Everyone Plays a Role: Utah Suicide Prevention Doug Thomas, LCSW Director- Division of Substance Abuse and Mental Health Kim Myers, MSW Suicide Prevention Coordinator Division of Substance Abuse and Mental Health
Suicide and Suicide Prevention Suicide is an incredibly complex public health issue that needs to be understood and addressed in multiple contexts Suicide in Utah and Nationally Suicide prevention and health care Columbia Suicide Severity Rating Scale Suicide Prevention in Utah 2
Suicide in the United States 3
Suicide in Utah 4
Suicide in Utah An average of 501 Utahns die from suicide. 3,968 Utahns attempt suicide each year. Suicide is the 6 th leading cause of death for all Utahns. More males die from suicide (4x) while more females attempt suicide (4x). Firearms are the most common method of death. The average total charges per year for ED visits and hospitalizations for suicide attempts was $29.3 million for Utahns Substances are present in over 40% of suicide attempts and 1/3 or half of all suicide deaths. 5
Suicide Death and Health Care Contacts 50% individuals have health care contact the month before a suicide death 22% a week before their death Only 45% had received a mental health diagnosis Most commonly visit PCP before death
Workforce Survey Intermountain Healthcare- 332 responses from all Utah counties (excluding Morgan and Juab) Questions on baseline knowledge of suicide, suicide prevention, and levels of skills and training 3 Key questions to gage where Utah is in workforce development for suicide prevention 7
I have received the TRAINING I need to engage and assist those with suicidal desire and/or intent. 45.00% 40.00% 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% All Intermountain Healthcare
I have the SKILLS I need to engage those with suicidal desire and/or intent. 40.00% 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% All Intermountain Healthcare
I have the SUPPORT/ SUPERVISION I need to engage and assist those with suicidal desire and/or intent. 45.00% 40.00% 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% All Intermountain Healthcare
Workforce Development This is changing Dedication from many organizations and agencies including Intermountain to improve our leadership and training so all of you in the front line feel trained and supported and have the skills needed to assist the individuals who come through your doors. 11
Columbia Suicide Severity Rating Scale Prevention depends on appropriate identification and screening Universal screening tool=benefits of shared language No specific mental health training needed to administer Valid and reliable tool Many versions Adult, Pediatric, Baseline, Since Last Visit, Screener, Full Risk Assessment, Military, etc 12
Columbia Suicide Severity Rating Scale Guides clinical judgment Improved identification of those at highest risk while decreasing false positives Outpatient Psychiatry Pilot Self Report Computer Version (523 Encounters) 6.2% positive screen on C-SSRS vs. 23.8% endorsed item #9 of PHQ-9 13
Utah s Priorities 1. Focus On Prevention And Early Intervention Of Substance Use And Mental Health Disorders 2. Reduce Utah s Rate Of Suicide 3. Develop A Recovery-oriented System Of Care Led By People In Recovery (Trauma-informed And Evidence Based) 4. Strengthen The System Of Care For Children/Youth (Family-driven, Youth-guided, Community-based, Culturally And Linguistically Competent) 5. Promote Integrated Programs That Address An Individual s Substance Use Disorder, Mental Health And Physical Healthcare Needs.
Coordinating Utahs Suicide Prevention Efforts Utah Suicide Prevention Plan Utah Suicide Prevention Coalition Building partnerships- coordinating across systems Working with communities, coalitions, health and behavioral health care providers, and more for a multi-faceted approach to prevention Strategies in prevention, intervention, and postvention 15
The Utah Suicide Prevention Coalition is a partnership of community members, suicide survivors, service providers, researchers, and others dedicated to saving lives and advancing suicide prevention efforts in Utah. www.utahsuicideprevention.org
Utah Suicide Prevention Plan Goal 1: Promote public awareness that suicide is a preventable public health problem. Goal 2: Develop broad based support through public/private partnerships dedicated to implementing and sustaining suicide prevention efforts. Goal 3: Improve the ability of health providers (including Behavioral Health) and first responders to better support individuals who are at risk of suicide. Goal 4: Develop and promote the adoption of core education and training guidelines on the prevention of suicide and related behaviors by all helping professionals, including graduate and continuing education programs. Goal 5: Increase access to health and behavioral health services, prevention programs and other community resources to better support individuals and families of individuals at risk of suicide.
Utah Suicide Prevention Plan Goal 6: Develop policy through State Agencies, legislature, and other avenues as possible to promote mental health and prevent mental illness and eliminate suicide. Goal 7: Promote efforts to decrease the risk of suicides by reducing access to lethal means. Goal 8: Improve surveillance, data, research and evaluation relevant to suicide prevention. Goal 9: Provide care and support to individuals affected by suicide deaths and attempts to promote healing and implement community strategies to help prevent further suicide attempts and deaths from suicides.
PREVENTION 19
Utah Prevention by Design A plan for enhancing and coordinating local community networks in systematic and evidence based approaches to the prevention of mental illness and promotion of mental health. Data-driven & outcome based Relies on existing prevention network and community based coalitions expanding their scope of interest/work Focus on reducing risk and increasing protective factors at the local level 20
Risk and Protective Factors Risk Protection Mental illness and substance abuse Previous suicide attempts Firearms in the household Non-suicidal self injury Exposure to friend s or family member s suicidal behavior Low self-esteem Family connectedness and school connectedness Reduced access to firearms Safe schools Academic achievement Self-esteem 21
Key Outcomes 2013 Partnerships with local coalitions in all 13 areas of the state 52 people trained as QPR Gatekeeper Training Instructors 4000+ community members trained as QPR Gatekeepers 300+ community members trained in Mental Health First Aid 36 community members trained as trainers for Connect Postvention 5 + Town Hall Meetings on Suicide Prevention Several school based suicide prevention initiatives began including Hope Squads, Positive Action Program, and Personal Empowerment Program Community Awareness campaigns as local level with social media, bill boards, and local media advertising
INTERVENTION 23
Zero Suicide in Care Creating the Zero Suicide Culture Ensuring Every Person has a Pathway to Care Developing a Competent Workforce Identifying and Assessing Suicide Risk Using Effective, Evidence-Based Care Continuing Contact After Care Evaluation www.zerosuicide.org
Columbia Suicide Severity Rating Scale
Stanley Brown Safety Plan
Postvention 27
Postvention A planned response after a suicide to help with healing and reduce risk of further suicide incidents. Strategies include: Media Training Connect Postvention Training (available statewide) Grief Support Support for survivors of suicide loss
For more information, please visit: dsamh.utah.gov www.utahsuicideprevention.org Division of Substance Abuse and Mental Health