The Rev. Talitha Arnold was just 2 years old when her father, a World War II veteran, took his own life.
"You just didn't talk about those things back then. We didn't even talk about suicide when I was in the seminary," says Arnold, who leads the United Church of Santa Fe in New Mexico.
Then, when the wife of one of her divinity school professors killed herself and no one muttered a word about it during the service, Arnold says she was appalled. "I was sitting there thinking, 'This was nuts. Why can't you name it?' " That was almost 40 years ago.
In the United States alone, someone dies by suicide once every 13 minutes. For the longest time, there was a cloak of secrecy about the details of a death by suicide, but talking about suicide may be the best hope for stopping it, according to researchers.
Until recently, many religious leaders were not well-prepared to talk about suicide with their congregants. Now some clergy have become an important part of suicide prevention.
"Where there's faith, there's hope, and where there's hope, there's life," says David Litts, co-leader of the Faith Communities Task Force of the National Action Alliance for Suicide Prevention.
Arnold also leads that task force. "If someone dies from heart disease, for instance, or in an accident, they may wonder where God is, but when someone dies by suicide, a whole lot of other questions get raised," she says. "When you can't talk about this in church, then it feels like God can't talk about it either."
But in her church, she says, there isn't shame surrounding suicide. During the pastoral prayer, for instance, she says she lifts up congregants dealing with cancer, heart disease or mental health issues. "It's a way of signaling to people this is a safe place to talk about such things and be honest about them."
In 2015, Barbara Bauer lost her 19-year-old son to suicide. She says her church, in Lake Forest, Calif., was a source of comfort. Her pastor's son had killed himself just two years earlier.
"Anybody who loses a child by suicide has some kind of guilt," she says. "Our church is very open to people and not judgmental. I felt we could be very real. We could cry. We could lament what might have been and what we could have done differently."
Looking beyond suicide as a sin
Historically, in many faiths, suicide has been considered a sin. Parishioners were stranded from finding solace in their houses of worship after a loved one died by suicide. Many faith leaders across the country have changed their understanding of suicide and mental illness through extensive training and peer support.
"Mental illnesses are not spiritual weaknesses or failure of faith," says Dr. Farha Abbasi, assistant professor of psychiatry at Michigan State University. She is also the director of the Muslim Mental Health Conference, which strives to dispel myths and cut through the fears that some Muslim Americans have around mental health.
She has worked with more than 100 imams to educate them in basic mental health and suicide prevention and trauma-informed care. She says it can be easy for imams to get overwhelmed by the demands of their congregations, which can include large populations of immigrants and refugees.
"We're now thinking differently," says Imam Sohail Chaudhry of the Islamic Center of East Lansing, Mich., which has about 1,500 congregants.
"In the past, we would jump to thinking of jinn, or spirit possession, as the only thing happening to a person in cases where they lost their ability to rationalize and make decisions. Now we understand that mental illness may be incapacitating that person," he says.
In 2012, roughly 23 percent of the nation's houses of worship provided mental health programming. That is according to the most recent data provided by a regularly conducted survey of American congregations, the National Congregations Study. Those services may include mental health ministries, special youth and adult programs, sermons and planned series of expert speakers on mental health concerns.
That percentage is up significantly from 2006, when only 8 percent of congregations reported sponsoring mental health programming.
The unique position of faith leaders
"Faith leaders have always been in a position to help whoever comes in their doors. One thing we found in our study was that certain congregational characteristics made a difference," says Eunice Wong, a behavioral scientist at the Rand Corp. and lead author of a recent study that analyzed data from the last wave of the NCS study.
One of many takeaways from the research was that congregations in predominantly African-American neighborhoods are more likely to sponsor mental health programming because their congregants are less likely to seek mental health treatment.
"It's definitely true that pastors have been challenged to become more qualified to address mental health issues," says Maurice Porter of Shiloh Baptist Church in Hartford, Conn., which is primarily African-American. "I'm sure there is more that can be done, but in my church, during weekly Bible studies, we always talk about specific issues we're going through emotionally and mentally."
When he sees a congregant in emotional pain, he says he tries to craft sermons around whatever issues they're going through because that is the time when everyone is assembled and listening.
And the same is true at Temple Aliyah in Woodland Hills, Calif., where Rabbi Ben Goldstein, who is also on Faith Communities Task Force, says he has experienced the toll of mental illness in his temple life and in his home life.
"People talk about mental health in whispers. I think there's definitely a fear to say what's going on. Our job on the task force is to eliminate that," he says.
In a recent High Holy Days sermon on the topic, he told congregants, "To all of those who are suffering from mental illness, know this: You are not alone. You are never alone. All you need to do is ask for help. Here, in this community, you will always have someone to whom you can look, to whom you can talk."
Cheryl Platzman Weinstock is an award-winning science writer specializing in women's health. She sits on the Connecticut Suicide Advisory Board. Find her on Twitter @CherylWeinstock.