SUICIDE PREVENTION
Hospital’s role
in suicide
prevention.
DEPARTMENT OF HEALTH
 Suicide Prevention Coordinator
 Funded local ef for ts
 Evergreen House - Coalition
 Bemidji State University
 NAMI MN
 QPR
 ASSIST
 Means Restriction
 SAVE
 Youth Summit
 PSA Contest (College students)
 Technical Assistance




New state plan
Technical assistance
Data analysis
DHS par tners
 Mental Health First Aid
 ASSIST
DATA TRENDS
National &
Minnesota
THE RATE OF SUICIDE IS INCREASING
THE MINNESOTA RATE HAS BEEN SIMILAR TO THE
U.S. RATE
Age-adjusted Rate per 100,000 Population
14
12
10.5
10.4
10.7
10.9
10.8
10
9.6
8
9.0
9.8
9.8
11.0
10.2
10.9
11.0
10.5
10.6
11.3
10.8
11.6
11.8
12.4
11.2
10.8
2
11.2
8.9
US
6
4
12.1
MN
2010 Leading cause of death ranking
US – 10th
MN – 9th
0
Year
YOUTH SUICIDE PREVENTION WORKS!
Age-adjusted Rate per 100,000 Population
18
17
16
14.1
14
12
10
11.5
11.9
12.4
11.4
12.6
15.6
15.6
14.6
13.7
12.9
13.8
12
10.7
10.6
11.2
11.4
10.8
11.1
4.8
5
10.2
9.9
9.4
8
14.5
14.9
8.9
6
4
4.7
4.3
4.8
5
5.1
4.9
5.6
4.7
2
4.6
65+
0
Year
25-64
5
5.7
<25
SUICIDE IS COMPLEX
• Painful
Loss
•Feel like
a burden
• Social
Isolation
Mental
Illness
Substance
Abuse
Adverse
Childhood
Experiences
Culture
• Access to
means
GROUPS WITH INCREASED RISK
 American
Indians/Alaska
Natives
 Suicide Survivors
 Suicide Attempt
Survivors (NSSI)
 Lesbian, gay,
bisexual, &
transgender (LGBT)
populations
 Members of the
Armed Forces &
veterans
 Men in midlife
 Older men
 Individuals:
 in justice & child welfare
settings
 with medical conditions
 with mental or
substance abuse
disorders
LESSONS FROM THE UK
 Providing 24-hour crisis teams
 Removing ligature points (materials that could be used for
suicide)
 Conducting follow up with patients within 7 days of discharge
 Conducting assertive community outreach, including providing
intensive support for people with severe mental illness
 Providing regular training to frontline clinical staf f on the
management of suicide risk
 Managing patients who are not complying with treatment
 Sharing information with criminal justice agencies
 Conducting multidisciplinary reviews and sharing information
with families after suicide.
NATIONAL STRATEGY FOR SUICIDE
PREVENTION
 Health care systems, insurers, and clinician recommendations
 4 main strategies
STRATEGY 1: HEALTHY & EMPOWERED
INDIVIDUALS, FAMILIES, & COMMUNITIES
 Communicate messages of resilience, hope and recovery to
patients, clients, and their families with mental and
substance abuse disorders.
STRATEGY 2: CLINICAL & COMMUNIT Y
PREVENTIVE SERVICES
 Screen for mental health needs, including suicidal thoughts
and behaviors, and make referrals to treatment and
community resources, as needed
 Incorporate lethal means counseling into suicide risk
assessment protocols and address means restriction in safety
plans.
 Increase the capacity of health care providers to deliver
suicide prevention services in a linguistically and culturally
appropriate way.
STRATEGY 3: TREATMENT & SUPPORTIVE
SERVICES
 Implement patient-informed alternatives to hospitalization for
individuals with suicide risk
 Develop alternatives to treatment in an emergency
department, such as same-day scheduling for mental health
services and in-home crisis care
 Develop and implement protocols to ensure immediate and
continuous follow up after discharge from an ED or inpatient
unit
 Educate family members and significant others about
appropriate steps they can take to support individuals at
suicide risk during treatment and/or after discharge from an
ED or inpatient unit
STRATEGY 4: SURVEILLANCE, RESEARCH
& EVALUATION
 Implement the recommendations for health care providers in
CDCs action plan for improving external cause of injury coding
within administrative data, such as emergency department
and hospital discharge system
 Routinely document suicide -related information (e.g., alcohol
use, drug use, description of intent) in emergency department
charts
 Initiate continuous quality improvement studies to determine
the ef fectiveness of policies and procedures intended to
rapidly connect individuals at risk for suicide with services.
CRISIS INTERVENTION RESOURCES




National Suicide Prevention Lifeline (& local crisis lines)
TXT4Life
Mobile crisis teams
SAFE-T – Suicide assessment five -step evaluation and triage
 http://store.samhsa.gov/product/Suicide -Assessment-Five-StepEvaluation-and-Triage-SAFE-T-/SMA09-4452
 County veteran service of ficer (CVSO)
 Veteran Crisis Line
WHAT DO YOU NEED?
WHAT ARE YOUR
PRIOROITIES?
?
Q&A




What
What
What
What
are you doing?
are your needs?
are your priorities?
can the state do to support your prevention ef forts