Suicide remains South Carolina’s quiet killer

Despite years of concerted prevention efforts, suicide remains South Carolina’s quiet killer, claiming about twice as many lives annually as more headline-grabbing causes of death, such as homicide and alcohol-related car crashes.

The numbers, experts say, are stark.

Every year, more than 800 South Carolinians take their own lives, making suicide the 12th leading cause of death in the state — and the third leading cause for teenagers and young adults. And at a rate of 14.68 people per 100,000, S.C.’s suicide rate is notably higher than the national average of 14.12.

In interviews this week, experts and advocates told Statehouse Report that S.C.’s suicide rate is driven by a complex set of demographic, cultural and legal challenges, including a large rural population, stubborn social stigmas surrounding mental health, and the widespread availability — and lethality — of guns.

What’s more, some advocates argue, recent policy changes at the federal level have further complicated efforts to reduce suicide nationally and in the Palmetto State.

In particular, they say, the Trump administration’s decision in July to end specialized counseling options for LGBTQ+ youth when they call the 988 national suicide prevention hotline was a step in the wrong direction.

“Specialized support services are deeply important,” said Cristina Picozzi, executive director of Columbia’s Harriet Hancock Center, noting that LGBTQ+ youth face higher risk of suicide than their heterosexual peers. “These services ensure that people [who are considering suicide] have a connection to individuals with the necessary training and knowledge.”

In response, Picozzi said, LGBTQ+-focused nonprofits across the state are working to close the gap through peer support services and referrals to specialized mental health providers.

“We’re doing what we can to pick up the slack,” she said.

State prevention efforts

Jessica Kobernik is the program manager for the Suicide Prevention Program in the S.C. Department of Behavioral Health and Developmental Disabilities.

In a Dec. 11 interview, she said her “small but pretty mighty” office is currently focused on four major prevention priorities, using a combination of state funding and federal grants.

S.C.’s 988 Lifeline: With call centers in Greenville and Charleston, the state’s 988 Suicide and Crisis Lifeline offers 24/7 counseling and mental health referrals. The 988 number is promoted widely throughout S.C., and is printed on the back of all school IDs from 7th grade through college. LGBTQ+ individuals are eligible to use this lifeline, but won’t receive specialized services.
Citizen training: Sometimes called “suicide first aid,” this initiative has trained more than 4,000 S.C. residents to recognize the warning signs of suicide and to intervene when necessary.
Youth-focused prevention: A statewide effort to embed suicide prevention outreach and educational materials into schools and local communities.
The Zero Suicide Framework: Aimed at adults 18 and over, this program works directly with large-scale organizations like the Medical University of South Carolina and the S.C. Department of Corrections to implement proven prevention practices throughout the state.

Other resources, Kobernik added, such as suicide screening, are available on the office’s website at osp.scdmh.org.

But in addition to state programs, she emphasized the importance of interventions by friends and loved ones.

“It’s OK to check in on anybody you might be worried about,” she said. “Let them know there’s hope out there, and the 988 Lifeline is there for them 24/7.”

That’s a point that Roper St. Francis psychiatrist Dr. Sarah Coker echoed on Dec. 11, saying it’s important to understand that “you’re not going to put the idea in anyone’s head.”

“Asking the hard question doesn’t make someone suicidal,” Coker said. “But it might just help them open up if it’s in a nonjudgmental way.”

Solving the biggest problem – guns

According to researchers, guns are the primary determining factor in whether any suicide attempt is completed.

In fact, statistics show that 90% of suicide attempts involving a gun result in death — as opposed to 5% to 10% using other means.

In South Carolina, guns are used in two-thirds of completed suicides — compared to about 55% around the country.

To address that problem, 22 states, including Florida and Indiana, have implemented extreme risk protection orders, or “red flag” laws, which allow police and prosecutors to temporarily remove a troubled person’s guns through a court proceeding where their rights are protected.

And according to a 2024 study by Duke University professor Jeffery Swanson, those laws are having a major impact, preventing one out of every 13 gun suicides in states where they’ve been passed.

“A red flag law is a unique legal tool that works for our country because it’s not gun control,” Swanson said in a Dec. 11 interview. “It just gives police officers clear legal authority with a court order to remove firearms temporarily from someone who poses an imminent risk to themselves or others.”

He added, “It’s not permanent and it’s not criminalizing. It’s just a civil restraining order, like a domestic violence order of protection.”

A push for a red flag law in S.C.

S.C. Sen. Darrell Jackson, D-Richland — a pastor who’s had to officiate at funerals for gun-suicide victims — says that kind of careful, rights-based approach makes sense in S.C.

That’s why, he said, he’s been introducing red flag legislation since 2022 — and why he plans to push hard for his current bill in 2026.

“I intend to aggressively pursue this legislation next session,” he said. “Red flag laws aren’t partisan and they aren’t just for blue states. This is just something we ought to do.”

The question, he said, is whether his GOP colleagues will give the bill a hearing, where people like Swanson could testify about their research. And to get there, he said, he’s prepared to compromise.

“I’m open to any changes that improve the bill,” Jackson said. “I just want to get to the point where we can have a real discussion and debate.”