“Patty is gone”, was what I heard when my sister Maureen called me on December 3, 2012. One year ago. My first thought was that Patty had left the care home and was heading back home. No, Patty had taken her life that morning. I did not have the opportunity to say goodbye. This was something that our family and her doctor had given a zero to 5 percent chance of happening. Suicide had been discussed with Patty and she had given her “guarantee” that suicide was not an option.

Her wonderful psychiatrist believed that Patty's strong, lifelong Catholic faith would always deter her from suicide. I held her hand at Mass the day before. Little did we know that she would be gone the next day. So, after 67 years, we live on with the great memories while wrestling with the mystery of suicide. There will not be any new memories. Lives have changed.

During this past year, in retrospect, I have come to the realization that instead of prescribing a 5 percent chance that Patty would have committed suicide, it should have been a 95 percent chance. Obviously, this is very easy for me to say one year later. However, this is not about me or Patty's family. It is about the millions of families that deal with mental illness on a daily basis. They must talk about suicide with each other constantly. They must be direct, open and honest in communications.

Patty was feeling trapped and believed that there was no way out. She wanted her unbearable pain to end. 90 percent of people who die by suicide in the US suffer debilitating mental illness, according to the National Institute of Mental Health. The reasons people choose suicide are multilayered and there is no easy explanation.

What was she thinking? How long had she planned the action? Did she have a plan? Why did she do it at that time? These are some of the questions that we now ask. One of our father's favorite words was fakery, although I am not certain it is a real word. The definition of fakery is the inclination or practice of misleading others through lies or trickery. How long did her fakery go on? Everything makes sense when you are suicidal.

Could we have pretended her suicide? This is the question that will be with our family forever with no answer. I find some solace in believing that she was determined to commit suicide. I may be deceiving myself, but I need to find some positives in this tragic story.

Should we have been trained to recognize the signs and symptoms of suicide? Yes. Patty had a special relationship with her doctor. She saw him often and he had guided her successfully through her previous bouts of depression. This time was different. Four months of pacing, non-eating and total withdrawal had consumed her. We discovered that drugs are not always the answer to make people better. Patty took enough drugs to stock a pharmacy. There is no magic cure for depression.

What was her Catholic belief system telling her? We were originally taught as children that suicide was a mortal sin. Patty knew that suicide allowed her to be inside God's embrace, enjoying a freedom she thought she could never enjoy here again. She knew, through her work with the homeless, that God has a special affection for those who are too bruised to survive in this world.

Americans are not prepared to talk about mental illness or suicide, because of the stigma. It leaves us with emotional, moral and religious scars. Suicide brings with it an ache, a chaos, and a darkness. There is no reason to feel shame or shame. 45.6 million American adults are living with mental illness.

How can someone really recognize the signs that a loved one may be contemplating suicide? Nobody can predict a suicide. You must be prepared to help someone you love who one day may experience a suicidal crisis. Take all talk of suicide seriously. Constantly ask the direct questions, “Are you thinking about suicide?” or “Are you having suicidal thoughts?” Do not treat the threat lightly – even if the loved one jokes about it. They are expressions of extreme distress.

Get your loved one help immediately by taking them to the hospital emergency room, calling 911 or the police department, call a suicide hotline or call their doctor. Do not leave the person alone. Make sure that they have no access to means of harm that could have been used in a suicide attempt. This includes cords of all sorts.

With a shortage of psychiatric beds, patients must have considered a danger to themselves or others for inpatient admission. Patients must communicate their dangerousness or distress in order to guarantee that they will be admitted for further treatment.

The idea of ​​certainty in our life is an illusion which is in place so we can function in everyday life. But nothing is certain. Suicide throws out this notification of certainty and forces us to realize that life is a gift. Remember the 95 percent rule!

With Love, Sis, we miss you.

Terry Rice is a Milwaukee, Wisconsin resident