Why We Support the Zero Suicide Model

The Tompkins County Legislature passed a resolution a year ago to support the Zero Suicide Model, calling on local healthcare and behavioral healthcare providers to follow the model’s systematic clinical approach to preventing suicides.

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Members of the Cayuga Health Partners Care Coordination Team

Cayuga Health Partners, a Physician-Hospital Organization comprising more than 40 medical practices and 200 physicians and a leader of healthcare delivery in Tompkins County, pledged to become a “Zero Suicide Champion” with the goal of implementing the suicide prevention model in our local healthcare network.

That pledge was made during a June 2018 meeting of the Tompkins County Suicide Prevention Coalition, formed in 2017 by more than 30 community-based organizations. Others announcing their commitment included Cayuga Medical Center, Tompkins County Mental Health Services, Alcohol & Drug Council of Tompkins County, Suicide Prevention & Crisis Service, Cornell Health of Cornell University, and Family & Children’s Service of Ithaca.

The Zero Suicide Model involves a foundational belief that suicide deaths for those engaged in the healthcare system are preventable. It is clear that safer suicide care is in the best interest of our patient population. I know for myself and my team, we all want to go to bed at night knowing we’ve done everything in our power to support the well being of the communities we serve.

The case for Zero Suicide is compelling. The New York State Office of Mental Health has released data showing that an overwhelming number of those who die by suicide are often already engaged in health systems. More than 80 percent of people who die by suicide have had health care visits in the prior 12 months—often more recently than that. These findings are consistent with national data.

Making the commitment to become a Zero Suicide Champion was the easy part. Now, utilizing the specific strategies and tools available free of charge to practices and providers nationwide through the Zero Suicide framework, Cayuga Health Partners is working to prevent suicides while improving the care for those who seek help.

Cayuga Health Partners is working in collaboration with Ithaca’s Suicide Prevention and Crisis Service in an effort to encourage individual practices and providers to embrace the Zero Suicide Model. In the fall of 2018, we launched a series of Lunch & Learn events featuring presentations about the model by SPCS Executive Director Lee-Ellen Marvin. To date, more than 60 percent of the primary care practices in the network have opened their doors to the presentations and discussions about the role they can play in suicide prevention. Members of Cayuga Health Partners have also played a role in supporting our partner organization, Cayuga Medical Center, in its own implementation of the Zero Suicide Model.

Cayuga Health Partners (formerly called Cayuga Area Plan/Preferred) is a partnership of the Cayuga Area Physicians Alliance (CAPA) and Cayuga Medical Center. Our network mission is to unify member organizations in the pursuit of high quality, accessible, and cost-effective healthcare for the population of patients we serve. In efforts to accomplish this, Cayuga Health Partners is a physician-led, physician-driven effort combining evidence-based best practices and innovative data collection technology in a way that aligns physician incentives and community partnerships to drive improvement in clinical quality.

For more information about the Zero Suicide Model, go to: http://zerosuicide.sprc.org/

—By Emily Mallar

Emily Mallar is the director of Care Management at Cayuga Health Partners

Exploring Strategies to Stop Bullying

Surveying students about the prevalence of bullying. Training teachers, coaches, parents, and young people on how to respond. Encouraging youth to be upstanders. Holding annual Bullying Prevention Day activities to spread awareness. These were a few of the ideas discussed Saturday at a two-hour Community Forum sponsored by the Tompkins County Bullying Prevention Task Force.

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Celia Clement reviewing feedback on school bullying

The Task Force held the forum to introduce its work to the public and to solicit ideas from the community on strategies to address bullying. More than two dozen government agencies, community organizations, and representatives from the county’s six school districts formed the Task Force in March.

“A lot of these conversations and diving deep into these topics can become very personal and very painful, which we want to honor,” said Nigel Gannon, a Healthy Living Program Specialist for New York State 4-H Youth Development, who moderated the forum.

“We have to develop spaces where we can have those emotions in a positive way. Remember that we are all feeling the same [about bullying], in some way, as individuals, as loved ones, as community members. We are not happy to be here, I think we are hopeful to be here. We’re going to help the Task Force get the information they need to try to move this forward.”

Scott MacLeod of The Sophie Fund kicked off presentations by Task Force working groups by reviewing basic information about bullying in national, regional, and local contexts.

He noted the federal government’s definition of bullying, and how it should be distinguished from other behaviors such as conflict, rudeness, and meanness:

“Bullying is any unwanted aggressive behavior(s) by another youth or group of youths who are not siblings or current dating partners that involves an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated.”

MacLeod explained how bullying has psychological, physical, and academic effects, and adversely affects youth who are bullied as well as those who engage in bullying. He said that youth who are perceived as different, especially LGBTQ children, are at greater risk. Persistent bullying, he added, can lead to or worsen feelings of isolation, rejection, exclusion, and despair, as well as depression and anxiety, which can contribute to suicidal behavior. MacLeod said that while there is no federal stature that expressly outlaws bullying, New York State’s Dignity for All Students Act (DASA) came into force in 2012 to protect students from bullying, harassment, and discrimination.

Citing statistics, MacLeod’s report said 19 percent of American high school students are bullied, and 14.9 percent experience cyberbullying. He said that data for the 2017-2018 school year, most likely reflecting underreporting, showed that Tompkins County school districts had 109 incidents of discrimination, harassment, and bullying , and 20 incidents of cyberbullying.

Celia Clement, a retired school social worker and now an independent consultant, delivered a report on potential approaches for addressing bullying in schools. She identified five areas for attention:

  • Communication: Families are not always getting the information they need about bullying definition, prevention, intervention, education, district policies and the laws involved such as the Dignity for All Students Act.
  • Education: Families and school staff want help around recognizing signs that their youth are struggling with mental health challenges, social challenges, or bullying. Students need to be educated as well around what is bullying, recognizing the difference between peer conflict and bullying, knowing the warning signs when adults need to be informed, and ways to intervene effectively when they see bullying, harassment or cyber bullying, or suicide warning signs.
  • Prevention: The key to successful intervention models is to include students as the core drivers when building programs that promote positive school cultures. There are existing local programs that can serve as models: Friendship Assistance Brigade, Stars, Be the One, and Welcoming Allies and Mentors.
  • Intervention: There is a need to educate school teaching staff and administrators about best practice around intervention when situations of conflict, bullying, harassment and cyber bullying occur—such as restorative practices as a way to support the target and to help the aggressor make changes. There is a need to offer strategies and tools to work with families in a way that promotes outcomes where everyone feels good about the process of addressing conflict and bullying situations.
  • Assessment: Schools need to conduct surveys about bullying to inform decisions for addressing the problem.

MacLeod also delivered a working group report on potential approaches for addressing bullying outside school property. He cited numerous ideas including holding an annual community forum and student leadership summit, providing training and information workshops, and launching awareness projects such as an annual Tompkins County Bullying Prevention Day.

Beth Hogan, a member of the Task Force’s Family Advisory Group, delivered a working group report on the concerns of parents surveyed by the group. She said parents experienced a significant increase in stress over bullying, and felt that they themselves were effectively being bullied. The parents believed that bullying was causing heightened levels of anxiety and depression in children, she added.

Hogan said that schools were reactive rather than proactive, and that mental health services inside and outside schools were inadequate. Hogan’s report called for frequent communication about bullying, including about the Dignity Act, to staff, families, and students. She said youth and parent involvement in bullying prevention should be a priority, and that the work should begin in the elementary grades.

Sophie Callister, a former student in the Lansing Central School District and now a student at Ithaca College, is the coordinator of the Task Force’s Student Advisory Group. “The bullying task force is something that means a huge deal to me because from third grade all through my school career it was a huge problem,” she said. “I want kids to feel like there is somebody willing to listen and help them and that they feel safe every day. I never really felt safe in school.” She said that rather than school counselors or psychologists the only person she felt she could go to for support was a math teacher. Callister said a goal of the task force is “to get the community involved—parents, students, everybody. This is not a time to be quiet.”

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Community Forum on Bullying Prevention, Tompkins County Public Library

Forum participants provided feedback and engaged in discussion in breakout sessions. On school programs, participants argued that schools under report bullying incidents and do not create safe spaces for students. They noted that teachers and coaches themselves sometimes engage in bullying by humiliating students/athletes. Participants suggested strategies including peer mentors and giving students tools for confronting bullying.

For public action, participants proposed holding local public forums within the county’s six school districts to better encourage family participation in bullying prevention initiatives. Participants supported the idea of providing training and workshop opportunities to educate the community about bullying and prevention methods, and called for a centralized resource to provide information about the Dignity Act and how to file complaints about bullying incidents. The participants also endorsed exploring synergies with existing programs and activities, such as the “Be the One” campaign.

Participants who focused on family and student involvement emphasized the need for developing a common language to understand bullying, and the importance of student-led initiatives for success. They noted that it was essential to view those who bully as people also in need of support to address the underlying causes of their behavior.

Some participants called for greater attention to students who may be experiencing suicide ideation, noting that four young people from the Lansing community have died by suicide in just the past year. Participants highlighted opportunities for students to become involved by forming chapters of organizations such as Active Minds and Sources of Strength, and participating in activities such as Mental Health First Aid for Teens.

Click here to read Becky Mehorter’s Ithaca Voice article on the Community Forum, “Task force brings community together to address bullying in local schools.”

Click here to read Matt Steecker’s article in the Ithaca Journal on the Tompkins County Bullying Prevention Task Force, “Finding solutions to bullying: Task force to hold forum at library.”

Click here to visit The Sophie Fund’s website resource page on bullying prevention.

A Film by Carlos Hernandez Rivera

Carlos Hernandez Rivera looks into the camera with all the beautiful innocence of a young man who loves science and Boy Scouts. But then his words describe two deaths—and his own determination to prevent such tragedies in the future. “I’m Carlos, and I was affected by suicide,” he says. “Two people that were close to me died within a short span of time.”

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Screenshot from The Damaging and the Uniting

So begins The Damaging and the Uniting, a short film produced, written, and directed by Hernandez Rivera, 14, to be screened at Cinemopolis June 6, about his experience of losing two friends to suicide during the current school year—Elliott Green, 16, a close buddy since Lansing Middle School, and Ryan Sibley, 14, a ninth-grade classmate this year at P-Tech Academy.

“This movie is personal,” Hernandez Rivera said before a private screening last week at P-Tech, a magnet high school/early college program in computer science and advanced manufacturing at TST BOCES. “I wanted to help, I wanted to help as many people as I can. I am motivated to help other people so they don’t go through tough times and so that suicide is not a problem anymore.”

The idea for the film came as Hernandez Rivera was developing a freshman-year capstone project. After Elliott’s death in March, Hernandez consulted with his teacher, Sunshine Miller, and decided to create a video that could raise awareness about mental health and promote suicide prevention. Then in April, as Hernandez Rivera was story boarding the film, came the terrible news that Ryan, his P-Tech science lab partner, had taken his own life.

Hernandez Rivera dedicates the film to Elliott and Ryan. He and Elliott had been pals for years. One of Hernandez’s fondest memories is of the two-day, 100-mile biking trip the duo made with another friend around Cayuga Lake last summer. They shared a passion for Boy Scouts—Elliott’s father is a scoutmaster—but were not above messing around, like the time they tried to sink each other’s canoes in a water-gun fight.

Hernandez Rivera remembers Ryan as an easy-going guy who was fun to hang around with. In the film, Hernandez Rivera includes a still image of a smiling Ryan at school wearing a “Family Guy” T-shirt. Their tight-knit class of 19 students had just taken a field trip to the Herbert F. Johnson Museum of Art at Cornell University. “He seemed happy on that trip,” Hernandez recalled. Ryan was an accomplished wrestler, who had recently become a Seaman recruit in the U.S. Naval Sea Cadet Corps.

Hernandez Rivera interviews two women to further show the human face of suicide and loss—Beth Dryer, who lost a younger brother, Brian, 25; and Melissa Addy, whose son Max died by suicide at 22. “It refocused my priorities in life, time was short,” recalled Dryer, adding, after an emotional pause, “This is tough, so clearly it still has a major impact on my life.” When Hernandez Rivera asked Addy about “the one thing” she misses about her son, she touchingly replied, “I miss everything.”

Hernandez Rivera described the blow he felt after his mother told him that Elliott had passed away. “I was in a good rhythm, and then Elliott dies,” he said. “I started falling back in school, I wasn’t doing as well. Sometimes I would get lost. I would walk into a room and say, ‘Whoa, how did I get here?’ I would blank out sometimes.”

“Then I’d be like, ‘I’m here. I’m here. I got this,’” he added. “Self-motivation has got me through it. I changed when Elliot passed away. I felt like I had to do more things, I had to talk to people. To communicate with people, it is a good skill to have.”

Hernandez Rivera explained that making the film has helped in his own struggle with grief. “It has given me faith in myself, that even though there are obstacles that are huge, that we will face traumatic things in our lives, we can get back up, and keep pushing on,” he said.

Suicide is an extremely delicate and even taboo topic for schools, but Miller threw her full support behind the project. “Carlos has given me courage,” she explained. “It would have been easy to just say, ‘No, we’re not doing this.’ Adults make all the decisions, which are good in lot of ways, but we’re too quick to say, ‘Lets not talk about this.’ This has changed me. I hope Carlos’s courage can light the way for real change in our schools surrounding how we deal with suicide.”

“This is why I went into education,” said Barry Derfel, TST BOCES assistant superintendent, speaking to Hernandez Rivera at the private screening at P-Tech last week. “I am really proud of the work that you have done. This is what school should be. At P-Tech, we collaborate with families, business, and community, to create fully accessible, meaningful, and relevant curricula. I don’t think here is anything more meaningful and relevant than this, that’s culturally responsive and sustaining.”

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Carlos Hernandez Rivera

Hernandez Rivera consulted Lee-Ellen Marvin of Ithaca’s Suicide Prevention and Crisis Service about conducting the interviews used in the film. He also had the help of Ithaca filmmaker Redouane Elghazi in the filming and editing. He won the support of the P-Tech administration not only to tackle suicide in a class project—and one involving the school itself—but to go forward with a public screening at Cinemopolis, Ithaca’s first-run movie theater specializing in independent, foreign, and locally produced films.

Hernandez Rivera’s dreams “are all over the place”— he thinks about becoming a global-warming scientist, working for NASA, or Space X, and even Tesla. For now, though, he is hoping that his film will help spread awareness about mental health.

“My goal is so that this doesn’t become an issue anymore, that suicide is a thing of the past,” he said. “We should realize that not everyone is as happy as they seem. Some people do need talking to, even if they look happy. If we’re having a bad day and we are mean to other people, just be nice.”

—By Scott MacLeod

Scott MacLeod is a co-founder of The Sophie Fund

The Damaging and the Uniting will be screened for the public June 6 from 5-6 p.m. and 6-7 p.m. @Cinempolis, 120 East Green Street, Ithaca, NY. 14850. Admission is free of charge.

The Damaging and The Uniting

 

 

Coping After a Suicide Death

A 2018 study found that on average 135 people are exposed to and may be affected by a person’s suicide death. This means that 5.5 million Americans are hit by a suicide loss every year. These findings highlight the importance of broader “postvention”— support for people who may be seriously impacted by grief, guilt, shame, isolation, depression, suicidal thoughts, or other responses to a suicide death.

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Volunteers from the American Foundation for Suicide Prevention

The American Foundation for Suicide Prevention provides an online library of resources for coping with suicide loss.

A few examples:

Children, Teens, and Suicide Loss

After a Suicide: A Toolkit for Schools

Postvention: A Guide for Response to Suicide on College Campuses

Personal Support for Survivors of Suicide Loss

Taking Care of Yourself

In addition, Ithaca’s Suicide Prevention & Crisis Service offers postvention services—click here for more information.

From SPCS’s website:

Trauma is an emotional response to challenging and unexpected events that can cause a great deal of stress, upset everyday routine, and interfere with your ability to function.

After-Trauma Services can help you cope with the stress of these sudden life events.

If you are a resident of Tompkins County in New York State, learn more about services here, or just call at 607-272-1505 to schedule.

Up to 8 free counseling sessions. Client and therapist create an intention for maximizing time together. Included are basic tools for ‘getting grounded’; education on what trauma is and it’s impact on human beings; development of healing plans; support and assistance in referral process.

Support Group for people coping with the loss of a loved one who died by suicide. Meetings are the first and third Tuesday of every month at 6:30pm. Please call 607-272-1505 to express interest in joining this group.

First Monday Group. On the first Monday of each month, at noon, colleagues in the field of mental health meet in the library of SPCS to learn from each other. Readings in between meetings inform the discussion.

Family sessions to process, collectively, traumas that have impacted everyone.

Facilitated workplace group discussions following a tragedy.

For more information or schedule an appointment with Sheila McCue, the director of After-Trauma Services here at SPCS, please email postvention@ithacacrisis.org or call 607-272-1505

To learn more about how Tompkins County is working to prevent suicide, click here.

State-Local Partnership in Suicide Prevention

The Sophie Fund on Thursday applauded New York Governor Andrew M. Cuomo’s 2019 “Justice Agenda” for including a proposal to strengthen suicide prevention infrastructure through state and local partnerships.

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“While there is much still to be done, we truly thank Governor Cuomo for his commitment to preventing suicide in our state and for taking concrete actions in order to do so,” said Scott MacLeod, a co-founder of The Sophie Fund. “The governor understands the importance of addressing this challenge at the community level and with results-oriented strategies.”

In his annual State of the State Book accompanying an address to the legislature on Tuesday, Cuomo called on New York State agencies to partner with communities in five critical areas of suicide prevention: innovative public health approaches; healthcare systems; cultural competence in prevention programming; comprehensive crisis care; and surveillance data. Under the proposal, communities that demonstrably strengthen suicide prevention infrastructure will receive a New York State designation.

MacLeod noted that recent progress in Tompkins County’s suicide prevention efforts stemmed in part from the vital support provided by the state Suicide Prevention Office and affiliated Suicide Prevention Center of New York. In July 2018, the Tompkins County Legislature unanimously passed a resolution to support the Zero Suicide Model, a pillar of the state’s comprehensive suicide prevention policy. The resolution called on local healthcare and behavioral healthcare providers to follow the model’s systematic clinical approach to preventing suicides.

The legislative act came a month after the newly formed Tompkins County Suicide Prevention Coalition voted overwhelmingly to recommend the Zero Suicide Model for healthcare providers as a countywide suicide prevention initiative.

“The state Suicide Prevention Office and Suicide Prevention Center of New York have been essential partners in the formation of the Tompkins County Suicide Prevention Coalition and in assisting local stakeholders with significantly expanding suicide prevention efforts,” said MacLeod. “We welcome the opportunity under Governor Cuomo’s proposal to expand our partnership with the state.”

Cuomo’s proposal builds on the work of the New York State Suicide Prevention Task Force formed at his direction in 2017. Cuomo charged the task force with identifying gaps in programs, services, and policies while simultaneously making recommendations to facilitate greater access, awareness, collaboration, and support of effective suicide prevention activities.

According to “Justice Agenda,” the 2019 State of the State Book:

“Suicide is an enormous public health problem. Suicide is the 10th leading cause of death in the United States. According to the Centers for Disease Control, from 1999 to 2016, suicide rates in New York State rose by nearly 30 percent, while other leading causes of death such as cancer, heart disease, and motor vehicle accidents all decreased. Each year nearly 1,700 New Yorkers die by suicide.”

In 2016, the state Suicide Prevention Office released “1,700 Too Many: New York State’s Suicide Prevention Plan 2016–17.” It focused on three main areas for battling the rising suicide rate: prevention in Health and Behavioral Healthcare Settings (Zero Suicide Model); Prevention in Competent, Caring Communities Across the Lifespan; and Suicide Surveillance and Data-Informed Suicide Prevention.