LANDSTUHL REGIONAL MEDICAL CENTER, Germany - A canoe plummets over a waterfall and crashes into boulders below.

Moments earlier, as it nears the precipice, a bystander almost yells out a warning but assumes the canoeist is in control of the situation and remains quiet. Prior to that, several hikers watch the same person paddling obliviously past numerous signs indicating rough water ahead.

As in the scenario above, speaking up and intervening early can save the life of a friend, colleague or loved one contemplating suicide, said Maj. David Reynolds, chief of Clinical Health Psychology at Landstuhl Regional Medical Center.

"It belongs to everyone," the Air Force psychologist said of responsibility to intervene. "If you're concerned someone you know is contemplating suicide, don't keep silent."

Intervention is critical, Reynolds said, because it can help change the perception of a person contemplating suicide who thinks of taking his life as a long-term solution to what may be only a short-term problem. The vast majority of people don't commit suicide because they want to kill themselves, he said, but as a way to end the torment of not being able to cope with their problem.

Common problems include separation, disabling physical conditions, alcohol abuse, feared legal repercussions, emotional rejection or any overwhelming situation people feel they can't escape from.

"It can rock your world," Reynolds said of the emotional impact some face as the gulf widens between reality and their belief in how things should be happening. As an example, he cited the case of a young airman who was seriously distraught because he had not become the millionaire he'd envisioned himself by his mid-20s.

Signs or symptoms of someone contemplating suicide can include withdrawal from society, giving away personal belongings or actions as obvious as saying final goodbyes. In one blatant incident, an airman kept a book about how to conduct suicide in full view of her colleagues. No one came forward and the young airman ultimately committed suicide.

There was a time when people hesitated broaching the subject of suicide for fear of placing the thought in their mind. But if you have enough suspicion and concern to think about approaching the subject with someone, Reynolds said it's almost certain the idea has already been contemplated.

When confronting someone, Reynolds said consideration should be placed on "how" or "what" to ask. A direct question such as, "Are you thinking about committing suicide'" may draw a negative response. A more meaningful response might be elicited by phrasing the question in a different way, such as "Are you thinking of hurting yourself'" or "When was the last time you thought about committing suicide'"

If someone indicates they are contemplating suicide, you should help ensure they receive counseling. But at any level of care from friends or healthcare professionals, Reynolds said the key is attempting to find out what the problem is and helping them see there are alternatives other than suicide and help them see beyond the immediacy of their problem.

That was the case with one suicide victim who, upon receiving the news he had prostate cancer, acted on his immediate reaction to end his life. If he had taken the time and opportunity to speak with a healthcare professional, Reynolds said his outlook might have changed given the knowledge that recent medical history points to the disease as treatable and curable in many cases.

But someone who is suicidal often sees problems with tunnel vision and visualizes their problems as worse than others. The magic question Reynolds said you want to help them answer is: "What is the one thing that would make life better so you wouldn't feel the need to commit suicide'"

For example, if a relationship suddenly ends while someone is deployed, the service member may be convinced they've lost the only person they'll ever love. A friend can point out countless others have been through the same experience and have gone on to discover love again.

And once someone is identified and receiving treatment, Reynolds noted the importance in keeping track of how they're getting along and remaining aware of how their problem is being resolved.

The good news about suicide prevention is that it works, said Reynolds, noting that suicide rates among servicemembers are statistically less than their civilian counterparts.

For more information about suicide prevention, visit:

National Suicide Prevention Lifeline

Army Behavioral Health

Suicide Prevention Resource Center

U.S. Army Center for Health Promotion and Preventive Medicine

(Chuck Roberts serves with Landstuhl Regional Medical Center Public Affairs in Germany.)

Editor's note: Sept. 7 Aca,!" 13 is National Suicide Prevention Week