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Suicide Prevention

Suicide Prevention. Scott Perkins, MSW, LCSW Missouri State of Health January 29, 2010. In 2008, there were 775 suicides in Missouri, an average of one suicide every 11 hours and 20 minutes. Violent Deaths in Missouri. National ranking and rate of suicide, 2006.

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Suicide Prevention

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  1. Suicide Prevention Scott Perkins, MSW, LCSW Missouri State of Health January 29, 2010

  2. In 2008, there were 775 suicides in Missouri, an average of one suicide every 11 hours and 20 minutes.

  3. Violent Deaths in Missouri

  4. National ranking and rate of suicide, 2006 01 Wyoming 22.5 17 Missouri 13.7 35 Mississippi 11.2 02 Alaska 20.1 19 Florida 13.5 35 Pennsylvania 11.2 03 Montana 20.0 20 Arkansas 13.4 38 Delaware 10.7 04 Nevada 19.5 21 Indiana 13.1 38 Minnesota 10.7 05 New Mexico 18.0 22 Vermont 13.0 40 Texas 10.0 06 South Dakota 16.0 23 Alabama 12.6 41 Georgia 9.9 07 Arizona 15.9 23 Washington 12.6 42 Hawaii 9.3 08 Oregon 15.6 25 North Carolina 12.5 43 California 9.1 09 Colorado 15.4 26 South Carolina 12.1 44 Maryland 8.8 10 Idaho 15.1 26 Wisconsin 12.1 45 Rhode Island 8.4 11 Oklahoma 15.0 28 Maine 12.0 46Connecticut 8.3 12 Kentucky 14.8 29 Louisiana 11.5 47 Illinois 7.9 12 West Virginia 14.8 29 New Hampshire 11.5 48 Massachusetts 7.0 14 Tennessee 14.5 29 Ohio 11.5 49 New York 6.9 15 North Dakota 14.2 29 Virginia 11.5 50 New Jersey 6.7 15 Utah 14.2 33 Nebraska 11.4 51 District of Columbia 5.2 • Kansas 13.7 34 Michigan 11.3 35 Iowa 11.2 USA Total Rate 11.1 Source: American Association of Suicidology

  5. Suicide Rate

  6. Suicide is a Leading Cause of Death Source: Missouri Vital Statistics 2008

  7. 1 2 3 4 Top Five Leading Causes of Death Missouri, 2008, Ages 5-54 Source: Missouri Vital Statistics 2008

  8. Suicides by Age – Missouri, 2008 Source: MO Dept. of Health & Senior Services

  9. Missouri Student Survey, 2008(grades 6-12) During the previous 12 month period: 14.8% of students had “seriously considered attempting suicide” 10.8% had made a suicide plan 6.3% had attempted suicide 11.4% of those who attempted had made an attempt that required medical attention 1/29/2010 Source: Missouri Student Survey 2008 • 10

  10. RISK FACTORS FOR SUICIDE Biopsychosocial Risk Factors • Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders • Alcohol and other substance use disorders • Hopelessness • Impulsive and/or aggressive tendencies • History of trauma or abuse • Some major physical illnesses • Previous suicide attempt • Family history of suicide Source: National Strategy for Suicide Prevention

  11. RISK FACTORS FOR SUICIDE Environmental Risk Factors • Job or financial loss • Relational or social loss • Easy access to lethal means • Local clusters of suicide that have a contagious influence Source: National Strategy for Suicide Prevention

  12. The Economy and Unemployment • Unemployment is bad for your general health. • Unemployment contributes to suicide risk, but does not “cause” suicides on its own. • Unemployment causes financial strain and can lead to depression and other problems as individuals perceive a loss of personal control. • We can expect a sharp downturn in the economy to increase suicide risk, especially among working-age adults and older adults whose retirement security is threatened. Source: Suicide Prevention Resource Center

  13. RISK FACTORS FOR SUICIDE Sociocultural Risk Factors • Lack of social support and sense of isolation • Stigma associated with help-seeking behavior • Barriers to accessing health care, especially mental health and substance abuse treatment • Certain cultural and religious beliefs (for instance, the belief that suicide is a noble resolution of a personal dilemma) • Exposure to, including through the media, and influence of others who have died by suicide Source: National Strategy for Suicide Prevention

  14. PROTECTIVE FACTORS FOR SUICIDE • Effective clinical care for mental, physical, and substance use disorders • Easy access to a variety of clinical interventions and support for help-seeking • Restricted access to highly lethal means of suicide • Strong connections to family and community support • Support through ongoing medical and mental health care relationships • Skills in problem solving, conflict resolution, and nonviolent handling of disputes • Cultural and religious beliefs that discourage suicide and support self-preservation Source: National Strategy for Suicide Prevention

  15. The Many Paths to Suicide Cause of Death Proximal Risk Factors “Triggers or Final Straws” Fundamental Risk Factors Biological Crisis in Relation Poison Genetic Load Sex Loss of Freedom Gun Race Age Personal/Psychological Increasing Hopelessness Contemplation of Suicide as Solution Fired/ Expelled Hanging Values Religion Beliefs Culture Shock/ Shift Child Abuse Loss of Parent Drugs or Alcohol WALL OF RESISTANCE Illness Autocide Model for Suicide Environmental Urban vs. Rural Major Loss Geo-graphy Jumping Season of year ? ? • All “Causes” are real. • Hopelessness is the common pathway. • Break the chain anywhere = prevention.

  16. Percentage of suicides by circumstances Source: www.cdc.gov/injury/wisqars/

  17. Percentage of suicides by circumstances Source: www.cdc.gov/injury/wisqars/

  18. Where to go for help: Hotlines • Call the National Suicide Prevention Lifeline, 1-800-273-TALK. You will be connected to the nearest available crisis center. www.suicidepreventionlifeline.org • Call Access Crisis Intervention (ACI) Hotline: www.dmh.mo.gov/cps/ACImap.htm • List of other hotlines: www.dmh.mo.gov/cps/issues/suicide/links.htm

  19. Where to go for help: Services • Missouri Network of Care: http://missouri.networkofcare.org • 2-1-1 Missouri: www.211missouri.org • SAMHSA’s Mental Health Services Locator: www.mentalhealth.samhsa.gov/databases/ • Substance Abuse Treatment Facility Locator: http://dasis3.samhsa.gov

  20. Regional Resource Centers • In 2009 the Missouri Suicide Prevention Project expanded the number of Regional Resource Centers from seven to fourteen. In addition to offering free gatekeeper training, many of these sites also offer other services such as educational presentations, depression screenings or support groups for survivors. www.dmh.mo.gov/cps/issues/suicide/ResourceCenters.htm

  21. New Regions (2008-2011)

  22. Annual Conference 5th Annual “Show Me You Care About Suicide Prevention” Conference Opening Presentation by Dr. David Jobes Thursday, July 29, 2010 Capitol Plaza Hotel, Jefferson City Followed by a half-day workshops on July 30th

  23. National Strategy for Suicide Prevention Contains 11 Goals and 68 Objectives, including: • Goal 9: Improve Reporting and Portrayals of Suicidal Behavior, Mental Illness, and Substance Abuse in the Entertainment and News

  24. Reporting on Suicide: Recommendations for the Media • An evidence-based report by the CDC, National Institute of Mental Health, Office of the Surgeon General, SAMSHA, American Foundation for Suicide Prevention, American Association of Suicidology, and Annenberg Public Policy Center. The nine page 2001 report available online at: www.sprc.org/library/sreporting.pdf

  25. Recommendations • Interviewing Surviving Relatives and Friends • Language • Special Situations: • Celebrity Deaths • Homicide-Suicides • Suicide Pacts • Stories to Consider Covering

  26. Stories to Consider Covering • Trends in suicide rates • Recent treatment advances • Individual stories of how treatment was life-saving • Stories of people who overcame despair without attempting suicide • Myths about suicide • Warning signs of suicide • Actions that individuals can take to prevent suicide by others

  27. At-a-Glance:Safe Reporting on Suicide • Two-page guide provides a list of recommendations on how to report on suicide while minimizing the risk of contributing to "copycat" suicides. Summarizes guidelines and includes additional resources on suicide and suicide prevention for reporters, editors, and others in the media. Available at: www.sprc.org/library/at_a_glance.pdf

  28. SPRC Customized Information Series www.sprc.org/featured_resources/customized/index.asp • Alcohol and Other Drug Abuse Counselors • Clergy • College students • Co-Workers • Correctional Professionals • Employers • First Responders: Emergency Medical Technicians and Firefighters • Law Enforcement Personnel • Media • Nurses • Primary Care Physicians • School Health and Mental Health Care Providers • Social Workers and Mental Health Counselors • Suicide Survivors • Teachers • Teens

  29. Additional Information DMH website includes: State Plan Online Calendar of related events Links to info on hotlines, statistics, support groups, resource centers, listserv, etc. www.dmh.mo.gov/cps/issues/suicide.htm

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