This was published in Mental Health Weekly regarding suicide prevention plans in NYS. Many of our state and advocacy colleagues are quoted: Glen Liebman, Lauri Cole, Marlene A. Schillinger, Mike Hogan, Ann Sullivan, Jay Caruthers. It also ties in Hillary Clinton’s mental health plan and efforts by the NIH to understand the efficacy of prevention plans across the state.
New York Suicide Prevention Plan to Coordinate Communities, Boost Training
Fueled by a tragic suicide epidemic affecting New Yorkers, state officials have released an extensive and multifaceted suicide prevention plan calling for a coordinated community, public health and health care approach to reduce the state’s suicide rate. Officials say a trained medical professional workforce will have a significant impact on reducing suicides.
The suicide prevention plan, 1,700 Too Many: New York State’s Suicide Prevention Plan 2016–17, was unveiled following the state’s first annual Suicide Prevention Conference September 12–13. The report title refers to the number of New Yorkers who died by suicide in 2014.
The report notes that suicide is the 10th-leading cause of death among all age groups in this country. In 2014, there were 8.6 suicides in New York state for every 100,000 New Yorkers (versus the 13.4 per 100,000 national rate). However, the number of suicides has increased by 32 percent in the past decade. Only four other states (California, Texas, Florida and Pennsylvania) had more suicide deaths than New York in 2014.
The state plans to coordinate this suicide prevention with key stakeholders. The New York Office of Mental Health (OMH) Suicide Prevention Office (SPO) was created in large part to coordinate and align suicide prevention efforts across the state, said Jay Carruthers, M.D., at the OMH Bureau of Psychiatric Services. “This will remain a core activity of SPO, working closely with its partners, including the Suicide Prevention Center of New York and the Suicide Prevention — Training, Implementation, and Evaluation group at the Center for Practice Innovations,” Carruthers told MHW.
Zero Suicide
The state’s suicide prevention plan is an extension of its Zero Suicide initiative, a commitment to suicide prevention in health and behavioral health care. “Zero Suicide has been successfully implemented at some agencies nationally,” said Carruthers.
In New York, the Institute for Family Health, a large federally qualified health center that provides medical, behavioral health and dental services for about 1 million New Yorkers, has been a national leader in Zero Suicide implementation, Carruthers said. “OMH has also piloted Zero Suicide at some OMH facilities and in Western New York as part of our National Strategy for Suicide Prevention grant from SAMHSA [Substance Abuse and Mental Health Services Administration],” he said.
Carruthers added, “While some states are pushing for broader Zero Suicide adoption, no state has successfully brought the model to scale. New York is seeking to be a model Zero Suicide state and is launching the largest Zero Suicide implementation in the nation with nearly 200 mental health clinics in the fall of this year.”
Multifaceted systems approach
New York’s 2016–17 suicide prevention strategy uses a multifaceted systems approach that targets both health/behavioral health care and community settings, with a commitment to continuously use data to inform and evaluate the effort over time.
Building on the strength of the current foundation for suicide prevention. the New York state strategic framework is divided into three main domains or strategies:
- Prevention in Health and Behavioral Health Care Settings.
- Lifespan Prevention Approach in Competent, Caring Com- munities, and
- Suicide Surveillance and Data- Informed Suicide Prevention.
The state’s strategy to focus on data and evaluation is facilitated by the fact that New York is joining the National Violent Death Reporting System, Mike Hogan, Ph.D., independent consultant and former commissioner of New York’s OMH, told MHW. The data involving violent deaths includes suicide, he said. “Data is one core element that’s very significant,” Hogan said.
The Zero Suicide focus will be on health care and behavioral health care settings, he said. “This is going to be the biggest test of Zero Suicide innovation so far,” said Hogan. Ann Sullivan, M.D., the OMH commissioner, is determined to work on suicide prevention with the utmost urgency, he said. Zero Suicide was also mentioned as part of Hillary Clinton’s mental health plan, he said.
The state is also planning to prevent suicide through upstream activities — for example, addressing youths in schools, he said. “One good example is the work of Peter Wyman, Ph.D., at the University of Rochester, who has developed a very successful school-based suicide prevention program that is also being widely implemented across New York,” said Hogan. The program, Sources of Strength, is aimed at preventing adolescent suicides.
The National Institute of Mental Health has provided grants to study the effectiveness of suicide prevention programs across participating clinics in the state (see related story on page 3), said Hogan, who is part of a new NYS Suicide Prevention Council, which includes researchers, state and local government, providers, school administrators, community advocates and those with lived experience.
Providers react
“The outreach, assessment and engagement with individuals who are at risk should be happening in all of health care and all educational settings,” Lauri Cole, executive director or the New York State Council for Community Behavioral Healthcare, told MHW. “We should be trying as a community and state to normalize this topic.”
Cole added, “I applaud the state for taking significant steps toward a more open and coordinated discussion of this very sad, but preventable, issue.”
Marlene A. Schillinger, CEO of Jewish Family Services, a Buffalo, New York–based agency, said that while the state’s suicide prevention plan is important, what’s really needed is a strong awareness campaign. “The most important thing is combatting stigma,’” Schillinger, a Mental Health First Aid trainer, told MHW. Reaching out at the grassroots level is imperative, she said. “A stigma [awareness] campaign goes above and beyond what the state is planning to do,” she said.
Schillinger’s anti-stigma campaign involves a collaboration with a number of agencies, she said. Erie County officials have provided some funding, and she is now looking at other funding streams, she said. “It’s a group of concerned providers who are at the grassroots level to raise awareness and reduce stigma,” she said.
Training welcomed
A core component of the plan relies on improved training for mental health and substance abuse providers in the identification and treatment of at-risk individuals. Glenn Liebman, CEO of the Mental Health Association in New York State, said it is sorely needed. “We don’t do a great job of training many in our clinics and our programs across the nation,” Liebman told MHW. “They don’t know the skill set to [address] suicide ideation or don’t have the training and knowledge that is necessary in this day and age.”
State agencies and other collaborations in the community need to work with clinics and other state- operated programs to ensure clinicians are really trained on suicide prevention, Liebman said. He said he is encouraged about the Zero Suicide model. “It’s really significant as we move forward to bring the model to community providers, peer programs and family programs,” he said. “As we infuse the Zero Suicide initiative into clinics and other state- operated programs, let’s evaluate and see how well it’s working.”
Liebman added, “Public aware- ness is key.” One very important component of that is the state’s public education bill that at MHW press time was days away from being signed by Gov. Andrew Cuomo. “If he signs that, every school that teaches health has to teach about mental health,” said Liebman. “Suicide prevention is a big component of educational training in middle and high schools.” •
To view the report go to http://omh.ny.gov/omhweb/resources/publications/suicde-prevention- plan.pdf