TSPN Call to Action TSPN AND TLC HELP DEVELOP SUICIDE PREVENTION LEGISLATION IN KENTUCKY

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1 VOLUME 6, ISSUE 5 MAY 2010 TSPN Call to Action T E N N E S S E E S U I C I D E P R E V E N T I O N N E T W O R K TSPN AND TLC HELP DEVELOP SUICIDE PREVENTION LEGISLATION IN KENTUCKY TSPN and TLC staff served as advisors to the Kentucky Suicide Prevention Group (KSPG) in the development of two suicide prevention bills that were ultimately signed into law by Kentucky Governor Steve Beshear. INSIDE THIS ISSUE: TSPN/TLC Site Move 2 Google Adds Lifeline Number We Can Help Us / Reachout.com New FAA Antidepressant Policy Indian Youth Suicide Prevention Epilepsy Drug Study 4 TSPN Regional Calendar Advisory Council Contact Information PO BOX NASHVILLE, TN PHONE: (615) FAX: (615) TSPN@TSPN.ORG House Bill 51 amends the Kentucky Revised Statutes (KRS) to require the state s Cabinet for Health and Family Services to post suicide prevention awareness and training information on its website. It also mandates the provision of suicide prevention awareness information to all middle and high school students at the start of each school year, effective as of the school year. Beshear signed House Bill 51 into law on March 4; it was passed unanimously by both houses of the Kentucky Legislature. Additionally, Senate Bill 65 amends KRS to require principals, guidance counselors, and teachers to complete a minimum of two hours of instruction in suicide prevention each school year. This aspect of the bill is similar in instruction and intent to the Jason Flatt Acts passed by California, Louisiana, Mississippi, and Tennessee earlier. Senate Bill 65 also allows for suicide prevention training for select employees through selfreview of suicide prevention materials. The legislation was passed unanimously by the Kentucky Legislature s Senate and passed in the House by a vote of Beshear signed it into law on April 13. A press release by Steve Ulrich of the KSPG Steering Committee recognized TSPN Executive Director Scott Ridgway and TLC Project Director Jason Padgett for presenting information on TSPN s youth suicide prevention efforts at a KSPG meeting. Many of the activities and concepts presented in the bill were incorporated into Senate Bill 65. KSPG is Kentucky s state-supported suicide prevention agency, which like TSPN seeks to provide education, awareness, and training to people across the Commonwealth. More information about the bills and the group s other projects is available from KSPG State Coordinator Michael McFarland at (502) , extension 4518, or michael.mcfarland@ky.gov. Members are also encouraged to explore the KSPG website (

2 TSPN CALL TO ACTION TSPN AND TLC JOIN MHAMT IN MOVE TO NEW OFFICE TSPN and TLC s central offices relocated last month, alongside the Mental Health Association of Middle Tennessee (MHAMT). The new offices are located at 295 Plus Park Boulevard, Suite 201, in Nashville, ZIP off Murfreesboro Pike, near the junction of Interstates 24, 40, and 440. Several other non-profit organizations have offices at the newly constructed building, most notably Citizens for Affordable Housing, the Center for Refugees and Immigration of Tennessee, the Founding Family Charitable Foundation for Adoption, New Vision Charter School, and Without Walls Church. The new offices provide TSPN with additional office space and a conference room shared with MHAMT. Other amenities include a conference center shared with other agencies, a board room for smaller meetings, and a refreshment center. TSPN will maintain its current post office box PO Box 40329, Nashville, TN, ZIP The office phone and fax will remain the same (see page 1). The move took place on April 22-23, with employees of TSPN, TLC, and MHAMT reporting for their first day of work at the new office on April 26. An open house for MHAMT s new location is set for 2-6 PM on May 19; all TSPN members are cordially invited to attend. RSVPs should be submitted to Kim Caudell at (615) or kfcaudell@mhamt.org. GOOGLE ADDS LIFELINE NUMBER TO SUICIDE-RELATED SEARCHES Searches on Google for information on suicide automatically bring up a notice about National Suicide Prevention Lifeline ( TALK), effective as of last month. Queries like ways to commit suicide and suicidal thoughts will automatically bring up the hotline marked with an icon of a red phone, making the listing more prominent than other linked results that might come up during the search. The move, put in place on March 31, follows the implementation of a similar notice for the national poison control hotline ( ) managed by the American Association of Poison Control Centers. That move had been suggested by a user of the search engine who had trouble locating a poison control center in an emergency. In contrast, the listing for the Lifeline was suggested by a company official. This screencap from the Google website shows the listing for the National Suicide Prevention Lifeline. Admittedly not all suicide-related searches (such as, I want to end my life ) will bring up the number. We looked at many of the possible queries that could reflect interest in the topic, Dr. Roni Zeiger, Google s chief health strategist, explained in an April 5 New York Times interview on the hotline s addition. We are starting relatively conservatively. In an April 8 ABC News interview, Lifeline project director John Draper reported that the notice on Google has led to a 10 percent increase in calls. "This is an extra 700 people that we could attribute at least in part to what Google is doing," he said. "We really recognize the impact that Google has, in the world of people searching for health information Any significant Internet presence makes a big difference in terms of reaching people who could be at risk for suicide." The move helps counter the tendency for websites encouraging suicide or describing suicide methods to float to the top of suiciderelated searches. A 2008 study in the British Medical Journal found that these websites are usually the ones that come up first in an online search, ahead of suicide prevention sites. PAGE 2

3 VOLUME 6, ISSUE 5 SAMHSA, AD COUNCIL LAUNCH YOUTH SUICIDE PREVENTION PROJECT The Substance Abuse and Mental Health Services Administration (SAMHSA) has launched a multimedia youth suicide prevention campaign in collaboration with the Ad Council and the Inspire USA Foundation. The campaign includes public service announcements for a variety of media and an interactive website. The website and campaign are being promoted through SAMHSA and the Ad Council s respective Facebook and Twitter accounts. The We Can Help Us project is aimed at youth aged and involves television and radio spots, along with posters in schools and malls as well as print ads in youth-oriented publications. The promotions direct troubled teens or those worried about someone else to which features information on depression, suicide, eating disorders, and Logo copyright 2009 reachout.com. relationship issues. The site also includes coping strategies and stories from young people who have worked through similar issues. The stories shared on the site incorporate video, audio and original animation. The National Suicide Prevention Lifeline ( TALK) is included on each page of the site. The Reach Out program was developed by the Inspire USA Foundation ( a branch of an Australian youth mental health non-profit with a longstanding interest in suicide prevention. Established in in 1992 with a website ( established in 1998, Reach Out Australia has toured over 300 schools across the country raising funds and awareness for mental health outreach to teens and young adults. Since its establishment, Australia s youth suicide rate has decreased by 56 percent, and in a recent poll 3 out of 4 Australian teens were familiar with the group. By creating an American branch of the organization, SAMHSA and the Ad Council hope to replicate its successes in the United States. We Can Help Us was developed by the advertising agency DDB New York with support from the Ad Council. The project will be promoted through several youth support agencies, such as Students Against Destructive Decisions (SADD) and National Organizations for Youth Safety (NOYS). "Our new campaign with SAMHSA and Inspire USA connects with teens by identifying with the various challenges they are facing, while empowering them to cope by showing them how their peers have made it through," explains Peggy Conlon, president and CEO of the Ad Council, in a March 31 SAMHSA press release on the campaign. "These ads and our online resources will give teens hope and this campaign has the potential to save many lives." NEW Faa POLICY LETS PILOTS TAKE ANTIDEPRESSANTS Effective as of last month, the Federal Aviation Administration (FAA) will permit pilots to take antidepressants provided the drugs have worked successfully over a twelve-month period. Authorities found that the old policy, which grounded pilots on antidepressant therapy, was discouraging them from seeking necessary treatment or disclosing use of medications which could have relevant sideeffects. "The concern that we have today is we have people who are either self-medicating or not seeking a diagnosis, said FAA Administrator Randy Babbitt in an April 2 CNN.com article. Either of those is unacceptable (the new policy) will allow those people to get the treatment, allow us to monitor and return them to the cockpit (as) safer, better pilots." The current shift comes after several FAA studies on the effects of depression and antidepressant therapy on pilots. Officials noted the development of more effective medications and the fading stigma attached to depression. The change was endorsed and promoted by the Aerospace Medical Association and several national and international aviation groups. (p)ilots on one of four antidepressants may apply for special medical certificates which will let them keep flying. From hereon out, pilots on one of four antidepressants citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), or sertraline (Zoloft) may apply for special medical certificates which will let them keep flying. These drugs were selected for their relative lack of side effects; other medications may be added to this list as more data on them becomes available. Pilots who are currently on antidepressants and who have not informed the FAA may do so within the next six months without loss or suspension of their licenses, although they will be grounded until they can prove a history of successful treatment. "Depression is a disease, and it's treatable just like any other disease. And there is a stigma out there that we want to remove. We want to make the skies safer, and we believe that this change in the policy will benefit that and achieve that," Babbitt was quoted as saying in his CNN.com interview. PAGE 3

4 TSPN CALL TO ACTION HEALTH CARE BILL INCLUDES INDIAN YOUTH SUICIDE PREVENTION Provisions to reduce the incidence of youth suicide among Native Americans are included in the recently passed healthcare bill Update and permanent reauthorization of the Indian Health Care Improvement Act (IHCIA) of 1976 was bundled with the Patient Protection and Affordable Care Act passed in March. Among the reforms authorized is a comprehensive youth suicide project for Indian reservations. Specifically, the updated IHCIA authorizes the expansion of a program originally developed by the Zuni tribe in New Mexico which has had proven results in reducing youth suicide. The program focuses on teaching coping and life skills to middle and high school students, a peer educator program, and connection of schools and parents with the larger community to present a unified support system for children and teens. In 2006, the latest year that figures are available from the CDC, the suicide rate for Native Americans aged was nearly three times that of the overall teen rate (12.24 per 100,000 versus 4.24 per 100,000). A March 25 Associated Press report on the problem notes that on some Indian reservations, the youth suicide rate is 10 times the national average. Understaffed and remote mental health care facilities, homelives complicated by substance abuse, and a pervasive mental health stigma are all contributing factors. "Teen suicide is a tragedy that is tearing apart too many Native American families, U.S. Senator Tom Udall (D-New Mexico) said in a March 24 press release. Udall was one of the first co-sponsors of legislation to reauthorize IHCIA as introduced by Sen. Byron Dorgan (D-North Dakota). "This is heartbreaking and unacceptable, and we are working to do something about it with this reform." Coloradas Mangus, age 15 from Mescalero, New Mexico, testifies before the Senate Indian Affairs Committee on suicide among Native American youth. Mangas reports losing five teenage friends to suicide, all on his reservation, and having survived an attempt himself. He asked the Committee to increase staff levels at the local mental health clinic and fund a youth shelter (AP Photo/Haraz N. Ghanbari). SOME EPILEPSY DRUGS CARRY HIGHER SUICIDE RISK, STUDY SUGGESTS Certain anti-seizure medications prescribed for epilepsy and other health conditions may carry an increased risk of suicide compared to other drugs, as suggested by a paper published last month in the Journal of the American Medical Association. According to an April 13 Health.com article, the report backs up a 2008 study by the US Food and Drug Administration (FDA) that reported the patients on anticonvulsants had double the risk of suicidality and suicide attempts although the overall risk was less than one-half of one percent and recommended placement of an advisory on all anticonvulsant drugs. The FDA study did not evaluate precise prescription drugs; the new study does so, reviewing outcomes of patients in the HealthCore Integrated Research Database (HIRD) who started one of 13 different anticonvulsants between 2001 and Researchers reviewed how many of them died by suicide or some other violent means and how many were treated for a suicide attempt at a hospital or emergency room, and kept track of what drug each patient was taking. The number of incidents with each medication was compared with topiramate, alias Topamax, an anticonvulsant used for a variety of health conditions. Patients on five of the drugs were more likely to die by suicide or attempt suicide than the control group which used topiramate. Specifically, the risk was 2.5 times higher for people taking tiagabine (Gabitril) and twice as high for people on oxcarbazepine (Trileptal). Patients on gabapentin (Neurontin), lamotrigine (Lamictal), and valproate (Depakote) also experienced higher rates of suicide and suicide attempts, even after accounting for patients physical and psychiatric diagnoses. The other seven carried no statistically significant increased risk. The research team recommends that patients on these drugs not stop taking them without consulting a physician, but should be aware of the risks involved. Some potential confounds have been noted with the new study. Topiramate itself sometimes exacerbates existing mental health conditions and as such is not usually prescribed to patients with a past history of or genetic predisposition to mental illness. Therefore, the control group may have already been at lower risk for suicidality and the risk for the drugs flagged by the study may have been somewhat inflated. Furthermore, the research team identified health diagnoses using standardized insurance billing codes which are not always precise. The citation for this study is as follows: Patorno, E., et al. (2010). Anticonvulsant medications and the risk of suicide, attempted suicide, or violent death. Journal of the American Medical Association 303(14): PAGE 4

5 VOLUME 6, ISSUE 5 TSPN REGIONAL CALENDAR No December meetings are scheduled unless otherwise marked. Dates in bold indicate alternate meeting dates intended to accommodate state holidays or other previously scheduled events. East Tennessee Region monthly, 3rd Thursday, 12:00 PM Mental Health Association of East Tennessee, Inc., 9050 Executive Park Drive, Suite 104-A, Knoxville, May 20, June 17, July 15, August 19, September 16, October 21, November 18 Memphis/Shelby County Region monthly, 3rd Tuesday, 11:00 AM The Community Foundation of Greater Memphis, 1900 Union Avenue, Memphis, May 18, June 15, July 20, August 17, September 21, October 19, November 16 Mid-Cumberland Region monthly, 2nd Thursday, 9:30 AM Tennessee Voices for Children, 701 Bradford Avenue, Nashville, May 13, June 10, July 8, August 12, September 9, October 14, and November 12 Northeast Region monthly, 4th Tuesday, 10:30 AM Boone s Creek Christian Church, 305 Boone s Creek Road, Gray, May 25, June 22, July 27, August 24, September 28, October 26, and November 23 Rural West monthly, 3rd Wednesday, 10:30 AM Behavioral Health Initiatives, 36C Sandstone Circle, Jackson, May 19, June 16, July 21, August 18, September 15, October 20, and November 17 South Central monthly, 1st Tuesday, 10:00 AM Mental Health Cooperative, 100 Berrywood Drive, Columbia, May 4, June 8, 8 July 6, August 3, September 7, October 5, and November 2 Southeast Region monthly, 1st Thursday, 10:00 AM Downtown Chattanooga YMCA, 301 West Sixth Street, Chattanooga, May 6, July 1, August 5, September 2, October 7, and November 4 Upper Cumberland Region monthly, 4th Thursday, 9:00 AM Volunteer Behavioral Health Care Systems, 1200 Willow Avenue, Cookeville, May 27, June 24, July 22, August 26, September 23, October 28, and November 18 Intra-State Department Meetings Tennessee Department of Mental Health and Developmental Disabilities, Third Floor Conference Room, Cordell Hull Building, 425 Fifth Avenue North, Nashville, (2:30 PM) July 28, October 27 Advisory Council June 1-2 (Montgomery Bell State Park, 1020 Jackson Hill Road, Burns) September 8 (Tennessee State Capitol) Blount County Mental Health Awareness and Suicide Prevention Alliance monthly, 1st Friday, 12:00 PM Blount County Health Department Conference Room, 302 McGhee Street, Maryville, TN May 7, June 4, July 2, August 6, September 3, October 1, and November 5 Davidson County Suicide Prevention Task Force monthly, 4th Thursday, 9:00 AM May 27, June 24, July 22, August 26, September 23, October 28, November 18 Giles County Suicide Prevention Task Force bi-monthly, 3rd Monday, 1:30 PM Giles County Career Center, 125 South Cedar Lane, Pulaski, May 17, July 19, September 20, and November 15 Hickman County Suicide Prevention Task Force monthly, 4th Friday, 1:30 PM Hickman Community Hospital, Senior Care Building, 135 East Swan Street, Centerville, May 28, June 25, July 23, August 27, September 24, October 22, and November 19 PAGE 5

6 ADVISORY COUNCIL CONTACT INFORMATION If you are interested in getting involved with TSPN on a local level or have other questions, contact the chairperson of your region as indicated by the map provided below: East Tennessee region Anne Young, MS, CAS (865) sayoung3@comcast.net or anneyoung@cornerstoneofrecovery.com Memphis and Shelby County Madge Tullis (901) kfttenn@ktullis.com Mid-Cumberland region Misty Yarbrough, BBA, BSW (615) myarbrough@mhc-tn.org Northeast region Harold Leonard, MA, LPC-MHSP (423) hleonard4113@charter.net Rural West region Anne Henning-Rowan, MS (731) annerowan@hughes.net South Central region Karyl Chastain Beal, MEd, CT (931) karylcb@bellsouth.net Southeast region Tim Tatum, MA (423) tim_tatum@chs.net Upper Cumberland region Jodi Bartlett, Ed. S, LPC-MHSP (931) or (931) , ext. 166 jbartlett@vbhcs.org Advisory Council Chair Harold Leonard, MA, LPC-MHSP (423) hleonard4113@charter.net Executive Director Scott Ridgway, MS (615) sridgway@tspn.org Advisory Council Chair Emeritus Sam Bernard, PhD, FAAETS, DABCEM (423) sam@sambernard.info Lake Lauderdale Obion Henry Weakley Dyer Gibson Carroll Crockett Haywood Madison Tipton Chester Henderson Benton Decatur Stewart Houston Humphreys Perry Montgomery Dickson Hickman Lewis Cheatham Maury Robertson Davidson Williamson Marshall Macon Sumner Clay Pickett Scott Claiborne Hancock Campbell Fentress Hawkins Trousdale Jackson Overton Union Smith Wilson Rutherford Bedford Cannon Putnam Morgan De Kalb Cumberland White Roane Warren Van Buren Rhea Coffee Monroe Grundy McMinn Sequatchie Bledsoe Meigs Anderson Grainger Hamblen Jefferson Knox Cocke Sevier Loudon Blount Greene Washington Unicoi Sullivan Carter Johnson Shelby Fayette Hardeman McNairy Hardin Wayne Lawrence Giles Lincoln Moore Franklin Marion Hamilton Bradley Polk