"Let me tell you that suicidal people don't want to die by suicide. They believe they have to, and there's a categorical difference."
Kevin Hines speaks from a place of deeply painful personal experience. Ten years ago Hines came very close to killing himself, leaping off the Golden Gate Bridge.
"I walked on that bridge probably for 40 minutes crying my eyes out," Hines said.
"Nobody said anything to you?" asked Axelrod.
"Nobody said anything."
Nineteen years old at the time, and suffering from a bipolar disorder, Kevin started to hallucinate.
"Hallucinations telling me when I got to this bridge, 'Jump now. Die now. You must die. You're a horrible person. Jump now.'"
Any discussion about preventing suicide should begin right here in San Francisco. More than 1,300 people have killed themselves by leaping off the Golden Gate Bridge since 1937, when the bridge opened.
On average, that's one every three weeks for the last 73 years . . . which makes the Golden Gate Bridge the most popular place in the world to commit suicide.
"The millisecond I hit free fall, the second my hands left the rail and my legs left the rail, I said, 'I don't want to die. What have I just done? What have I just done? God, please save me."
He hit the water at 75 miles an hour, crushing several of his vertebrae.
But instead of joining the 1,300 people who jumped and died, Kevin Hines joined another club - one of about 30 known to have jumped and survived.
"Out of those people that have survived, 19 have come forward and said that the second they jumped they didn't wanna die," said Hines
Of course, the bridge most of us heard about this past week is New York's George Washington Bridge, where Tyler Clementi, a Rutgers University freshman and promising musician, jumped to his death.
A secretly-recorded video of Clementi in bed with another man had been posted online.
The news that it was allegedly put there by his roommate caused protests against bullying to erupt on the Rutgers campus.
"People are very upset and hurt that it could happen here, and are very surprised," said one student.
Clementi's impulse was the classic example of a "permanent solution to a temporary problem" that suicide prevention experts battle . . . part of a national phenomenon that makes suicide the third leading killer of our country's youth.
While they are far more likely to kill themselves by firearms, suffocation and poisoning than by jumping, the latest thinking in preventing suicide is something called "means reduction" - eliminating access to ways people can kill themselves until the impulse passes and they can get help.
"Means reduction" at the Golden Gate Bridge translates into plans for a net that will cost $45 million.
"If it was there when I was attempting to jump," Hines said, "I would not have jumped."
It's the same idea behind the barriers that have gone up on the bridges over the gorges in Ithaca, New York, where six Cornell University students committed suicide last year.
"The question is, can one suicide lead to another through some sort of a copycat mechanism?" asked Dr. David Skorton, Cornell's president. "And the answer is, it can happen."
The experts fear the contagion effect that suicide can produce, especially among the young.
So we're not going to show you any pictures of those who died at Cornell, nor describe the circumstances of their deaths.
But one thing we can tell you about suicide: You may hear about a bad break-up or stress as the cause of a suicide. Those usually mask underlying mental health issues as the real explanation.
"We have to get used to the idea that it's okay to raise our hand and say 'I'm struggling,'" said Dr. Skorton.
Skorton, a physician for 36 years as well as a university president, feels the most important way to prevent suicides is to take away the stigma of seeking mental health care.
"I'm going to tell you, Jim, there was a part of my life where I had struggles, and I had counseling," said Dr. Skorton. "And it turned me around and changed my life, and blazed a trail for a successful career for me. So, it's a very, very important thing to get past that stigma."
Just a few weeks ago at Cornell, the freshmen moved into a campus where the professors, grad students and resident advisors have been getting intensive training on the tell-tale signs of trouble, complete with a video made with students from Cornell's theater department.
"We hope that you feel some sense of responsibility that as members of a community, that we want to watch out for each other. We really want to take care of each other," said Catherine Thrasher-Carroll, the university's mental health promotion coordinator.
The impulse often comes even earlier than college.
In 2009, 13.8% of U.S. high school students - that's almost one out of seven - reported they seriously considered attempting to kill themselves, according to the Centers for Disease Control and Prevention.
"We don't always see the subtle symptoms because it's hard to sort out what's adolescent moodiness, and what's the early signs of depression," said Laurie Flynn. She missed her own daughter's signs before she attempted suicide.
Her daughter survived, and Flynn is now passionate about early detection.
She runs Columbia University's nationwide TeenScreen program, designed to identify 14- to 17-year-olds who are at risk.
So far over a million kids have been screened in a thousand testing locations.
"We will ask the youngster, 'Gosh, you've had problems here, serious problems for quite some time, why didn't you say anything?'" said Flynn. "And the youngsters always come back with, 'Nobody ever asked me.' We ask."
Jamie Tworkowski asks as well. And his targets are the young people other screening systems miss.
Tworkowski tours the country reaching out to teenagers and young adults at concerts and festivals.
"We talk about some really difficult issues," he said. "We talk about issues that are not simple, that are complex."
"Meeting people that go through the same thing as you, it's really helpful," said one girl.
"We're trying to fight for people to believe that their life is worth living and worth fighting for," said Tworkowski.
His crusade was born on the arms of a girl he knew.
"She took a razor blade the night I met her, after I met her, and wrote a word that I probably can't say on camera, wrote it across her forearm," said Tworkowski. "She deeply believed this sense of failure and regret that her 19 years on the planet didn't give her much to be proud of."
Tworkowski started an organization, To Write Love on Her Arms. Funded mainly through the sale of T-shirts, the group's MySpace, Facebook and Twitter responses number in the hundreds of thousands.
"I think we were touching on a real need there, where people felt alone in their struggles, alone in their loneliness or their pain," said Tworkowski, "and really trying to let people know or trying to believe the possibility that their story could have a different ending."
For Kevin Hines, that different ending now means he can spread the word through music videos. When it comes to suicide, prevention starts with discussion.
"Not talking about it is getting us nowhere," said Hines. "Let's start talking about it on a regular basis but let's talk about it properly."
"So somewhere in the equation of helping young people in despair is not just getting them the information but telling them in some way, 'I hear you. I see you. I'm with you,'" said Axelrod.
"Yeah," said Hines. "I think, hopefully, there's an element of caring for this person, that they feel heard. I think we never know what can save a life. But I think it's important that we go there and that we try."
The stakes of not hearing those who are young and vulnerable were brought home to the students of Rutgers University, who mourned Tyler Clementi's death.
"For something like this to happen, it's just unacceptable," said one student.
And to fight the unacceptable, the one key weapon seems to be to let struggling young people know they are not alone.
"If we developed a social support, if we identified those who are struggling, if we make it okay to raise our hands and say, 'I need help,' if the help is there, and if we restrict the means to follow an impulse, we will prevent suicides," said Dr. Skorton.
For more info:
Centers For Disease Control: Suicide Prevention
National Suicide Prevention Lifeline
Suicide Awareness Voices Of Education
To Write Love On Her Arms
Cornell University Gannett Health Center
Friends Of Emmet