SEBRING - It's a situation familiar to licensed mental counselor Charleen Stroup.
An elderly patient has been diagnosed with a terminal disease and he does not want to go through the pain of the dying process.
Or he has lost a loved one and cannot deal with the feeling of loneliness and helplessness and sees no way out.
So he takes his own life.
Between 2010 and 2012, 53 suicides were reported in Highlands County, and state calculations based on population give Highlands County a higher-than-average rating for suicide deaths compared to the rest of the state.
The Florida Department of Health data also shows that men are four to five to even six times more likely to die from self-inflicted wounds than women, and almost all the suicides reported in the data were among whites.
Marlene Jehs, chairwoman of the Florida Suicide Prevention Coalition, said suicide rates among men between the ages of 54 and 68 are usually higher.
"They don't go to counseling, they don't seek help," she said.
The economic downturn also has been tough on men of the age group. From providing for their families, they suddenly find themselves without jobs.
Stroup said men are more likely to take their life through lethal means - like putting a gun to their head or hanging themselves - while women are more likely to, say, overdose on pills.
The deadly effect of pills on the body takes much longer to show, she said, and the chances of getting medical help also make intervention greater among women.
She remembers an occasion when she checked on a female patient while working as a home health nurse.
The lady was not in the habit of drinking alcohol, so Stroup put two and two together when she found her wobbling one day.
Turns out she had downed all her medications.
Stroup got medical help for her, and the lady lived, even though she was not happy about being saved.
The department of health's three-year-rolling rates, an aggregate of three consecutive years, gave Highlands County a rating of 18.2 from 2010 to 2012. The state rating was 13.7.
While the state rating has been largely constant - moving one point or two - Highlands County's largely declined from a high of 20.3 from 2004-2006 until it spiked a little bit between 2010 and 2012.
Stroup believes our concentration of elderly residents is one reason why our suicide rates are higher.
Along with the elderly, suicides are also more common among young adults, she said. Suicide is the third leading cause of death among teenagers, the Centers for Disease Control states.
"Those between the ages of 25 and 55 have low numbers," she said.
Yearly countywide numbers provided by the Florida Suicide Prevention Coalition show 18 suicides reported in 2012 in Highlands County, up from 16 in 2011 and down from 19 in 2010.
Between 2001 and 2012, the highest number of suicides reported were in 2009 with a total of 23. That's also when the economic crisis was at its worst in Highlands County.
From 2009-11, there were 56 suicides reported among whites in Highlands County; two among non-whites.
From 2010-2012, the number was 52 among whites and one among non-whites, the data shows.
Compared to the state, the rate of suicides among whites is much higher in Highlands County, while the suicide rate among non-whites is correspondingly lower compared to the Florida, the data indicates.
While people may be plunged into depression and loneliness after a life-changing event, such as losing their loved one, they don't automatically become suicidal.
She tells her patients and those she encounters in her support groups that everyone grieves differently, and asking questions like "Why it happened to me?" is part of the grieving and healing process.
Strong social support is one factor that accelerates the healing process but it's not the only component, she said.
Use of "substances" - from non-legal to higher-than-normal doses of legal medications - can cloud a person's judgement, leading to some disastrous consequences.
Jehs blames cuts in funding for mental health facilities as a bad sign for those who need help.
Dorothy Reed, behavioral health coordinator for the Highlands County Jail, said many of the inmates that come in have mental health issues along with substance abuse problems.
Those who threaten to hurt themselves are put on a 24-hour suicide watch. Those who attempt suicide are sent to the Crisis Stabilization Unit in Bartow.
Reed said she wished there was a way some inmates could be assessed for mental health issues and sent to a crisis intervention center instead of jail.
As far as trends go, Reed said they haven't seen much change.
"It's not really changing. The population is increasing," she said.
· Boys complete suicide five times more often than girls.
· Females attempt suicide more often than males.
· Teenage suicide rate has tripled over the past two decades
(from 4.1 per 100,000 in the 1950's to 12.5 per 100,000 in 1980).
The rest of the population remains the same.
· Sixty-five hundred American teenagers complete suicide every year.
· Nine out of ten suicide attempts take place in the home
(just before parents come home from work).
· Cluster suicides have increased.
· About half of the suicide victims had been in trouble with the law or at school.
· Almost half of the suicide victims were known to abuse alcohol or other drugs.
Centers for Disease Control & Prevention (CDC)