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National Violent Death Reporting System: Suicide More Prevalent Than Homicide

Suicides accounted for nearly two-thirds of all violent deaths in 17 states that participated in the National Violent Death Reporting System (NVDRS) in 2013, according to a new government report.
 
The Centers for Disease Control and Prevention has found that 66.2 percent of the 19,251 violent deaths studied were caused by suicide. In comparison, 23.2 percent of the violent deaths were homicides. The overall collective suicide rate among the 17 states in 2013 was 13.3 per 100,000 population. The suicide rate in Alaska in 2013 was 23.4 per 100,000 population, according to the Alaska Bureau of Vital Statistics.   
 
The CDC first began collecting data for the NVDRS in 2003 from seven states, including Alaska, to monitor the occurrence of violent deaths and help develop, implement, and evaluate programs and policies to reduce and prevent violent deaths. By 2013 there were 17 states gathering statistics on violent deaths to be studied collectively, including Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin. The CDC’s goal is to get all 50 states, U.S. territories, and Washington, D.C. to eventually participate in NVDRS data collection.
 
The new report reinforces some previously known information about deaths by suicide, while also providing a more comprehensive overview than most studies offer. Of the 17 states studied, men died by suicide nearly four times the rate of women, with 21.0 and 5.9 deaths per 100,000 population respectively. Rates among males were highest for men 85 years of age and older, with a rate of 45.5 per 100,000 population. The rate among females between the ages of 45 and 54 was the highest among women, with 10.3 deaths by suicide per 100,000 population.
 
The new report indicates that American Indian/Alaska Natives and non-Hispanic whites had the highest rates of suicide of any ethnicity, with 18.7 and 16.4 per 100,000 population respectively. The rate of Alaska Natives in 2013 in Alaska alone was much higher, with 46.9 per 100,000 population, according to the Alaska Bureau of Vital Statistics.      
 
According to the report, firearms were the most common means used, causing 51.4 percent of all deaths by suicide. Hanging/strangulation/suffocation was the next most common means at 24.5 percent, with poisoning the next most common means at 15.5 percent.
 
One thing unique about the NVDRS study is that it looks at the “precipitating circumstances” of the deaths by suicide in nearly 90 percent of the cases. In those cases where precipitating circumstances were analyzed, researchers found that that 46.2 percent of the deceased had a diagnosed mental health problem at the time of their death. Also, 34.8 percent of them left a suicide note, 32.4 percent had a history of suicidal thoughts or plans, 19.7 percent had a history of previous suicide attempts, and 25.7 percent had disclosed suicidal ideation to another person.
    
The NVDRS provides the CDC with one of the most in-depth studies on violent deaths and allows them to better understand the common variables that lead to violent deaths such as suicides and homicides. The four goals of the NVDRS are:
·         Collect and analyze timely, high-quality data for monitoring the magnitude and characteristics of violent deaths at national, state, and local levels;
·          Ensure data are disseminated routinely and expeditiously to public health officials, law enforcement officials, policymakers, and the public;
·         Ensure data are used to develop, implement, and evaluate programs and strategies that are intended to reduce and prevent violent deaths and injuries at national, state, and local levels; and
·         Build and strengthen partnerships among organizations and communities at national, state, and local levels to ensure that data are collected and used to reduce and prevent violent deaths and injuries.
 
For more information on the study, titled “Surveillance for Violent Deaths – National Violent Death Reporting System, 17 States, 2013,” visit: http://www.cdc.gov/mmwr/volumes/65/ss/ss6510a1.htm?s_cid=ss6510a1_e

CDC Releases Report on Suicides by Occupation

The Centers for Disease Control and Prevention has released its most comprehensive study yet on suicide rates by occupational groups, expanding the information of what jobs might have higher risks for suicide.
 
The report provides new light on suicide rates by occupations, but more importantly it advocates for increased community connectedness, enhanced social support, access to preventative services, and the reduction of stigma to help-seeking in the workplace.
 
While released July 1, the study focuses on deaths by suicide of people aged 16 and older in 17 states that were reported in the CDC’s National Violent Death Reporting System in 2012. Researchers split occupations into 30 categories and analyzed the deaths by suicide of men and women, a first-time and robust effort by the CDC.
 
The report finds that people working in the “farming, fishing, and forestry” category had the most deaths by suicide per capita of any occupation for men. Women in the “protective services” category, such as police officers and firefighters, had the most deaths by suicide per capita of any occupation for women.
 
“Occupational groups with higher suicide rates might be at risk for a number of reasons, including job-related isolation and demands, stressful work environments, and work-home imbalance, as well as socioeconomic inequities, including lower income, lower education level, and lack of access to health care,” according to the report.   
  
The report advocates for increased workplace approaches to suicide prevention. It states that workplace wellness programs for supervisors and employees can help them intervene on behalf of coworkers if they are exhibiting signs of suicidal ideation. Employee assistance programs can also help serve as gateways to behavioral health treatment. The report also suggests employers make online screening tools available and web-based prevention tools to increase awareness of mental health issues.
 
“Evidence-based suicide prevention strategies implemented in the workplace have the potential to reduce the numbers of suicides among all occupational groups,” according to the report.
 
The CDC hopes to expand on its research in the coming years to have a better idea what risks may be attributed to certain occupations. The National Violent Death Reporting System expanding from 17 states in 2012 to 32 states in 2014. The CDC plans to look at those figures in the future in the hopes of examining occupational trends over time.
 
To view the report visit: http://www.cdc.gov/mmwr/volumes/65/wr/mm6525a1.htm?s_cid=mm6525a1_e

Researchers Conclude Historical Trauma Led to Canadian Inuit Suicides

Scientists have concluded that the rapid rate of suicide among the First Nation Inuit of the Nunavut territory of Canada is likely due to a change in the intensity of social detriments, including historical trauma. As a result of the intergenerational transmission of historical trauma, they are seeing a measurable increase in the rates of emotional, physical, and sexual abuse, violence, and alcohol and substance abuse.
 
The Partners in the Nunavut Suicide Prevention Strategy released the Nunavut Suicide Follow-Back Study: Identifying the Risk factors for Inuit Suicide in Nunavut in 2013 titled Learning From Lives That Have Been Lived that details the increasingly high rates of suicide in the territory. The rate of suicide among the Inuit people of the territory has dramatically increased over the prior three decades, being just over 120 per 100,000 at the time the report was released, or roughly 10 times the Canadian suicide rate.
 
The study looked retrospectively into the lives of the 120 people that died by suicide in the territory from 2003-2006 as well as those with comparable backgrounds who are still living to better understand the risk and protective factors associated with suicide. Researchers conducted 498 interviews with friends and families, as well as with 120 living individuals that came from the same community of origin, had similar dates of birth, and were the same gender as the deceased. The age range of the deceased ranged from 13-62 in the study, and concluded that the average age of the individuals that died by suicide was 24.6 years old and that the majority of the deceased were male. The authors of the study wrote that they followed strict privacy guidelines to ensure that the anonymity of the individuals studied, their families, and their communities, is preserved.
 
The study concluded that there were significant demographic differences between the suicide and comparison groups, including:
·         More individuals in the comparison group were married or in a common-law relationship, whereas more individuals in the suicide group were single;
·         More individuals in the comparison group were employed or in school and more individuals who died by suicide were unemployed;
·         Individuals in the suicide group were more than twice as likely to have been involved in legal problems compared to the living individuals;
·         Individuals who died by suicide were almost four times as likely to have had less than 7 years of education than the comparison group.
 
The study also concluded that those that died by suicide and those in the comparison had differences in childhood experiences, including:
·         Significantly more individuals in the suicide group had experienced childhood abuse (47.5%) than the comparison group (27.5%);
·         Significantly more individuals in the suicide group had been physically and/or sexually abused (21.6% and 15.8% respectively) in childhood than the comparison group (13.3% and 6.7% respectively).  
 
Researchers asked the interviewees to complete the Barratt Impulsiveness Scale in order to determine how the suicide and comparison groups differed in impulsivity, and concluded that those that died by suicide showed significant higher rates of impulsiveness. The same was shown with aggression when the interviewees completed the Brown Goodwin Lifetime History of Aggression scale.   
 
The study also concludes that the rates of mental illness and substance abuse were significantly higher amongst those that died by suicide. While approximately 8% of the general Canadian population will experience major depression at some point in their lifetime, 61% of the 120 people studied that died by suicide were diagnosed with a major depression disorder opposed to 24% of the comparison group. The study also found that significantly more of those that died by suicide used marijuana, and nearly twice as many were diagnosed with a current alcohol abuse or dependence disorder than the comparison group. The suicide group also had significant differences than the comparison group when it came to personality disorders, including more with borderline personality disorder, conduct disorder, and antisocial personality disorder.
 
The report also concludes that those that died by suicide had accessed mental health services more than the comparison group. Twice as many individuals who died by suicide took psychiatric medication than the comparison group, however, the majority of individuals did not take psychiatric medication (80%). And twice as many that died by suicide were hospitalized for a psychiatric illness compared to the comparison group.
 
The Partners in the Nunavut Suicide Prevention Strategy is a partnership between Nunavut Tunngavik Inc., Embrace Life Council, Government of Nunavut, Canadian Institutes for Health Research, Nunavut Coroner’s Office, Royal Canadian Mounted Police, McGill University and Douglas Mental Health University Institute. The group is working to better utilize resources in the territory after concluding that unemployment, childhood maltreatment, sexual abuse, impulsiveness, aggression, depression, and substance and alcohol abuse are risk factors for Inuit suicide in Nunavut. The group’s vision for the study is that it will help de-normalize suicide in the territory and bring the rate down to the Canadian average, or hopefully, below the national rate.
 
To review the study visit: https://alaskaindigenous.files.wordpress.com/2012/07/learning-from-lives...

National Guide Advocates for Police Mental Health Wellness Programs

A new national guide has been released advocating that all police departments implement mental health wellness programs for their officers and building resiliency within their agencies in case of a mass casualty event.
 
The U.S. Department of Justice’s Office of Community Oriented Policy Services and the National Alliance on Mental Illness partnered in the wake of the 2012 Sandy Hook Elementary School shooting in Newtown, Conn. to create the comprehensive guide on how to prepare for, react to, and deal with a mass casualty event in any community. While the guide, Preparing for the Unimaginable: How chiefs can safeguard officer mental health before and after mass casualty events, is primarily geared toward law enforcement agencies and officers, it addresses the roles of all emergency responders.
 
NAMI reached out to the Newtown Police Department in the days after the tragedy that left 26 dead, including 20 first-grade students, to offer support services for its officers and first responders. Newtown Chief of Police John Edwards explained that with all of the demands, pressures, and stresses facing his department in the immediate aftermath, the best support they could provide was to create a comprehensive best-practices guide on how departments should handle a mass casualty event - because there was not one currently available.
 
“U.S. law enforcement has learned from tragic events over the years and now trains to respond to threats with the best equipment and practices known today,” Edwards writes in the introduction to the guide. “However, many chiefs are not prepared to deal effectively with the intense scope and unanticipated duration of the aftermath of these events, and many chiefs are unaware of the impact such events will have on their communities and the officers in their agencies.”
 
Edwards goes on to explain that without a mental health wellness program and proper mental health services in place for officers, cumulative stress or a mass casualty event can lead to post-traumatic stress disorders and other mental health issues among law enforcement officers.
 
“Protecting the health and wellness of officers under our command is as important as any training an officer gets throughout his or her career,” he writes. “Our officers make many sacrifices during their careers, and their emotional well-being should be among our top priorities.”
 
The 162-page guide is a call to action for all police departments and Sheriff’s departments to be prepared in case of a mass casualty event, which it highlights are statistically rare, and to have the tools and infrastructure in place in the rare case of such an event. The guide is organized in three parts: Why Mental Wellness Matters to You and Your Agency; Preparing for a Mass Casualty Event; and, Managing a Mass Casualty Event and its Aftermath. The guide, created by a team of law enforcement officials, mental health professionals, and physicians, also has an appendix with handouts and other resources that can be used and distributed in the event of a mass casualty event.
 
The authors acknowledge that the guide provides a roadmap of best practices on how to plan for and respond to a mass casualty event and understand that different communities and agencies might have other policies and procedures in place that might be in conflict with recommendations in the guide. The guide is designed to have two main functions; as a planning and preparation document, as well as a playbook in how to effectively respond to a mass casualty event in the event a comprehensive plan is not already in place. The main outcome the authors hope the guide will achieve is that it will create dialogue about law enforcement officer wellness and to support chiefs that will inevitably face mass casualty events in the future.
 
The authors strongly recommend that all law enforcement agencies form a work group to recommend officer wellness programs and education. They say having such programs in place can help build resiliency within departments and cut down on future costs like mental health disability claims. They recommend the work groups include command staff, supervisors, union leadership, mental health providers affiliated with the agency, and mental health providers from the broader community. It recommends each work group task itself with four essential roles:
 
• networking with mental health providers;
• assessing what sort of wellness education officers need;
• making recommendations about ongoing officer wellness programs; and,
• making recommendations about changes to policy related to psychological services after critical incidents.
 
The authors note that law enforcement officers are generally strong willed and resilient individuals, but that no one is immune from potential incidents that could trigger mental illness.
 
“While they may be more resilient, law enforcement officers also quietly deal with an outsized share of our society’s violence and death,” they write. “As a result, too many officers struggle with alcoholism, post-traumatic stress disorder, and depression. It has become increasingly evident to police leaders that every officer deserves support to deal with the stresses and horrors that are part of the job.”
 
To view the report visit: http://www.nami.org/About-NAMI/Publications-Reports/Public-Policy-Reports/Preparing-for-the-Unimaginable/Preparing-For-The-Unimaginable.pdf
 
 
 
 
      

Alaska Postvention Guide Videos Now Available on YouTube

Families and communities often don’t know where to access resources after a death by suicide, but there are a number of postvention resources available in Alaska. Postvention, the act of responding to a death by suicide, is a topic the State of Alaska has focused extensively on in recent years.
 
In 2014, the Statewide Suicide Prevention Council in partnership with the Department of Health and Social Services’ Division of Behavior Health created the Alaska Suicide Postvention Guide: Preparing to Heal to help communities and families in the wake of a suicide. In 2015, the Council and DBH again teamed up to create an accompanying DVD as an extra resource, titled Helping Our Communities Heal: Alaska Suicide Postvention. The entire video can now be viewed on YouTube in 14 installments.
 
The videos talk people through the concept of postvention, how to appropriately respond in the first 72 hours, and how to create a community postvention plan. Six of the videos are directed toward specific groups, including family members and close friends, community behavioral health providers, faith communities and clergy, funeral directors and memorial officiants, schools, and members of the media.
 
There are also four short interviews to provide additional insight on key aspects of postvention. Council member Barbara Franks provides her experience as a survivor of suicide loss. Former Council member and licensed clinician Sue May explains how to take care of yourself after a suicide occurs. Council member Sen. Berta Gardner provides a message for first responders. And Tony Hopfinger of the Alaska Dispatch News discusses the role of the media when reporting on suicide. In addition, Sen. Lisa Murkowski provides an introduction that highlights the issue of suicide in Alaska and why suicide prevention, intervention, and postvention are important.  
 
To watch the videos visit the following links:
Section 1: A message from Senator Lisa Murkowski. Part 1 of 14 https://www.youtube.com/watch?v=93eW07HJpCk
Section 2: Chapter One: Introduction. Part 2 of 14 https://www.youtube.com/watch?v=v11kEikV7rw
Section 2: Chapter Two: The first 72 Hours. Part 3 of 14 https://www.youtube.com/watch?v=8P6Z5amPYko
Section 2: Chapter Three: Postvention Planning: Next Steps. Part 4 of 14 https://www.youtube.com/watch?v=EtsP5kHJ25k
Section 3: Family Members and Close Friends. Part 5 of 14 https://www.youtube.com/watch?v=z4_PDEmtz6g
Section 3: Community Behavioral Health Providers. Part 6 of 14 https://www.youtube.com/watch?v=FAXLZ_mKxeQ
Section 3: Faith Communities and Clergy. Part 7 of 14 https://www.youtube.com/watch?v=bYUC8nvvze8
Section 3: Funeral Directors and Memorial Officiants. Part 8 of 14 https://www.youtube.com/watch?v=0kKSkfemEcE
Section 3: Schools. Part 9 of 14 https://www.youtube.com/watch?v=ajqf3svs6N4
Section 3: Members of the Media. Part 10 of 14 https://www.youtube.com/watch?v=uc20QjMC3nA
Interviews: Barbara Franks “Survivor of Suicide Loss.” Part 11 of 14 https://www.youtube.com/watch?v=eU3wu0AwEfc
Interviews: Sue May “Taking Care of Yourself.” Part 12 of 14 https://www.youtube.com/watch?v=WH2G6PZuThM
Interviews: Berta Gardner “A Message for First Responders.” Part 13 of 14 https://www.youtube.com/watch?v=YqvUsh-hxW0
Interviews: Tony Hopfinger “Role of Media.” Part 14 of 14 https://www.youtube.com/watch?v=by7Lf1es4bU
 
To view or download the postvention guide, visit: http://dhss.alaska.gov/SuicidePrevention/Documents/pdfs_sspc/Postvention.pdf

Teen Suicide Prevention Grant Applications Announced

 

(Anchorage, ALASKA) – The Alaska Children’s Trust and The Alaska Community Foundation are currently accepting applications for projects that will directly enhance community-based efforts to prevent teen suicide. Communities across Alaska are encouraged to apply. The application deadline is Monday, February 15, 2015 at 5 p.m.
 
Preference will be given to projects that: (1) incorporate strategies outlined in the Alaska State Suicide Prevention Plan FY 2012-2017; and (2) empower Alaskans to work together to promote community wellness. Grants will fund activities that encourage Alaskans to take responsibility for preventing teen suicide, give Alaskans the tools they need to respond to teens at risk of suicide, and encourage Alaskans to work together and collaborate on this important issue. Activities should focus on promoting physical, mental and spiritual wellness to prevent teen suicide in Alaska. Organizations may be awarded grants in amounts varying between $2,000 and $5,000. Matching funds are encouraged.

“Building strong and supportive communities for our youth requires all of us to work together,” states Nina Kemppel, President & CEO of The Alaska Community Foundation. “We are honored to work together with state and private funding to prove that – when Alaskans come together, we can accomplish great things.”

For more information or if you have questions about applying, visit www.alaskacf.org/grants or call Katie St. John at (907) 334-6700.

 

Established in 1995, The Alaska Community Foundation is a public nonprofit that connects people who care with causes that matter. Holding approximately $75 million in more than 360 funds for the benefit of Alaskans, ACF grants $3-4 million each year to charitable projects and nonprofit organizations across the state. Our mission is to transform gifts from Alaskans into an extraordinary contribution for our state’s future. For more information, visit www.alaskacf.org or call (907) 334-6700.

SSPC set to meet in Anchorage

The Statewide Suicide Prevention Council will hold its quarterly meeting January 11-13, 2016 in Anchorage. The meeting will be held in Conference Room 896 of the Frontier Building, located at 3601 C Street. The meeting is open to the public. To participate via teleconference dial 1-800-315-6338 and enter code 4656518#.
 
The meeting will convene at 1 p.m. on Monday, January 11, and will recess that day at 4:30 p.m. The meeting will reconvene at 9 a.m. on Tuesday, January 12, and recess at 4:30 p.m. On Wednesday, January 13, the meeting will reconvene at 9 a.m. and will adjourn at 12:15 p.m.
 
Public comment will be held from 2:15-3:15 p.m. on Monday, January 11. People can participate in public comment in person or over the phone by dialing 1-800-315-6338 and entering code 4656518#.
 
The focus of the meeting is to review the current Alaska State Suicide Prevention Plan and begin the process of working on the new state plan to be released in 2017. To view the agenda visit: http://dhss.alaska.gov/SuicidePrevention/Documents/pdfs_sspc/sspc_agenda_20160111.pdf
 
For more information contact Eric Morrison at (907) 465-6518 or eric.morrison@alaska.gov.

Increasing services for Alaska Native and American Indian service members, veterans, and their families

New efforts are underway to help reduce mental health stigma, substance abuse, and suicidal ideation amongst Alaska Native and American Indian service members, veterans, and their families.
 
The Substance Abuse and Mental Health Services Administration is partnering with sovereign tribal governments, state governments, and other federal agencies to support the healing of a population it says is underserved and needs more services. SAMHSA created the Office of Tribal Affairs and Policy in 2014 to improve the overall access to behavioral health and the effective delivery of services to tribal communities. SAMHSA recently hosted a webinar, “Working Together with Native Communities to Support the Healing of our Service Members, Veterans, and their Families,” to highlight those efforts.
 
According to SAMHSA, Alaska Natives and American Indians have higher rates of substance abuse (with the exception of alcohol) and mental health issues than the general population. Alaska Natives and American Indians have also served at a higher rate in the Post-9/11 service period than veterans of other races. Alaskan Native and American Indian veterans also have lower personal income than other races, and are more likely to not have medical insurance.
 
Seprieono Locario, Tribal Action Plan and Wellness Coordinator of SAMHSA’s Tribal Training and Technical Assistance Center, said during the webinar that more can be done to help provide mental health resources to Alaska Native and American Indian service members, veterans, and their families. There is a need for more collaboration, he said, including strengthening relationships between tribes and states, commitments from tribes to their veterans, collaboration between tribes, and creating new laws and policies to support innovative and collaborative efforts. Peer-to-peer support amongst veterans is also greatly needed.
 
Locario advocated for creating opportunities to strengthen relationships between sovereign tribal governments and state governments to increase mental health services for Alaska Native and American Indian service members, veterans, and their families, many of whom live in rural areas with less immediate access to the services they need. There is a need to formalize comprehensive services for veterans in those rural areas, and he recommends tribal and state government-to-government consultation in order to change policies. States can also promote veteran wellness by increasing cultural resources and practices and integrating them into their behavioral health systems.
 
Locario also noted that tribes making commitments to their veterans can also help strengthen the safety net for those that may be experiencing a mental illness. Things such as publically acknowledging military service at tribal events and gatherings, having returning home ceremonies, and tribal peer-to-peer veteran services can help overall community wellness.
 
Lieutenant Colonel John Frederikson, retired from the U.S. Airforce and now a professor at the University of Montana, presented during the webinar about the unique challenges veterans face in Montana and how to effectively respond in rural areas of the state. Mutually respectful partnerships between tribal and state organizations are crucial to success, he said.
 
In the past there have been instances where government or university researchers have exploited tribes. That is still a concern today of well-intentioned but culturally uninformed researchers, he said. Being that tribes exist as sovereign nations, it is their responsibility to determine the type of research that serves their tribal members, and any research outcomes or products should be the property of the tribes.
 
Montana, which has the second largest veteran population in the country, has some unique issues due to the number of tribes in rural areas. There is a lack of readily accessible psychological and other mental health support services in the rural parts of the state as well as a lack of funding for services. However, Montana does have a primary Veterans Affairs hospital at Ft. Harrison in Helena, as well as four Regional Vet Centers, and 12 VA clinics, and most veterans are within 2 hours of one of the locations.
 
Suicide remains a high risk in tribal communities in Montana, Frederikson said, and is often associated with poverty. On one reservation over a 5-year period, approximately 50 percent of suicide calls involved a veteran or his or her children. Protective factors need to be increased to help address the problem, he said. Those include cultural beliefs that discourage suicide and support resilience, greater connections to the land, positive role models and mentors, and healthy and safe peer activities.
 
For more information on SAMHSA’s Service Members, Veterans, and their Families Technical Assistance Center email smvftacenter@prainc.com .

How to talk about suicide after the fact

Alaska Public Media has produced a roundtable segment on "How to talk about suicide after the fact" with staff from the Alaska Dispatch News and suicide prevention and postvention trainer Eric Boyer of the University of Alaska Anchorage. To view the video follow this link: https://www.youtube.com/watch?v=65dMPLS5kIk.

Information Requested for Annual Implementation Report

The Statewide Suicide Prevention Council is presently working on the 2015 Casting the Net Upstream Implementation Report. The Council is requesting input from the public to be included in the report. Any information about suicide prevention, intervention or postvention efforts, trainings or events is being requested from the public to add to the content of the report. Please contact Council assistant Eric Morrison at eric.morrison@alaska.gov or (907) 465-6518 if you have any information to help contribute to the annual report.

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