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Cynthia Mauzerall’s older brother, David, died by suicide seven years ago.

“He was definitely someone that I looked up to and a mentor to me,” she said.

Cynthia – a certified counselor even before she lost her brother – spoke to David on the phone the night before he killed himself.

“I didn’t directly ask him the question: Have you thought about taking your life?” she said. “You know, that’s a hard thing. Now I know that’s the No. 1 thing that needs to be done.”

Today, Cynthia’s a counselor at the College of Idaho, the leader of a monthly suicide-survivor’s group and a prominent suicide-prevention advocate. Idaho's the only state in the nation without a dedicated suicide hotline.

Cynthia believes such a service prevent many Idahoans from taking their own lives by asking the questions she didn’t: Are you thinking about killing yourself? And: Do you have a plan to do so?

“I feel like I missed it,” Cynthia said, “and I let him down and that was very painful for me to feel that way. I of all people was on the phone with him the night before. How could I not ask those questions?”

At the most basic level, clinicians believe, suicidal people lack hope. Cynthia believes even providing a little bit of faith over the telephone might sustain an individual long enough to provide him with the resources he needs to stay alive.

Idaho claims the fourth-highest suicide rate in the nation (67 percent higher than the national average). Suicide is the second-leading cause of death among adolescents and young adults in the state. Between 2006 and 2010, 81 percent of all suicides in Idaho were by men.

Cynthia says she still lives with regret, but in the last couple of years she’s learned her brother’s cause of death doesn’t nullify his accomplishments – and it’s on those she now prefers to dwell.

“I was so proud of the work he did,” she said of David. ”I remember being there the day he was sworn in as a lawyer and it was really one of the proudest moments I remember being with him.”