Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

Transcription

1 Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials Friday, April 30, p.m. - 3:30 p.m. Central, 11 a.m. - 2:30 p.m. Mountain Plaza Conference Center A BryanLGH Medical Center East 1600 S. 48th Street Lincoln, NE and via the Nebraska Statewide Telehealth Network at these locations: Alliance Norfolk Scottsbluff

2 Table of Contents Introduction to the Planning Forum!... 1 To Prepare for the Forum, Please:!... 1 What to Expect at the Forum!... 1 How Will My Input Be Used?!... 2 Planning Forum Agenda!... 3 Report 1: Nebraska State Suicide Prevention Plan!... 4 Report 2: Recommendations for Suicide Prevention in Nebraska!... 9 Report 3: 2010 Nebraska State Suicide Prevention Summitʼs What More Needs to Be Done? Recommendations! Inventory of Existing Suicide Prevention Services and Needs! Other Needs Identified! Data on Suicide in Nebraska! Summary! Causes of Death! Suicide Deaths! Hospital Discharge Rates (attempted suicide)! Your Recommendations Worksheet! Instructions! How to Write SMART Objectives!... 31

3 Introduction Introduction to the Planning Forum The Nebraska Suicide Prevention Strategic Planning Forum aims to gather stakeholder input on a new three-year strategic plan for preventing suicide in Nebraska. The Nebraska State Suicide Prevention Coalition, organizer of the Forum, believes this new strategic plan must build on these three prior planning efforts in order to succeed: The Nebraska State Suicide Prevention Plan Recommendations generated at the 2006 Nebraska Suicide Prevention Symposium Recommendations generated at the 2010 Nebraska State Suicide Prevention Summit Therefore, the Planning Forum is organized around three reports contained in these briefing materials. Each report lists a past plan s objectives or recommendations and gives a progress report on their implementation. The intent is to show what ideas have already been discussed, and what actions have already been taken, to avoid treading old ground or reinventing the wheel. To Prepare for the Forum, Please: 1. Read the three progress reports. 2. Read the Inventory of Existing Suicide Prevention Services and Needs. 3. Read Data on Suicide in Nebraska. 4. Most important: Complete the Your Recommendations Worksheet (found at the end of this document). We re asking you to do all this in advance because the Forum agenda is tightly packed; there will no time to catch up during the meeting, and there will be no presentations reviewing these materials. We are also aiming for a full and fair discussion where everyone s voice is heard. We can better achieve that when everyone arrives prepared. What to Expect at the Forum The forum will be engaging, enjoyable, and fast-paced, with lots of participant-driven discussion in small and large groups. The order of events is: 1. Welcome and instructions 2. Small-group discussions to write strategic plan recommendations 3. Begin large-group discussion to share strategic plan recommendations 4. Break 5. Continue the earlier large-group discussion on sharing strategic plan recommendations 6. Large-group discussion to narrow down the strategic plan recommendations 7. After the meeting, voting online to prioritize strategic plan recommendations generated at the Forum Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 1

4 Introduction The Forum will take place in Lincoln, and in Alliance, Norfolk, and Scottsbluff via the Nebraska Statewide Telehealth Network. Each Telehealth site will have a volunteer small-group facilitator who agrees to remain neutral while helping participants there generate and advocate for their own strategic plan recommendations. Each site s facilitator will also help resolve any technical difficulties with the Telehealth network that may arise. Lincoln participants will be split into two small groups, each of which will have its own smallgroup facilitator. A neutral forum facilitator, working from Lincoln, will oversee the entire effort. How Will My Input Be Used? A detailed report of your input will be the primary information the Nebraska State Suicide Prevention Coalition considers when it meets later this year to write a new three-year strategic plan for suicide prevention. 2! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

5 Introduction Planning Forum Agenda All times are Central. 12 p.m. Brown Bag Lunch and Registration Participants network with each other and eat lunches they have brought. 12:30 p.m. Welcome and Instructions The forum facilitator welcomes participants and briefly reviews the meeting objective and procedures for the small and large-group discussions. 12:40 p.m. Small-Group Discussions Relying heavily on the briefing materials for guidance, each small group drafts one (and only one) strategic plan objective. 1:25 p.m. Input Objectives No later than this time, each small group s facilitator types her/his group s objective into a shared online document. 1:30 p.m. Large-Group Discussion, Part 1 2 p.m. Break The forum facilitator reads each group s objective from the shared online document. He calls on the first group to spend three minutes explaining the objective. After that, he allows three minutes for other groups to ask questions. He repeats this process with new groups until the break. 2:15 p.m. Large-Group Discussion, Part 2 Discussion begun earlier continues. When all groups have presented their objectives, the forum facilitator leads a discussion aimed at combining similar recommendations. With everyone s consent, the forum facilitator may edit items live in the shared online document to reflect changes suggested in the discussion. 3:20 p.m. Thank You and Voting Instructions The forum facilitator thanks participants and explains how to go online to vote on prioritizing the strategic plan objectives generated at the forum. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 3

6 Report 1 Report 1: Nebraska State Suicide Prevention Plan In 2005 the Nebraska State Suicide Prevention Committee, forerunner of the Nebraska State Suicide Prevention Coalition (NSSPC), developed the Nebraska State Suicide Prevention Plan. The plan has never been updated. Presented here is a progress report on the plan s objectives. Dave Miers of BryanLGH Medical Center and Don Belau of the Youth Rehabilitation and Treatment Center-Geneva provided the progress information. Please note: References to our Web site below refer to No action taken is a statement of fact, not a value judgment regarding the objective. Awareness Promote awareness that suicide is a preventable public health problem. Awareness Objective To Do As you read this Report, please write recommendations of your own using the worksheet at the end of this document. Disseminate information about resources and web sites available through faith based organization, service clubs, non profits, corporations and occupational health through private, public, and non-profit partners in the NSSPC and broader community Continue to reach out to public/private schools and colleges with special emphasis to the age group of by including them in NSSPC activities Reach out to the elderly through Aging Services by the dissemination of educational materials on depression and suicide prevention Developed our Web site. January prevention summit available statewide via 24 telehealth sites. NSSPC received Kim Foundation grant, then offered mini-grants to schools so a staff member could become a school suicide prevention specialist. Fourteen school staff received training. Two school districts received minigrants which are used to fund awareness activities within the school and community in One NSSPC member is with Aging Services. Dave Miers has conducted suicide prevention trainings at Aging Partners in Lincoln (formerly Lincoln Area Agency on Aging). 4! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

7 Report 1 Awareness Objective Provide State and Regional prevention programs with information about suicide prevention Work with public health and Cooperative Extension to more fully involve youth organizations in suicide prevention activities Build on Project Relate activities to reduce stigma associated with seeking help for mental health problems. Engage local foundations to promote activities associated with mental illness awareness week, suicide prevention month, and mental health month Through the University of Nebraska Public Policy Center and a recent grant, we have conducted Question, Persuade, Refer train-the-trainer trainings. As a result, there is one trainer in each of Nebraska s six behavioral health regions. January prevention summit reached youth organizations. Garrett Lee Smith Suicide Prevention Grant has awarded five community grants across Nebraska; they focus on reaching youth. Don Belau and Dave Miers provided a workshop at the 2009 Nebraska Public Health Conference (April 8-9), which addressed these objectives: Identify the mission of the Nebraska State Suicide Prevention Coalition Be able to identify suicide prevention activities that the local community can consider Discuss the benefits of suicide prevention activities on both the state and local levels In Lincoln, we recognized Mental Illness Awareness Week in October, and recognize Mental Health Awareness Month in May. It is a community-wide effort through the local awareness group. The Kim Foundation, founder of Project Relate, has a weekly radio show, Not Alone. Don Belau and Dave Miers appeared on the show to talk about suicide prevention in 2008 and Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 5

8 Report 1 Awareness Objective Increase access to community linkages with MH/SA services Provide a link on the DHHS Suicide Prevention website for free depression screening provided by BryanLGH Medical Center Interchurch Ministries of Nebraska will publicize notice of screening availability to churches and encourage parish health nurses to include depression screening as wellness activities BryanLGH Medical Center s depression screening resource is available via our Web site and youthsuicideprevention.nebraska.edu. Project Relate Web site is also linked. Don Belau provided Grand Rounds presentation at BryanLGH Medcical Center addressing self-injurious behaviors of adolescents, which is connected with suicide prevention. Done. Interchurch Ministries a very active member of the NSSPC. The University of Nebraska Public Policy Center contracted with Interchurch Ministries through the Garrett Lee Smith Suicide Prevention Grant, and Interchurch hired a suicide prevention coordinator, Danielle Sodergren. Interchurch Ministries provides short-term mental health funding for those in need in rural settings. 6! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

9 Report 1 Intervention Develop and implement suicide prevention programs. Intervention Objective Empower organizations to seek American Association of Suicidology (AAS) national certification for crisis centers by encouraging Region 5 to educate the other Regions on the AAS Accreditation process Encourage organizations to become networked under a single, toll-free telephone number, SUICIDE ( ) through the Kristin Brooks National Hopeline Network Put links to AAS and Hopeline Network on the DHHS Suicide Prevention website Expand Suicide Prevention Curriculum (SPC) training to law enforcement officers and fire personnel to include mandated training of new officers and renewed information for veteran officers Partner with the School Community Intervention Program (SCIP) at the Lincoln Medical Education Partnership to implement the Signs of Suicide (SOS) program to provide classroom suicide prevention education and depression screening Implement the Emergency Department Means Restriction Education program to educate parents and problem solve with them about how to limit access to lethal means following an episode in which a child presents with increased risk of suicide. Provide community-wide crisis management support (postvention education) for dealing with a loss as a result of suicide by implementing training through the LOSS program (Local Outreach to Suicide Survivors). Community Mental Health Center of Lancaster County was certified in the past; not sure whether certification is current. NSSPC uses the number on multiple documents, including the Web site. At all talks coalition members give, they distribute cards with the number and encourage its use. Done. Training is required for all new law enforcement officers going to Grand Island training academy. Recently Behavioral Health Region 5 (Lincoln) did a training for veteran officers. Omaha may be conducting similar training focusing on mental health. Lincoln Public Schools implemented SOS for 6th and 9th grade students. NSSPC provided training. We've worked on it but have not been successful getting something implemented. We are getting connected with the trauma centers in Nebraska. Started a LOSS program in Lincoln/ Lancaster County on July 1, We have interest from four communities that want to replicate the program. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 7

10 Report 1 Intervention Objective Continue to promote the use of the Teen Screen program by medical facilities that serve youth Continue use of Nebraska s Green Line program for juvenile residential settings Continue to update and distribute SPC via NEBHANDS website Don Belau has promoted it. Some facilities are using it, but some smaller communities don t have the resources to implement it. We still support it, but are not actively doing anything. Don Belau developed and uses the program at the Youth Rehabilitation and Treatment Center at Geneva. Don continues to promote the program and continues getting requests to talk about it. The Suicide Prevention Curriculum, developed in the early 2000s, has a core module for the general public and four targeted modules: educator, law enforcement, clergy, and health care. We continue to use those, but have not updated them online. NEBHANDS Web site still in active use. Methodology Promote and support research on suicide and suicide prevention. Methodology Objective Promote evaluation on the Green Line Program to support its inclusion as evidence based practice Promote University of Nebraska research on suicide prevention, and Selective Serotonin Reuptake Inhibitors (SSRIs) role in suicide prevention Encourage Public Health integration of Mental Health data on suicide attempts, Regional Center admissions and Crisis Center admissions Don Belau evaluates Green Line at the Youth Rehabilitation and Treatment Center at Geneva. No action taken. Unsure whether action has been taken. 8! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

11 Report 2 Report 2: Recommendations for Suicide Prevention in Nebraska On June 23, 2006, the Nebraska Health and Human Services System Injury Prevention Program, the Injury Community Planning Group (ICPG), and the Nebraska State Suicide Prevention Committee sponsored the Nebraska Suicide Prevention Symposium. The Symposium, held in Lincoln, Nebraska, brought together a variety of interested stakeholders to develop recommendations for suicide prevention in Nebraska. To Do As you read this Report, please write recommendations of your own using the worksheet at the end of this document. After a full-day conference featuring small- and large-group discussions and an expert panel discussion, participants came up with 11 recommendations and voted to prioritize the recommendations shown below. No plan has been written to implement these all of these recommendations as a whole. However, some progress has been made on a number of individual items, in part with help from the demonstrable stakeholder consensus developed at the 2006 Symposium and described in the report, Recommendations for Suicide Prevention in Nebraska: A Report on the Nebraska Suicide Prevention Symposium. We recategorized the recommendations to match the AIM model used in these briefing materials. Dave Miers of BryanLGH Medical Center and Denise Bulling of the University of Nebraska Public Policy Center provided the progress information. Please note: References to our Web site below refer to No action taken is a statement of fact, not a value judgment regarding the objective. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 9

12 Report 2 Awareness Promote awareness that suicide is a preventable public health problem. Awareness Objective Consider advertising on the popular Web site myspace.com or other Web sites popular with young people to draw attention to the suicide education Web site. Coalition members who attended the March 2010 Substance Abuse and Mental Health Services Administration (SAMHSA) meeting in Las Vegas learned the latest about social networking s role in youth suicide prevention and plan to apply that knowledge to future efforts. The Web site must be multi-lingual. No action taken. Publish suicide data and prevention resources in print and on a state suicide education Web site. Target the resources especially to rural areas, health care providers, and schools. Implement a yearlong, statewide public awareness campaign that includes a focus on firearm safety tied to the new law allowing concealed weapons in Nebraska and employs communications tools developed by Project Relate. Focus on properly securing firearms, given that Nebraska s law allowing people to carry concealed weapons will go into effect in January Focus especially on reaching the more independent-minded residents of Nebraska s rural areas. Data are included in the 2010 Nebraska State Suicide Prevention Summit report, which is on our Web site. The 2010 Nebraska State Suicide Prevention Summit included substantial rural outreach efforts and participation at 24 telehealth sites across Nebraska. No campaign has been implemented. There is an effort underway to develop a communication plan for the coalition, and the Ad Council recently unveiled an adolescent suicide prevention advertising campaign. We looked into this, but were to unable to secure donations of gun locks in order to distribute them for free. We plan to pursue this again. The 2010 Nebraska State Suicide Prevention Summit, which included substantial rural outreach efforts and participation at 24 telehealth sites across Nebraska. We are getting a lot more interest from across the state than ever before. 10! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

13 Report 2 Awareness Objective Avoid reinventing the wheel by taking advantage of Project Relate s already-developed public service announcements. Also employ Project Relate s teen improvisational theater group for outreach. Depending on the availability of funds, consider all media outlets newspapers, radio, television, and Web advertisements. As one option for funding, lobby broadcast stations to adopt suicide prevention as their public-service program for the year and give free air time. Ensure that information about suicide prevention is delivered in culturally and linguistically appropriate ways. Find celebrities touched by suicide and recruit them to speak at news conferences across the state. We continue to use Project Relate information and public service announcements. The new Ad Council campaign is almost identical to Project Relate s. We could try to disseminate both campaigns. Papillion-LaVista South High School developed a skit about mental health and suicide prevention, then performed it for a year at middle and high schools across Nebraska. The skit is now in the public domain and available at The 2010 Nebraska State Suicide Prevention Summit received extensive news coverage, but we have not purchased any newspaper, radio, television, or Web advertisements. No action taken. A member of Lincoln s Local Outreach to Suicide Survivors (LOSS) team teaches cultural diversity at Southeast Community College. We assigned her to provide cultural awareness training to our teams. The 2010 Nebraska State Suicide Prevention Summit s speaker, Tom Osborne, attracted extensive news coverage. Osborne encountered troubled college students throughout his coaching career. NET Television s June 19, 2008 depression summit featured famous former talk show host Dick Cavett. While the summit wasn t the coalition s direct effort, a coalition member was a discussion panelist. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 11

14 Report 2 Intervention Develop and implement suicide prevention programs. Intervention Objective Collaborate with the Nebraska Department of Education and the Nebraska Health and Human Services System to develop a statewide program of suicide assessment and prevention to integrate in school curricula. Implement the Columbia University TeenScreen Program in schools. Partner with Nebraska Health and Human Services System to provide behavioral health professionals when schools need them to implement the TeenScreen program. Lincoln Public Schools and Omaha Public Schools adopted the Signs of Suicide curriculum. The closest we ve come to a statewide effort is a Kim Foundation-funded effort that trained 14 Educational Service Unit personnel across Nebraska to become School Suicide Prevention Specialists through the American Association of Suicidology. This is not going to happen. Some schools did implement this program, but other schools were hesitant. As a coalition, our intent is focus on implementing evidence-based screening in general, not promoting specific programs. At the March 2010 Substance Abuse and Mental Health Services Administration (SAMHSA)grantee meeting in Las Vegas, we heard there s a real push not to screen unless you have a system in place to track and refer. In Nebraska, there s no formal followup system. We do partner with the Nebraska Department of Health and Human Services (formerly known as Nebraska Health and Human Services System), but the agency does not have behavioral health professionals. 12! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

15 Report 2 Intervention Objective Make suicide education a part of the teacher certification process. Deemphasize handing out information to teenagers, and instead work to develop caring relationships with them. Consult rural stakeholders to determine what resources they need. Provide resources appropriate to a variety of groups, including health care providers, parents, and teachers. Expand the Emergency Department Means Restriction Education program to include all emergency responders, not just emergency room staff. Include suicide training in, for example, emergency medical technician (EMT) training. Develop a best-practice standard procedure for emergency personnel statewide to use in situations involving attempted suicide, to cover especially what measures are taken to assist people who survive suicide attempts. We have started this. Schools have prevention specialists. But this is achieved through teacher inservice education, not teacher training through colleges and universities. Conversations have been held with the Nebraska Department of Education exploring online, free training that could become mandatory for teacher renewal certificates. No action taken. Accomplished at the 2010 Nebraska State Suicide Prevention Summit, which included substantial rural outreach efforts and participation at 24 telehealth sites across Nebraska. Coalition members regularly give presentations to a variety of groups. Our Web site points to a large number of resources. In the future, those resources will be better organized by target group. To start this effort, Denise Bulling and Dave Miers recently spoke with state trauma coordinators about implementing means restriction education. EMTs do not receive this training, but cadets at the Nebraska Law Enforcement Training Center in Grand Island do. No action taken. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 13

16 Report 2 Intervention Objective Provide continuing education units (CEUs) to encourage medical personnel to take suicide training courses. Provide critical incident stress management training for first responders who respond at the scene of a completed suicide. Provide the Emergency Department Means Restriction Education program training to others in the community, for example religious leaders and counselors, so they can educate parents about means restriction as well. Also provide the training to law enforcement personnel at small jails, where suicide rates are high. There is no formalized system in place. However, Lexington provided two trainings, with CEUs, for their medical staff. No action taken. No action taken. We have not targeted those facilities, but cadets at the Nebraska Law Enforcement Training Center in Grand Island receive suicide prevention training. Methodology Promote and support research on suicide and suicide prevention. Methodology Objective Gather all suicide data available from state, county and local agencies, hospitals, and other organizations in order to obtain a better understanding of suicide in Nebraska. Work to gather data from correctional facilities on inmate suicide attempts and completions. All the data we have now come from the Nebraska Department of Health and Human Services Injury Prevention Program. That program already receives hospital discharge data. The City of Lincoln chose to give us data from the Lincoln Police Department. It would be helpful to get such data from across the state. It would also be helpful to get professional partner data in the state-sponsored system. We are getting funding to get systems set up to allow us to collect such data. We have invited the Nebraska Department of Corrections to join the coalition, but have not asked them for data. 14! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

17 Report 2 Methodology Objective Because only some hospitals report discharge data, information on suicide attempts and completions from hospitals is incomplete. Work to get more hospitals to report these data. No action taken. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 15

18 Report 3 Report 3: 2010 Nebraska State Suicide Prevention Summitʼs What More Needs to Be Done? Recommendations The Nebraska State Suicide Prevention Coalition convened the Suicide Prevention Summit on January 29, 2010 in Lincoln, Nebraska, and at 24 sites across the state via the Nebraska Statewide Telehealth Network. One activity at the summit was small-group discussions in Lincoln and at the Telehealth sites on the questions, What are we doing in local communities to prevent suicide? and What more needs to be done? Below are answers to that second question. In the 2010 Nebraska State Suicide Prevention Summit Final Report, these recommendations are organized by the sites (e.g. Lincoln, Burwell, Chadron) that generated them. Here, we recategorized the recommendations to match the AIM model used in these briefing materials. Dave Miers of BryanLGH Medical Center provided the progress information. Please note: References to our Web site below refer to No action taken is a statement of fact, not a value judgment regarding the objective. Awareness Promote awareness that suicide is a preventable public health problem. To Do As you read this Report, please write recommendations of your own using the worksheet at the end of this document. Awareness Objective Reduce stigma. Our Web site aims to do this. Everyone thinks the problem is handled elsewhere. Some good groups are around, but we need a centralized website of statewide resources, where we can see what is available in different areas of the state. Our Web site links to a Kim Foundation map of statewide resources. Posters/billboards in community and schools. Before the Summit, the Kim Foundation had printed Project Relate posters aimed at male and female adolescents, sent them to every school in Nebraska, and asked that they be posted. (The posters are the bottom two ones on this page: 16! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

19 Report 3 Awareness Objective Survivors of Suicide Walk. Such walks are held in Omaha and Beatrice yearly. The coalition has been asked to support these efforts, but we have not taken action yet. Mental Health Awareness at the Mass during the month of May. People to speak at schools, church organizations, community gatherings, PTAs, etc., who have been directly affected by suicide, so parents/guardians/spouses, etc. may not overreact if youth or significant other has suicidal ideation. If youth or loved one is searching on computer about suicide, how does one talk to them about their feelings? Make hotline numbers available to all, such as posting signs in restroom stalls (e.g. domestic violence organizations does this). Community outreach needs to be continued, and awareness of local, state, and national programs about depression and suicide. More resources made available. One on one mentoring programs, greater communication and follow-up. No action taken. The coalition has no formal speakers bureau, but coalition members give talks at least once a month. Some research on teens indicates they know the warning signs and risk factors, but they don t know how to respond when they see them in a friend. The Question, Persuade, Refer model may help. BryanLGH Medical Center in Lincoln distributes hundreds of business cards with the SUICIDE hotline number. With the new Ad Council campaign available, the next step is talking about how to disseminate it statewide. No action taken. Education with law enforcement. In Behavioral Health Region 5, coalition member and law enforcement officer Joe Wright provided training for veteran officers on suicide prevention. High schools and middle schools should be doing more suicide awareness. This has been done indirectly through the Kim Foundation-funded effort to train 14 Educational Service Unit (ESU) personnel across Nebraska to become School Suicide Prevention Specialists through the American Association of Suicidology. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 17

20 Report 3 Intervention Develop and implement suicide prevention programs. Intervention Objective Community-based coalition to work on needs. Since the 2010 Nebraska State Suicide Prevention Summit, four communities have developed their own coalitions. Need more community networking with community leaders. Bring service providers/personnel together to focus on the needs of programs in the community for suicide prevention. Resources are fragmented, making emergency referrals difficult. Continued coordination of efforts among school and community organizations. More simple screening instruments (551) need to be available. Better training needed for counselors. Suicide prevention should be a focus area for treatment specialists. No action taken. No formal meetings have taken place yet. here depends on the community. The coalition has done statewide education on emergency protective custody. It is important to know whom to call and where to take a suicidal person, depending on whether she or he will voluntarily enter care. A Kim Foundation-funded effort trained 14 Educational Service Unit (ESU) personnel across Nebraska to become School Suicide Prevention Specialists through the American Association of Suicidology. We are developing a map showing which ESUs were included. We hope to get additional funding to expand the training. No action taken. The University of Nebraska Public Policy Center has researched clinician trainings and plans to provide one. Turnover of overworked therapists. No action taken. Need for advanced mental health practitioners. No action taken. We always need improved access to mental health providers. We hope our Web site will help connect people with resources. 18! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

21 Report 3 Intervention Objective Licensed Mental Health Providers in schools. No action taken. This is a school-byschool issue dependent on funding. The group felt that more education is needed in the school systems. We wanted to know about the Gatekeepers training. The idea of linking to the chat lines with the 800 number was excellent. There are no resources for kids between the ages of in our community and we need help in educating the public about resources already in place. Coalition member Kate Speck is working on getting information on the Question, Persuade, Refer model out to trained people in Nebraska s behavioral health regions. No action taken. Free mental healthcare in the schools. No action taken. Establish peer support program in schools. No action taken. However, the Teammates mentoring program is available, but not through our coalition. Work with youth as young as elementary age to build coping skills and awareness. Train school personnel in the SOS Signs Of Suicide and have students know who they can reach out to at school. Chat line manned 24 hours for youth or others feeling distressed. Line implemented with National Suicide Hotline Uniformity in list of providers/services in the area, for referrals. No action taken. We have worked on this previously, but not since the summit. Previously, the coalition had a daylong training for Lincoln Public Schools counselors on suicide prevention. All middle school and high school students get exposed to the SOS curriculum. A national hotline exists. At the summit, the Nebraska Family Helpline was introduced. Calls are routed to Boys Town. Implement chatting online capability. No action taken. Survivors of Suicide Support Groups in the community; once established, branch out to include extended persons who have been affected by a/the suicide. No action taken. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 19

22 Report 3 Intervention Objective Implementation of Local Outreach to Survivors of Suicide (LOSS) Team(s). Implementation of grassroots program, if extended family is far away, work to bring them to the family experiencing the crisis of a loss due to death by suicide. Since the summit, four communities have expressed interest in LOSS. Don Belau has been in contact with them. Lincoln already has a team. This is done through LOSS teams. We have provided assistance to in-state families when their out-of-state family member committed suicide. Methodology Promote and support research on suicide and suicide prevention. Methodology Objective Research what other communities are doing. We learned what other states are doing when four coalition members attended a March 2010 Substance Abuse and Mental Health Services Administration (SAMHSA) grantee meeting in Las Vegas. There needs to be a way to determine what treatment specialists have training in suicide prevention. No action taken. 20! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

23 Inventory of Existing Suicide Prevention Services and Needs Inventory of Existing Suicide Prevention Services and Needs Dave Miers of BryanLGH Medical Center conducted an informal, nonscientific survey of registered participants before the January 2010 Suicide Prevention Summit. The survey s purpose was gauging the state of existing services and determining future needs. The survey contained the following questions: Which of these suicide prevention practices are going on in your local area? Are there other specific suicide prevention practices you are aware of in your area? What do you think your area or community needs to help prevent suicide? Please note: All figures are numbers of responses, not percentages. Figure 1: Which of these suicide prevention practices are going on in your local area? N=152 Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 21

24 Inventory of Existing Suicide Prevention Services and Needs Figure 2: Are there other specific suicide prevention practices you are aware of in your area? N=53 Figure 3: What do you think your area or community needs to help prevent suicide? N=91 22! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

25 Inventory of Existing Suicide Prevention Services and Needs Other Needs Identified Developing a life course approach, linking pregnancy-related depression screening/services, with parent education/support, infant mental health, Part C early intervention, etc., on through childhood, adolescence, and adulthood. Take a socio-ecological approach, considering community supports to reduce stress, isolation, and other related factors. We need more mental health therapists and counselors to work with the community. The tribe needs to be able to work together, and better cooperation and better providers would help. There are so many psychosocial and environmental factors here on the reservation that contribute to suicidal, homicidal, and self-harming ideations, plans, and behaviors. They appear at times as suicidal ideations and gestures; they become a way of coping with life. There needs to be a strong native cultural component in any of the strategies used to confront this problem. We are a rural/frontier area. We need to learn more about why suicide rates are higher in rural areas and begin addressing those contributing factors. For example, we need to problem solve access to resources in rural areas. Community coordinator to support schools with updated information and community resources. One thing that would be beneficial is more mental health practitioners as full time staff in school buildings. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 23

26 Data on Suicide in Nebraska Data on Suicide in Nebraska Peg Prusa-Ogea prepared this compilation of Nebraska suicide data collected by her office, the Injury Prevention Program of the Nebraska Department of Health and Human Services. Included are the following figures: Causes of Death Five leading causes of death, all races, both sexes Five leading causes of injury death, males Suicide Deaths Age-adjusted By age Age-adjusted, by gender By age and gender Children ages By method used By method used and gender Hospital Discharge Rates (attempted suicide) By age and gender By method used By method used and gender All figures save Figure 10, Children ages 10-17, concern Nebraska residents only. Summary In Nebraska, suicide was the second leading cause of death for those ages ! For males age 35-64, suicide is the leading cause of all injury deaths;! more males in those age groups died from suicide than from motor vehicle crashes or other injuries. Males are more likely to die from suicide and females are more likely to be hospitalized for suicide attempts. The suicide rate for Nebraska young people ages is higher than the national average. The means used in over 50% of suicide deaths was firearms. Almost three-quarters of hospitalizations resulting from suicide attempts were from poisoning. 24! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

27 Data on Suicide in Nebraska Causes of Death Figure 4: Five leading causes of death, all races, both sexes, Source: WISQARS ; National Center for Health Statistics (NCHS), National Vital Statistics System Figure 5: Five leading causes of injury death, males, Source: WISQARS ; National Center for Health Statistics (NCHS), National Vital Statistics System Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 25

28 Data on Suicide in Nebraska Suicide Deaths Figure 6: Age-adjusted suicide death rates, N=881. Source: Nebraska Department of Health and Human Services Vital Statistics, Figure 7: Suicide death rates by age, Source: Nebraska Death Certificate Data, ! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

29 Data on Suicide in Nebraska Figure 8: Age-adjusted suicide death rates by gender, Source: Nebraska Death Certificate Data, Figure 9: Suicide death rates by age and gender, N=881. Source: Nebraska Department of Health and Human Services Vital Statistics, Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 27

30 Data on Suicide in Nebraska Figure 10: Suicide rates, children ages 10-17, U.S. and Nebraska, Figure 11: Suicide deaths by method used, N=881. Source: Nebraska Department of Health and Human Services Vital Statistics, ! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

31 Data on Suicide in Nebraska Figure 12: Suicide deaths by method used and gender N=881. Source: Nebraska Department of Health and Human Services Vital Statistics, Hospital Discharge Rates (attempted suicide) Figure 13: Suicide attempt hospital discharges by age and gender, *Fewer than five discharges. N=8,974. Source: NE Hospital Discharge Data Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 29

32 Data on Suicide in Nebraska Figure 14: Suicide attempt hospital discharges by method used Source: NE Hospital Discharge Data Figure 15: Suicide attempt hospital discharges by method used and gender, N=8,974. Source: Nebraska Department of Health and Human Services Vital Statistics, ! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

33 Your Recommendations Worksheet Your Recommendations Worksheet Instructions 1. As you read the three progress reports in this document, please write your own strategic plan objective recommendations. This will make your small group s effort to write a strategic plan objective much more productive. 2. We are following the common Awareness, Intervention, and Methodology (AIM) model used in the Nebraska suicide prevention plan. Within each of these categories, we have provided some sub-categories to guide your thinking. Please use them, or not, as you prefer. 3. Please note that while we are asking you to write a large number of recommendations in advance, on the day of the forum your small group will narrow everyone s recommendations down to just one. But please write as much as you can ahead of time, because there s no time for individual brainstorming on the day of the forum. 4. Please write in the SMART format described below, or as close thereto as possible. How to Write SMART Objectives If at all possible, when you re writing your strategic plan recommendations, try to keep them SMART: Specific, Measurable, Achievable, Realistic, and Time- Framed. Specific: This means the objective is concrete, detailed, focused and well defined. The objective must be straightforward and emphasize action and the required outcome. Use the 5 Ws. Who is involved? What must be accomplished? When should this happen? Where will this occur? Why should this be done? Measurable: You should be able to measure whether you are meeting the objective. Ask questions such as How much? How many? How will we know the objective is accomplished? Attainable: Are the objectives achievable and attainable? Consider whether the human and financial resources are available and can be directed to achieve the objective. Relevant: Is the objective important to the people who will have to work to achieve it? Consider whether the objective matters to more people than just the people writing it. Time-Framed: There are clear start and end dates. Don t forget to keep the deadline attainable. Example (from another domain) Between August 1, 2010, and June 15, 2011, the Career Education staff from Bright Futures will have planned and conducted four job training workshops for 50 recent GED graduates in the Topeka area in order to improve their employment prospects. Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 31

34 Your Recommendations Worksheet Awareness Promote awareness that suicide is a preventable public health problem. Public Awareness Education Data and Publicity Law Enforcement/ Emergency Personnel Category Category 32! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials

35 Your Recommendations Worksheet Intervention Develop and implement suicide prevention programs. State Coalition Committee Development Local Coalition Building/Coordination Collaboration on National/Regional Levels Schools and Youth Survivor Support (Postvention) Category Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials! 33

36 Your Recommendations Worksheet Methodology Promote and support research on suicide and suicide prevention Training Evaluation Data and Publicity Evaluation Collaboration on National/Regional Levels Category Category Category 34! Nebraska Suicide Prevention Strategic Planning Forum Agenda & Briefing Materials