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Presentation

Data Driven Suicide Prevention & Means Reduction
Wesley Schweikhard & Ken Crandall
Facilitators
Know the Signs >> Find the Words >> Reach Out
1
Today’s Panel
Theresa Ly, MPH
Suicide Prevention Program Specialist
EDC
[email protected] | 916.494.9616
Sandra Black, MSW
Education Development Center |
[email protected] | 530.771.7551
Robert K. Stohr, M.S., L.M.F.T.
Division Director
Suicide Prevention Center
[email protected]
310-895-2352/Fax310-895-2370
Katie Cassidy, M.S.
Community Development Coordinator
Shasta County Health & Human Services
Agency
(530)225-5940
[email protected]
Using Data for
Suicide Prevention
Sept. 18, 2013
CalMHSA Statewide
Coordinating Workgroup
Theresa Ly, EDC
Using data for planning
• Provides a focus for prevention & intervention
activities
• Evaluation tool
• Informs policy
• Disproves common misconceptions
4
Types of data relating to suicide
Mortality*
Attempts*
Ideation
Cost of injury
Associated risk factors
Access to mental health
services
• Crisis hotline access
•
•
•
•
•
•
* can be
paired with
information
about method
5
How to use data
• Get a fuller picture by examining data over a
number of years (at least 5)
• Look at multiple data sets to get a better
understanding of suicide in your community
• For example, if mortality data shows that males
have higher suicide rates…
• And crisis center data shows that fewer males are
calling in for assistance…
• This may suggest a need to re-examine how
resources are portrayed and marketed to men
6
Considerations when using data
Age-Adjusted Mortality Rate per 100,000 for Suicide Fatalities of
Humboldt County Residents, 2008-2012
30.0
24.8
25.0
23.7
23.5
19.7
19.2
Rate/100,000
20.0
15.0
10.0
5.0
AAMR
0.0
2008
2009
5-year trend
2010
Year
2011
2012
7
When using data…
• Don’t sensationalize the data
• Consider social math
“183 suicides have occurred in Nevada County in
the past 10 years”
vs.
“As many people died by suicide in the past 10
years in Nevada County as would fill almost 4
school buses”
8
Case studies
• Trinity County: Examined coroner data and
found that people who killed themselves in
Trinity County resided within the County
• San Diego: Used 10 years of suicide mortality
data to determine that middle-aged white
men were at highest risk for suicide and
implemented the Tough Times Campaign as a
result
9
Demographics
Call Volume
Reason for Call
Risk
Follow-Up
Caller
Satisfaction
Robert Stohr, M.S., L.M.F.T., Division Director
Georgina Parra Morris, Ph.D., Program Evaluator
Didi Hirsch Mental Health Services
[email protected]
(310) 895-2318
Crisis Line Common Metrics
Topic
Input:
Demographics
•
Important in increasing access to Crisis line.
Reason for Call
•
•
Educates people about what presenting problems are and how main issues are defined.
Knowing about presenting mental illness is useful during call.
•
•
•
•
Shows the work that is being done by Crisis Lines.
The number of people who call a crisis line is an outcome that speaks to efficacy.
Useful for expanding scope to other counties and regions.
Gives us trends that help identify communities that are being served and service gaps.
Risk
•
•
Follow-Up
•
•
People at varying levels of risk call Crisis Lines.
Pairing level of risk with resolution of call can help in understanding reduction of suicide
risk.
Allows for outreach to highest risk callers and serves as a reminder to call again.
Allows for tracking calls post-attempt & post-hospitalization.
Call volume
Caller Satisfaction •
Provides information on effectiveness of call.
What are caller’s presenting problems?
*Data for July 2013. Data is based on 10 Crisis Centers that are part of CA Suicide Prevention Network.
Reducing Access
to Lethal Means
Sept. 18, 2013
CalMHSA Statewide
Coordinating
Workgroup
Sandra Black, MSW EDC
What do we mean by “lethal means”?
•
•
•
•
•
•
Firearms
Poisons/drugs/medications - Overdoses
CO, plastic bags - Suffocation
Ropes - Strangulation
Heights - Jumping
Sharp objects - Cutting
15
Suicide methods in California 2001-2010
Other, 1874
Poisoning
6856
Jumping 1282
Cut/Pierce
845
Firearm
14335
Hanging
9245
16
What do we mean by “restricting
access”?
Insulate, limit or create barriers between a
person and means of harm
Temporarily removing the person from the
means
OR
removing the means from the person
17
Restricting access is not a new idea!
18
“Won’t they just die some other way?”
•
•
•
•
•
•
•
Bern, Switzerland (Reisch & Michel, 2005)
Augusta, Maine (Pelletier, 2007)
New Zealand (Beautrais, 2001)
Bristol, England (Bennewith, 2007)
United Kingdom (Kreitman, 1976)
Sri Lanka (Gunnell, 2007)
90% of suicide attempt survivors don’t later die
by suicide
19
Means Matter*
• Many suicide attempts occur with little
planning during short term crisis
• When the means to die by suicide are less
available or less deadly, suicide rates decline
– More time for crisis to pass
– More time for intervention to occur
*Harvard School of Public Health Means Matter Campaign http://www.hsph.harvard.edu/means-matter/
Why focus on firearms?
• Most lethal & most commonly used method
• Suicidal acts with firearms are fatal 85% of the
time
• Study showed that firearms used in youth suicides
mostly belong to a family member, usually a
parent
– As many as 64% were stored unlocked
Programs & Strategies
Responsible gun ownership is the key
• Engage gun shops, range owners & hunter safety
instructors
• Gun Storage – Locks, Safes, Ammo Separation
Protecting people during a suicidal crisis using
lethal means counseling
• Assess whether a person at risk has access to firearms or
other lethal means
• Work with them and their support system to restrict
access until they are no longer feeling suicidal
Moving on to other means
• How can we restrict access to other means?
Cold Spring Canyon Bridge Barrier,
Santa Barbara County
24
25
26
How to address overdoses?
•
•
•
•
Prescription drug monitoring
Information at pharmacies
Drug collection programs
Increase availability of treatment
27
Reducing suicide no matter what
method
• Counseling on access to lethal means
• Screening and assessments
• Reducing media contagion
28
“Injury prevention research can have real and
lasting effects. Over the last 20 years, the number
of Americans dying in motor vehicle crashes has
decreased by 31%. Death from fires and drowning
have been reduced even more, by 38% and 52%,
respectively. This progress was achieved without
banning automobiles, swimming pools, or matches.
Instead, it came from translating research findings
into effective interventions.”
• Drs. Arthur Kellermann and Frederick Rivara, JAMA 2012
Resources
• Means Matter at www.meansmatter.org to download
materials and use them in your work
• CALM: Counseling on Access to Lethal Means
Free online workshop
http://training.sprc.org/course/description.php#cours
e3
• Find programs in the Best Practices Registry at
www.sprc.org/bpr
30
Shasta County
Suicide Prevention & Firearm Safety
Know the Signs >> Find the
Katie Cassidy, MS
Shasta County Health & Human Services Agency
(530) 225-5940
Words >> Reach Out
[email protected]
Presentation
Introduce Shasta County
Suicide Prevention Workgroup
Suicide Prevention & Firearms Safety
50.8%
female
86.7%
identify as
White
47
people per
square mile
Median age
41.8
years
91.5%
speak English
at home
Shasta
County
Residents:
3 part assessment:
Shasta County Suicide Data,
Community Perception,
Community Response
Know the Signs >> Find the Words >> Reach
“When spider
webs unite, they
can tie up a lion.”
~ Ethiopian
Proverb
Out
Challenges
Stigma
It is hard to
measure
prevention
Public criticism
through media and
common myths &
O u t misconceptions
Data
Effective
Prevention
Strategies
Easy
Suicide
Prevention
“Have fun
stormin' da
castle.”
“Think it'll
work?”
“It would
take a
miracle!”
Challenges:
Anything resembling gun
control
Assuming that firearms
owners are not safe
Telling people what to do
with their guns in their
own homes
Recommendations that
were not feasible, legal or
responsible
Solutions:
Be clear about the
purpose/intent of the
project
Include the experts
Purpose
Communicate suicide
prevention information
and resources to our
communities.
Engage firearms owners
in suicide awareness
and prevention efforts.
Who are the Experts?
Shasta County Suicide
Prevention Workgroup
Law Enforcement
Firearms Retailers
Firearms Safety
Instructors
Shooting Clubs
Gun Ranges
Next Steps
Materials were
created/adapted
Feedback was
sought from friends
and families
Packets were
distributed to Law
Enforcement
February 2012
26 packets were
mailed to Shasta
County firearms
experts
Initial follow-up
contact via phone
and email
March 2012
Additional follow up via
phone, email and in person
visit (5 interviews completed)
Survey tool (possibly too
formal)
Good feedback was obtained
What
worked:
Reinforcing
positive
practices
Highlighting
safety
successes
Initial
Impressions:
Education on safe handling of
firearms is always of first
importance
Advising locked containers is
the preferred method of
storage
Provide more specific
information on who is
allowed to take custody of
firearms for someone
Let people know California
approved locks are free and
where to obtain
Out
Initial Impressions:
Most important issue for
anyone around guns is safety,
safety, safety.
More focus on safety is good.
#1 and #2 cover it all.
Everyone needs to be aware of
gun safety.
It might be prudent to
emphasize storing OTHER
weapons in safes or with locks.
This is great info. Safety
should
always be reinforced.
Know the Signs >> Find the Words
>> Reach Out
Additional feedback:
“This information
will be most
productive if
included with other
methods.”
“Universal suicide
prevention education
would be good, for
example what to do with
someone before they get
to the point of choosing
the method.”
“Any information that
helps identify and get
help before the 5150 call
is good for gun owners.”
“Information on EARLY
warning signs, drug use and
who to call (phone
numbers) for options would
be good.”
Advice for
the project:
Several instructors
would like to teach
firearm safety for the
general public,
especially non-firearm
owners at a suicide
prevention summit.
Advice for
the project:
“Put this info with other
information about
suicide prevention, it is
better than trying to
make it stand alone.”
Keep this advice in the
context of overall safety,
NOT emergency
information.
Advice for
the project:
This will help keep
someone from trying to
grab a gun out of
another’s hand.
Warning signs are key.
Advice for
the project:
Advice for
the project:
Reinforce safety
information including
proper storage with
locking devices.
Lessons Learned:
Suicide prevention info should not
only be about firearms.
Safety is a huge concern to firearm
owners; safety messages are good
to reinforce.
Suicide prevention information is
important to everyone, important
to reinforce early warning signs and
resources for help.
Include information and resources
on how/where to help.
Brochures are posted in Sheriff’s
office
Butte County is adopting similar
approach
Gun store sponsorship for
Out of Darkness Walk
Plans to revisit and follow up
www.shastasuicideprevention.com
Suicide Prevention Best Practices Project
Superior Region Needs Assessment Data
Suicide Death Rates from 2000-2010
Rate Per 100,000
25.0
20.0
18.6
19.5
19.1
20.3
18.2
19.4
20.1
18.6
19.1
20.3
15.8
15.0
10.0
9.1
9.3
9.0
9.4
9.2
8.6
8.8
9.3
9.7
9.7
9.8
5.0
Superior Region
CA
0.0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
40.0
35.0
Suicide Death Rates By Gender (2010)
35.3
Rates Per 100,000
30.0
Superior
Region
25.0
20.0
16
15.0
10.0
7.1
4.6
5.0
0.0
Male
Female
CA
Suicide Death Rates by Age (2010)
60.0
Superior Region
48.3
50.0
CA
Rate Per 100,00
40.0
34.2
31.8
28.0
30.0
22.0
20.0
17.1
16.4
15.6
10.0
10.0
16.3
10.0
5.3
0.0
0.0
1.1
10-14
15-19
20-24
25-44
45-64
65-84
85+
Suicide Deaths by Cause/ Mechanism (2010)
60.0%
55.0%
50.0%
Superior Region
38.3%
40.0%
30.5%
30.0%
20.5%
20.0%
10.0%
1.2%
2.3%
17.0%
2.9%
3.8%
0.0%
20.0%
3.5%
5.0%
CA
Suicide Deaths by Cause/Mechanism (2010): Ages 20-44
45%
41%
39%
40%
35%
Superior
Region
CA
39%
30%
30%
25%
20%
14%
15%
10%
5%
0%
0%
2%
4% 5%
18%
2%
6%
70%
63%
Superior
Region
CA
60%
50%
39%
40%
28%
30%
19%
20%
10%
26%
11%
3% 3%
3% 4%
0%
1%
5%
70%
57%
60%
60%
Superior
Region
CA
50%
40%
27%
30%
16%
20%
10%
0%
16%
10%
0% 1%
0%
3%
7% 5%

Presentation

Transcription

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