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Julie Cerel - Youth Suicide Prevention

Julie Cerel - Youth Suicide Prevention

Julie Cerel, a licensed clinical psychologist and professor in the College of Social Work at the University of Kentucky, talks about the rise in youth suicide and tools to help a person in crisis.
S14 E29 Length 26:32 Premiere: 5.19.19

Effective Tools for Youth Suicide Prevention

Suicide isn’t always linked to a diagnosed mental health issue like depression or anxiety. Sometimes it’s the result of a confluence of routine life stressors that can push a person to his or her breaking point.

Some 47,000 Americans take their own lives each year. Young people are especially vulnerable: suicide is the second leading cause of death among youth aged 15 to 24.

As KET begins a rebroadcast of its acclaimed youth mental health series You Are Not Alone, Renee Shaw sat down with Julie Cerel, a licensed clinical psychologist and professor in the College of Social Work at the University of Kentucky, to discuss her research into suicide.

Factors Contributing to Higher Suicide Rates
Between 2000 and 2016, the rate of death by suicide in the United States increased 30 percent, according to the Centers for Disease Control and Prevention. Historically more males commit suicide, but females are catching up: Suicides among women and girls increased by 50 percent in that time period.

“Fortunately most people that make one attempt will never, ever go on to make another one,” says Cerel. “But having had that one attempt, it puts some at higher risk” of dying by suicide in the future.

Cerel says they may be a number of reasons for the increase. One is that health officials are more open about acknowledging suicide as a cause of death.

“It used to be that unless there was really explicit evidence that it was a suicide,” says Cerel, “coroners or medical examiners wouldn’t call it a suicide because they thought it was helping the family.”

Media may also play a role. Cerel says coverage of celebrity suicides, especially stories that contain details of the methods used, can influence suicidal behavior in others. Some mental health professionals also attribute a recent Netflix series to a spike in suicides. Cerel says “13 Reasons Why” offered an unrealistic view of suicide that depicts how a young girl sought to use her own death as a form of revenge against the people who tormented her.

“Unfortunately when most people are suicidal, their thinking is not as systematic and clear, they just want to be out of the pain that they’ve been in,” says Cerel.

Other factors include the rise of the internet and social media, lack of access to quality health care and mental health services, and greater availability of more lethal means of death, such as weapons in the home.

“This isn’t about gun control per se,” says Cerel. “It’s more about not wanting anyone in your household, especially your child, to die by your family’s gun.”

How to Respond to Someone at Risk
The signs that someone may be considering suicide are varied. The person may begin to isolate themselves from friends and loved ones, or they may give away prized possessions. There may be increased drug or alcohol use, or their personal appearance or work or school performance may suddenly decline. They may talk about feeling hopeless or being mired in unbearable pain.

If you see these signs in a family member or friend, a co-worker or a neighbor, Cerel recommends taking a direct approach and saying, “You’ve really been scaring me. Are you thinking about suicide?”

Then you’ll need to be prepared to direct that person towards resources to help them. Cerel recommends keeping the National Suicide Prevention Lifeline emergency number in your cellphone. It’s 800-273-8255. She says operators there can provide referrals to local resources, do short-term crisis counseling, or address an actual emergency. Crisis counselors are also available by texting 741741.

Cerel acknowledges these conversations aren’t easy. Even saying the word suicide is difficult for some people. But the more comfortable we get with the language, the easier it becomes to openly discuss these critical issues, she says. Some communities and organizations offer special training in a prevention strategy named QPR, which stands for question, persuade, and refer, that any individual can take.

Life Beyond a Loss
Based on her own research, Cerel says a single suicide can impact the lives of 135 other people, from relatives and friends, to people at school, church, and work. But Cerel says she’s found that survivors can find ways to move beyond the tragedy.

“For some people, having this worst imaginable loss leads them to place in their lives they never would have been,” says Cerel. “It doesn’t necessarily mean that their life is going to be horrible forever and ever. They can end up in places much better than they might have dreamed.”

Cerel says certain occupations come with greater risk factors for mental health problems and suicide risk. For example, police and other first responders may have to deal with dozens of suicide cases over their careers. Cerel says that kind of exposure can increase the risk of suicidal behavior in the witness.

Following the death of celebrity chef and travel journalist Anthony Bourdain, Cerel and her colleagues launched initiatives to help people in the food service industry. She says the high-stress lifestyle with its irregular hours, little access to health care, and high rates of substance abuse can make restaurant workers especially vulnerable. Cerel contends such outreach efforts are critical to increasing the public dialogue about suicide.

“It’s important for us to talk about the fact that there are people that have thoughts of suicide or have made suicide attempts, and that doesn’t define the rest of their lives,” Cerel says. “People can be successful, having been treated for depression or having attempted suicide… Just because people have mental illnesses, just like physical illnesses, they don’t have to define our lives.”

Related Content:

Suicide Prevention/Teaching Hope

Helping Kentucky’s Youth with Mental Health Problems

Building Effective Programs to Improve Mental Health

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Renee speaks with Kristin Ashford, Ph.D., a professor in the University of Kentucky College of Nursing whose research focuses on prenatal care and interventions aimed at preventing/ending tobacco use and illicit drugs. The program features a young woman who's participating in "Get Fit and Quit" recovery/smoking cessation program that is a partnership between the UK College of Nursing, Chrysalis House (a treatment center for women), and the YMCA. Part of KET's on-going initiative "Smoking and Health" funded in part by a grant from the Foundation for a Healthy Kentucky.

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Renee Shaw and psychologist Julie Cerel, Ph.D., a professor in the University of Kentucky College of Social Work, discuss grief and mental health challenges from the COVID-19 pandemic.

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Steve Beshear - S13 E5

Former Kentucky Governor Steve Beshear discusses his new book, People Over Politics, that covers the tests and triumphs of his administration from 2007-2015. He talks about embracing the Affordable Care Act and expanding Medicaid in Kentucky, his philosophical evolution on same-sex marriage, his unsuccessful struggle with advancing expanded gambling, the persistent plight of funding public employee pensions, among other issues.

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Gordon Hamlin - S13 E7

Renee's guest Gordon Hamlin, president of Pro Bono Public Pensions and a retired attorney, offers ideas about how to fix Kentucky's ailing public pension systems. Hamlin recommends that Kentucky transition to a shared risk pension plan: longer working careers, elimination of cost of living adjustments, and transition to career average formula.

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Youth Mental Health and Suicide Prevention - S13 E8

Renee Shaw discusses youth suicide prevention with Julie Cerel, a professor, licensed clinical psychologist, and president of the American Association of Suicidology. She also talks with Courtney Parr, who shares her powerful and inspiring journey to better mental health.

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State Sen. Julie Raque Adams and State Rep. Addia Wuchner, chairs of the Senate Health and Welfare and House Health and Family Services committees, respectively, discuss upcoming health care issues that will be addressed during the 2018 Kentucky General Assembly.

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Good Samaritans - Surgery on Sunday; Bluegrass Families First and One Parent Scholar House - S13 E12

Lexington plastic surgeon Dr. Andrew Moore talks about Surgery on Sunday, providing outpatient essential surgical services at no cost to income-eligible, uninsured or underinsured individuals. Then, Kelly Duffy talks about Bluegrass Families First (BFF), a non-profit that provides opportunities for early childhood development, adult education, and other services helping Lexington families move toward self-sufficiency. BFF supports three organizations: The Family Care Center; The Nest Center for Women, Children, and Families; and One Parent Scholar House. Mirsada Simic talks about One Parent Scholar House and its Child Development Center with a 5-star curriculum program.

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Sexual Harassment Issues - Consultant Rus Funk - S13 E14

Renee's guest is Rus Funk, a consultant on gender equity, anti-racism, and violence prevention. He serves on the board of the National Center on Sexual and Domestic Violence. Funk talks about the spate of sexual harassment charges that have dominated news headlines and offers advice on helping men learn how to modify their behavior to create a professional and respectful work environment.

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Silas House - S13 E16

Novelist, activist, and educator Silas House discusses his book to be released later this year that focuses on parenthood, his work as an advocate for environmental and gender equity causes, and other topics.

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DV8 Kitchen - S13 E17

Renee visits DV8 Kitchen, a restaurant and bakery in Lexington that provides second chance employment opportunities for people in substance recovery who are trying to redirect their lives. She speaks with Rob and Diane Perez about their vision for the restaurant and its support from the community. Renee also talks with employees at the eatery to hear their stories of recovery and how DV8 Kitchen helps them.

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Gerald Smith - S13 E20

Dr. Gerald Smith, a history professor at the University of Kentucky and co-editor of The Kentucky African American Encyclopedia, joins Renee to discuss race relations in honor of Black History Month. Topics include activism around removing Confederate statues, the status of black leadership in Kentucky, and Dr. Smith's thoughts on the needed response from the faith-based community in eradicating racism.

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Educational Innovation - S13 E21

Educational innovation in the mountains is leading to a teaching and learning renaissance in southeast Kentucky. Renee and her guests, Dr. Dessie Bowling, associate director of the Kentucky Valley Educational Cooperative and Rose Shields, rural project manager for the Center for Excellence in Rural Health at the University of Kentucky, discuss recent innovative education practices in the region.

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Remembering Dr. Martin Luther King, Jr. - S13 E23

Connections remembers Dr. Martin Luther King, Jr. on the 50th anniversary of his assassination. Renee speaks with organizers of a commemorative event in Frankfort and shares highlights from speeches at the MLK Memorial March to Move.

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Child Marriage Laws in Kentucky - Donna Pollard - S13 E24

Renee speaks with Donna Pollard, a child marriage survivor and founder of Survivors' Corner, who has become the ambassador for changing child marriage laws in Kentucky with the passage of Senate Bill 48 that was signed into law by Gov. Matt Bevin on March 29, 2018. SB 48 raises the legal age to marry to 18 in Kentucky with some exceptions.

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Kosair Charities Face It Movement; Terry Brooks - S13 E25

In part one, Renee speaks with Keith Inman with Kosair Charities and Dr. Jennifer Green, University of Louisville Child Abuse Pediatrics Fellow about Kosair Charities Face It Movement that provides resources for parents and caregivers on child abuse. In part two, Dr. Terry Brooks, executive director of Kentucky Youth Advocates, talks about legislation passed in the 2018 Kentucky General Assembly that benefits children and families.

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Renee speaks with Lexington pediatrician Dr. Donna Grigsby about early childhood brain development and the impact of adverse childhood experiences on cognitive and physical health. Dr. Grigsby discusses how to develop literacy skills in young children.

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Criminal Justice Reform - Cherise Fanno Burdeen - S13 E34

Cherise Fanno Burdeen, CEO of the Pretrial Justice Institute (PJI), talks about her organization's mission to reduce incarceration rates and their efforts to reform the bail system.

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Shining a Spotlight on Epilepsy - S13 E35

Renee speaks with filmmaker Tiffany Webb, whose documentary, Voice of the Epilepsies, chronicles the story of a young girl living with epilepsy and her family's determination to treat the seizure disorder. Webb also discusses her own experience of being diagnosed with epilepsy.

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Tiffany Manuel - Affordable Housing - S13 E42

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Marcie Timmerman - Mental Health and Wellness - S13 E43

Renee speaks with Marcie Timmerman, executive director of Mental Health America of Kentucky. Timmerman discusses her organization's work to help those suffering from mental illness find effective treatment.

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Betty Baye - S9 E1

Former Louisville Courier-Journal columnist and editorial writer Betty Baye discusses her career and columns, new paradigms of journalism, the impact of digital media, and her future projects.

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Restaurateur and Chef Ouita Michel

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Sec. Vickie Yates Brown Glisson - S12 E44

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Walter Gilliam - S12 E40

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Leadership - Marian Guinn and Lisa Williams; Colene Elridge - S12 E38

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  • Tuesday June 8, 2021 5:30 am ET on KETKY
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Patricia Peacock - S12 E30

  • Monday June 7, 2021 10:30 pm ET on KETKY
  • Monday June 7, 2021 9:30 pm CT on KETKY
  • Monday June 7, 2021 2:00 pm ET on KETKY
  • Monday June 7, 2021 1:00 pm CT on KETKY
  • Monday June 7, 2021 5:30 am ET on KETKY
  • Monday June 7, 2021 4:30 am CT on KETKY

Kentucky Authors - Prisha Hedau; Carly Muetterties and Maddie Shepard

  • Saturday June 12, 2021 4:30 pm ET on KETKY
  • Saturday June 12, 2021 3:30 pm CT on KETKY
  • Sunday June 6, 2021 4:30 pm ET on KETKY
  • Sunday June 6, 2021 3:30 pm CT on KETKY
  • Sunday June 6, 2021 8:00 am ET on KETKY
  • Sunday June 6, 2021 7:00 am CT on KETKY
  • Wednesday June 2, 2021 11:30 pm ET on KET
  • Wednesday June 2, 2021 10:30 pm CT on KET
  • Wednesday June 2, 2021 6:00 pm ET on KET
  • Wednesday June 2, 2021 5:00 pm CT on KET
  • Sunday May 30, 2021 6:00 pm ET on KET2
  • Sunday May 30, 2021 5:00 pm CT on KET2
  • Sunday May 30, 2021 12:00 pm ET on KET
  • Sunday May 30, 2021 11:00 am CT on KET

Cory Jewell Jensen - S12 E18

  • Friday June 4, 2021 10:30 pm ET on KETKY
  • Friday June 4, 2021 9:30 pm CT on KETKY
  • Friday June 4, 2021 2:00 pm ET on KETKY
  • Friday June 4, 2021 1:00 pm CT on KETKY
  • Friday June 4, 2021 5:30 am ET on KETKY
  • Friday June 4, 2021 4:30 am CT on KETKY

David Thompson - S12 E11

  • Thursday June 3, 2021 10:30 pm ET on KETKY
  • Thursday June 3, 2021 9:30 pm CT on KETKY
  • Thursday June 3, 2021 2:00 pm ET on KETKY
  • Thursday June 3, 2021 1:00 pm CT on KETKY
  • Thursday June 3, 2021 5:30 am ET on KETKY
  • Thursday June 3, 2021 4:30 am CT on KETKY

Mitzi Sinnott - S12 E3

  • Wednesday June 2, 2021 10:30 pm ET on KETKY
  • Wednesday June 2, 2021 9:30 pm CT on KETKY
  • Wednesday June 2, 2021 2:00 pm ET on KETKY
  • Wednesday June 2, 2021 1:00 pm CT on KETKY
  • Wednesday June 2, 2021 5:30 am ET on KETKY
  • Wednesday June 2, 2021 4:30 am CT on KETKY

FDA Commissioner Dr. Robert Califf - S12 E2

  • Tuesday June 1, 2021 10:30 pm ET on KETKY
  • Tuesday June 1, 2021 9:30 pm CT on KETKY
  • Tuesday June 1, 2021 2:20 pm ET on KETKY
  • Tuesday June 1, 2021 1:20 pm CT on KETKY
  • Tuesday June 1, 2021 5:30 am ET on KETKY
  • Tuesday June 1, 2021 4:30 am CT on KETKY

Phil Wilkins - S11 E43

  • Monday May 31, 2021 2:00 pm ET on KETKY
  • Monday May 31, 2021 1:00 pm CT on KETKY
  • Monday May 31, 2021 5:30 am ET on KETKY
  • Monday May 31, 2021 4:30 am CT on KETKY

Christopher 2X

  • Saturday June 5, 2021 4:30 pm ET on KETKY
  • Saturday June 5, 2021 3:30 pm CT on KETKY
  • Sunday May 30, 2021 4:30 pm ET on KETKY
  • Sunday May 30, 2021 3:30 pm CT on KETKY
  • Sunday May 30, 2021 8:00 am ET on KETKY
  • Sunday May 30, 2021 7:00 am CT on KETKY
  • Wednesday May 26, 2021 11:30 pm ET on KET
  • Wednesday May 26, 2021 10:30 pm CT on KET
  • Wednesday May 26, 2021 6:00 pm ET on KET
  • Wednesday May 26, 2021 5:00 pm CT on KET
  • Sunday May 23, 2021 6:00 pm ET on KET2
  • Sunday May 23, 2021 5:00 pm CT on KET2
  • Sunday May 23, 2021 12:00 pm ET on KET
  • Sunday May 23, 2021 11:00 am CT on KET

Tameka Montgomery - S11 E42

  • Friday May 28, 2021 10:30 pm ET on KETKY
  • Friday May 28, 2021 9:30 pm CT on KETKY
  • Friday May 28, 2021 2:00 pm ET on KETKY
  • Friday May 28, 2021 1:00 pm CT on KETKY
  • Friday May 28, 2021 5:30 am ET on KETKY
  • Friday May 28, 2021 4:30 am CT on KETKY

Dominique Wilkins - S11 E41

  • Thursday May 27, 2021 10:30 pm ET on KETKY
  • Thursday May 27, 2021 9:30 pm CT on KETKY
  • Thursday May 27, 2021 2:00 pm ET on KETKY
  • Thursday May 27, 2021 1:00 pm CT on KETKY
  • Thursday May 27, 2021 5:30 am ET on KETKY
  • Thursday May 27, 2021 4:30 am CT on KETKY

Gary Tuggle - S11 E40

  • Wednesday May 26, 2021 10:30 pm ET on KETKY
  • Wednesday May 26, 2021 9:30 pm CT on KETKY
  • Wednesday May 26, 2021 2:00 pm ET on KETKY
  • Wednesday May 26, 2021 1:00 pm CT on KETKY
  • Wednesday May 26, 2021 5:30 am ET on KETKY
  • Wednesday May 26, 2021 4:30 am CT on KETKY

Dr. Leana Wen - S11 E39

  • Tuesday May 25, 2021 10:30 pm ET on KETKY
  • Tuesday May 25, 2021 9:30 pm CT on KETKY
  • Tuesday May 25, 2021 2:00 pm ET on KETKY
  • Tuesday May 25, 2021 1:00 pm CT on KETKY
  • Tuesday May 25, 2021 5:30 am ET on KETKY
  • Tuesday May 25, 2021 4:30 am CT on KETKY

Terrence Walton - S11 E38

  • Monday May 24, 2021 10:30 pm ET on KETKY
  • Monday May 24, 2021 9:30 pm CT on KETKY
  • Monday May 24, 2021 5:30 am ET on KETKY
  • Monday May 24, 2021 4:30 am CT on KETKY

Sarah Taylor Vanover - Early Childhood Education

  • Saturday May 29, 2021 4:30 pm ET on KETKY
  • Saturday May 29, 2021 3:30 pm CT on KETKY
  • Sunday May 23, 2021 4:30 pm ET on KETKY
  • Sunday May 23, 2021 3:30 pm CT on KETKY
  • Sunday May 23, 2021 8:00 am ET on KETKY
  • Sunday May 23, 2021 7:00 am CT on KETKY
  • Wednesday May 19, 2021 11:30 pm ET on KET
  • Wednesday May 19, 2021 10:30 pm CT on KET
  • Wednesday May 19, 2021 5:59 pm ET on KET
  • Wednesday May 19, 2021 4:59 pm CT on KET
  • Sunday May 16, 2021 6:00 pm ET on KET2
  • Sunday May 16, 2021 5:00 pm CT on KET2
  • Sunday May 16, 2021 12:00 pm ET on KET
  • Sunday May 16, 2021 11:00 am CT on KET

U.S. Agriculture Secretary Tom Vilsack - S11 E37

  • Friday May 21, 2021 10:30 pm ET on KETKY
  • Friday May 21, 2021 9:30 pm CT on KETKY
  • Friday May 21, 2021 2:00 pm ET on KETKY
  • Friday May 21, 2021 1:00 pm CT on KETKY
  • Friday May 21, 2021 5:30 am ET on KETKY
  • Friday May 21, 2021 4:30 am CT on KETKY

Kimberly Johnson - S11 E36

  • Thursday May 20, 2021 10:30 pm ET on KETKY
  • Thursday May 20, 2021 9:30 pm CT on KETKY
  • Thursday May 20, 2021 5:30 am ET on KETKY
  • Thursday May 20, 2021 4:30 am CT on KETKY

Jason Merrick - S11 E35

  • Wednesday May 19, 2021 10:30 pm ET on KETKY
  • Wednesday May 19, 2021 9:30 pm CT on KETKY
  • Wednesday May 19, 2021 2:00 pm ET on KETKY
  • Wednesday May 19, 2021 1:00 pm CT on KETKY
  • Wednesday May 19, 2021 5:30 am ET on KETKY
  • Wednesday May 19, 2021 4:30 am CT on KETKY

Fayette County Veterans Treatment Court - S11 E34

  • Tuesday May 18, 2021 10:30 pm ET on KETKY
  • Tuesday May 18, 2021 9:30 pm CT on KETKY
  • Tuesday May 18, 2021 2:00 pm ET on KETKY
  • Tuesday May 18, 2021 1:00 pm CT on KETKY
  • Tuesday May 18, 2021 5:30 am ET on KETKY
  • Tuesday May 18, 2021 4:30 am CT on KETKY

Dr. Lynne Saddler - S11 E33

  • Monday May 17, 2021 10:30 pm ET on KETKY
  • Monday May 17, 2021 9:30 pm CT on KETKY
  • Monday May 17, 2021 2:00 pm ET on KETKY
  • Monday May 17, 2021 1:00 pm CT on KETKY
  • Monday May 17, 2021 5:30 am ET on KETKY
  • Monday May 17, 2021 4:30 am CT on KETKY

U.S. Senator Mitch McConnell

  • Saturday May 22, 2021 4:30 pm ET on KETKY
  • Saturday May 22, 2021 3:30 pm CT on KETKY
  • Sunday May 16, 2021 4:30 pm ET on KETKY
  • Sunday May 16, 2021 3:30 pm CT on KETKY
  • Sunday May 16, 2021 8:00 am ET on KETKY
  • Sunday May 16, 2021 7:00 am CT on KETKY
Top

Season 14 Episodes

The 'I Was Here' Project

S14 E36 Length 27:42 Premiere Date 8.4.19

Mike Runyon and Sherita Miller; Wendy Kobler

S14 E35 Length 26:57 Premiere Date 7.28.19

Filmmaker Lynn Novick

S14 E33 Length 28:27 Premiere Date 7.14.19

Brent Hutchinson; Christine Thompson - Education

S14 E32 Length 27:37 Premiere Date 7.7.19

Lieutenant Governor Jenean Hampton - Youth Mental Health

S14 E31 Length 26:32 Premiere Date 6.2.19

Julie Cerel - Youth Suicide Prevention

S14 E29 Length 26:32 Premiere Date 5.19.19

Dale Suttles - Sunrise Children's Services

S14 E28 Length 27:33 Premiere Date 5.12.19

Education in Rural Eastern Kentucky

S14 E27 Length 28:13 Premiere Date 5.5.19

Joshua A. Douglas - Voting Rights Reform

S14 E25 Length 26:32 Premiere Date 4.21.19

Jay Box - Ky. Community & Technical College System

S14 E24 Length 26:32 Premiere Date 4.14.19

Author and Life Coach Colene Elridge

S14 E23 Length 26:19 Premiere Date 4.7.19

FIRST STEP Act - Criminal Justice Reform

S14 E22 Length 27:44 Premiere Date 3.31.19

Cheryl A. Oldham

S14 E21 Length 26:38 Premiere Date 2.22.19

Linda Hampton - Early Childhood

S14 E20 Length 29:47 Premiere Date 2.15.19

Donald Mason

S14 E19 Length 26:34 Premiere Date 2.8.19

Community Action Council; First 5 Lex

S14 E18 Length 28:53 Premiere Date 2.1.19

Seamus Carey

S14 E17 Length 26:57 Premiere Date 1.25.19

Michael Benson

S14 E16 Length 27:32 Premiere Date 1.18.19

Dr. Aaron Thompson

S14 E14 Length 28:13 Premiere Date 1.11.19

Mary Todd Lincoln and Lincoln Lexington Walking Tour

S14 E13 Length 28:55 Premiere Date 12.14.18

Youth Suicide

S14 E12 Length 29:22 Premiere Date 12.7.18

Jean Schumm and Amanda Gale

S14 E11 Length 28:22 Premiere Date 11.16.18

M. Christopher Brown II

S14 E10 Length 28:02 Premiere Date 11.9.18

Frank Harris

S14 E9 Length 25:17 Premiere Date 11.2.18

U.S. Rep. Andy Barr

S14 E8 Length 29:16 Premiere Date 10.26.18

Amy McGrath

S14 E7 Length 29:02 Premiere Date 10.19.18

Kevin Chapman - Youth Mental Health

S14 E6 Length 28:47 Premiere Date 10.12.18

Carol Cecil; Resa Gonzalez - Youth Mental Health

S14 E5 Length 26:03 Premiere Date 10.5.18

Joe Bargione - Youth Mental Health

S14 E4 Length 28:57 Premiere Date 9.28.18

WKU President Timothy Caboni

S14 E3 Length 28:40 Premiere Date 9.21.18

Dr. Neeli Bendapudi

S14 E1 Length 28:47 Premiere Date 9.14.18

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