National Strategy for Suicide Prevention (NSSP)
Rates of Suicide in the United States Nearly 40,000 people in the United States die from suicide annually The highest number of suicides among both men and women occurred among those aged 45 to 54 There are 3.6 male suicides for every female suicide From 1999 to 2010, the age-adjusted suicide rate for adults aged 35 to 64 in the United States increased significantly (28.4%). Half of these deaths occurred by use of a firearm Substance Abuse and Mental Health Services Administration 2014
New Mexico New Mexico has the 5th highest suicide rate in the United States The New Mexico suicide rate is more than 50% higher than the United States rate In 2014 - 450 New Mexicans died by suicide (21.1 deaths per 100,000 residents) Suicide is the 7th leading cause of death in New Mexico Suicide rates have been increasing in New Mexico and the United States since 2000 Suicide is the 2nd leading cause of death among New Mexico residents 10 to 39 years old From the NMDOH Health Fact Sheet September 2015
Providers see People at Risk of Suicide What percentage of people who die by suicide had contact with their primary care providers in the month prior to their suicide? 50% What percentage of people who die by suicide had contact with their primary care provider in the year prior to their death? 80% What percentage of people who die by suicide saw a behavioral health provider within the month before they died 20% What percentage of people who die by suicide visited the Emergency Department within 2 months before they died? 10% SAMHSA Suicide Safe http://store.samhsa.gov/apps/suicidesafe/
Myth #1 “Asking a depressed person about suicide may put the idea in their heads” This is FALSE Does not suggest suicide, or make it likely Open discussion is more likely to be experienced as relief than intrusion Used with permission from Columbia University
Myth #2 “There’s no point in asking about suicidal thoughts…if someone is going to do it they won’t tell you” This is FALSE Many will tell clinician when asked, even if they would never volunteer Ambivalence is characteristic Contradictory statements/behavior common Many give some hints/warnings to friends or family, even if don’t tell clinician Used with permission from Columbia University
Myth #3 “Someone making suicidal threats won’t really do it, they are just looking for attention” This is FALSE Those who talk about suicide or express thoughts about wanting to die are at risk for suicide 80% of people who die by suicide give some indication or warning Used with permission from Columbia University
Myth #4 “If you stop someone from killing themselves one way, they’ll probably find another” This is FALSE “Means restriction” has strong evidence as suicide prevention strategy Examples: England 1998 – blister packaging for Tylenol = 44% reduction in Tylenol overdose over next 11 years Israeli military 2006 - restricted gun access on passes, suicide rate dropped 40% in military Used with permission from Columbia University
NSSP Goals NSSP has 4 Strategic Directions and 13 Goals NSSP grant (Sept. 2014- Sept. 2017) focuses on Goals 8 & 9 Goal 8: Promote suicide prevention as a core component of health care services Goal 9: Promote and implement effective clinical and professional practices for assessing and treating those identified as being at risk for suicidal behaviors
NM Suicide Prevention Efforts 3 NM pilot sites to implement the Zero Suicide model in their organizations and communities https://www.youtube.com/watch?v=6L3AeGnUbuQ Grant Efforts Continue to identify opportunities
Collaboration & Support As a state, we all play a role to continue a suicide prevention model post-grant cycle We, the NSSP Core Team, would welcome the opportunity to collaborate and support your departments’ current suicide prevention efforts
Thank you! Jackie Nielsen Project Director HSD/Behavioral Health Services Division Jacqueline.Nielsen@state.nm.us 505-476-9267 Megan Phillips Program Manager HSD/Behavioral Health Services Division Megan.Phillips@state.nm.us 505-476-6290
New Mexico Suicide Prevention and Crisis Intervention Federal Review James Wright, LCPC Public Health Advisor Suicide Prevention Branch
New Mexico • Awarded: – 2015 Planning Grant Certified Community Behavioral Health Clinics – 2014 National Strategy Suicide Prevention – 2012 Garrett Lee Smith Youth Suicide Prevention – Block Grant Suicide Prevention Requirements
National Action Alliance for Suicide Prevention
National Action Alliance for Suicide Prevention
Task Forces Infrastructure High-Risk Populations Interventions American Indian / Alaska Clinical Workforce Data and Surveillance Native 2.0 Preparedness Research Prioritization Military / Veterans 2.0 Crisis Services Suicide Attempt Survivors Faith Communities Public Awareness and Survivors of Suicide Loss Education Workplace
Zerosuicide.org
Defining the Problem: Health Care is Not Suicide Safe • 45% of people who died by suicide had contact with primary care providers in the month before death. Among older adults, it’s 78%. • 19% of people who died by suicide had contact with mental health services in the month before death. • South Carolina: 10% of people who died by suicide were seen in an emergency department in the two months before death.
Defining the Problem: Behavioral Health Care is Not Suicide Safe • Ohio: Between 2007-2011, 20.2% of people who died from suicide were seen in the public behavioral health system within 2 years of death. • New York: In 2012 there were 226 suicide deaths among consumers of public mental health services, accounting for 13% of all suicide deaths in the state. • Vermont: In 2013, 20.4% of the people who died from suicide had at least one service from state-funded mental health or substance abuse treatment agencies within 1 year of death.
Zero Suicide… • Makes suicide prevention a core responsibility of health care • Applies new knowledge and proven tools for suicide care • Supports efforts to humanize crisis and acute care • Is a systematic approach in health systems, not “the heroic efforts of crisis staff and individual clinicians.” • Is embedded in the National Strategy for Suicide Prevention (NSSP) and Joint Commission Sentinel Event Alert.
The Joint Commission Sentinel Event Alert #56 • Primary, emergency and behavioral health clinicians should: – Review each patient’s personal and family medical history for suicide risk factors. – Screen all patients for suicide ideation using a brief, standardized, evidence-based screening tool. – Review screening questionnaires before the patient leaves the appointment or is discharged. – Safety plan and ensure continuity of care.
Fundamental components • LEAD- Make explicit commitment to reduce suicide deaths. • TRAIN- develop confident, competent, caring workforce. • IDENTIFY- Identify every person at risk of suicide. • ENGAGE- Engage clients in a suicide care management plan. • TREAT- Treat suicidal thoughts and behaviors directly. • TRANSITION- Follow patients through every transition in care. • IMPROVE- Apply data-driven quality improvement. http://zerosuicide.org
ZS Resources • Zero Suicide Organizational Self-Study • Zero Suicide Workforce Survey • Zero Suicide Data Elements Worksheet
Five Major Suicide Prevention Components • Garrett Lee Smith State and Tribal Suicide Prevention Grant Program • Garrett Lee Smith Campus Suicide Prevention Grant Program • National Suicide Prevention Lifeline – Crisis Center Follow-up Grant Program • Suicide Prevention Resource Center • Suicide Prevention Tribal Initiative
Purpose of GLS and NSSP The purpose of these programs are to support states and tribes in developing and • implementing statewide and/or tribal youth and adult suicide prevention and early intervention strategies, grounded in public/private collaboration. Such efforts must involve public/private collaboration among youth and adult-serving institutions and agencies and should include schools, educational institutions, justice systems, foster care systems, substance abuse and mental health programs, primary and emergency care, workforce development and other child, youth and adult supporting organizations. • Goals are accomplished through a number of activities- some, but not all of which, are gatekeeper trainings, screening programs, coalition and task force building, outreach and awareness campaigns and direct services. Grantees must use NREPP or BPR programming and can create specific training and screening for target populations • Many grantees identify or have identified Military Families and Veterans as high risk target audience
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