Walking for Hope and Change

More than 200 people raised over $30,000 in the 11th Annual Greater Ithaca Out of the Darkness Walk on September 9 organized by the American Foundation for Suicide Prevention’s Greater Central New York Chapter.

2023 Out of the Darkness Walk at Myers Park

The walk, which took place in Meyers Park in Lansing on the edge of Cayuga Lake, is among 400 held across the country every year designed to raise awareness and collect funds for research, training, and programming.

This year’s Greater Ithaca walk was held during National Suicide Prevention Awareness Month. Walkers included many people who lost a loved one, friend, or colleague to suicide.

L³ Lisa’s Lagomorph Legion was the top fundraising team this year, collecting $6,285. Team Hope brought in $3,507; Jack’s Pack $2,377; Team 22 $1,150; and CFCU Standing with Stacy $1,110.

To add a donation to AFSP, click here

“Our mission, to save lives and bring hope to those affected by suicide, would not be possible without each of you,” Crystal Howser, the walk chair, said in remarks kicking off the event.

Howser said that she volunteers with AFSP to remember and honor the memory of her father, Jerry Howser, and the many others who lost their battle to depression and other mental illnesses. 

“We strive to be a source of strength for our community and let everyone know they are not alone,” she added. “On this journey, strangers turn into friends and friends turn into family as we connect with one another and navigate through our grief. Together, we are strong. Together, we are making a difference.”

AFSP’s Cheyanne Scholl, Crystal Howser, and Karen Heisig

Dave Ashton, morning host on Ithaca’s WYXL-FM, said that suicide is the eleventh leading cause of death in the United States and can no longer be swept under the rug.

“By showing up today, you are sending the message that mental health is as real as physical health. You are sending the message that reaching out for help is the strong thing to do. Suicide is a health issue that affects all of us,” he said.

Scott MacLeod, co-founder of The Sophie Fund, a mental health advocacy organization in Ithaca, said that the most recent statistics indicate a 5 percent increase in the national suicide rate in 2021 and 2.6 percent increase in 2022.

But he cited contributions to greater local suicide prevention efforts, by AFSP as well as the Tompkins County Suicide Prevention Coalition, Suicide Prevention & Crisis Service, Cayuga Health System, and others. He said that medical providers are working toward implementing the Zero Suicide Model, a quality improvement program designed to more effectively identify at-risk individuals and close gaps in in their care management.

The 2023 walk was sponsored by:

CFCU Community Credit Union; The Strebel Planning Group’s Fund for Community Enrichment; Suicide Prevention & Crisis Service; Maguire Automotive; Borgwarner; Pizza and Bones; Lansing Funeral Home; Ithaca Beer Company; Texas Roadhouse; Moore Family Farm; Cayuga Health System; Visions Federal Credit Union; Lansing Redemption Center; Cayuga Lake National Bank; Tioga State Bank Foundation; Ithaca Apartment Management/Solomon Organization; Antlers Restaurant; GreenStar Food Co+op.

Town Hall: How Healthcare Helps Prevent Suicides

The Tompkins County Suicide Prevention Coalition will host “How Healthcare Helps Prevent Suicides,” a community town hall to discuss local efforts to implement the “Zero Suicide” model for improving healthcare support for at-risk individuals.

The town hall, at the Greater Ithaca Activities Center (GIAC) on September 28 from 5:30 p.m. – 7:30 p.m., will feature panel discussions about why suicide is a public health challenge and how the Zero Suicide model is used by healthcare systems to prevent suicide deaths.

Whole Health Commissioner Frank Kruppa will kick off the town hall with opening remarks.

Organizations serving as presenters and panelists include: Tompkins County Mental Health Services; Cayuga Health System; Cayuga Medical Associates; Guthrie Medical Group, Cortland; Cornell University; Ithaca City School District, Alcohol and Drug Council; U.S. Department of Veterans Affairs; Suicide Prevention & Crisis Service (988 Call Center); Cayuga Addiction Recovery Services; Smile Through the Storms; and The Sophie Fund.

In addition, Coalition work groups will give brief presentations on their work to improve suicide data collection and analysis, prevent suicides among young people, and reduce access to lethal means within at-risk populations.

Several local mental health agencies and organizations will provide information tables with staff who can answer questions. They include: Tompkins County Whole Health; Tompkins County Office of Veterans Services; U.S. Department of Veterans Affairs; Mental Health Association in Tompkins County; Suicide Prevention & Crisis Service (988 Call Center); American Foundation for Suicide Prevention Greater Central New York; and the National Alliance on Mental Illness Finger Lakes.

Zero Suicide is an emerging suicide prevention model designed to save lives by closing gaps in suicide care in healthcare as well as behavioral health settings.

The model calls for systematic use of screening for self-harm, safety planning for patients deemed at risk, referrals to appropriate levels of further care, safe transitions of care between providers, and evidence-based treatment for suicidality, among other tools.

“We recognize the critical role of healthcare in preventing suicide deaths,” said Zoe Lincoln, Whole Health Planner with Tompkins County Whole Health and Coordinator of the Tompkins County Zero Suicide Steering Committee, a collaborative group of local healthcare leaders. “The Town Hall highlights county-wide dedication to saving lives through evidence-based best practices, via the Zero Suicide Model. Together, we strive to elevate the standard of care and support for our community members in need.” 

Implementation of Zero Suicide across local healthcare is one of the objectives listed in the Coalition’s 2022-2025 Strategic Plan. In 2022, leaders from community and campus healthcare providers formed the Tompkins County Zero Suicide Steering Committee to lead and coordinate efforts.

The Tompkins County Suicide Prevention Coalition was formed in 2017 and is comprised of health agencies, community organizations, and individual members who share a determination to prevent suicide deaths in the community.

“We are excited to present this Town Hall with a focus on Zero Suicide,” said Sally Manning, Racker Program Director and convenor of the Coalition. “We recognize suicide as a serious public health concern. The Coalition has a vision for our community where no lives are lost to suicide. This is a chance to learn more about suicide prevention and what we can all do to help those who may be struggling.”

The Sophie Fund has encouraged Tompkins County providers to work toward implementing the Zero Suicide model, beginning with a presentation by leading experts for healthcare leaders in October 2017. The Sophie Fund then sponsored a series of five presentations and trainings on Zero Suicide for healthcare leaders and clinicians in 2021-22.

Support Ithaca’s Suicide Prevention Champions

Hey, Ithaca! It’s National Suicide Prevention Month. Mark your calendars to support our own community’s efforts to save lives and reach those who are struggling.

The Greater Central New York chapter of the American Foundation for Suicide Prevention holds its annual Greater Ithaca “Out of the Darkness” walk in Myers Park on Saturday September 9 with check-in starting at 9:30 a.m.

The local walk is among 400 held across the country every year to raise awareness and collect funds for AFSP’s mission, which includes research, training, programming, and education. Walkers include many people who have lost a loved one, friend, or colleague to suicide.

Click here to register for the walk or to make an online donation toward AFSP-CNY’s $60,000 fundraising goal.

“It has been 25 years since we lost my sad to suicide, and not a day goes by that I don’t think about him and miss him dearly,” said Crystal Howser, walk co-chair and captain of Team Hope.

“It is my goal to work hard, educate, erase stigma and help fight to prevent suicide losses from happening. This is our eleventh walk in Tompkins County. We need to let others know they are not alone and it is okay to reach out for help.”

“Boots & Bling” is a Western Gala fundraiser at the Ithaca Hotel on Saturday from 5-9 p.m. to support Ithaca’s Suicide Prevention & Crisis Service. A night of dinner, dancing, inspiration, and connection will celebrate SPCS’s milestones, growth, and future vision.

Reservations closed for the event on September 1, but to make a donation to SPCS anytime you may click here. The funds will support SPCS’s critical mission as a regional call center for the 988 Suicide & Crisis Lifeline as well as a trainer and educator for suicide prevention in the community.

We Can Prevent Suicide Deaths Together

Despite increasing openness about mental illness amid efforts to fight stigma, suicide remains a taboo word. Many people experience suicidal thoughts, but keep that to themselves. However, suicide deaths are preventable, and many recent advances enable us to better prevent them.

September is National Suicide Prevention Month, an opportunity for all of us to learn more about mental illness, suicide, and what we can do to help those who may be struggling. It is a time to redouble efforts to break down the stigma that too often holds us back.

The recent advances include better screening tools for identifying people at risk of suicide, improved care management protocols, upgraded crisis response measures, and suicide-specific therapy treatment. Another advance is the introduction last year of the 9-8-8 hotline number to support people experiencing a mental health crisis.

The 988 Suicide & Crisis Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, seven days a week, across the United States. You can also call 988 if you are concerned about a loved one, friend, or colleague. Veterans and/or their loved ones and friends can call 988 and then press 1 to reach the Veterans Crisis Line.

988 calls go to into a nearby crisis center, one of 200 across the country. When people call or text 988, or connect to chat online, they will be connected to trained counselors that are part of the Lifeline network. Trained counselors listen, understand how the caller’s problems are affecting them, provide support, and connect them to resources if necessary.

The previous Lifeline phone number (1-800-273-8255) will always remain available to people in emotional distress or suicidal crisis. Calls and texts to the Lifeline soared 33 percent since the simpler 988 number was introduced in July 2022.

According to KFF (formerly the Kaiser Family Foundation), in its first 11 months of operation 988 received nearly 4 million contacts, including 740,000 chats and more than 600,000 texts; an additional 1 million connections were made to the Veteran’s Crisis Line.

Ithaca’s 54-year-old Suicide Prevention & Crisis Service has long been part of the Lifeline network. Besides connecting through 9-8-8, its trained counselors can also be reached by dialing 607-272-1616.

The Lifeline has been proven to be effective. According to its administrator, numerous studies have shown that callers feel less suicidal, less depressed, less overwhelmed, and more hopeful after speaking with a Lifeline counselor. 

The Lifeline is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered by Vibrant Emotional Health. SAMSHA provides a Partner Toolkit to help promote the 988 number and other suicide prevention services.

The latest statistics released last month by the U.S. Centers for Disease Control serve as a reminder of America’s mental health crisis.

After declining in 2019 and 2020, suicide deaths increased approximately 5 percent in the United States in 2021. Provisional estimates now indicate that suicide deaths further increased by 2.6 percent in 2022, according to the CDC. One encouraging indicator in the provisional data was that suicide deaths of people aged 10-24 declined by 8.4 percent.

Overall, suicide rates have risen more than 30 percent in the past two decades.

The latest figures underscore “the depths of the devastating mental health crisis in America,” according to U.S. Surgeon General Vivek Murthy. “These numbers are a sobering reminder of how urgent it is that we further expand access to mental health care, address the root causes of mental health struggles, and recognize the importance of checking on and supporting one another. If you or a loved one are in emotional distress or suicidal crisis, please know that your life matters and that you are not alone.”

Take a moment to review the warning signs for suicide, as provided by the American Foundation for Suicide Prevention (AFSP). Be sure to get help for yourself or others if you see the signs. You may save a life.

According to AFSP, something to look out for when concerned that a person may be suicidal is a change in behavior or the presence of entirely new behaviors. This is of sharpest concern if the new or changed behavior is related to a painful event, loss, or change. Most people who take their lives exhibit one or more warning signs, either through what they say or what they do.

Warning sign: Talk

If a person talks about:

Killing themselves

Feeling hopeless

Having no reason to live

Being a burden to others

Feeling trapped

Unbearable pain

Warning sign: Behavior

Behaviors that may signal risk, especially if related to a painful event, loss or change:

Increased use of alcohol or drugs

Looking for a way to end their lives, such as searching online for methods

Withdrawing from activities

Isolating from family and friends

Sleeping too much or too little

Visiting or calling people to say goodbye

Giving away prized possessions



Warning sign: Mood

People who are considering suicide often display one or more of the following moods:



Loss of interest




Relief/Sudden Improvement

For local, state, and national resources, visit The Sophie Fund’s suicide prevention page.

If you or someone you know feels the need to speak with a mental health professional, you can call or text the 988 Suicide and Crisis Lifeline at 9-8-8, or contact the Crisis Text Line by texting HOME to 741-741.

Zero Suicide Model Expert to Tompkins Healthcare: “The Time is Now”

A top expert urged Tompkins County healthcare leaders on August 9 to pursue implementation of the Zero Suicide Model, a framework designed to prevent suicide deaths by closing gaps in the care provided by healthcare systems.

Brian Ahmedani, suicide prevention expert at the Henry Ford Health System

Brian Ahmedani, director of the Center for Health Policy & Health Services Research at the Henry Ford Health System, said Zero Suicide has proved to be highly effective in Henry Ford’s pioneering work on the model over the past two decades. During a period between 2008 and 2010, he said, not a single Henry Ford behavioral health patient died by suicide.

Citing the continuing rise in the U.S. suicide rate in the past 20 years, Ahmedani said research now shows that healthcare systems can play an important role in reversing that trend..

 “We need to do something about this, and the time is now,” he said. “So your charge is to map out a perfect system of care, develop processes and policies that align with that perfect system of care, and figure out who is going do each part of that system of care.”

Ahmedani made his remarks in a presentation to the Tompkins County Zero Suicide Steering Committee, a group of healthcare leaders formed in 2022 to work on implementing the model within and across healthcare systems serving the community. The presentation was sponsored by The Sophie Fund.

Ahmedani explained that the Zero Suicide model for healthcare as well as behavioral health settings entails patient screening, risk assessment, and care coordination.

It starts with systematic screening of all patients using evidence-based tools to determine if they have any suicide risk. If a patient screens positive, then a risk assessment is conducted to determine the onward care that is aligned with their level of risk. Zero Suicide calls for care coordination to avoid system gaps, and for the use of evidence-based treatments for suicidality such as Cognitive Behavioral Therapy.

Ahmedani said that the model calls for the provider and an at-risk patient together to develop a safety plan, a quick guide to help in a crisis that includes their personal warning signs, coping strategies, emergency contacts, and reminders of how to stay safe away from lethal means. Just the safety plan along with a follow-up caring contact message with a patient reduces suicide risk by 20 percent, he said.

“When somebody has suicidal ideation, it’s sort of like having paralysis of your brain, your body shuts down and it can only think of this escape pathway. So if you have a rehearsed plan, they know what they can do instead. If they don’t have a plan, that’s when they continue to get stuck in this this fixation when this intense wave of wanting to hurt yourself comes over your brain and takes over,” he said.

Explaining Zero Suicide’s inclusion of healthcare settings, Ahmedani noted that until 2012 conventional wisdom felt that suicide prevention was a mission left to the behavioral health field.

But he said that research indicates that more than 83 percent of people who died by suicide had made some type of healthcare visit in the weeks and months prior to their death; 92 percent of people making a suicide attempt had seen a healthcare provider very recently. Moreover, he added, studies now show that more than half of the people who die by suicide had no mental health diagnosis.

“That means they’ve never received psychotherapy, they’ve never come in for a suicide attempt in the past, there is no evidence of mental health diagnosis in their entire clinical history,” Ahmedani said.

“What that means is that we need different approaches for suicide prevention. We can’t just rely on waiting for someone to get a mental health diagnosis before we think about suicide prevention. Most people are connecting with healthcare systems before they’re dying. They’re right in front of us.”

Ahmedani said that primary care practices are an important setting for identifying people at risk who may never have sought mental health treatment.

“Most people are actually going to primary care before they’re dying by suicide. If we don’t do anything in primary care, we won’t be able to reach the vast majority of people who are right in front of us before they’re dying by suicide.”

Ahmedani said that behavioral health settings continue to be critical for preventing suicide, because patients with a mental health diagnosis are already known to be at an elevated risk. “But even if we provided perfect care in behavioral health, we could only reach about one third of the people who are dying by suicide,” he said.

Another argument for all healthcare settings also playing a role, Ahmedani said, is a realization that suicidality is not a symptom of a disease like depression but is actually its own disease that needs to be identified and treated as a comorbid condition.

“We really need to think more broadly than that it’s just some symptom of depression or symptom of substance use or symptom of something else, and that if we treat that thing then the suicide risk will go away. We actually have to treat those things concurrently. Both things need to be treated,” he said.

Ahmedani said that unlike longstanding strides to prevent cardiovascular disease, most of the effective interventions outlined in the Zero Suicide Model have only been developed by Henry Ford and others over the past two decades.

“The interventions really haven’t penetrated healthcare systems in the way that other disease treatments have,” he said. “But we have an opportunity to do that now. So I’m really encouraging us to think about how we can take advantage of it,” he said.

“This program is set up perfectly to structure within a healthcare system using pragmatic approaches and interventions that fit within healthcare so they don’t overburden the resources and staffing and all the costs. It  is designed to work effectively in your program.”

Ahmedani stressed the importance of creating a healthcare system team to lead implementation of Zero Suicide, as they did in pioneering the model at Henry Ford.

“Our major recommendation is that you start and launch these services with a team of people that can represent the different perspectives in your healthcare system,” he said. Henry Ford’s team included system leadership, clinicians from different levels, and patients “so that we could really design a system of care that works for everybody,” he said.

Creating system teamwork to prevent suicide deaths removes a burden of responsibility from “the individual heroic clinician who works 24 hours a day, seven days a week trying to stay up and do all these things,” he said. “If we work as a team, we can reduce burnout, we can be more effective, and we can deliver services that end up leading downstream to a better result in preventing suicide.”

Ahmedani said that after implementing Zero Suicide’s quality care process improvements, Henry Ford saw a 75-80 percent reduction in suicide deaths among behavioral health patients within the first year. He said that reduction would then be sustained for more than 22 years even as the U.S. and Michigan suicide rates continued to climb; during an 18-month period from 2008-2010, no behavioral health patients died by suicide.

“Without doing all these things, people fall through the cracks. People aren’t identified, they see multiple providers most of the time, they interact with our healthcare system in lots of different ways, and we don’t figure out who they are. If we do each of those processes, people don’t fall through the cracks,” he said.

“We’ve got a lot of data that show that this program works not only at Henry Ford but it works at a lot of different health care systems. The goal of Zero Suicide is that, instead of thinking that suicide is inevitable like we used to, we’re now thinking suicides are preventable.”

To the surprise of many, Ahmedani said, Henry Ford increased its behavioral health revenue eight-fold after implementing Zero Suicide by reformatting and restructuring the way that it provides care.

He said that medical practices utilizing collaborative care models are able to bill insurance for suicide prevention procedures like screening, risk assessment, and care coordination. He said Blue Cross in Michigan is leading a partnership with healthcare incentivizing or paying for suicide prevention procedures.

Ahmedani said about 50,000 people die by suicide in the United States each year but that the scope of the problem is even bigger. He said 2 million people in the U.S. make a suicide attempt every year, and 15 million are thinking about suicide at some point in the year.

“So we’re talking about somewhere between 4-5 percent of the U.S. general population who are affected by suicide during a year. That’s a lot of people,” he said.

He said that suicide is the only one of the 15 leading causes of death in the United States whose annual rate has been increasing. The annual rate increased 25-30 percent over the past two decades, he said.

Ahmedani said that a significant step forward occurred with the release of the 2012 National Strategy for Suicide Prevention, which drew on Henry Ford’s work and for the first time declared that suicide prevention should be a core component of healthcare services and not only behavioral health.

Afterwards, The Joint Commission, a leading healthcare accrediting body, issued recommendations for preventing suicide in healthcare settings and requirements for using the latest processes and intervention tools in behavioral health settings.

Ahmedani noted that some people in healthcare get “twitchy” about the seemingly unrealistic notion of aiming for zero suicide deaths. “The long-term aspirational goal is to prevent every suicide, but the operational goal is to implement a system of care that focuses on error reduction,” he explained.

He noted that “designing for zero” is a practice seen in many areas, such as surgical operating theaters, airline travel, automotive manufacturing, and nuclear power plants. Setting a goal of zero suicides maintains a focus on continuous quality improvement, he said, reducing the opportunity for complacency. “If we strive for any other number, then we aren’t moving towards the ultimate goal,” he said.

Ahmedani serves as chair of Michigan Governor Gretchen Whitmer’s Suicide Prevention Commission. Besides his work on Zero Suicide at Henry Ford, he is a principal investigator for a number of current clinical trials and studies around suicide and healthcare; one of them is evaluating the implementation of the Zero Suicide Model in various settings of six healthcare systems in five states serving 10 million patients a year.

The creation of the Steering Committee was a response to Goal 2 of the Tompkins County Suicide Prevention Coalition’s Three-Year Strategic Plan 2022-2025 adopted in February 2022. One of Goal 2’s objectives is to “form a Zero Suicide Work Group comprised of leading health and mental health providers to share ideas, experiences, and challenges, and lead collaborative, sustainable efforts to implement the Zero Suicide Model throughout Tompkins County.”