Elfrida Johnson sat on the stairs of her porch crying.
One trembling hand held a lit cigarette; the other absently stroked an orange cat.
This is what a broken woman looks like, she said.
"I don't know when I will be able to get over it," said Johnson, 52.
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Johnson's sister, Aletha King, took her own life. She died Aug. 17 after she lay on the railroad tracks behind her home at Ponderosa Mobile Home Park off Lisle Road at the Fayette-Scott County line. She died of multisystem trauma after being struck by a train, according to coroner's reports.
King's death is one of two suicides that grabbed headlines in Lexington this year. In July, former University of Kentucky basketball star Melvin Turpin, 49, apparently shot himself at his Masterson Station home, according to coroner's reports.
As of Friday, the deaths of King and Turpin were among 37 cases this year that were ruled suicides by the Fayette County coroner.
Since 2005, there have been more than 250 deaths — an average of 50 a year — that were classified as suicides in Fayette County, according to Deputy Coroner Miles White. (Not all of those are Fayette County residents; some were flown to University of Kentucky Chandler Hospital from other counties.)
There have been more than 3,000 suicides statewide since 2005, according to data from the Kentucky Violent Death Reporting System.
Suicides outnumber homicides in Kentucky nearly three to one, according to the Cabinet for Health and Family Services. Statistics from 2007, the most recent available, ranked Kentucky 10th highest in the nation for suicide deaths per capita.
It's a number that state and local officials are trying to reduce. The effort to increase awareness will ramp up this week during National Suicide Prevention Week.
Throughout the week, organizations all over the country will hold forums, conferences and speeches to raise awareness of suicide prevention. Topics focus on recognizing warning signs, such as a family history of depression or withdrawing from friends and activities, and teaching people how to seek help through hot lines and local mental health centers.
This year, two new state laws require suicide training in Kentucky public schools.
The University of Kentucky counseling center is also embracing national training initiatives to educate college students about suicide, said Mary Bolin, director of the UK center.
The counseling center hopes to teach students through "layperson's training" or "gatekeeper training" to recognize the warning signs of suicide, and how and where to get help.
"It's not meant to turn people into professionals," Bolin said. "But in an ideal world, everyone would have some basic level of awareness of suicide risk factors and warning signs."
That's critical because for each person who commits suicide, 20 more might attempt it and hundreds more threaten it, said Dan Phillips, a criminal justice professor at Lindsey Wilson College and suicide specialist.
Officials said the ultimate goal is to address suicide before it occurs.
Johnson said King, a woman her family described as "wonderful" and "big-hearted," had been depressed for a long time but had managed her mental problems.
Turpin's family has said there were no warning signs, leading some to question whether his death really was a suicide.
Though Turpin's wife had suffered a stroke about three weeks before he died, Margaret Burrus, his sister, said Turpin had appeared to be coping.
"I still say he didn't do it. It was a possible accident," she said. "I don't see how someone can shoot a gun to his chest."
A mother gets involved
According to Jan Ulrich, acting suicide prevention coordinator with the Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities, suicide is the second leading cause of death in the state for 15- to 30-year-olds, after accidental deaths such as car crashes.
It's something she has intimate knowledge of.
In 2002, her son Nathan Eisert, a Western Kentucky University basketball player, killed himself after battling depression. His battle seemed to escalate after an injury that took him off the court.
That is, in part, why Ulrich got involved with the Kentucky Suicide Prevention Group, a grant-funded state advocacy group, and later took a job with the Cabinet for Health and Family Services, which reviewed two recent pieces of legislation to bring suicide prevention education into Kentucky public schools.
Senate Bill 65, which was signed into law April 15, requires that principals, guidance counselors and teachers receive a minimum of two hours of suicide prevention training each year. House Bill 51, signed March 4, requires that all public middle and high school students receive suicide awareness information by Sept. 1 of each school year.
The goal, Ulrich said, is to teach kids to recognize the signs when they or a friend feel suicidal, and to report their suspicions to a qualified adult.
"Over and over and over again I hear from students that ... 'she told me she was going to do it. I didn't believe her. I didn't know what to do,'" Ulrich said. "They think that the best way they can help a friend is to keep a secret."
Schools have some flexibility in how they meet the new guidelines, but Ulrich said she's been impressed because so many schools are going above and beyond by hosting forums and discussions rather than simply handing out pamphlets.
"If you give a teen a brochure, you know where it's going to end up," she said. "If you're lucky, the trash. But probably the floor."
When her son died, Ulrich said she was startled when she found out how prevalent suicide is in Kentucky.
"As I started hearing more about the specifics, I started getting angry," Ulrich said. "I knew to teach my kids to look both ways to cross the street, the dangers of smoking and drinking." But she didn't know to teach about suicide.
Simply talking, listening
Lexington police spokeswoman Sherelle Roberts said officers respond to several calls a week from people threatening to commit suicide, or from their friends or family.
All sworn officers in Lexington receive 16 hours of training as recruits and additional training every three years for dealing with the mentally ill, including suicidal people, Lt. Rodney Sherrod with the police training academy said.
Sherrod said officers are trained to talk, listen, reassure and be patient.
"Officers have got to be able to communicate to this person," he said. "We don't teach (officers) to use any type of deception or tricks. You can escalate the situation by the way you talk."
As with layperson's training, police training says that talking and listening can be key to saving a life.
Often, Bolin said, suicidal people might be swayed even by hearing the simple phrase "What's wrong?"
"Sometimes it's enough for them to realize 'somebody cares about me enough to take time out of their busy day to sit and talk with me.'"
Warning signs were there
According to Shirley Conn, King's older sister who lives in Homestead, Fla., King was born in Whitesburg, where her father was a sheriff's deputy and her mother worked part-time in a school cafeteria. The two divorced when King was about 7.
For almost as long as Conn can remember, King, 54, suffered from depression. She took medication after being diagnosed as unipolar and bipolar. She also suffered from costochondritis, an inflammation of the cartilage between the ribs and breastbone that caused constant pain, Johnson said.
Despite that, Johnson said, she didn't recognize the warning signs. Even at her worst, she said, King was full of love and always tried to make others laugh.
King had moved back to Kentucky about five months before taking her life. She had stayed with Conn and then her niece, Conn's daughter, in Florida for more than a year before moving in with Johnson.
Looking back, King's sisters said they can see signs that King planned to take her life, warning signs identified in layperson's training.
"I didn't know what they were," Johnson said. "I wish I did because maybe I could have stopped her. But I can't bring her back now."
On Aug. 16, the day before King died, Conn received a text message from King saying "she had a great day, telling me she'd talk to me soon."
Often, Bolin said, people feel a sense of relief after making the decision to commit suicide. For a day or two before, they might seem happier and more active, she said.
The week before King's death, Johnson said, she found King lying on the front porch after taking too much of her medication. Looking back, Johnson said, she thinks King was trying to commit suicide by overdosing.
"If someone has made a suicide attempt previously, they are statistically more likely to make another attempt," Bolin said.
Conn said her family has a history of depression, and four members committed suicide before King.
Having a family history of suicide can be a warning sign in and of itself, Bolin said, because suicidal people "have had that example as a perceived solution."
While suicide prevention education might have set guidelines, grieving the death of a loved one is painful, vague and different for every one Bolin said.
"It's a complicated kind of grief."
Family members are dealing with King's death in their own ways. Johnson, who said she initially wore King's clothes as a way to stay close to her, is in the process of moving King's possessions to storage, to eliminate those reminders.
Conn said the hardest part about the death was keeping it from their mother, who is 84 and in the advanced stages of Alzheimer's disease. She has forgotten her daughter has died, Conn said, and regularly asks Conn to call King to check in.
But both women said they took comfort in knowing King was in a better place, and they hoped that her pain had finally ended.
"She was an angel. And now she is our angel," Conn said. "I know now that she is at rest and at peace, and she's watching over me, and that's what is getting me through this."