NM COMPREHENSIVE STRATEGIC HEALTH PLAN 2008

CHAPTER EIGHT: YOUTH SUICIDE PREVENTION

REPORT FROM LS VEGAS REGIONAL MEETING 4/14/08

Report Submitted by Patsy Nelson

April 15, 2008

Goal

Reduce suicides in youth through age 24 by effective development and implementation of suicide prevention, intervention and post-vention* programs.

Background Information:

Suicide among youth aged 15-24 is a major health crisis in New Mexico. In 2004, the national youth suicide rate was 10.1 per 100,000 while New Mexico’s rate was an alarming 25.5 per 100,000. Nationally, suicide is the third leading cause of death for this age group. In New Mexico it is the second leading cause of death.

New Mexico’s Framework for Action*

  1. Promote awareness that suicide is a public health problem that is preventable.
  2. Develop broad-based support for suicide prevention.
  3. Develop and implement strategies to reduce stigma associated with being a consumer of behavioral health, substance abuse and suicide prevention services.
  4. Develop and implement suicide prevention programs.
  5. Promote and support youth partnership in planning, implementation and evaluation of suicide prevention programs.
  6. Promote efforts to reduce access to lethal means and methods of self-harm
  7. Implement training for recognition of at-risk behavior and delivery of effective treatment
  8. Develop and promote effective clinical and professional practices
  9. Improve access to and community linkages with behavioral health and substance abuse services.
  10. Improve reporting and portrayals of suicidal behavior, behavioral illness, and substance abuse in the entertainment and news media
  11. Promote and support research on suicide and suicide prevention
  12. Improve and expand surveillance systems

* New Mexico’s Framework for Action is adopted and aligned with the National Strategies for Suicide Prevention: Goals and Objectives for Action.

Key Terms and Definitions:

  • Post-vention/Recovery- Intervention conducted after a suicide, largely taking the form of support for the bereaved (family, friends, professionals and peers). Family and friends of the suicide victim may be at increased risk of suicide themselves.

The aim is to support and debrief those affected; and reduce the possibility of suicide contagion. Interventions recognize that those bereaved by suicide may be vulnerable to suicidal behavior themselves and may develop complicated grief reactions.

Postvention includes procedures to alleviate the distress of suicidal bereaved individuals, reduce the risk of imitative suicidal behavior, and promote the healthy recovery of the affected community. Postvention can also take many forms depending on the situation in which the suicide takes place. Schools and colleges may include postvention strategies in overall crisis plans. Individual and group counseling may be offered for survivors (people affected by the suicide of an individual).

  • Youth- for purposes of this document refers to ages 0-24
  • Stigma – An attribute, behavior, or reputation which is socially discrediting in a particular way; it causes an individual to be mentally classified by others in an undesirable, rejected stereotype rather than in an accepted, normal one
  • Suicide attempt survivors- individuals who have survived a prior suicide attempt
  • Suicide survivors- family members, significant others, or acquaintances who haveexperienced the loss of a loved one due to suicide; sometimes this term is also used to mean suicide attempt survivors.
  • Peer to Peer programs- Within every school, an informal "helping network" exists. Students with problems naturally seek out other students, in addition to teachers and other school staff, whom they trust. They seek them out for advice, for assistance, or just for a sympathetic ear. This program is based on the premise that students turn to their friends when they need help. Students are trained to increase their natural helping skills to seek adult help for themselves and their friends.

State Government

Policy Strategies:

  • Increase the number of State Agencies with comprehensive suicide prevention plans that incorporates the New Mexico Framework for Action.
  • Develop technical assistance and support available to build capacity across the state to implement and evaluate suicide prevention programs.
  • Increase the number of suicidal persons with underlying behavioral health disorders who receive appropriate behavioral health treatment.

Programs and Services Strategies

  • Increase the number of evidenced-based and practiced-based suicide prevention programs in schools, colleges and university, work sites, correctional institutions, and family, youth and community service programs.
  • Implement a public information campaign designed to transform public attitudes toward behavioral health and substance abuse disorders and to view persons who obtain treatment as pursuing basic health care.

Infrastructure Strategies

  • Improve and expand surveillance and data collection/interpretation systems, including the New Mexico Child Fatality Review.
  • Support projects to link and analyze information on self-destructive behavior from various, distinct data systems.

Las Vegas Regional Meeting Input:

  • Return to statute within Children’s Code: Any child seeking BH services can receive services without parent permission (confidential), not just children over age 14.
  • Importance of awareness of post-vention services in the prevention of youth suicide.

Tribal Government(Wait for feedback from NA/AI focus groups)

Key concepts from workgroup:

  • Develop and implement strategies for the Native community, including social marketing and outreach campaigns, to reduce the code of silence associated with being a consumer of behavioral health, substance abuse and suicide prevention services.
  • Implement training to reduce service disparities in NA communities and to develop, advocate and implement legislative mandates.
  • Facilitate training to non-NA agencies and providers to improve awareness of traditional beliefs, customs and culture.
  • Increase suicide prevention, education and outreach to at-risk youth and families.
  • Facilitate discussion with NA communities on the issue of youth suicide.
  • Build community capacity and community driven models.

Local Government/Communities

Policy Strategies

  • Increase cooperation and collaboration between community providers and agencies, including faith-based organizations, to adopt policies designed to prevent suicide.
  • Change procedures and/or policies in certain settings, including hospital emergency departments, substance abuse treatment centers, behavioral health treatment centers and various institutional treatment centers, designed to assess suicide risk to enhance triage systems and allocation of resources for those in need of specialized treatment.

Programs and Services Strategies

  • Implement public awareness campaigns designed to raise awareness of the early warning signs of suicide, tips on how to respond and strategies to limit access to lethal means of self-harm..
  • Increase the number of suicide prevention programs in schools, colleges and universities, work sites, correctional institutions, and family, youth and community service programs.
  • Implement support programs for persons who have survived the suicide of someone close.

Infrastructure Strategies

  • Establish partnership with a youth organization and engage them in planning, implementation and evaluation of local youth suicide prevention programs.
  • Organize and/or participate in the local Behavioral Health Community Collaborative to improve coordination and to ensure implementation of New Mexico’s Framework for Action.

Las Vegas Regional Meeting Input:

  • Develop community youth centers to provide care after school for children whose parents work.
  • Develop volunteer youth programs to encourage youth to develop compassion for others.

Education Systems*(includes all k-12 schools – public, Tribal and federal, and all public higher education institutions – community colleges, colleges and universities.)

Policy Strategies

  • Implement a public awareness in schools, colleges and universities designed to transform negative attitudes toward behavioral health and substance abuse disorders.
  • Require schools, colleges and universities to develop crisis response plans that includes standard protocols for responding to a suicide, incorporating a continuum of services that include prevention, intervention and postvention/recovery.

Programs and Services Strategies

  • Improve education for school nurses, teachers and other educational staff on how to identify and respond to students at risk for suicide, and
  • Provide educational programs for students and families on how to identify and respond to persons at risk for suicide.
  • Increase the number of peer-to-peer mentoring programs in schools, colleges and universities designed to

Infrastructure Strategies

  • Identify and implement evidenced-based curriculum in schools, colleges and universities to enhance suicide awareness among students.
  • Define and implement screening guidelines for schools, colleges and other educational institutions, along with guidelines on linkages with services providers.
  • Require participation in statewide resilience surveillance surveys such as the Youth Risk and Resilience Report (YRRS) to access risk and resiliency of youth.
  • Create additional funding for schools and community partnerships for shared work in programs that reduce risk factors and increase resiliency in youth.

Health Care Providers and Organizations

Workforce Development Strategies

  • Ensure that individuals who typically provide services to suicide survivors have been trained to understand and respond appropriately to their unique needs (e.g. emergency medical technicians, firefighters, police, and funeral directors.)
  • Provide comprehensive training to health professionals, including nurses, physician assistants, physicians, social workers, psychologists and other counselors, to ensure they are able to provide proper assessment, treatment, management and referral of suicidal patients.

Policy and Program Development

  • Increase the number of health insurance plans to cover behavioral health and substance abuse care on par with coverage for physical health care.
  • Implement utilization management guidelines for suicidal risk in managed care and insurance programs.
  • Integrate behavioral health and suicide prevention into health and social services outreach programs for at-risk populations.
  • Implement support programs for persons who have survived the suicide of someone close.

Business and Work Sites

  • Increase the number of service learning and mentoring programs available for youthto create a productive workforce and participate in civic engagement.
  • Provide suicide awareness training for all employees to ensure they know the early signs of suicide and are aware of how to respond appropriately, especially as it relates to youth at-risk for suicide.
  • Implement an information campaign designed to transform employee attitudes toward behavioral health and substance abuse disorders and to view persons who obtain treatment as pursuing basic health care

Families and Individuals

  • Actively engage, involve and partner with youth in planning, implementing and evaluating community activities such as peer-to-peer mentoring to prevent youth suicide, reduce bullying and to increase respect for diversity.
  • Foster programs that address community and family violence and harm reduction
  • Promote awareness in oneself, one’s family and friends of the early warning signs of suicide and how to respond appropriately, especially as it relates to youth at-risk for suicide.
  • Participate in public awareness campaigns designed to raise awareness of the early warning signs of suicide, tips on how to respond and strategies to limit access to lethal means of self-harm.