When we hear of a suicide, or worse yet, when a loved one or friend commits suicide, we are left asking, why? Why did they take their own life? Why didn’t I see signs this person was thinking about killing themselves? Why didn’t I do something? Why, Why, why?

Thoughts like these haunt families and friends of a victim whose life was lost at their own hands. The vast majority of those who survive a suicide attempt later admit that they did not want to die, but they wanted to end the pain. Individuals struggling with suicidal thoughts are in pain. And the more pain they feel, the higher the likelihood they will consider a plan.

One every eight seconds. One in ten. One service member a day. What do all of these have in common? Suicide. Every eight seconds, an American takes his or her own life. It’s the tenth overall cause of death. In fact, among the top ten causes of death, only suicide, Alzheimer’s disease and drug overdose are increasing. And one active duty service member kills themself each day.

Even one is too many. We must and can address this tragedy. BeThe1To is the National Suicide Prevention Lifeline’s Campaign to help prevent this tragic loss of life. They recommend five action steps backed by evidence to decrease the risk of suicide: Ask, Keep Them Safe, Be There, Help Them Connect and Follow Up.

Today, I’ll share about the first two, and in subsequent articles, I’ll discuss the others. So, what to do?

The most important thing we can do is ASK. If we see someone struggling, ask, “Are you thinking about suicide?” Contrary to what some may think, asking this question won’t increase the risk of suicide. One caution: don’t promise the person considering taking their own life you won’t tell anyone.

Risk factors for suicide include a previous attempt to take one’s life, non-suicidal self-harm behaviors, exposure to someone close who committed suicide, depression or other mental illnesses, a major loss (for example, a relationship, job or financial), substance abuse, a firearm in the house and a life-threatening, severe or fatal disease.

Suicidal individuals are in crisis. Not only do they believe ending their lives is the only way to end their pain, but they also believe that others would be better off without them. This is why it’s so important to ask, “Are you thinking about suicide?” We all need to care enough to ask and to listen. Asking is the first step. Ask, ask, ask.

On the heels of asking, we must be vigilant to Keep Them Safe. It’s important to know if they’ve already done something to harm themselves. Ask if they’ve made a plan. If so, do they have the means to carry out the plan? For example, if they say they say they are going to shoot themselves, do they have access to a firearm and ammunition? If it is by an overdose, do they have access to medication? The more detailed the plan, including the place, time of day, what they’ll wear, whether or not they’ll contact someone to say goodbye or leave a note, the greater the risk they are going to attempt suicide.

The goal is to provide time and space between the suicidal individual and their intended means of carrying out their plan, especially by more lethal means, such as firearms and medications. This has proven to decrease rates of suicide. Providing this buffer by reducing access to lethal means works. It saves lives.

It is proven that those planning suicide by a highly lethal method generally do not look for a different, less deadly method when they are cut off from the more lethal method. You owe it to them. You owe it to yourself. One life is too many!

Dr. Skip Mondragon, an internal medicine specialist and retired U.S. Army Colonel. He spent over 26 years serving in the Army, including 30 months in combat zones. Instead of soldiers, he now cares for patients at the Hope Clinic in Waxahachie.