Peer Support, Not Perfect Words, Key to Suicide Prevention

Trigger warning: suicide

Health care providers don't need perfect words to support patients experiencing suicidal thoughts—they need presence, according to a new Managed Care Cast episode that discussed suicide prevention from both professional and lived-experience perspectives.

Jeremy Carter, manager of housing strategy at UPMC and founder of the Pittsburgh-based peer support nonprofit Still Here, shared that his own suicide attempt followed a period of profound numbness rather than visible distress.

"People think suicide often looks like crying, despair, panic, but sometimes, like for me, it looks like going to work, smiling, functioning, checking every box, while feeling just absolutely nothing inside," he said.

Connection Over Clinical Checklists

Mandy Fauble, PhD, LCSW, vice president of operations for Western Behavioral Health at UPMC and a longtime Applied Suicide Intervention Skills trainer, said patients remember whether they felt cared for and heard more than any specific question on a suicide risk assessment. She emphasized slowing conversations down and building relationships before moving to intervention steps like safety planning.

Both speakers underscored that recovery is nonlinear and extends well beyond a single crisis contact. Carter noted that resources like the 988 Suicide & Crisis Lifeline are valuable for interrupting isolation in the moment but represent "the beginning of seeking help," not the finish line.

Addressing Care Gaps

Fauble also pointed to substance use disorder as an underdiscussed risk factor often siloed from suicide prevention conversations, urging clinicians to assess individual risk holistically rather than by diagnostic category.

"Recovery is real, and just like people who are struggling with suicide, they don't have to do it alone,” Fauble said.

For providers uncertain how to start these conversations, Carter's advice was direct: acknowledge the disclosure, express care, and know community resources—because clinical treatment alone doesn't cover every need.

If you or someone you know is in crisis, call the 988 Suicide & Crisis Lifeline or visit SAMHSA.gov for more resources.

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