Suicide Prevention

The North Coast Mental Health Action Team is currently formulating a suicide prevention campaign that will build awareness; increase the opportunity for the community to identify people at risk; provide meaningful connections to appropriate services; and enhance the web of support for community members. These ideas are important for us as a community to reduce and eliminate suicidal self-directed violence, a term used to more accurately describe suicide by the Center for Disease Control and Prevention (CDCP).

Suicidal self-directed violence is responsible for an average of 21 deaths each year in Mendocino County (6 deaths/Coast, 15 deaths/Inland based on 2006-2016 statistics).  For Northern California counties, including Mendocino, there is a higher per capita rate of suicidal self-directed violence compared to the rest of the state. “Age-Adjusted Death Rate due to Suicide” indicator, on HealthyMendocino.org, shows 23.6 deaths/100,000 population compared to the CA value of 10.3 deaths/100,000 population. According to the CDCP, suicide is the second leading cause of death among young people ages 15-24 in the US.¹   For US Veterans, a study released in June 2018, reports, “In 2015, an average of 20.6 active-duty Service members, non-activated Guardsmen or Reservists, and other Veterans died by suicide each day.”² The World Health Organization reports, “Suicide is one of the leading causes of death worldwide and is an important public health problem. Among those aged 15-44 years, self-inflicted injuries are the fourth leading cause of death and the sixth leading cause of ill-health and disability.“³ 

There are innovative changes currently being implemented. For example, in 2016, California Assembly Bill 2246 was passed requiring school districts serving 7th-12th graders to implement a Suicide Prevention Policy by the beginning of the 2017-2018 school year. The Bill was inspired by a national survey conducted by the Jason Foundation that found the primary person a student would reach out to if they were having thoughts of suicide is a teacher. The Suicide Prevention Policy focuses specifically on suicide prevention, intervention, and postvention (activities which reduce risk and promote healing after a suicide death). Teachers and school staff all over California were trained last summer to ensure they have the knowledge, tools, and resources to respond appropriately.⁴

Zero Suicide, a Substance Abuse and Mental Health Services Administration (SAMHSA) sponsored organization, promotes a multifaceted approach for providers of behavioral and physical health services. The Zero Suicide initiative targets the following areas:

• Leadership through making an explicit commitment to reduce suicide deaths;
• Training of all clinical and non-clinical staff to develop a confident, competent, and caring workforce to respond effectively, commensurate with their roles, to clients at risk for suicide;
• Identification of every person at risk for suicide through screening and assessment practices;
• Engagement of clients in a Suicide Care Management Plan, following closely everyone at risk for suicide;
• Treating suicidal thoughts and behaviors directly with evidenced-based treatments that focus explicitly on the suicide risk;
• Following patients through every transition in care ensuring safe hand-offs between care-givers; and
• Improving systems through leveraging data to inform system changes that will lead to improved patient outcomes and better care for those at risk.⁵

There are many web sites that are available for ‘just in time’ education or innovative ways to increase youth awareness. For example, “Know the Signs-Suicide is Preventable”, is a prevention campaign that provides education and access to resources online. “Know the Signs,” “Find the Words,” and “Reach Out” are the key components to this campaign.⁶

“Directing Change” targets youth in emotional crisis. The Directing Change Program and Film Contest engages youth to learn about the topics of suicide prevention and mental health through the creation of short films. Take a peek at the winners from this year’s contest (http://www.directingchangeca.org/films/).⁷ 

Protective factors help reduce the risk for suicidal self-directed violence. For youth, protective factors include parent engagement, school connectedness, and positive parenting practices. Parents of teens can improve protective factors by taking an active role in their teen’s life. For example, monitoring youth’s activities, ensuring fathers are involved and talking to their teen about how to avoid risky sexual behavior, improving quality of information relative to raising lesbian, gay or bisexual youth, learning how to have meaningful discussions about sex, relationships, and the prevention of HIV, STIs and pregnancy, and connecting youth to a trusted primary care provider to talk about sensitive subjects like mental health.⁸

For the general population, protective factors include effective clinical care for mental, physical, and substance use disorders, easy access to a variety of clinical interventions and support, family and community support (connectedness), support from ongoing medical and mental health care relationships, skills in problem solving, conflict resolution, and nonviolent ways of handling disputes, and cultural and religious beliefs that discourage suicide and support instincts for self-preservation.⁹

Suicidal self-directed violence is preventable. As a community, we must continue our efforts to build awareness, support programs that enhance protective factors and improve the networks of support. 

The North Coast Mental Health Action Team meets the last Tuesday of each month at 5pm at the Healing Center on Main, 544 S. Main Street, Suite A, Fort Bragg, California.  Call (707) 961-0115 for more information.

Help is available…

1-855-838-0404

Redwood Community Crisis Center, a division of Redwood Community Services, Inc., operates 24/7 and is available for people in crisis. Early intervention support services are available for people who need immediate help with symptoms of mental illness but might not need psychiatric hospitalization. Early intervention support focuses on helping people choose their best path while identifying coping skills and support networks. The services are available to everyone including children, teens and adults. 

Crisis Text Line: Text “home” to 741741 anywhere in the United States for any type of crisis. A live, trained crisis counselor will respond.

Life Line Chat:  https://suicidepreventionlifeline.org/chat/

National Suicide Hotlines:  http://www.suicidehotlines.com/california.html

Upcoming Training Opportunities: Mendocino County MHSA sponsored ASIST (Applied Suicide Intervention Skills Training) training in July in Ukiah, and October in Fort Bragg. Contact Robin Meloche for more information: (707) 472-2332

1. National Center for Injury Prevention and Control. (2018). Ten leading causes of death and injury. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/injury/wisqars/LeadingCauses.html)
2. VA National Data Report – 2005-2015, June 2018. Average Number of Veteran and Non-Veteran Suicides per Day.  Retrieved from: https://www.mentalhealth.va.gov/docs/data-sheets/OMHSP_National_Suicide_Data_Report_2005-2015_06-14-18_508-compliant.pdf
3. The World Health Organization. (2018) Violence and Injury Prevention. Self-Directed Violence. Retrieved from: http://www.who.int/violence_injury_prevention/violence/suicide/en/
4. California Legislative Information. Assembly Bill 2246 Pupil Suicide Prevention Policies (2015-2016).  Retrieved from:  https://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201520160AB2246
5. Zero Suicide in Health and Behavioral Health Care. Zero Suicide Tool Kit. Learn more about the fundamentals of Zero Suicide Implementation.  Retrieved from: http://zerosuicide.sprc.org/toolkit
6. Know the Signs – Pain isn’t always obvious. Suicide is Preventable. Retrieved from: http://www.suicideispreventable.org/
7. Directing Change. Retrieved from:  http://www.directingchange.org/main/about/
8. Centers for Disease Control and Prevention.  Adolescent and School Health.  Protective Factors.  Retrieved from:  https://www.cdc.gov/healthyyouth/protective/index.htm
9. Centers for Disease Control and Prevention. Suicide Risks and Protective Factors. Retrieved from: https://www.cdc.gov/violenceprevention/suicide/riskprotectivefactors.html

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Lisa Burtis is the Adult Services Clinical Coordinator at Redwood Community Services in Fort Bragg.