A person can say “I'm fine” and still be struggling, and the people best placed to notice are often not clinicians. That was the thread running through the suicide prevention panel at the 2026 Say the Words Suicide Symposium, where speakers and panelists with different vantage points talked about warning signs, stigma, and what actually reaches someone in the moment.
This is a heavy topic, and it's okay to step away if you need to. If you or someone you know is struggling, call or text 988 (veterans can dial 988, then press 1), or text HOPELINE to 741741.
What was the Say the Words Suicide Symposium?
Say the Words is an in-person mental health event series that brings together practitioners, people with lived experience, and the people who support them. The Suicide Symposium, held September 24, 2026, was the first event in the series, presented in partnership with NAMI Southeast Wisconsin and supported by a grant from the Charles E. Kubly Foundation. This conversation, “Warning Signs, Real Places,” was the prevention panel of the day’s programming.
Who was on the panel?
Barb Bigalke (moderator) is the founder and executive director of the Center for Suicide Awareness and the creator of the HOPELINE, an emotional support text line.
Lisamarie Arnold is the executive director of REDgen (Resilience Education for the Next Generation), a school-based, peer-to-peer prevention program serving students in grades 6 through 12 across more than 35 chapters in Wisconsin.
Dr. Maria Amarante is a Licensed Professional Counselor and trauma-informed therapist, and the founder and clinical director of the Multicultural Trauma and Addiction Treatment Center of Wisconsin.
Mark Ross is a U.S. Marine Corps veteran who lives with PTSD and hosts The Speak Your Truth with Mark Ross Podcast and Soldier Stories Podcast.
Why isn't asking “Are you okay?” always enough?
Dr. Amarante said she pays attention to a shift in energy more than the words someone uses. Even when a person says “I'm fine,” she explained, their body language can tell her they're drowning. She also watches for isolation, like when daily texts slow to once a week or once every two weeks. And she cautioned that assessment tools only go so far, since someone can check every box on them and still be drowning.
Mark Ross put it this way: “People hide it well. And asking them if they're okay is not necessarily the answer. You have to look at what they're not doing.”
Barb Bigalke added that it's up to the community “to go beyond those check boxes,” asking the questions a checklist can't.
Who can help prevent suicide besides a clinician?
Almost anyone, according to Barb Bigalke. “Suicide prevention doesn't need to be so clinical,” she said, and people often tell her they can't help because they don't have a license. She pointed to the coach who is a trusted adult, the teacher, and the bartender who notices when a regular isn't in for the Friday fish fry, and described prevention as a community action rather than the job of only a counselor, social worker or psychologist.
What made Mark Ross reach out for help?
Mark said he struggled in silence for a long time, before he knew what PTSD was, and that as a man he felt the stigma of saying he wasn't well. The turning point came at work, when a coworker who was an Army veteran handed him a pamphlet about PTSD and its symptoms. “All the symptoms listed, this is me. All of it,” he said. His coworker told him he'd been running with it for too long, and Mark went to the VA and told a social worker everything.
He said being vulnerable was new to him, since he wasn't raised that way, and that it is what led him to start his podcasts. Today he says he has more good days than bad, and he calls living with PTSD his “forever journey.” His message to others: “It's okay to not be okay,” and “What you do with it after you acknowledge it, that's the point.”
How does peer-to-peer suicide prevention work in schools?
Lisamarie Arnold described how REDgen students learn resilience skills from their peers, practice them, and take the message out through activities in their schools. Every REDgen student is QPR trained. The model works, she said, “because kids talk to kids,” and the program also teaches students when and why to go to a trusted adult.
She was candid about the barrier: in some schools, the school board says no to talking about mental health at all. Her response is to keep sharing facts, including that suicide is not contagious, and to keep presenting mental health as part of overall health.
What is Dr. Amarante's “be-with” exercise?
She described it as simple: look the person you're talking with in the eye for the whole conversation, without a phone or a TV competing for your attention, and turn toward them even when you're in the car. She also pointed to the value of being with someone in silence. “Look them in the eye long enough for them to notice,” she said, and watch what happens to the connection.
What does someone need to hear when they almost say something?
Barb Bigalke asked each panelist for one line.
Lisamarie Arnold: that you're listening, that you care, and that they are important.
Mark Ross: “I'm always a phone call away,” and everyone needs at least one person they can depend on.
Dr. Amarante: you don't need to be a professional to save a life. You need to be present, ask the tough question, and stay to listen to the answer.
Key takeaways from the panel
Watch what someone is doing, not only what they say.
Checklists and assessments can miss people, so slow down and ask directly.
Prevention is a community action, not only a clinical one.
Peers reach peers: kids talk to kids.
Presence counts: eye contact, listening, and staying for the answer.
Getting help can start with one person speaking up, as it did when Mark's coworker handed him that pamphlet.
Where to find support
If you or someone you know is in crisis or thinking about suicide, call or text 988, the 988 Suicide & Crisis Lifeline. Veterans and service members can dial 988, then press 1. You can also text HOPELINE to 741741 to reach a trained, nonjudgmental crisis counselor, a service created by Barb Bigalke's Center for Suicide Awareness. If someone is in immediate danger, call 911.
More from the panelists: Center for Suicide Awareness, REDgen, and the Multicultural Trauma and Addiction Treatment Center of Wisconsin.
Watch (on YouTube) or listen to the full panel on your favorite podcast platform (here’s Spotify & Apple podcasts), with new episodes every Tuesday.
