Sept. 22 was the last time Anna Hofstetter saw her dad.
Rick Hofstetter came to her son’s seventh birthday party, and even brought the cake, an elaborate dragon which his girlfriend had made. But he didn’t stay long, not even for the cake cutting.
When her daughter celebrated her fifth birthday a month later, “Opa” was noticeably absent.
Rick, 63, died by suicide the evening of Oct. 1 at his girlfriend’s home in the Greenwood area.
Anna, the second-youngest of his four children, learned about it in a phone call the morning he was found.
“I was shocked,” she said.
Two days earlier she had just had a dream about her dad dying, but not like this. “I remember thinking, ‘I’m too young to lose my dad,’ and I woke up and it took me a minute, like, ‘It’s just a dream; all is good.’ And I definitely don’t think that was a premonition by any means, but it was two days later I got the call,” she said.
Rick, best known in Brown County as the longtime owner of Story Inn, had been splitting his time between Brown County and the Indianapolis area for awhile. He and Anna, of Nashville, would see each other a couple times a month; they would rarely go a week without talking.
Often, their conversations were about surface stuff. Sometimes, they were deeper. Usually, Anna would initiate those.
“My dad was a kind of a secretive person, and he wouldn’t share a lot of stuff with us,” she said. “As a child, it was hurtful, but as a parent, I’m kind of trying to understand (where he was coming from).”
At the party, Anna and her dad kidded about the water balloons the kids were throwing. “We were joking about how maybe in hundreds of thousands of years, or millions of years, this intelligent species of archaeologists will uncover the backyard, and they’ll be doing carbon-dating on these little water balloon bits and figure out, ‘Oh, circa 2019, that was 20 years before the human race went extinct.’ … That’s the last conversation I really had with him.”
He called a day later to explain why he left the party early — because he and his girlfriend planned to have dinner at a particular time — but that was it. “I said, ‘It’s no big deal; it’s fine,’” Anna remembered.
Looking back now, she said it was odd he didn’t really interact with the kids at the party. “He loved being the center of attention, and kids have a lot of attention to give, especially if there’s an old man being silly with them.”
She knew Rick had been dealing with a lot of stressors, financially and with his health. But it was tough to get that kind of information out of him.
After his death, Anna and her siblings decided they wanted to talk about the fact that their dad died by suicide in hopes of reaching other people, and of normalizing the idea of discussing tough emotional issues.
“Nobody’s perfect,” Anna said — not even her dad, though he often claimed he knew everything. That was plausible to a young girl; he was a champion swimmer, a Duke University-educated attorney and law professor, in addition to owning Story’s quirky inn, gourmet restaurant and tavern.
But everyone has things they struggle with, she said, and she wishes people would feel more free to talk about them — even if what they’re dealing with privately might conflict with who they appear to be publicly.
“I think my dad, he didn’t want to become old,” Anna said. “He was always such a strong guy, and he started having these health problems about a year ago … and I didn’t realize it, perhaps, that he was so sick. I didn’t know. He was so secretive about a lot of things.
“Maybe that’s one of the answers of preventing, is like, I remember several occasions I would talk to my dad, like he put Story up for sale and he didn’t even tell me about it; he wrote us an email. There was no discussion about it. … I know now, it must have been a little embarrassing for him, and I get that, but what he probably didn’t understand is that I didn’t care what kind of a situation he was in; I just wanted to be kept in the loop,” she said.
Organizations that focus on suicide prevention stress that the causes behind suicide are complex.
Some risk factors make it more likely that someone may consider, attempt or die by suicide, according to the National Suicide Prevention Lifeline. Those include alcohol and other substance abuse disorders, impulsive and aggressive tendencies, major physical illness, job or financial loss, loss of a relationship, stigma associated with asking for help, and lack of healthcare including access to mental health treatment, among others.
Anna believes that her father’s medical problems and mounting bills were “a contributing factor to his depression,” though she doesn’t know if he recognized that for what it was. He’d always been “really disapproving” of mental health treatment, she said.
The National Alliance on Mental Illness reports that 90 percent of people who die by suicide had shown symptoms of a mental health condition. “Depression is the most common condition associated with suicide, and it is often undiagnosed or untreated,” says the American Foundation for Suicide Prevention.
Talking about it is what mental health professionals recommend.
“If you or someone you love are thinking about suicide, tell someone, anyone,” said Amanda Kinnaird, child and family services manager for Brown County Centerstone.
It can be hard for someone who’s experiencing those thoughts to reach out, she said. “Ask them directly: ‘Are you thinking about ending your life?’” If they are, “Listen without judgment and seek professional intervention immediately,” she said.
“Remember, mental illness and addiction are treatable and recovery is possible.
‘Remain hopeful’
Nationwide, suicide as a cause of death has steadily increased since 2006, according to an Indiana State Department of Health report released in 2017.
From 2011 to 2015 — the most recent report available — suicide was the 10th leading cause of death in Indiana.
Seventeen residents of Brown County died by suicide during that period out of 4,696 total in Indiana. Taking into account Brown County’s number compared to the county’s population, Brown County ranked fourth-highest of all 92 Indiana counties for suicide deaths between 2011 and 2015.
Between 2016 and 2019 thus far, 11 more people died by suicide in Brown County, according to Coroner Earl Piper’s records. Nine of those deaths have occurred in the past two years, and four of them have been since this August.
Men accounted for 79.4 percent of all suicide deaths in Indiana, and 93.4 percent of those were white men.
“Although statistics on Indiana suicide are discouraging, we must remain hopeful and focused on education and prevention,” Kinnaird said. Resources are improving for Brown County residents, she said, and “efforts are being made to combat the negative impact of stigma related to mental health and substance use.”
“Just as physical health needs fluctuate in nature and significance over time, so do mental health needs,” she said.
Rick’s girlfriend, Justine Fearnow, said that that was one of the last conversations she had with him: “’You need to talk to somebody. You need to have some kind of a sounding board. You need to talk about this, and it’s obviously getting really stressful for you,’ and he said, ‘I can’t afford it.’ He said, ‘You get what you pay for.’ … Which is not necessarily true; there are mental health centers that will provide services at low cost, and they’re perfectly fine. So he was not really open to that. And I think he perhaps had a little darker side to him than was recognizable to most people.”
Mental health professionals and groups that focus on suicide prevention say that suicide is not preceded by a single event; there are almost always multiple causes built up over a long period of time.
Those groups give several warning signs that loved ones can look for in a person who might be considering suicide. Those include feelings of hopelessness, feeling trapped or desperate, identifying as a burden to others, saying others would be better off without them, reckless behaviors, mood changes, uncontrollable anger, loss of purpose, and withdrawal from family and friends.
Other indicators may include putting affairs in order, giving away possessions, saying goodbye or providing a testimonial of their love for people, anxiety or agitation, or talking about wanting to die or the subject of suicide.
The majority of suicidal people show warning signs, according to the American Foundation for Suicide Prevention.
It was obvious to Fearnow that Rick was struggling, but it wasn’t like him to cede control. They talked about how he was feeling, she encouraged him to seek help, and she reassured him that everything was going to be OK.
“He saw himself as stoic and strong, and like things were spiraling out of his control, and that really bothered him. … You just don’t think that a person’s going to get that far down, because he had a lot to live for. He had people to talk to. He had very good close friends, a couple male friends who he loved to sit and have beers with and just talk. We had our relationship. He had lots of friends, and he had grandchildren who just adored him. …
“You would think that the supports that he had available would have been enough, but it depends on the person, too, and how willing they are to accept help from other people. … They have to believe what you’re telling them, that things will get better.”
Kinnaird says she hopes that continued work to release the stigma about mental health treatment will help people take that step.
“For those individuals not able to take that leap yet, I would encourage families to remove lethal means and take other safety planning measures, such as ensuring crisis lines are available and family and friends are checking in on their loved one,” she said.
“It may also be helpful for family members to seek professional support for themselves to best determine how to take care of themselves and steps to support their loved one. If someone is ever worried about the immediate safety of a family member, you can call in emergency services for support as well.”
Unanswered questions
Coroner Piper, who’s also worked as a funeral services assistant for 28 years, has talked with many families as they’re trying to work through a loved one’s death, including deaths from trauma such as suicide.
From survivors, “You constantly have the ‘What could I have done to have changed this?’ You have the guilt syndrome, which is misplaced for the most part. You have the ‘I find it hard to believe that they would have done this,’ so there’s the denial portion that we run into. And then you get the ones that are ‘This was not totally a surprise; we tried everything we could do, and we don’t know what else we could have done to have helped.’
“And then anger comes out … ‘How could this person … be so selfish because of what they’ve done damage-wise on the family?’ They’re trying to deal with it, understand it, explain it, so it’s quite traumatic in some circumstances, and really, sometimes, it’s been several minutes up to half-hours and longer just talking to families about their feelings, just to vent.”
For every suicide, it’s estimated that an average of six people are directly impacted and suffer “intense grief,” according the Indiana State Department of Health. Those are considered to be “survivors of suicide,” and that group also is at increased risk, the ISDH reports.
“You want to have one more conversation,” Fearnow said, “one more time to say, ‘No, this isn’t what you need to do; this is not the course to take. But we are left to move forward, and we all will hopefully, successfully do that.”
Saturday, Nov. 23 is International Survivor of Suicide Loss Day. That morning, the Suicide Prevention Coalition of Johnson County will have an event at the Franklin library designed to bring loss survivors into the same space to connect and find understanding and hope. A similar event will occur in Bloomington that afternoon at St. Mark’s Methodist Church.
“We often feel as if no one knows what we’re going through, and to an extent, that’s true,” said Kathleen Ratcliff, executive director of Upstream Prevention Inc., which is helping to organize the Franklin event.
“However, there are others who are also feeling loss and grief following a suicide, and bringing survivors together to share and process grief in a safe environment can help the healing process.
“The coalition wants to break down the stigma and silence that surrounds suicide, and one of the ways we’re seeking to do this is to offer this day of hope and healing,” she said.
Fearnow has been leaning on her family to help her cope, and the comfort of her animals, including Rick’s dog, Snow.
Anna has been talking to her therapist. It’s helping.
“I keep thinking about what was going through his mind in the moments leading up to it,” Anna said.
As for the big question, “Why?” “I think that’s one of those things that’s never going to be answered, but it’s hard not to think about it,” she said.
“Fortunately, as far as I am in this whole process, I haven’t felt guilty per se, which I think, from what I understand, it’s what a lot of people struggle with. I don’t know why I haven’t felt that way — maybe I will, maybe I won’t. I don’t know.”
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The Brown County Democrat does not normally identify victims of suicide, but Rick Hofstetter’s family wanted to be open and transparent about his cause of death.
“We were hoping that maybe something good could come out of something so tragic,” said daughter Anna Hofstetter of Nashville.
ReportingOnSuicide.org provides professional guidance for journalists covering this topic, which we studied. “Covering suicide carefully, even briefly, can change public misperceptions and correct myths, which can encourage those who are vulnerable or at risk to seek help,” the site says.
“I don’t know how thrilled he would be about this becoming public, but I think about, the same time, he kind of gave those rights up,” Anna said. “… I just hope that it can bring light to this affliction that so many people struggle with and maybe help more people talk about it more openly.
“It’s important to talk about these things … so that people don’t feel so alone.”
Gather together with others
Nov. 23 is International Survivor of Suicide Loss Day.
The Suicide Prevention Coalition of Johnson County — a new group formed this past spring — is hosting an event that morning at the Franklin branch of the Johnson County Public Library, 401 State St.
Suicide survivors, friends and family are invited to gather at 9:30 a.m. that Saturday for a light breakfast. A program will start at 10 a.m., offering visitors a chance to network and connect with creating a craft to take home and remember their loved one through the holidays and beyond. The program, ending at noon, also will include the showing of a short documentary produced by the American Foundation for Suicide Prevention, a discussion and a closing ceremony.
Suicide loss survivors and their supporters are asked to register to attend at afsp.org/survivorday. With questions, or to make a donation to support this event, contact Kathleen Ratcliff at [email protected].
A similar event will take place in Bloomington the afternoon of Saturday, Nov. 23, sponsored by the Monroe County Suicide Prevention Coalition. It will be at St. Mark’s Methodist Church, 100 State Road 46, from noon to 3 p.m. Details are posted at afsp.org/survivorday.
Because the Christmas holidays are a difficult time for people who are grieving, in the past the Nashville United Methodist Church has sponsored “The Longest Night” service, a non-denominational prayer service to provide a space for people who are grieving and for whom the holidays are difficult. Details about that service this year will be announced soon.
Warning signs of suicide
- Talking about wanting to die
- Looking for a way to kill oneself
- Talking about feeling hopeless or having no purpose
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious, agitated or recklessly
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Displaying extreme mood swings
Warning signs are associated with suicide, but may not be what causes a suicide, according to the National Suicide Prevention Lifeline. The more of these signs a person shows, the greater the risk.
What to do to help
It’s important to be “patient and supportive” when approaching someone who may be struggling, says HalfOfUs.com, a website devoted to mental health. “You may not be able to understand how your friend is feeling and it may seem uncomfortable and awkward to discuss personal and emotional issues, but you can listen and let them know they aren’t alone.” Some key points to convey in that conversation:
- We all go through tough times.
- You can feel better.
- It’s OK to ask for help.
If someone you know exhibits warning signs of suicide:
- Do not leave the person alone.
- Remove any firearms, alcohol, drugs or sharp objects that could be used.
- Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK.
- Take the person to an emergency room or seek help from a medical or mental health professional.
Local resources in place
Suicide prevention resources are improving in Brown County, says Amanda Kinnaird, child and family services manager for Brown County Centerstone. A Centerstone office recently moved and expanded in Nashville. It’s at 1156 Old State Road 46. The phone number for appointments is 800-344-8802; the crisis line number is 800-832-5442.
Centerstone also has a presence in Brown County schools as a “partnership to provide life skills and therapy” in the schools. “This initiative addresses a major barrier facing many rural communities: accessibility,” Kinnaird said. “Early intervention is key to improving outcomes.” Head Start also has opened its classrooms to Centerstone services.
Adults can access many types of treatment through Centerstone, including therapy, life skills, health coaching, recovering coaching, etc., Kinnaird said. Centerstone also has a psychiatrist and a nurse practitioner who see adults and children in the Nashville office when medications are a part of the care plan.
“If you are interested in joining our local System of Care, please reach out to [email protected],” Kinnaird said. “There are several initiatives this group is currently undertaking in Brown County to combat mental health stigma and to more effectively address suicide prevention.”
Schools’ role
Last week, the Brown County Schools Board of Trustees passed an update to its suicide prevention policy.
According to a state law passed in the summer of 2018, all superintendents, principals, teachers, librarians, school counselors, school psychologists, school nurses, school social workers and “any other appropriate school employees” are now required to receive “evidence-based youth suicide awareness and prevention training.”
Superintendent Laura Hammack said that the district had a suicide awareness and prevention in policy in place prior to this, but it needed to be improved. School counselors have worked with other team members for about a year to develop a much more comprehensive policy, and that’s what the board approved Thursday night, she said.
The policy includes a response procedure for aiding students who may be at risk; a re-entry procedure for students returning to school after a mental health crisis; and a “postvention” process detailing a school’s response to a student’s death by suicide. It also includes guide sheets for educators and parents when talking to a student who may be in crisis.
On the Web
Indiana Fact Sheet from the American Foundation for Suicide Prevention: https://afsp.org/about-suicide/state-fact-sheets/#Indiana
American Foundation for Suicide Prevention: https://afsp.org/chapter/afsp-indiana
Combating mental health stigma: https://bringchange2mind.org
National Suicide Prevention Lifeline: https://suicidepreventionlifeline.org
Centerstone mental health services: centerstone.org
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