Transcript Building a Statewide Suicide Prevention Network

Rural Health
Association
of Tennessee
November 13, 2014
Micky Roberts, MBA
Defining Suicide

Suicide: Death caused by self-directed injurious behavior with any intent
to die as a result of the behavior.
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Suicide attempt: A non-fatal self-directed potentially injurious
behavior with any intent to die as result of the behavior. A suicide attempt
may or may not result in injury.
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Prevention: Interventions designed to stop suicidal behavior before it
occurs. These interventions involve reducing the factors that put people at
risk for suicide and suicidal behaviors. They also include increasing the
factors that protect people or buffer them from being at risk.
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Postvention: Actions taken after a suicide has occurred largely to help
persons affected by the suicide loss, such as family, friends, and co-workers
of the deceased.
“Saving Lives in Tennessee”
Postvention
Prevention:
• Support groups
• Work with media
• Work with schools
and businesses
• Suicide prevention
trainings
• Advocacy/public
policy
• Suicide awareness
Intervention
• Crisis counseling
• 911
• Hospitalization,
walk-in centers,
CSUs
TSPN’s Advisory Council
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Governor-appointed
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Independent and nonpartisan
Two-year appointments
Consecutive pending reappointment
Review and evaluate TSPN activities and
objectives through committees
 Advocate for public policy change on the
statewide level regarding suicide prevention
 Preside over eight regional networks
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TSPN Regions and Current Regional Chairs
Sabrina Anderson
Boys and Girls Clubs of
Jackson-Madison County
832 Lexington Street
Jackson, TN 38301
(731) 422-2008
[email protected]
Anne Stamps
Center Director
Cumberland Mountain
MHC / Dale Hollow MHC
501 Spruce Street
Livingston, TN 38570-2025
Christen Thorpe, MS, CRC, CATSM
(931) 484-8020 or
Pastoral Counseling Centers of Tennessee 823-5678
(615) 383-2115, extension 70
[email protected]
[email protected]
Mid-Cumberland
Rural West
Stewart
Obion
Weakley
Robertson
Sumner
Macon
Humphreys
De Kalb
Carroll
Fayette
Hardeman McNairy
Williamson
Hardin
Memphis/
Shelby County
Area
Waring Porter
Pastor, All Saints Presbyterian Church
(901) 233-2175
[email protected]
Claiborne
Perry
White
Campbell
Lewis
Bedford
Coffee
Lawrence
Giles
Lincoln
South Central
Karyl Chastain Beal, M.Ed, CT
Parents of Suicides/Friends and
Families of Suicides
(931) 388-9289
[email protected]
Franklin
Van
Buren
Washington
Carter
Greene
Knox
Cumberland
Jefferson
Cocke
Sevier
Loudon
Blount
Rhea
Grundy
Marion
Sullivan
Hawkins
Union
Roane
Warren
Maury
Northeast
Hancock
Morgan
Rutherford
Hickman
Wayne
Fentress
Putnam
Wilson
Chester
Shelby
Scott
Smith
Davidson
Dickson
Gibson
Jackson Overton
Harold Leonard, MA, LPC-MHSP
Cognitive Behavioral Specialists of the
Tri-Cities
(423) 245-5608
[email protected]
East Tennessee
Pickett
Clay
Trousdale
Houston
Haywood Madison
Tipton
Upper Cumberland
Henry
Decatur
Dyer
Anne Young, MS, CAS
Cornerstone of Recovery
(865) 970-0500
[email protected]
McMinn
Bradley
Monroe
Polk
Southeast
Eve Nite
Mental Health Cooperative of Chattanooga
(423) 697-5952
[email protected]
Advisory Council Chairperson
Tim Tatum, MA, LPC-MHSP
Pine Ridge Treatment Center
(423) 339-4351
[email protected]
Executive Director
Scott Ridgway, MS
(615) 297-1077
[email protected]
TSPN: A Public/Private
Partnership

Participants (Private)
 Survivors and attempters
 Mental health and public
health professionals
 Existing suicide prevention groups (i.e., AFSP, AAS,
Jason Foundation, SPRC, Yellow Ribbon)
 Clergy
 Journalists
TSPN’s Regional Networks
Implement TSPN objectives on the local level
 Organize regional awareness and educational
events
 Provide assistance in local postvention efforts
 Promote public policy change locally and
statewide
 Local support for statewide TSPN projects
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Suicide in the US, By the Numbers
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40,600 deaths in U.S. in 2012 (compared to 34,935
deaths in auto accidents that year)*
Average of 110.9 per day
1 person every 13.0 minutes
1 person over the age of 65 every 79 minutes
1 person between ages 10-24 every 102 minutes
*CDC, 2013
Brief Suicide Statistics
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Suicide is the 10th leading cause of death
among Americans.
Suicide attempts impact a larger population.
 More individuals survive suicide attempts than die
and are in need of medical attention for serious
injuries.
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Suicides doubled homicides from 2008-2010
 Est. number of people hospitalized from self-
inflicted injuries increased from 155,000 in 2009 to
224,000 in 2011
Suicide in Tennessee by the
Numbers
1,017 reported suicide deaths in 2013
 Suicide rate at 15.7 per 100,000—highest rate
since 2008
 National suicide rate for 2012: 12.9 per
100,000
 In 2012, Tennessee’s suicide rate ranked 20th
in the nation
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Suicide in Tennessee by the
Numbers
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34 confirmed suicide deaths in 2012 within 10-19
year old age group (rate at 5.0 per 100,000)
(32)2007-(31)2008-(44)2009-(38)2010-(32)2011
Between 2004-08, suicide rate dropped by 32%
(from 45 to 31)
Between 2010-11, rate dropped by 28% (from 38 to
32)
Suicide in Tennessee by the
Numbers
Every day we lose three people to suicide
 One person aged 45-54 every two days
 One person over the age of 65 every three
days
 One person between the ages 10-24 every
four days
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Suicide by the Numbers
2008
965
Tennessee
(15.7)
36,035
U.S.
(11.8)
2009 2010 2011
2012
939
932
938
956
(15.1) (14.7) (14.6) (14.8)
36,909 38,364 39,518 40,600
(12.0) (12.4) (12.7) (12.9)
Source: TDOH, 2011; CDC, 2010
2013
1,017
(15.7)
N/A
Counties with
Highest Suicide Rates, 2012
County
TSPN Region
Rate per 100,000
population
Actual number of
deaths
Smith
Upper Cumberland
41.9
8
Cheatham
Mid-Cumberland
35.6
14
Giles
South Central
31.0
9
Grainger
East Tennessee
30.9
7
Stewart
Mid-Cumberland
30.1
4
Cannon
Upper Cumberland
28.9
4
Cumberland
Upper Cumberland
28.1
16
Humphreys
Mid-Cumberland
27.4
5
Marshall
South Central
25.9
8
Claiborne
East Tennessee
25.2
8
Counties with
Highest Suicide Rates, 2013
County
TSPN Region
Rate per 100,000
population
Actual number of
deaths
Pickett
Upper Cumberland
59.1
13
Lewis
South Central
50.2
6
Overton
Upper Cumberland
45.3
10
Hancock
Northeast
45.1
3
Stewart
Mid-Cumberland
44.9
6
McNairy
South Central
38.3
10
Perry (tie)
South Central
38.1
3
White (tie)
Upper Cumberland
38.1
10
Houston
Mid-Cumberland
36.2
3
Giles
South Central
34.8
10
Leading Methods of Suicide Death
in Tennessee, 2013
Source: TDOH, 2014
Current Factors in Play

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Lingering effects of the Great Recession
 US suicide rate increased by 4.8% between 2007 and 2010
 Tennessee suicide rate went up 15% (13.7 to 15.7) between 2007 and
2008… still elevated
Cuts to mental health services
 From 2009 to 2011, states cut mental health budgets by a combined
$4 billion-largest single combined reduction to mental health
spending since 1970s (Mental Health America, 2013)
 Rural areas are hardest-hit by cuts and have greater issues with access
to begin with
Current Factors in Play

Suicide in midlife on the rise
 Age-adjusted suicide rate for adults aged 35–64 years in
the US increased by 28.4% between 1999-2010 (CDC,
2013)
 Aging baby boom generation is moving into this
demographic
 This generational cohort has always had a higher suicide
since those before or after
Warning Signs of Suicide
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Talking about suicide, death, and/or no reason to live
Preoccupation with death and dying
Withdrawal from friends and/or social activities
Experience of a recent severe loss (especially a relationship) or the threat of a significant loss
Experience or fear of a situation of humiliation of failure
Drastic changes in behavior
Loss of interest in hobbies, work, school, etc.
Preparation for death by making out a will (unexpectedly) and final arrangements
Giving away prized possessions
Previous history of suicide attempts, as well as violence and/or hostility
Unnecessary risks; reckless and/or impulsive behavior
Loss of interest in personal appearance
Increased use of alcohol and/or drugs
General hopelessness
Recent experience humiliation or failure
Unwillingness to connect with potential helpers
Suicide in Rural Communities

Higher suicide rates due to:
 Fewer mental health/social service resources
 Community stigma
 Increased access to lethal means
 Lack of transportation
The Public Health Approach to
Suicide Prevention
Define the
problem
Identify the
causes
Implement
interventions
Test
interventions
Evaluate
effectiveness
This approach is most likely to produce significant and sustained reductions in suicide. The public health approach to suicide
prevention focuses on identifying broader patterns of suicide and suicidal behavior throughout a group or population.
An ideal, evidence-based intervention is one that has been evaluated and found to be
safe, ethical, and feasible, as well as effective.
Understanding Risk Factors, Protective Factors, and Warning Signs
Heart Attack
Suicide
Examples of Risk Factors
(Individual Level)
Indicate someone is at a
HIGHER RISK of a heart attack
or suicide
•Obesity
•High LDL cholesterol
•Physical inactivity
•Prior suicide attempt
•Mood disorders
•Substance abuse
•Access to lethal means
Examples of Protective
Factors (Individual level)
Indicate that someone is at
LOWER RISK for heart attack
or suicide
•Exercise
•Sound diet
•High HDL cholesterol
•Stress management
•Connectedness
•Availability of physical and
mental health care
•Coping ability
Examples of Warning Signs
Indicate that someone is
having a heart attack or is
seriously considering suicide
•Chest pain
•Shortness of breath
• Cold sweat
•Nausea
•Lightheadedness
•Threatening to hurt or kill
oneself
•Seeking a means to kill oneself
•Hopelessness
•Increasing alcohol or drug use
•Dramatic mood changes
Applying
Primary Prevention
Principles to Suicide
Prevention
Proven Primary Prevention Strategies
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Strategy 1—Promote National Suicide Prevention
Lifeline (1-800-273-TALK)
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Objective: Promote Lifeline and TSPN.org website as
statewide resources for suicide prevention
Activity:
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Get local media to promote the Lifeline number & TSPN website
Distribute resources that include the number (especially TSPN
pamphlets and resource directories)
Encourage churches and civic groups to promote the Lifeline and TSPN
website
Add Lifeline to appropriate websites
Proven Primary Prevention Strategies
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Strategy 2—Promote Gun Safety Project
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Objective: Help firearm dealers and firing range owners spot
and engage troubled/suicidal customers
Activity:
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Share guidelines with gun store/firing range owners about how to
avoid selling or renting a firearm to a suicidal customer
Encourage gun stores and firing ranges to display and distribute
project materials
Educate public about safe firearm use and storage, including
temporary removal of guns from premises if someone there may be
suicidal
Proven Primary Prevention Strategies
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Strategy 3—Promotion of suicide prevention
curricula in schools
Objective: Implement means for educating students
and staff about suicide prevention
Activity:
 Promote mental health programs like Mental Health 101
and I.C. Hope
 Promote suicide prevention programs like the Jason
Foundation’s “Promise for Tomorrow” program
 Promote adoption of anti-bullying programs with a suicide
prevention component
Proven Primary Prevention Strategies
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Strategy 4—Promote suicide prevention training
and assessment
Objective: Train general public in suicide prevention,
with an emphasis on potential gatekeepers
Activity:
 Promotion of evidence-based training programs like QPR
to schools and community groups
 Promotion of appropriate training programs (e.g., ASIST)
to mental health and medical professionals
 Inclusion of information about suicide prevention training
in directories, pamphlets, etc.
Proven Primary Prevention Strategies
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Strategy 5— Promote support to the survivors of
suicide
Objective: Connect survivors to sources of support
throughout the state
Activity:
 Promotion awareness of and attendance in the survivors
of suicide support groups
 Promotion the development of new survivor of suicide
groups.
 Inclusion of information about support groups in
directories, pamphlets, online, etc.
Columbia Suicide Severity Rating
Scale
Excellent Suicide Risk Assessment Tool
 http://www.cssrs.columbia.edu/
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 Can download various scales
 Can get training re: how to administer
Suicide Prevention
Awareness Month
Observed every September since 2001
 Statewide and local awareness events
 Statewide and local proclamation project (88
out of 95 counties covered this year; 130
documents)
 Awareness walks
 Exhibits at local conferences and other events
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TSPN’s Publications
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Brochures:
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Survivors of Suicide groups
Older adults
Youth
Midlife
Veterans
Bullying and suicide
Substance abuse and suicide
GLBT
African-Americans
TSPN’s Publications
Church bulletin inserts
 Regional resource directories
 TSPN Call to Action (monthly)
 Status of Suicide in Tennessee (annual)
 Out of the Shadows (bi-monthly, survivors)
 can you hear me? (bi-monthly, attempt
survivors)
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Resources:
Telephone, Internet & Apps
National Suicide Prevention Lifeline
 Apps 
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Internet
TSPN App
 Suicidepreventionlifeline.org
 TSPN  tspn.org
 SPRC  sprc.org
 AAS
 suicidology.com
 NSPL
33
Resources
TSPN website: www.tspn.org
 National Suicide Prevention Lifeline:
1-800-273-TALK (8255)
 Survivors of Suicide groups listed at
http://tspn.org/for-survivors-of-suicide
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