Call to Action: Suicide Prevention in Tompkins Healthcare

Jenna Heise, who became the director of suicide prevention implementation for New York State earlier this year, tells of a powerful moment in her work during her previous position at Texas Health and Human Services.

She was attending a high school event in Corpus Christi where a young man spoke. He had been treated for suicidality at a hospital that practiced Zero Suicide, a suicide prevention model for healthcare systems. “The principal come up and said, with tears in her eyes, ‘That young man, he’s alive because of you,’” Heise recalled.

Heise, widely recognized for her work in advancing the Zero Suicide Model in Texas and beyond, related the story during “Call to Action: Suicide Prevention in Healthcare,” a special presentation on the Zero Suicide Model for Tompkins County’s healthcare leaders sponsored by The Sophie Fund on November 16. The presentation via Zoom was attended by senior leaders from 11 hospitals, college health centers, and community behavioral health services, and a representative of the Tompkins County Suicide Prevention Coalition.

Heise used her Corpus Christi story to illustrate the potential of the Zero Suicide Model. “I did this in Texas, across 254 counties, in a statewide effort,” she said. “I know that you can do this. Yes, it works. I can’t tell you how many times I have heard from staff, how many times I’ve been on calls where I’ve heard from loved ones.”

She pointed to healthcare systems where Zero Suicide has been implemented with success, notably the Henry Ford Health System in Michigan. She said that within four years the suicide rate among its patients decreased by 75 percent. In some years the system recorded zero suicide deaths compared to an average 89 suicides per year previously.

Citing data that shows rising death rates, Heise called suicide a “public health crisis.” She said suicide was the second leading cause of death in the U.S. for people in the 10-14, 15-24, and 25-34 age groups, and the 10th leading cause of death overall. She referenced local data indicating that Tompkins County has averaged 12 suicide deaths per year in the past five years, and noted that each suicide tragedy impacts many other individuals such as family members, friends, colleagues, and peers.

Heise said that healthcare providers have traditionally treated suicidal patients in a fragmented approach, whereas the Zero Suicide Model brings together a framework of best practices for a more effective safety net for suicidal individuals seeking professional healthcare. The framework, she added, is based on “mind blowing” research into how to prevent suicide deaths.

“We don’t have to wonder what works,” she said. “We don’t have to throw the kitchen sink at it anymore. We can know what works, and we can use that.” She compared the promise of working more confidently with the Zero Suicide Model with her own experience as a young clinician, when she felt like “a deer in the headlights” when confronted with treating people who had made a suicide attempt.

She argued that it makes sense for prevention efforts to focus on medical providers because so many people who take their own lives are seeing healthcare professionals. She said that 80 percent of people who died by suicide had a healthcare visit in the year before their death. Forty-five percent had a primary care visit, 37 percent an emergency department visit, and  20 percent contact with a mental health service.

Heise quoted Michael Hogan, a former mental health commissioner for New York State and a co-developer of the Zero Suicide Model, saying, “We should treat suicide prevention in health care systems as we treat heart attack prevention.”

Heise walked the Tompkins healthcare leaders through the elements of the Zero Suicide framework, starting with the critical importance of top leadership. “When we talk about leadership, we’re talking about buy-in from the top down,” she explained. “We have to have leaders. Without every level of the agency working together with a consistent message and plan, it’s doomed to fail.”

Training staff in using evidence-based tools is essential, Heise said. She highlighted the importance of properly using the correct screening and assessment tools to identify suicidal individuals and provide them with an appropriate care plan. She noted that the model also calls for engaging patients through developing safety plans that provide them with coping skills for averting crises, and for the use of proven therapies for directly treating suicidality, such as Cognitive Behavioral Therapy for Suicidal Patients (CT-SP).

Ensuring safe transitions through care is another key element of the model, Heise said. This involves “warm handovers” when additional professional services are needed, and following up with suicidal individuals with “caring contacts” such as emails, texts, or postcards. Finally, she said, Zero Suicide calls for continuous attention to improving policies and procedures through data collection and other assessment measures.

“It’s a bundle of best practices that you use from the minute you meet the patient, all the way through their intake, their time with you, they’re getting ready to leave, and then the time they leave their care with you,” Heise said. “And then you follow up with them. It’s the entire continuum of care.”

Heise encouraged providers who have not already embarked on implementing the Zero Suicide Model to begin the process by conducting the Organizational Self-Study and Workforce Survey found in the model’s toolkit.

“Look at your organization as a whole, and where you are with certain best practices for suicide care,” she said. “The work force study is where you send out this blanket survey to all of the folks at your agency, to let you know what they know and don’t know.”

Heise said that Zero Suicide promotes a “just culture” in healthcare because it emphasizes the role of the system rather putting responsibility for suicide care and suicide deaths on individual clinicians. “We call it a preventable death, and what we mean by that is not that any of us could have stopped somebody from dying by our single efforts,” she said. “This is really looking at the bigger picture.”

Following Heise’s presentation, Scott MacLeod, co-founder of The Sophie Fund, announced planning for follow-up events to advance the Zero Suicide Model in Tompkins County; they included an expert briefing for healthcare managers and an introductory presentation for primary care practices.

The Sophie Fund proposed that Tompkins County healthcare leaders begin a formal and regular dialogue on Zero Suicide to share ideas and experiences, and to work on securing funding for a county implementation coordinator and training programs, MacLeod said.

He acknowledged the tremendous pressures and stress on healthcare providers amid the Covid-19 pandemic, but expressed hope that leaders will respond to the “Call to Action” with further efforts to implement the Zero Suicide Model.

“We are grateful for your work to improve suicide care in Tompkins County,” he said. “We invited our community’s top healthcare leaders to this ‘Call to Action’ today because leadership is the number one element of the Zero Suicide Model.”

The Sophie Fund launched a Zero Suicide initiative in 2017 by organizing an expert briefing on the model for local healthcare leaders. In 2017, the model was recommended by the Tompkins County Suicide Prevention Coalition and endorsed by the Tompkins County Legislature.

The Sophie Fund organized the November 16 Zero Suicide presentation to support the New York Office of Mental Health’s renewed focus on implementing the Zero Suicide Model and the U.S. Surgeon General’s 2021 Call to Action to Implement the 2012 National Strategy for Suicide Prevention.  

Among those attending Heise’s presentation were Frank Kruppa, director of the county Health Department and commissioner of Mental Health Services, and Harmony Ayers-Friedlander, deputy commissioner.

Other agencies represented were Cayuga Medical Center; Cayuga Health Partners; Guthrie Cortland Medical Center; Suicide Prevention and Crisis Service; Family & Children’s Service of Ithaca; MindWell Center LLP; REACH Medical; Cornell Health, Cornell University; Center for Counseling and Psychiatric Services, Ithaca College; and Health and Wellness Services and Mental Health Counseling, Tompkins Cortland Community College.

Kids Getting Bullied: What Adults Can Do

Bullying can have serious immediate and lasting harmful impacts on children, yet 64 percent of those who are bullied do not report the experience to an adult, according to Bailey Huston, coordinator of PACER’s National Bullying Prevention Center. Huston spoke at “Kindness, Acceptance, and Inclusion in the Age of Covid-19,” a webinar hosted by the Tompkins County Bullying Prevention Task Force on October 27 in a program marking National Bullying Prevention Month.

DOWNLOAD: Resources from PACER’S National Bullying Prevention Center

Huston reviewed the four main types of youth bullying: verbal bullying, using words to tease or harass; emotional bullying, such as manipulation, gossip, or exclusion; physical bullying, such as kicking, hitting, damaging or stealing property, or unwanted touching; and cyberbullying, using technology such as social media to hurt or harm.

“We all know that conflict is a normal part of a kids life, and it can be hard to figure out if it is bullying or just conflict,” Huston said. Yet, she added, it is crucial to understand the distinction. She explained that conflict is between individuals of equal circumstance who are not seeking to cause harm, whereas bullying involves a power imbalance where a perpetrator is not concerned about causing harm and may actually be motivated by a desire to control.

“Some common views about bullying are that ‘It’s part of growing up,’ ‘It makes you tough,’ ‘Kids will be kids,’ ‘It’s only only teasing,’” said Huston. “But bullying should not be part of growing up.” In fact, she argued, bullying can negatively impact a child’s education, health, and safety.

Students who are bullied may avoid going to school, which can cause a decline in academic performance and even dropping out, Huston said. Bullying can lead to stomach aches, headaches, and sleep problems, and emotional problems like depression and anxiety, she said. Finally, bullying behavior can result in physical harm to bullies and their targets, she said.

It is important to emphasize, Huston said, that bullying is a behavior, and behavior can be changed. The focus on addressing bullying should be on the behavior, and not the person, she said.

“We avoid using words like the ‘bully’ or the ‘victim,’” she explained. “Behavior like bullying can be changed. It is not a permanent part of who they are. This behavior does not have to define them. When you pull back those layers, we can see there are number of ways we can redirect the behavior in positive ways.”

Bailey advised parents to talk to children about bullying, and support and empower them if they are bullied. She encouraged parents to start a conversation with their children at a young age, and to provide constructive backup if and when they experience bullying. She said it is important for children to know that being bullied is not their fault and not their responsibility alone to stop the bullying. Huston said students should be encouraged to report bullying to a teacher or trusted adult, and advised against encouraging them either to stand up to the person bullying them or to just ignore the bullying.

Huston noted that PACER’s National Bullying Prevention Center provides a wealth of educational as well as support materials on its website.

To address a serious bullying problem, Huston suggested developing actions plans. She said a “Student Action Plan” can reflect on the issue and develop steps to change the situation. A “Parent Action Plan” should keep a record of incidents which should include any written information, the date of the event or events and person or persons involved, and their child’s own account of what happened, she said.

Additionally, Huston said, parents should decide on the best approach for taking action—for example, whether to approach school staff, health professionals, law enforcement, or other community members about the problem. She said parents should learn their legal rights in the situation, and know the procedures for reporting a problem. Many schools have specific procedures for reporting incidents, but Huston noted that Pacer’s website provides a template letter that parents can use as well. (Click here to download).

For more resources, click here for The Sophie Fund’s bullying prevention page.

A Parent’s Guide to College Student Mental Health

Sending kids off to college is an exciting experience for many parents. Naturally, our focus is on the wonderful opportunities they will have, as we look with pride upon their promising passage into adulthood. But these stressful times require parents to also fully grasp the serious mental health challenges their students may face, and be equipped to provide support.

DOWNLOAD: A Parent’s Guide to College Student Mental Health (PDF)

What do parents need to know?

Though some may hide or downplay it, rates of depression and anxiety are high among college students. Many students carry suicidal thoughts. Sexual assault is prevalent among college students. Hazing violence as an initiation rite at fraternities and some student organizations is a serious problem. All of these conditions pose greater risks for students who arrive on campus already with a mental health disorder. College psychological counseling centers are typically overwhelmed by demands for appointments, and navigating community mental health services and insurance coverage can exacerbate the stress.

In short, student mental health can be a complicated matter, and failing to deal with it adequately can lead to serious consequences.

“Mental health problems can affect many areas of students’ lives, reducing their quality of life, academic achievement, physical health, and satisfaction with the college experience, and negatively impacting relationships with friends and family members,” says the Suicide Prevention Resource Center (SPRC). “These issues can also have long-term consequences for students, affecting their future employment, earning potential, and overall health.”

Making matters worse, research is finding that Covid-19 pandemic conditions have caused a spike in stressors among college students. A survey of 2,086 college students conducted at the beginning of the pandemic by Active Minds showed that 80 percent felt Covid-19 had “negatively impacted” their mental health, and 20 percent said their mental health had “significantly worsened.”

A study in Spring 2020 showed a moderate-to-severe level of depression in 48.14 percent of survey participants, a moderate-to-severe level of anxiety in 38.48 percent, and 18.04 percent with suicidal thoughts. More than 70 percent indicated that their stress/anxiety levels had increased during the pandemic.

Another study in mid-2020 found that the prevalence of moderate-severe anxiety increased from 18.1 percent of first-year students before the pandemic to 25.3 percent within four months after the pandemic began; and the prevalence of moderate-severe depression increased from 21.5 percent to 31.7 percent.

Additional specific data to know:

  • 52.7 percent of college students surveyed reported that academics have been “traumatic or very difficult to handle,” and 19.8 percent “felt so depressed that it was difficult to function” in the past 12 months, according to the Spring 2019 National College Health Assessment; 9.3 percent seriously considered suicide in the last 12 months, and 1.6 percent had attempted suicide.
  • 36.9 percent of surveyed college students seeking counseling in the 2019-2020 academic year had experienced “serious suicidal ideation,” (up from 24 percent in the 2010-11 academic year who “seriously considered attempting suicide”), according to the Center for Collegiate Mental Health 2020 Annual Report; 10.9 percent of the students seeking counseling had actually made a suicide attempt.
  • 15.6 percent of female seniors (or higher) participating in the Association of American Universities 2019 Campus Climate Survey on Sexual Assault and Sexual Misconduct reported being raped (“completed penetration using physical force or the victim was unable to consent or stop what was happening”) since enrolling in college.
  • In the past month, 23.9 percent of college students used illicit drugs, and 33 percent engaged in binge alcohol drinking, according to a 2019 study by the Substance Abuse and Mental Health Services Administration (SAMHSA).

When parents do fully grasp the scope of the challenges, then they need to understand the risk factors and warning signs for a mental health crisis, and how to support their students if they should exhibit cause for concern. Help can range from staying connected with moral support and positive encouragement to evaluating and navigating mental health treatment options at the college counseling center, in the community, or back home during a health leave of absence.

McLean Hospital, a psychiatric teaching hospital of Harvard Medical School, provides these basic tips for parents:

  • Prepare Your Child for the Unexpected
  • The Importance of Staying in Touch and Validation
  • Encourage Healthy Habits
  • Make Room for Mistakes
  • Have a Plan Focused on Student Mental Health
  • Learn About College Mental Health Services
  • If a Student Is Struggling, Get Help Immediately

List of helpful resources curated by The Sophie Fund for supporting your Ithaca-based college student’s mental health:

Mental Health

Risk Factors, Protective Factors, and Warning Signs, American Foundation for Suicide Prevention

Mental Health Conditions, National Alliance on Mental Illness

Parents

Parent and Family Guide: Supporting Your College Student Through Mental Health Challenges, Forefront Suicide Prevention

Set to Go: For Families, The JED Foundation

Set to Go: The Transition, The JED Foundation

A Parent’s Guide to College Student Mental Health, McLean Hospital

Mental Health in College, National Alliance on Mental Illness

Life on Campus, Mental Health America

What Parents Need to Know: #GoodforMEdia’s Guide to Social Media, Center for Youth Mental Health and Wellbeing, Stanford University

College Depression: What Parents Need to Know, Mayo Clinic

Cornell University and Ithaca College

Cornell University: Families of New Students

Cornell University: How to Support Your Student

Cornell University: Family Guide 2021-2022

Ithaca College: Guiding a First-Year College Student

College Mental Health Reports

Mental Health Review Final Report April 2020, Cornell University

“Commending Cornell’s Mental Health Recommendations,” The Sophie Fund

“Recommendations for Improved Student Mental Health at Cornell University,” The Sophie Fund

“Aiming for a Student Mental Health Gold Standard at Cornell University,” The Sophie Fund

Report of the Task Force on Managing Student Mental Health July 2020, Harvard University

Task Force on Student Mental Health and Well-being, Office of the Provost, February 2018, Johns Hopkins University

The Healthy Minds Study

Depression, Anxiety, Loneliness Are Peaking in College Students, The Brink, Boston University

Center for Collegiate Mental Health 2020 Annual Report

The Association for University and College Counseling Center Directors Annual Survey 2018

National College Health Assessment Spring 2019, American College Health Association

Supporting Students: A Model Policy for Colleges and Universities, Judge David L. Bazelon Center for Mental Health Law

Addressing the Mental Health Needs of Students on College Campuses, Judge David L. Bazelon Center for Mental Health Law

Mental Health on College Campuses: Investments, Accommodations Needed to Address Student Needs, National Council on Disability

Behavioral Health Among College Students, Substance Abuse and Mental Health Services Administration (SAMHSA)

Suicide

Suicide among College and University Students in the United States, Suicide Prevention Resource Center

Consequences of Student Mental Health Issues, Suicide Prevention Resource Center

Sexual Assault

2020 Report on the AAU Campus Climate Survey on Sexual Assault and Sexual Misconduct, Association of American Universities

Campus Sexual Violence, Rape, Abuse & Incest National Network (RAINN)

Hazing

Hazing in View: College Students at Risk, National Study of Student Hazing 2008

Substance Use

College Drinking, National Institute on Alcohol Abuse and Alcoholism

Substance Abuse In College Students: Statistics & Addiction Treatment, American Addiction Centers

Recent Media Articles

“Did Covid Break Students’ Mental Health?,” October 14, 2021, The Chronicle of Higher Education

“College students struggle with mental health as pandemic drags on,” Washington Post, October 14, 2021

“A ‘Breaking Point’ in Campus Mental Health,”  July 15, The Chronicle of Higher Education

DOWNLOAD: A Parent’s Guide to College Student Mental Health (PDF)

Ithaca Cupcakes 2021: Special Awards

Contestants in the 6th Annual Ithaca Cupcake Baking Contest wowed the judges with their recipes, originality, craftsmanship, and creativity delivered in their photos, videos, and stories. Congratulations to winners of the Special Awards!

Yummiest Shark Fins Award

Lionel Bakum

Lights, Camera, Action! Award

Emily Rosato

It’s a Great Pumpkin Award

Henry Bowes

Sommelier Award

Heather Lee Williams

Necessity Is the Mother of Confection Award

Stacia Humby

Cupcakes Are Gorges Award

Eleanor Gabler

True to Yourself Award

Patti Meyers and Hudson

Cherry On Top Award

Shauna Defone

Apple of My Eye Award

Ann Phelan

It’s About Thyme Award

Takoda Warner

Chocolate Happiness Award

Holly Taylor

Lionel Bakum’s Pretty Darn Yummy Cupcakes

Emily Rosato’s Salted Caramel Chocolate Cupcakes

Henry Bowes’s Pumpkin Spiced Latte Cupcakes

Heather Lee Williams’s Partners in Wine Cupcakes

Stacia Humby’s Chocolate Cherry Almond Cupcakes

Eleanor Gabler’s Waterfall Cupcakes

Patti Meyers and Hudson’s Pillsbury Lemon Cupcakes

Shauna Defone’s Chocolate Cherry Cordial Cupcakes

Ann Phelan’s Spiced Apple Pie Cheesecake Cupcakes

Takoda Warner’s Vegan Orange Lemon Cupcakes

Holly Taylor’s Super Moist Chocolatey Cupcakes

Ithaca Cupcakes 2021: Honorable Mention Awards

One of the judges in the 6th Annual Ithaca Cupcake Baking Contest commented that the entries were too beautiful to eat. That certainly goes for the seven cupcake submissions that received Honorable Mention awards.

Kudos and thanks to all 24 contestants—you are the best in every way!

Honorable Mention awardees are presented with $25 gift certificates from the Downtown Ithaca Alliance.

Honorable Mention

Aušra Milano

Effat Rahman

Kelly and Rosemary Rowland

Tamarynde Cacciotti

Debbie Barbash

Simon LeRoux

Annika Donlick

Aušra Milano’s Brown Butter Carrot Cupcakes: Brown butter carrot cake with cream cheese frosting and candied carrot roses

Effat Rahman’s Corpse Bride Cupcakes: Earl Grey-infused Victoria sponge cake filled with blueberry-lemon jam and topped with blue whipped cream, paper butterflies, paper flowers, and sugar pearls

Kelly and Rosemary Rowland’s Dark Chocolate Peanut Butter and Jelly Surprise Cupcakes: Rich dark chocolate cake coated with a thin layer of jam with peanut butter frosting and a miniature peanut butter cup buried inside

Tamarynde Cacciotti’s Crème Brûlée Cupcakes: Vanilla-flavored cake with sugar lace and handmade gum paste flowers

Debbie Barbash’s Tropical Paradise! Cupcakes: Vanilla-flavored cake topped with creamy mango frosting, sprinkled with coconut flakes and dry mango pieces

Simon LeRoux’s Vanilla Lavender Cupcakes: Vanilla and lavender-flavored, mushroom-shaped cake with a honey buttercream frosting and marzipan snails and spots

Annika Donlick’s Fall Harvest Double Chocolate Cupcakes: Chocolate cake with decadent chocolate frosting and homemade fondant hand-sculpted into pumpkins, apples, corn, and zucchini