An Overview of SAMHSA Programs and Initiatives Suicide Prevention

Transcription

1 An Overview of SAMHSA Programs and Initiatives Suicide Prevention Charles Smith, PhD Regional Administrator-Region VIII Substance Abuse & Mental Health Services Administration U.S. Department of Health & Human Services Improving Combat Veterans Care Sioux Falls, South Dakota May 13, 2016

2 ~ 41,149 Americans die by suicide

3 Pyramid of Suicidal Behaviors U.S. Adults (2013) 41,149 Suicides* 572,000 Hospitalizations*** 494,169 Attempts/Self-harm Requiring Medical Attention**** Pyramid: Top tier shows the number of suicides in Bottom tier shows the number who seriously considered suicide in ,300,000 Suicide Attempts** 9,300,000 Seriously Considered Suicide** (2,700,000 Made a Plan) Source: * Centers for Disease Control and Prevention, Understanding Suicide: Fact Sheet. ** SAMHSA. Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings. Rockville, MD *** SAMHSA. The NSDUH Report: Suicidal Thoughts and Behaviors among Adults. Rockville, MD **** US Consumer Product Safety Commission. National Electronic Injury Surveillance System All Injury Program, 2013.

4 10 Leading Causes of Death by Age, U.S. (2013)

5 Suicide: National View Slide 5

6 Suicide: Regional Comparisons

7 Suicide Deaths by Method U.S. (2013)

8 ~50 % of those who die by suicide have major depression the suicide rate of people with major depression is 8x that of the general population 8 ~90 %of people who die by suicide have a mental disorder, substance abuse disorder, or both at the time of their death.

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10 Every year > 650,000 persons receive treatment in emergency rooms following suicide attempts : 55% in emergency department visits for drug-related suicide attempts by men 21 to : 49% in emergency department visits for drug-related suicide attempts by women 50+

11 Data and Disparity Suicides o 4 males : 1 female o Highest risk: elderly white males (85+) o o Largest numbers: middle-aged (40-60 yrs.) males at 2x s baseline rate of other Americans and working-aged males (20-64) = 60 % of suicides Higher risk: young and middle-aged AI/AN Suicide attempts o o o Female > male Rates peak in adolescence and decline with age Higher risk: LGBT youth and young Latinas

12 Can National strategies reduce suicide rates? Yes, and it requires o A sustained, comprehensive approach: everyone has a role. o Data-driven strategy. o Active effective clinical systems approach. o Active effective community component that includes workplaces, schools, faith-based organizations, justice systems, as well as all health care systems. o Implementation of national strategies/national efforts (examples England and Taiwan) *This has worked: U.S. Air Force and the Henry Ford Health System have used similar roadmaps to reducing suicide rates.

13 National Action Alliance for Suicide Prevention

14 NAASP: Accomplishments & Progress National Strategy For Suicide Prevention Suicide Care in Systems Framework (basis of Zero Suicide model) Suicide Prevention and the Clinical Workforce: Guidelines for Training First-ever prioritized suicide prevention research agenda The Way Forward (Suicide Attempt Survivors Task Force) Responding to Grief, Trauma, and Distress After a Suicide (Loss Survivors Task Force)

15 SAMHSA s Suicide Prevention Portfolio SAMHSA SI #1: Prevention of Substance Abuse & Mental Illness o Creating communities where individuals, families, schools, faith-based organizations, and workplaces take action to promote emotional health and reduce the likelihood of mental illness, substance abuse including tobacco, and suicide. o Goal 1.3: Prevent suicides and attempted suicides among populations at high risk, especially military families, LGBTQ youth, and American Indians and Alaska Natives. National Suicide Prevention Lifeline o Crisis Center Follow-up Grant Program Suicide Prevention Resource Center Garrett Lee Smith State and Tribal Suicide Prevention Grant Garrett Lee Smith Campus Suicide Prevention Campus Grant National Strategy for Suicide Prevention (FY 17) Native Connections

16 National Suicide Prevention Lifeline TALK (8255) o 24/7 164 crisis centers Provides counseling and mental health referrals Chat services available Answered 1.5M calls in 2015

17 Advances the National Strategy for Suicide Prevention through public health approach Executive Secretariat for National Action Alliance for Suicide Prevention Technical assistance to states, territories, tribes, GLS grantees Training/outreach/partnerships (primary care, EDs, behavioral health providers) Training (e.g., free online classes [CALM]) The Weekly Spark

18 Garrett Lee Smith State & Tribal Youth Purpose: Suicide Prevention Grant Program o Support states and tribes develop and implement statewide /tribal suicide prevention and early intervention strategies, grounded in public/private collaboration. o Public/private collaboration among youth-serving institutions and agencies including schools, juvenile justice systems, foster care systems, etc. o Commit to making suicide prevention a core priority in youth-serving systems Target age range: years old 45 current grantees; 5-year program

19 Garrett Lee Smith Campus Suicide Prevention Purpose Grant Program o Facilitates a comprehensive approach to preventing suicide in institutions of higher education. o Assists colleges and universities build consistent foundation to prevent suicide attempts and completions and to enhance services for students with mental and substance use disorders that put them at risk for suicide and suicide attempts. o Services include training, linking campuses to communitybased mental health, awareness, more Target: College/University Students 59 current grantees; 3-year program

20 National Strategy for Suicide Prevention (NSSP) Grant Program Purpose: o Promote suicide prevention as a core priority in health care systems. o Implement effective clinical and professional practices for assessing and treating those at risk for suicidal behavior. o 3-year program to states to implement the 2012 National Strategy for Suicide Prevention. Target: Working-age adults, years old. 4 current grantees (NM, NY, OK, TN); 3 year program

21 Native Connections Tribal BH Grant Program Purpose: o To prevent and reduce suicidal behavior and substance abuse and promote mental health among American Indian/Alaska Native young people ages o Each program will reflect he needs, values, and culture of their community. o Programs are strength-based. Target: American Indian/Alaska Native youth, ages 0 24 years. 20 current grantees; 5 year program.

22 Suicide Safe SAMHSA s Suicide Prevention App for Health Care Providers Helps providers integrate suicide prevention strategies into their practice and address suicide risk among their patients. For primary care and behavioral health providers. Based on SAMHSA s Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) card. Free for Apple and Android mobile devices Visit bit.ly/suicide safe to learn more. Suicide Safe helps Providers Learn how to use the SAFE-T Explore interactive sample case studies. Quickly access and share information and resources. Browse conversation starters. Locate treatment options. Read content in larger font for viewing on smaller screens. View newly added suicide prevention video resources for providers.

23 SAMHSA Publications

24 Recent SAMHSA Publications

25 Suicide Warning Signs

26 Additional Resources SAMHSA programs SAMHSA Publications (free) Suicide Prevention Resource Center National Action Alliance for Suicide Prevention

27 Partnership: SAMHSA & HRSA Rural Suicide Prevention Toolkit for Primary Care (WICHE) Regional HRSA and SAMHSA connections o Region VIII Suicide Prevention Learning Community o Developing Suicide Prevention as a core component of health care Interagency Agreement to conduct military culture training in Area Health Education Centers across the country. (4,500 providers trained to-date in 112 AHECs)

28 Suicide Prevention: A Core Component of Health Care What does it look like? o The clinical workforce is routinely trained in suicide risk assessment, management, and treatment. o Accrediting and certifying bodies have standards and guidelines related to suicide prevention. o Continuity of care during high-risk transition times is assured. o Deaths by suicide and non-fatal suicide attempts are routinely monitored and reviewed to help guide suicide prevention efforts. o Continuous quality improvement efforts focused on suicide prevention are conducted.

29 Partnership: SAMHSA & VA - Preventing Suicide Among Veterans Interagency Agreement TALK press 1 Veterans Crisis Line answered 6,125 calls monthly o 85% identified themselves as veterans, service members, or their friends and family members (FY12) o Majority of callers are men, ages ,960 emergency rescues (FY13) Chat service 24/7 (+4,000 chats/month) Texting VA adopted SAMHSA s Treatment Improvement Protocol Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment and created a complementary training video.

30 Keeping the Focus on SMVF at SAMHSA Military Families Strategic Initiative ( ) Executive Order 13625: Interagency Task Force on Military and Veterans Mental Health State interagency teams, strengthening SMVF behavioral health systems, and community capacity Implementation of best practices Building workforce capacity via military culture competency training Building peer and grassroots/community capacity Increasing collaboration to VA

31 SMVF TA Center

32 SAMHSA Service Members, Veterans & their Families (SMVF) Policy Academies Partnerships o DoD, National Guard Bureau, VA, The National Council, NASMHPD, NASADAD Goal o For States and territories to strengthen behavioral health systems for service members, veterans, and their families. Mechanism o 46 states, 4 territories, and DC established a longterm, 10-member interagency team, endorsed by the Governor.

33 Participating States and Territories (2016) SMVF Leadership Academy Participants 2016 Alaska Alabama Arizona California District of Columbia Delaware Guam Hawaii Illinois Kentucky Massachusetts North Carolina Nebraska New Hampshire New Mexico Nevada New York Oklahoma Rhode Island South Dakota Tennessee Texas Virginia Washington West Virginia

34 HOW DO WE NORMALIZE THERAPY? MAN THERAPY / DR. RICH MAHOGANY mantherapy.org

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36 Charles H. Smith, PhD SAMHSA Regional Administrator Region VIII 1961 Stout Street, Denver, CO ( ) Behavioral Health is Essential to Health Prevention Works Treatment is Effective People Recover