Umatter Suicide Prevention Awareness Training Supplementary Slides on the following:

1. Umatter Suicide Prevention Awareness Training Supplementary Slides on the following: • Untreated Mental Illness • Impacts on the Brain • Marijuana Use & Co-occurring • Lethal Means • Populations at Higher Risk

2. Untreated Mental Illness • Over 90 percent of people who die by suicide have a mental illness at the time of their death. • The most common mental illness is depression. Untreated depression is the number one cause for suicide.

3. What impacts the Brain? • Biochemical disturbance in the brain • Brain trauma (i.e. concussion) • Illness • Lack of sleep • Lack of nutrition • Environmental www.suicide.org

4. Substance use is often part of Suicide - Those who have a substance use disorder are10X more likelyto attempt suicide. - Alcohol is present in 30-40% of suicides and suicide attempts. https://store.samhsa.gov/shin/content/SMA09-4381/TIP50.pdf - Youth who report abusing prescription meds (including opioids) have a higher rate of suicidal thinking (CDC YRBS 2018) - The rate of suicide attempts using self-poisoning in children less than 19 years old increased significantly since 2011, occurring predominantly in young girls. (Journal of Pediatrics 2019)

5. More on Marijuana • Rate of planning & attempting suicide increased in tandem with increased use of marijuana (VDH, Marijuana use in VT, 2015) • Approximately 33% of adolescents who use cannabis regularly exhibit anxiety, depression, or PTSD. (DSM-5) • Approximately 60% of adolescents who use cannabis regularly exhibit ADHD and /or conduct disorders. (DSM-5)

6. Why Means Matters ? • A Suicide crisis is often relatively brief • Suicide attempts are often undertaken quickly with little planning • Some suicide methods are far more deadly than others • 90% of those who survive near lethal attempts, do not go on later to die by suicide www.meansmatter.org

7. Lethal Means in Vermont Includes drowning, piercing, motor vehicle, unspecified

8. Suicide & LGBTQ+ Youth In the last 12 months, LGBTQ+ youth were • 3x more likely to have felt sad or hopeless every dayfor at least 2 weeks • 4X more likely to have hurt themselves on purpose • More than 4X more likely to have made a suicide plan • 4.5X more likely to have made a suicide attempt (VT 2017 YRBS data)

9. Refugees and New Americans Vermont has seen more suicide deaths in some refugee communities • Kymelya Sari’s reporting in Seven Days VT (7/18/18) found that at least four Bhutanese-born people have died in VT since 2012 CDC reported that in the US, Bhutanese-born refugees are about twice as likely as the general US population to die by suicide (2013)

10. Native and Indigenous People Native people have the highest rates of suicide of any racial or ethnic group in the US. Suicide is the leading cause of death among Native youth. Risk Factors include: • Historical trauma - “long-term, intergenerational impact of colonization, cultural suppression, and historical oppression of Native peoples.” • Substance use • Poverty • Sexual or physical abuse • 25% of Native youth experience PTSD, which is three times the rate of the general population MHTTC; Mental Health in our Native American Communities; Vol.1 Issue 1 Spring 2019

11. Veterans • Veteran’s rate of suicide is 1.5 times higher than that of the general population • VT veterans’ suicide rate has been higher than the national rate almost every year from 2005-20016 • In 2016, 25 veterans died by suicide in VT. This equals a rate of 56.8 per 100,000 people (88.8% higher than national rate) • Key risk factors include:medical issues, PTSD, challenges reintegrating into society and finding employment, isolation and not talking about their struggles (2016 VA National Suicide Data Report)

12. Adult Males • From 2000-2016, suicide rates for males have increased 21% nationally and 39% in VT Suicide Death Rate per 100,000 by Gender and Age, Vermont, 2010-2014. Adapted from Injury and violence in Vermont report, by The Vermont Department of Health, 2018. • Males are 4 times more likely to die by suicide than females • Much of the overall growth in suicide rates in the US can be attributed to males 35-64 years of age • Key risk factors include: substance use, criminal/legal problems, financial hardship, problems with close relationships, veteran status, loss or lack of social connectedness • Men are less likely to reach out for help and use of more lethal means

13. Older Adults / Seniors Suicide attempts are more often lethal in older adults due to physical fragility, keep plans private and avoid intervention, live alone, and the use of firearms • Older males are more likely than females to die by suicide • Key risk factors are: • undiagnosed depression, physically limiting conditions, chronic pain, isolation and lack of social connections, substance use, loss of purpose