Changing the Conversation from Suicide to Suicide Prevention: Messages that can Save Lives

Transcription

1 Changing the Conversation from Suicide to Suicide Prevention: Messages that can Save Lives John Draper, Ph.D. Lifeline Executive Director GLS Plenary March 2018

2 If only the signs were this easy to read LIFENET NYC DMH Anti-stigma campaign, 2000 Hotlines & Public Health: Promote Awareness & Help-seeking

3 Even Superheroes Need Help Sometimes LIFENET, Project Liberty, NY State, 2002 Post-9/11: Disaster Mental Health and Resilience

4 Lifeline: Online Messenger Millions of suicide prevention stakeholders across the United States are promoting the Lifeline, with 75% of Lifeline callers first learning of the service from online resources Any search that is suicide related results in a prominently displayed one box through our partnership with Google. Our partnerships with social media companies reach up to seven million people annually. Lifeline has more FB fans than any other suicide prev. organization When people in the United States mention suicide to Apple iphone s Siri, she refers them to the Lifeline.

5 : Lifeline Web Site Visits 2016 unique visitors (2.6m) were 22% more than 2015 (2.1m) 2017 unique visitors (4.5m) were nearly 75% more than ,000 User Overview February December , , ,000 Series1 200, ,

6 Lifeline and the Mass Media

7 What is Our Message for This?

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9 Limitations of Traditional Suicide Prevention PH Messaging Does publicizing warning signs work? If action step is only Hotlines or Professionals: Suicide Prevention is other people s business! If our efforts are mostly Safe Messaging : Does not intentionally work with media to reduce suicide rate (just avoid making it worse) Behavior change = telling people what more they can do is most effective Reactive and endless pursuit of bad actors; how will we know it s working? Can potentially alienate media as partners in reducing suicide (Give them stories to help their reporting!)

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11 USA National Action Alliance for Suicide Prevention Priority #3 One of Top 3 Priorities: Change the public conversation around suicide and suicide prevention. The Action Alliance will leverage the media and national leaders to change the national narratives around suicide and suicide prevention to ones that promote hope, connectedness, social support, resilience, treatment and recovery.

12 The Tale of Tragedy and Misery 44, 965 Suicides* 750,000 Hospitalizations** 1,000,000 Attempts Requiring Medical Attention** 2,600,000 Suicide Attempts** 12,600,000 Seriously Considered Suicide** SLIDE FROM DR. DeQuincy LeZine, Prevention Communities Inc. Primary author, The Way Forward, publication of the NAASP Source: * National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. (2009). Web-based Injury Statistics Query and Reporting System (WISQARS). Available from: And CDC YRBS, 2016 **Substance Abuse and Mental Health Services Administration, Results from the 2015 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-42, HHS Publication No. (SMA) Rockville, MD: Substance Abuse and Mental Health Services Administration, And CDC YRBS, 2016.

13 Changing the Conversation 12,600,000 Seriously Considered Suicide** 2,600,000 Suicide Attempts** 1,000,000 Attempts Requiring Medical Attention** 38,364 Suicides* 750,000 Hospitalizations** 44,965 Suicides

14 NAASP Response to CDC Report on Suicide Rates The CDC data remind us that there is more we must all do to prevent suicide in our communities. However, it is important to be aware of data that indicates suicide prevention is effectively occurring daily, in ways that are rarely finding headlines. For every one person who tragically dies by suicide in the U.S., there are approximately 278 people who have moved past serious thoughts about killing themselves, and nearly 60 who have survived a suicide attempt, the overwhelming majority of whom will go on to live out their lives. These untold stories of hope and recovery are the stories of suicide prevention, stories which are informing the Action Alliance s efforts to prevent more suicides every day. Excerpt from NAASP Press Release, 4/22/2016

15 NAASP: Framework for Successful Messaging

16 Public Health Messaging Reduces Deaths 43% reduction in heart disease deaths since 1969 (over half due to prevention efforts) 23% decline in cancer death rates since 1991 (over half deaths can be prevented via behavior change)

17 Key Message #1 Primary Audience: Potential Helpers YOU can take actions that can help prevent suicide.

18 Samaritans

19 Teaching Community Members Can Save Lives GLS Evaluations, : Counties with GLS programs had sig. lower suicide rates for ages the year after GLS activities were implemented. Impact on suicides did not persist after a year. Authors: staff turnover, need for refresher gatekeeper training, focus on comprehensive programming fades over time. Walwrath, C, Garraza, LG, Reid, H, Godston DB & McKeon, 2015

20 What does the public think about suicide prevention? 2015 Harris Poll, by NAASP, AFSP, ADAA: Most (94%) believe suicide is preventable Most (93%) would do something if someone close to them had suicidal ideas Most believe mental health conditions like depression increase suicide risk Most believe mental health care is helpful Most (55%) have been affected by suicide (someone close died by suicide, had thoughts of suicide, etc.)

21 Public and MH Professionals: What Can I Do to Help? The Public. Almost 50% of Americans identified barriers that stopped them from trying to help someone at risk for suicide, such as (Harris poll 2015): fear that they would say or do something to make things worse rather than better, and not knowing how to find help for a person in crisis. The Professionals. NY State survey (2014) of 1585 providers, 64% little or no suicide prev training NAASP Survey (2013) of 30,000 MH professionals. Approximately half reported not enough skills, training or supports to work with suicidal persons

22 What Help Do Suicidal Persons Need? Australia survey of 127 persons with LE of suicide, 33 mental health professionals. Suicidal persons wanted: To have their suicidal thoughts taken seriously To be asked about suicide directly To be listened to nonjudgementally and be supportive Professionals rated more highly taking action. Pirkis on Report to beyondblue, IASP, 2017

23 What do Suicidal Persons Want? WHO Study, Bruffaerts, et al, 2011(over 55,000 persons in 21 countries with recent suicidal thoughts/behaviors) Of 45%-51% attempt survivors that did not receive care: 58% said low perceived need for care 40% wish to handle the problem alone 15% structural barriers (financial, distance) 7% stigma Gould, Munfakh, Kleinman & Lake, 2012 (376 suicidal Lifeline callers from 16 centers interviewed) Of the 48% not linking to care after the call, over half said that the problem was not severe enough and could be managed on their own without treatment

24 Self-Help and Suicide Prevention Gould et al, SLTB, 2012: Our findings emphasize the necessity of respecting and targeting individuals strong need for self-efficacy to optimize their receipt of help.the strategy of enhancing and promoting self-care and informal care has long been employed by crisis counselors, and our findings suggest that this should continue.

25 First Line Coping Strategies 198 adults with history of mental illness/treatment and at least one suicide attempt were asked: If your darkness and despair escalated to actual thoughts of suicide, what has helped you in the past to not take that action? (write up to 5 coping strategies) Alexander et al, 2009 Spirituality/religious practices 18 % Talking to someone/companionship 14 % Positive thinking 13 % Using mental health system 12 % Considering consequences to people close to me 9 % Using peer supports 8 % Doing something pleasurable 8 % Protecting myself from means 5 % Doing grounding activities 4 % Considering consequences to myself/fear 2 % Doing tasks to keep busy 2 % Maintaining sobriety 1 %

26 BeThe1To.com (2016)

27 #BeThe1To Action Steps

28 Facebook: Promoting self/other help to prevent suicide We know that one of the best ways to prevent suicides is to promote caring connections between people. How to help suicidal persons on Facebook

29 What Can I Do to Prevent Suicide? Video: Nearly 30m views Stories across media Over 16m subscribers Both messages conveyed

30 Key Message #2 Primary Audience: Persons at Risk Healing, hope and help are happening. Stories of positive coping with suicidality, hope and recovery Research demonstrating treatments or actions that prevent suicide

31 Papageno Effect The possibility of a suicideprotective effect of media items on positive coping in adverse circumstances, which has been discussed in the literature on a purely theoretical basis, was empirically supported by the present findings. Reporting of individual suicidal ideation (not accompanied by attempted or completed suicide) was associated with a decrease in suicide rates. Niederkrothenthaler et al, Brit. Jrnl Of Psychiatry, 2010 The study suggests that prevention of suicidal behavior by media reports is possible. Niederkrothenthaler et al, 2010

32 Stories of Hope & Recovery

33 Papageno Effect from SP Websites RCT exposed 161 adults to 3 German suicide prevention websites (educational information, coping tips, stories of persons with lived experience): Significant, sustained increase in suicide prevention knowledge Signficant reductions in suicide ideation among participants with SI results lend further support for Papageno Effect the websites clearly highlighted the fact that individuals with suicidal ideation were not alone and further provided examples of persons with lived experience of suicidality. Til, Tran, Voracek & Neiderkrotenthaler, Brit Jrnl of Psychiatry, 2017

34 Papageno: Logic s Logic s song named after the Lifeline was released in April 2017, and the song s video came out in August The song became a #1 hit globally, and the video has been seen by over 200m people. Both were nominated for Grammy Awards; the song was performed at Grammys & MTV s VMAs. Calls increased 26% after VMA and 30% after Grammys Avg. daily calls six months later (after song s release): 31% increase over prior six months Calls are 60% higher than this time one year ago

35 Over 210m views Many thousands of positive comments Grammy nominated Logic s Video: Papageno Effects

36 Changing the Conversation

37 Changing the Conversation

38 Changing the Conversation what might [survivors of suicidal experiences] say if they did not fear judgment, scrutiny and stigma? They might tell you something that I have heard from hundreds of survivors, that I lived myself; the truth that, for many, going through struggles with suicide completely transforms their lives for the better. Eduardo Vega, MH Advocate, Huff Post, 7/19/2017

39 Next steps National/International Consensus on Positive Message Framework (coming) Sharing (or creating) content related to action steps Bethe1to.com #BeThere (veteranscrisisline.net) Take 5 to save lives (do your part) Share (or create) stories of help and recovery Lifeline Stories of Hope and Recovery Livethroughthis.org

40 Thank you! Dr. John Draper Executive Director, Lifeline Frances Gonzalez Lifeline Communications Director (212)

41 Our Panelists: Stories of the Storytellers Craig A. Miller Author/Speaker Video of story: Shelby Rowe, MBA OK GLS Youth Suicide Prevention Project Director Video: Blog: