Our #BeThe1To Campaign

As of today, the beginning of National Suicide Prevention Week, I am thrilled to announce the launch of our local #BeThe1To Campaign. #BeThe1To is part of a larger campaign led by The National Suicide Prevention Lifeline to raise awareness about the hotline and find ways to recognize and take action when you see an individual in crisis.

 

 

Stay tuned in the coming weeks to our social media on ways to better learn five steps and see our page for copies of the digital assets.  Also stay tuned to our Facebook page this month (National Suicide Prevention Month) for more details on the action steps.

Means Reduction and Guns: Having The Tough Conversations

On April 5, 2019 The Suicide Prevention Center of New York held the “Means Reduction Academy” in Albany, NY.  The topic of means reduction is complex and often requires a multi-disciplinary approach. Approximately of half deaths by suicide are by firearm. The study of means reduction sought to understand if there are ways to reduce access to firearms for suicidal individuals. This issue often becomes political as gun rights advocates often cringe at the thought of infringing on second amendment rights. Clinicians are often quick to wonder how we can legally take guns away from suicidal individuals.

Using a multi-disciplinary approach, trainers demonstrated how it is possible to focus on data, put politics aside, come to a shared definitions of the problem, and most importantly take action.  2 leading public health experts (Eliane Frank of Dartmouth-Hitchcock and Catherine Barber of Harvard Chan School of public health) and two leaders in the gun community (John Yule of The Wildlife Taxidermy and Sports Center and Ralph Demico, VP of Gun Owners of New Hampshire) presented as a team. They created a unique partnership in New Hampshire and shared lessons they learned and other effective campaigns.

First Catherine laid out the public health data on why means matter.  She first gave the example of the Sri Lanka was  struggling with Pesticides as a means for suicide.  It was a highly lethal means and was available easily due to the need in the country. They recognized the need, created a public health campaign, and reduced the risk. She described how means reduction in guns requires a similar intervention. That guns are incredibly lethal means but and we can do something about it.

 

Identifying lethal means is important but what is even more critical is that suicidal thoughts are often time limited and time and space from lethal means is the key intervention.

 

 

These are the key points why reducing access to lethal means.

 

 

Members from the New Hampshire gun community ended up partnering with both Catherine and Elaine Frank.  Both Ralph and John underscored the importance of not jumping to conclusions about those who own guns. Also if you don’t know the answer to something, its’s best to ask. They talked about the need for clinicians to understand how guns work.  That certain terminology matters. That instead of referring to something as a “clip” it is called a magazine. And rather than referring to guns as “weapons” refer them to “fire arms”.  It matters when discussing messaging which will examine further in a bit.

Clinically, Elaine Frank worked participant through the basics of C.A.L.M (Counseling On Lethal Means). This is a one hour free training on how clinicians can begin to have a conversation with clients in crisis about reducing access to guns. The emphasis is not taking legal action but how one can develop shared decisions with clients around this. The emphasis is working together to co-create a plan to keep one safe. This is a valuable training that all clinicians should take an hour of their time to enroll in.

The conference ended with some example of PSA’s and messaging for public health campaigns. They provided a powerful example of a public service announcement in Utah called “Is Your Safety On?” This brief video is a good summary of how we need to frame this issue..

 

You can find more information about the Utah Campaign and resources about Means Reduction are available at the Suicide Prevention Resource Center website. These examples highlight the need for those interested in the public health space to partner with gun groups around these messages.  Also American Foundation For Suicide Prevention partnered with the National Shooting Sports Foundation to develop educational materials on guns and suicide.  This is another example of how groups can come together around a shared understanding of the problem.

 

 

It was mentioned several times how we need to come together not “against guns” but being “anti-suicide”. We can achieve this by working together to understand the numbers effected, the means, and come to a shared understanding of the problem. The solutions are complex but together we can temporarily reduce lethal means for those in crisis.

 

Sean Erreger, LCSW

Co-Chair Rensselaer County Suicide Prevention Task Force

 

 

 

 

 

What Do We Know About Suicides in Rensselaer County?

Next week I am headed to the  3rd Annual New York Statewide Suicide Prevention Conference. Each year it grows and it’s great to see New York State to bring together National, State, and local initiatives together to share best practices.

One of the strategies in New York State Suicide Prevention Plan is to increase and ensure we have the most accurate data on suicide loss. This will assist state, county, and local municipalities develop strategies to address these problems.  Also to build our funding, New York State wants coalitions to take a data-driven approach.  To this end New York State has opened health data by population and county to help us better understand hat we need to build healthier communities.

As I began to look at the data I thought educating the community about how we have experienced suicide. While looking at this open data, it resonated to look at other “deaths of despair” and how it effects our county.

The Data

A little caution about this data. This is official data reported to the New York State Department of Health Bureau Vital statics. It is often limited by the accuracy of those who report deaths to both coroners, the local health department, and deaths that my take place in another state/jurisdiction. Here is what is publicly available data about Suicide Deaths in our county.  Although they are taking steps to improve data accuracy and collection, this is just an overview of what we are experiencing here in Rensselaer County…

Suicide Data:

 

Year Suicide Deaths in Ren. Co Per 100,00 Residents in Ren. Co Suicide Deaths Statewide Statewide per 100,000
2007 14 9.0 1,368 7.1
2008 10 6.4 1,391 7.1
2009 19 10.3 1,400 7.2
2010 12 7.5 1,513 7.8
2011 18 11.3 1,625 7.3
2012 21 13.1 1,637 8.5
2013 10 6.3 1,642 8.3
2014 21 14.1 1,657 8.3
2015 19* 1,639*

 

One can see the first problem I alluded to earlier. The last complete data set publicly available is from 2015. One can project the overall statewide trend is increasing with a slight decrease in 2015.  Telegraphing trends from the Rensselaer County Data is challenging but our suicide deaths and the rate per 100,000 people is not decreasing. This continues to be challenge for our task force.  Looking at statewide data one can see this a challenge for the entire state.

 

What Do We Do?

At first glance the data on suicides in our county reveal no pattern. Again we are limited by timely and accurate data.  I am excited to be representing our task force at the 3rd Annual Suicide Prevention Center of New York Conference to get an update and the state of data collection. Although it comes with it’s challenges the intentional examination of improved data collection can better inform our practices. The trend is sadly in the upward direction in the State and locally. We are committed to working locally to try to make a difference. I hope that you will consider joining our Task Force….

 

Please follow us on Facebook and look for regular meetings and other local events.

You can also Join our Slack Channel.

 

 

 

Recognizing The Unique Needs of Our Rural Areas

An article in yesterday’s U.S News And World Report is getting attention in the suicide prevention community. It also has me reflecting on the need to understand the unique needs for the rural part of our county.  The article was entitled “Study: Farmers Don’t Have Enough Mental Health Services” it goes on to describe the findings of the study highlighting the feelings of loneliness and isolation. Last spring, the same research lab identified that farmers are one of the highest risk occupations for suicide.

Also in her research Dr. Sally Spencer-Thomas highlights some of the risk factors for farmers:

  • Access to and familiarity with lethal means. Studies indicate that farmers trying to die by suicide are most likely to use means to which they have easy access (Behere & Bhise, 2009). In India, for example, poisoning by pesticide consumption is the most common method. In England and Wales, on the other hand, firearms are more accessible, and thus they are the most-frequently used method for death by suicide.
  • Exposure to death. Not only do they tend to have easy access to firearms, but also experience in using them (e.g. killing sick animals (Malmberg et al., 1997; Malmberg et al., 1999).
  • High Stress Outside of their Control. Farmers experience high occupational stress and related problems, including concern over new laws, anxiety about changing farming methods, long working hours, unpredictability of weather, and financial problems resulting from market fluctuations (Malmberg et al., 1997; Malmberg, Simkin, & Hawton, 1999).
  • Family tensions. Since farming is often a family business, family problems are intricately tied to farmers’ livelihood (Malmberg et al., 1997; Malmberg et al., 1999). When conflicts arise in their families, farmers may lose their livelihood in addition to closeness with family members (Malmberg et al., 1997). Farming is not simply an occupation, but a way of life. Familial conflict as well as isolation due to the impact of modern technology on the farming industry may lead to a feeling of thwarted belongingness among farmers (Joiner et al., 2009).
  • Isolation. Farmers are becoming more isolated due to mechanization of farming (Malmberg et al., 1997).
  • Stoicism. Farmers tend to feel as if they need to stay positive when dealing with hardship. Expressing negative thoughts and feelings in farming culture is discouraged, which leads to stigma around mental health problems (Judd et al., 2006).

 

Not to assume that all occupants of rural Rensselaer County are farmers, but these risk factors may also be present.  I began to reflect on what we have done as a task force to engage the rural area of our county…

This was a headline from The Bennington Banner in preparation for our listening session that was held on February 12, 2015. Held almost three years ago to the day, this was last time we intentionally reached out to the rural part of our county.  Every once and while in the task force meetings we mention how we need to understand the needs of this part of our county better. We would like to perhaps crowd source how we can do this better.

We would love to hear from you.  If you are a resident of a rural part of the county, do the above risk factors resonate with you?  Are there protective factors or strengths that perhaps can be added?  Do we need to host another forum? What information would you like to hear from the task force and is there anything else we need to know from you? Thanks for taking the time to read the post and also feel free to stay tuned to our Facebook page for how you can help.