doesn't matter if you're ready or if you're not. I was reading an article, excuse me, tt was a report from the Rand Corporation that said no state is ready.  

Anna: Can you talk me through when you're answering calls, what, what is the experience of the caller? And then when do they connect with you and what do you see?

Ralph: If a call comes in, there'll be a little flag here. I will click, you know, pick up the phone. And then I will hear ‘press one to accept this lifeline call.’ We press one and then we're connected. At that moment, this contact form will pop up on their second screen. 

Anna: I see. 

Ralph: What happens is, as the person is calling, talking to the caller, you know, you start making some, some assumptions and you start filling out: why, why did you call? Um...

Anna: Is there a question here about access to firearms, on this survey, when a caller calls in? 

Ralph: It doesn't ask specifically, but do you have any methods? This is where we would put in a note saying ‘has, has access to a gun.’ It's Wyoming, everybody has access to a gun. And then here we have the suicide risk assessment section. And then…

There’s this little dial on the side of the screen that guides what the lifeline staff do next.

Ralph: When it gets to the red, then we're really in– we have somebody who is at immediate risk. And then all hands on deck, if we have enough information, we will then call, we’ll call emergency services and get somebody there right away. The last thing that we want to do is call 911. Um, I have been on a call with Casper police and this was a third-party caller who was worried about his friend and I was on the line the entire time. And I would just say that the way this police officer in Casper handled the situation was amazing. I wish everybody would. I've also had some other in smaller towns where the response from 911 has been, um, ‘oh, we know exactly who it is, she does this all the time.’

Anna: I see. Do you have a memory of sitting right here looking at these two screens and having a phone call with somebody that, um, that really sticks out to you? Where you were really glad that you here in Greybull were the one answering the phone?

Ralph: There was, uh, I spoke to a woman who said– many times they begin, ‘I'm not suicidal, but,’ and I listened and she said, ‘You're not going to understand what it's like. I have all of these things going on in my life. And you don't know what it's like to live in a small town.’ And I said, ‘I live in Greybull.’ 

Anna: Hm. 

Ralph: You could hear the sigh. You could hear the sense of relief, 'You know exactly what this is like. I live in Cody.' And I was tempted to say, ‘and that's the big city I go to, to go shopping.’

Calls get personal at the Wyoming Lifeline — for those who dial in and for the people picking up the phone. Adam Smith does that full time for the Lifeline. He grew up in town.

Adam: I actually left, uh, Greybull the day after I graduated. Um, I really didn't like it here. 

But he moved back to take care of his dad, who was diagnosed with bipolar disorder and struggled with his mental health. 

Adam: And I’d get a call from my mom, like, ‘okay, you got to come home, you know, he's not doing well.’ And I would hop on a plane immediately and come home. But, um, yeah. And that's, that's kinda what brought me back about four years ago too. And I just decided to stay.

Anna: And, and was it your sense and your father’s sense, um, that he got adequate care? There was good care for him as somebody struggling with–

Adam: Actually no, he didn't. Um, he had to go to three different, uh, for better words, mental hospitals, before he got the treatment he needed. And the treatment he got was in Denver, Colorado.

Anna: I see. He had to leave the state.

Adam: That helped him. Yes, he did. 

Anna: Uh-huh. So you're like in your, uh, sort of late thirties, coming up on your late thirties, when you move home, um, what did you think you were going to do for work when you came home? 

Adam: That's a really good question. Um, I had no idea because there's ranching jobs, there's the railroad. Uh, and then there's like bartending jobs, I guess I might've landed one of those. Or cooking in a restaurant, something like that. And then I found an IT position. And then one day Ralph came in and I heard him kind of, I was getting a cup of coffee, I think, or something. And they were talking about the lifeline. And I was like, what's this all about? And I was like, ‘is there any openings?’ And Ralph was like, ‘actually we're looking for another person.’

Anna: On a typical – we’re talking in February – on a typical day, how many calls would you get where you, would you say where you, where you are concerned that, that the person who's calling in might harm themselves? 

Adam: Um, it varies. It really does vary. There can be sometimes three calls a day. Sometimes there can be none. Um, I think probably one of the worst ones I had where I had to stay with the one person on the phone because, uh, we're waiting for dispatch to get there to help her. And, uh, yeah. Some of them are hard calls for sure. Very hard calls. Because you feel at times, like, I don't know, I do anyways, like I betrayed the person's trust when that knock on the door comes and it's the police. And, uh, you know, they're so either deep in a psychosis or they're, you know, really intent on ending their life that they feel betrayed. But I think that them calling the lifeline is them, a part of them still wants to live. So I try not to take that to heart too much, but it's kind of hard sometimes. 

Anna: Yeah. Have you ever struggled with mental illness yourself?

Adam: Uh yeah, I have. I am bipolar. Um, and I told Ralph that when he hired me actually. And we would, we would kind of joke about it when I would work on, uh, some days I'd come in to the office and be like, ‘well, it's kind of one of those manic days Ralph.’ And he'd just be like, ‘oh, okay.’ And, you know, cause I would have super high energy, and making coffee and running around the office, you know, doing things for people.

Anna: What is it like for you when you have a difficult emotionally draining phone call and then your colleagues are not nearby? You're, you're handling it by yourself?

Adam: Well, for me, it's music, really, is what helps me the most. Um, Elliot Smith, I don’t know, um, Grateful Dead.

Anna: Something Adam, about listening to Elliot Smith after an emotionally taxing phone call...

Adam: I find Elliot Smith's music actually really kind of, I don't find it depressing at all. Some of it can be, but you know, some of it can be really upbeat too, I find.

Anna: And beautiful. Just beautiful.

Adam: And, oh yeah. Just amazingly beautiful music.

If you call the Wyoming Lifeline and there aren’t any local operators available, you're rolled over to a national call center. 

But Adam just got a little extra help, when the Wyoming Lifeline hired one more person to answer calls locally, thanks to a small federal grant. And earlier this year, the legislature directed more than than $2 million dollars in Covid relief money to further increase suicide lifeline capacity in the state.

Jason: Usually within minutes, I can tell when I'm starting to have negative thoughts. Sometimes I've noticed it the moment it happens. So I've been able to shut it down. 

Back in Casper, Jason is occasionally living with negative thoughts and learning how to respond to them. His psychiatrist diagnosed him with OCD, which made sense to Jason– it felt like something he could work with.

Anna: Um, are, does your, do your bosses know– are you open about your mental health diagnosis at work among coworkers?

Jason: Uh, yeah. Actually where I work now, um, for not much longer, cause right, right now I'm, I'm driving a semi and it's not, you know, the best career, especially to have for a young family. So I've been trying to get out of there. Um, I have a degree in geology, so that's been my ultimate goal. That's actually where I'm gonna go, fortunately– fortunately, I’m gonna use my degree here in about two weeks, just put in my notice.

He told me he’ll be working as a production geologist at a uranium mine.

Anna: Is that nearby, near, near your home? 

Jason: Uh, kinda. It's a two hour drive, so, um, further away than I woulda want, but it's in the industry that I want. So I'll definitely take and give. 

Anna: That's awesome. Um, will you come and go each day, do you think? 

Jason: Uh, yeah. There's a few that work out there that are from Casper already and they all carpool every morning in a company vehicle. 

Anna: Oh, that's nice. So you'll have some buddies on the road. 

Jason: Mhm, yeah.

Anna: Yeah. Um, I just have a few more questions for you, Jason. Um, one is, uh, do you have any firearms in your house? 

Jason: Uh, yeah, I'm actually a hunter. Um, my wife is too. Which I know that sounds weird that the person that's open and still has suicidal thoughts has firearms in the house. But yeah, we do. To me, it's how you go about having 'em in your house. 

Anna: Have you, like, do you have a safety plan as far as the firearms in your house for when you don't feel healthy?

Jason: Uh, yeah. They're in a safe that's locked up that I don't have the code to or the key to. 

Anna: Oh, really? 

Jason: So that's, that's about as safe as you're gonna get. 

Anna: And how did you decide that you didn't get to know the code?

Jason: Uh, actually when I first started all this, we didn't have a safe. And so it was based off of, my wife trusted me to let her know that I wasn't safe to have firearms in the house. And that's not a safe plan at all. It's not a good plan and have a– it's not. But it worked. But at the, the entire time I was like, we need to get a safe. And told my wife that ‘you're the only one that's gonna use the code, know the code.’ 

Anna: You said that.

Jason: Yeah, it was, it was all my idea. So I don't want to be able to have the code and, and be able to get to the firearms. Now, like, if she's at work and I'm on a day off and wanna go shoot guns with my buddies, that she, she will let me have the code. But as soon as she gets home, she changes it.

Anna: I see.

Jason: So there, so then there's, I don't know the code for more than a few hours.

Anna: Mm-hmm. And do you feel comfortable, like, will you go out hunting by yourself?

Jason: Now I do, yeah. But at first after, uh, my first time being institutionalized in 2013, uh, I was terrified to be alone anywhere– around the house, driving, hunting. I was– cause I didn't know what I would do. I couldn't trust myself. But now I, I'm comfortable with it. I've done it a few times since then, even after my attempt. Just, it's almost being out there, hiking around, looking for wildlife, whatever it is is just. It almost seems impossible at times to be suicidal, for me. It's kinda like it doesn't even, doesn't even come up.

That’s Jason Whitmire, in Casper, Wyoming. Again, if you are struggling with your mental health, please reach out. You can call 988.

Death, Sex & Money is a listener-supported production of WNYC Studios in New York. This episode was produced by Lilly Clark, along with Katie Bishop, Julia Furlan and Caitlin Pierce. The rest of our team is Zoe Azulay, Afi Yellow-Duke, Emily Botein, and Andrew Dunn.

Thanks to Carol Bell and Savannah Collins for their help on this episode. 

The Reverend John Delore and Steve Lewis wrote our theme music. 

I’m on Instagram @annasalepics, that’s P-I-C-S. The show is @deathsexmoney on Twitter, Facebook, and Instagram.

Thank you to Jeri Lim in Whitestone, New York for being a sustaining member of Death, Sex & Money and supporting us with a monthly donation. Join Jeri and support what we do here by going to deathsexmoney.org/donate.

I’m Anna Sale and this is Death, Sex & Money from WNYC.