Suicide Prevention: A New “Call to Action”

U.S. Surgeon General Jerome Adams on January 19 issued a “Call to Action” report to implement the 2012 National Strategy for Suicide Prevention, a detailed roadmap for preventing suicide in a comprehensive and coordinated way. “Much remains to be done,” the report warned. “Suicide prevention continues to lack the breadth and depth of the coordinated response needed to truly make a difference in reducing suicide.”

The report noted a new urgency behind suicide prevention efforts: the COVID-19 pandemic has now created conditions that may further suicide risk, such as increased social isolation, economic stress, and reduced access to community and religious support. “Problems resulting from the pandemic—including physical illness, loss of loved ones, anxiety, depression, job loss, eviction, and increased poverty—could all contribute to suicide risk,” Adams said.

The report said that in 2019 more than 47,000 Americans died by suicide, and that the national suicide rate increased 32 percent—from 10.5 to 13.9 per 100,000 people—in the 20-year period from 1999 to 2019. The report notes that for every person who dies by suicide, thousands more experience suicidal thoughts or attempt suicide—in a 2019 survey, 1.4 million U.S. adults reported attempting suicide in the past year and 3.5 million adults reported making a suicide plan.

“Although research has identified many strategies that can be effective in preventing suicide, these evidence-informed approaches have not yet been brought to scale,” the report said. Indeed, it added, an assessment of progress toward implementation of the National Strategy showed that few efforts have been comprehensive or strong enough to have a measurable impact on reducing suicidal behavior.

[If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.]

The report highlights the Zero Suicide Model as one of the key instruments for saving lives. In 2018, the Tompkins County Suicide Prevention Coalition and the Tompkins County Legislature endorsed the model, which incorporates recommendations for “a gold standard of care for people with suicide risk.” The model stresses the need to include suicide prevention as a core component of all health care services, rather than limit it to services provided by mental health specialists, and to improve professional and clinical training and practice for preventing suicides.

The report calls for increased use of a key component of the Zero Suicide Model: a suicide safe care pathway, to ensure that patients at risk for suicide are identified and provided with continuing care tailored to their needs.

“All patients are screened on past and present suicidal behavior, and positive screens are followed by a full assessment. Individuals identified as being at increased risk are entered into a suicide safe care pathway, thus ensuring that they are provided with the attention and support they need to stay safe and recover.

“Components include periodic assessments of suicidality and ongoing follow-up, including contacting patients who fail to show up for an appointment or withdraw from care. The inclusion of family members and other identified support persons in pathway implementation may help support patient engagement.

“Implementation of a suicide safe care pathway requires that protocols and systems be in place to collect and analyze data to track services, ensure patient safety, and assess treatment outcomes. The system should collect data on process measures, such as screening rates, safety planning, and services provided; care outcomes; suicide attempts and deaths; and any other relevant factors, such as sociodemographic characteristics, clinical history, and referrals to other sources of care.

The report noted that in response to the need for a minimum standard of care for individuals at risk for suicide, the National Action Alliance for Suicide Prevention in 2018 developed Recommended Standard Care for People with Suicide Risk: Making Health Care Suicide Safe. It identifies individual recommended practices—such as screening and assessment for suicide risk, collaborative safety planning, treatment of suicidality, and the use of caring contacts—that can be adopted in outpatient mental health and substance misuse settings, emergency departments, and primary care.

Read: What Tompkins County is doing to prevent suicide deaths

The surgeon general’s Call to Action states that while that all 13 goals and 60 objectives of the 2012 National Strategy remain relevant, it is time to focus on six key actions in order to reverse the current upward trend in suicide deaths in the United States.

The Call to Action identifies four strategic directions: Healthy and Empowered Individuals, Families, and Communities; Clinical and Community Preventive Services; Treatment and Support Services; and Surveillance, Research, and Evaluation.

Within those directions, the Call to Action identifies six main actions to pursue:

Activate a broad-based public health response to suicide

Address upstream factors that impact suicide

Ensure lethal means safety

Support adoption of evidence-based care for suicide risk

Enhance crisis care and care transitions

Improve the quality, timeliness, and use of suicide-related data

Download: The Surgeon General’s Call to Action

SUMMARY OF THE CALL TO ACTION REPORT

Action 1. Activate a Broad-Based Public Health Response to Suicide: Inspire and empower everyone to play a role in suicide prevention.

1.1 Broaden perceptions of suicide, who is affected, and the many factors that can affect suicide risk.

1.2 Empower every individual and organization to play a role in suicide prevention.

1.3 Engage people with lived experience in all aspects of suicide prevention.

1.4 Use effective communications to engage diverse sectors in suicide prevention.

Action 1: Priorities for Action

  • State government and public health entities should implement the Suicide Prevention Resource Center’s Recommendations for State Suicide Prevention Infrastructure to support comprehensive (i.e., multi- component) suicide prevention in communities.
  • Prevention leaders from the public and private sectors, at all levels (national, state, tribal, and local), should align and evaluate their efforts consistent with the Centers for Disease Control and Prevention (CDC) resource Preventing Suicide: A Technical Package of Policy, Programs, and Practices, to expand the adoption of suicide prevention strategies that are based on the best available evidence.
  • Federal agencies and state, tribal, local, and county governments and coalitions should strengthen their prevention efforts by developing strategic suicide prevention plans based on available public health data. Mechanisms for the prompt sharing of innovations and best practices should be developed and supported.
  • State and local suicide prevention coalitions and health systems should actively reach out to organizations serving populations at high risk for suicide; these systems should also reach out to individuals with lived experience in order to learn from them and engage them in designing prevention efforts.
  • The public and private sectors should invest in patient-centered research and include people with lived experience in research design and implementation.
  • Federal agencies, mental health and suicide prevention non-governmental organizations, and others conducting communication efforts should ensure that suicide prevention communications campaigns (1) are strategic, (2) include clear aims for behavior changes that support broader suicide prevention efforts, and (3) measure their impact.
  • The federal government (Congress) should expand and sustain support for states, territories, communities, and tribes to implement comprehensive suicide prevention initiatives similar to the Comprehensive Suicide Prevention Program, funded by CDC, and the Garrett Lee Smith youth suicide prevention grants, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), which have been shown to reduce suicide in participating counties, particularly in rural areas. Funding targeting substance use disorder should be broad enough in scope to allow for interventions that address suicide prevention and related workforce and infrastructure needs.

Action 2. Address Upstream Factors that Impact Suicide: Focus on ways to prevent everyone from suicide.

2.1 Promote and enhance social connectedness and opportunities to contribute.

2.2 Strengthen economic supports.

2.3 Engage and support high-risk and underserved groups.

2.4 Dedicate resources to the development, implementation, and evaluation of interventions aimed at preventing suicidal behaviors.

Action 2: Priorities for Action

  • Private companies and workplaces should leverage their health care benefits purchasing power to enhance employee mental health (e.g., invest in benefits and programs to prevent and treat behavioral health problems) and work to shape worksite values and culture to promote mental health by providing access to crisis support, support to employees following a suicide, and ongoing mental health wellness programming.
  • Suicide prevention leads in federal, state, tribal, and local public health and behavioral health agencies should partner with their counterparts in labor and workforce, housing, health care, and other public assistance agencies to collaborate on strengthening economic supports for families and communities.
  • Foundations and other philanthropic organizations that support early intervention programs— particularly those targeting (1) social determinants of health (e.g., reducing poverty and exposure to trauma, improving access to good education and health care, improving health equity) and/or (2) enhanced social interactions (e.g., improved parenting skills) and problem-solving and coping skills— should ensure that these programs include outcomes related to suicide (e.g., ideation, plans, attempts) and evaluation of those programs for suicide-related outcomes.
  • Federal government and private sector research funders should support the analysis of existing data sets of longitudinal studies to determine the impact of various interventions (e.g., home visitation, preschool programs, substance misuse, child trauma) on suicidal ideation, plans, and attempts, and on deaths by suicide. This could include such projects as the CDC’s efforts to assess and prevent adverse childhood experiences and examine their effect on suicide-related problems, and National Institutes of Health (NIH) initiatives that focus on aggregating prevention trial data sets to better understand the long-term and cross-over effects of prevention interventions on mental health outcomes, including suicide risk,88 and to address suicide research gaps.

Action 3. Ensure Lethal Means Safety: Keep people safe while they are in crisis.

3.1 Empower communities to implement proven approaches.

3.2 Increase the use of lethal means safety counseling

3.3 Dedicate resources to the development, implementation, and evaluation of interventions aimed at addressing the role of lethal means safety in suicide and suicide prevention.

Action 3: Priorities for Action

  • The federal government and private sector entities can support efforts to ensure that updated information on lethal means safety policies, programs, and practices (e.g., ERPOs, firearm owner and retailer education, bridge barriers, medication packaging, carbon monoxide shut-off sensors in vehicles) is incorporated into existing national clearinghouses and resource centers so that local municipalities, states, and tribes can adopt and evaluate them for their prevention benefits.
  • States, communities, and tribes should collaborate with the private sector to increase awareness of and take action to reduce access to firearms and other lethal means of suicide, including opioids and other medications, alcohol and other substances or poisons, and community locations (e.g., railways, bridges, parking garages) where suicidal behaviors have occurred. This urgent multi-sector effort is key to saving lives by reducing access to lethal means for individuals in crisis.
  • Health systems and payers should leverage their existing training and resources and collaborate on a national initiative to train general and specialty health care providers and care teams on safety planning and lethal means counseling.
  • SAMHSA and the VA should coordinate to ensure that lethal means safety assessment and counseling are incorporated into the assessment and intervention procedures of the National Suicide Prevention Lifeline and Veterans Crisis Line call centers, particularly in preparation for the national launch of 988.
  • The federal government can prioritize and fund research and program evaluation analyzing community and clinical lethal means safety interventions (e.g., ERPOs, firearm owner and retailer education, bridge barriers, medication packaging, carbon monoxide shut-off sensors in vehicles) at the population level.
  • State and federal governments should collaborate with the private sector on a synchronized public health communication campaign addressing lethal means safety in the context of suicide prevention, which should then be evaluated to determine prevention benefits and inform future communication efforts.

Action 4. Support Adoption of Evidence-Based Care for Suicide Risk: Ensure safe and effective care for all.

4.1 Increase clinical training in evidence-based care for suicide risk.

4.2 Improve suicide risk identification in health care settings.

4.3 Conduct safety planning with all patients who screen positive for suicide risk.

4.4 Increase the use of suicide safe care pathways in health care systems for individuals at risk.

4.5 Increase the use of caring contacts in diverse settings.

Action 4: Priorities for Action

  • The federal government, professional associations, and accrediting bodies should collaborate to address barriers to adopting the Action Alliance’s Suicide Prevention and the Clinical Workforce: Guidelines for Training to ensure increased clinical training in evidence-based care for suicide risk during graduate education and post-graduate training.
  • State behavioral health licensing boards should add continuing education requirements for suicide prevention in order for clinicians to maintain licensure or certification.
  • Payers from the public and private sectors should incentivize the delivery of evidence-based care via existing levers in contracting and reimbursement.
  • Federal and state policymakers and commercial payers and health systems should take specific steps to improve outcomes for individuals with mental health and substance misuse conditions in primary care by using effective methods (e.g., CoCM) to integrate mental health and substance misuse treatment into primary care.
  • To enhance workflows for suicide safe care, health systems should collaborate with EHR vendors to develop options for integrating screening, suicide safe care pathways, and safety planning into their EHR systems.

Action 5. Enhance Crisis Care and Care Transitions: Ensure that crisis services are available to anyone, anywhere, at any time.

5.1 Increase the development and use of statewide or regional crisis service hubs.

5.2 Increase the use of mobile crisis teams.

5.3 Increase the use of crisis receiving and stabilization facilities.

5.4 Ensure safe care transitions for patients at risk.

5.5 Ensure adequate crisis infrastructure to support implementation of the national 988 number.

Action 5: Priorities for Action

  • The federal government and the private sector should address gaps, opportunities, and resource needs to achieve standardization among crisis centers in interventional approaches and quality assurance in preparation for the launch of 988.
  • The federal government, states, and the private sector should work together to optimize system design, system operations, and system financing for 988 as the hub of an enhanced, coordinated crisis system, and enhance coordination between Lifeline 988 centers and 911 centers to reduce overreliance on 911 services and ED boarding (the practice of keeping admitted patients on stretchers in hallways due to crowding).
  • The federal government should fund the necessary infrastructure to support crisis care (e.g., Congressional support for the 5 percent SAMHSA Mental Health Block Grant set-aside; core services identified in SAMHSA’s National Guidelines for Behavioral Health Crisis Care) and should provide technical assistance to states looking to evolve crisis systems of care.
  • The federal government and foundations should support research to identify effective models of mental health crisis response (e.g., coordinated efforts among mental health specialists, peers, and law enforcement) to improve short- and long-term effects on communities of color and other marginalized populations.
  • The federal government and private sector payers should support the use of follow-up phone calls or texts within 24 hours of discharge from psychiatric hospitalization or emergency room discharge to check in with the patient, provide support, and maintain contact until the person’s first outpatient appointment.
  • The federal government should establish universally recognized coding for behavioral health crisis services, and public and private sector partners should collaborate with payers and health systems to increase adoption of the new coding.
  • The federal government should support the development of an essential benefits designation that will encourage health care insurers to provide reimbursement for crisis services, thus reducing the financial burden on state and local governments to pay for those services, delivered within a structure that supports the justice system and ED diversion.

Action 6. Improve the Quality, Timeliness, and Use of Suicide-Related Data: Know who is impacted and how to best respond.

6.1 Increase access to near real-time data related to suicide.

6.2 Improve the quality of data on causes of death.

6.3 Expand the accessibility and use of existing federal data systems that include data on suicide attempts and ideation.

6.4 Improve coordination and sharing of suicide-related data across the federal, state, and local levels.

6.5 Use multiple data sources to identify groups at risk and to inform action.

Action 6: Priorities for Action

  • The federal government should support near real-time collection of data on deaths by suicide and nonfatal suicide attempts in a group of sentinel states to develop the framework for a national early warning system for suicidal behavior in the U.S. The system would create a central database that links multiple data sources and would build state and local capacity to translate data trends into prevention efforts in a timely manner. In addition, the federal government should expand ED SNSRO to monitor nonfatal suicide-related outcomes, track spikes and potential clusters in suicide attempts, and identify patterns, all of which can then inform prevention activities.
  • The public and private sectors should collaborate on a near real-time suicide dashboard that pulls data from existing national, state, tribal, and community databases to make data on deaths by suicide and suicide attempts timelier and more accessible, thus linking the dashboard to prevention actions on the ground.
  • The federal government should implement Recommendation 1.8 of the Interagency Serious Mental Illness Coordinating Committee, which calls on public and private health care systems to routinely link mortality data for serious mental illness (SMI) and serious emotional disturbance (SED) populations, and supports the standardization of similar data gathering across state and local systems for SMI and SED populations within the justice system.
  • Professional organizations connected to coroners and medical examiners at the state and national levels should release guidance on and support wide-scale implementation of coding sexual orientation and gender identity in death investigations.
  • The federal government should implement the PREVENTS Executive Order recommendation for the U.S. Department of Health and Human Services and the VA to propose legislative changes that mandate a standardized process for uniform ED data reporting across the United States specific to the external cause of injury (e.g., suicide attempt).
  • Health care systems should work with public sector agencies to support the linkage of mortality data with health record, social, geographic, education, and criminal justice data systems to strengthen data quality and increase accountability for patient outcomes across key systems.
  • State suicide prevention coordinators and community suicide prevention leaders should routinely monitor available data to identify trends and evaluate their own efforts.

A Mother’s Movement Against Bullying

Jane Clementi is the founder of the Tyler Clementi Foundation, which works to end online and offline bullying in schools, workplaces, and faith communities. She started the advocacy organization in 2011 to honor her son, Tyler. He died by suicide at age 18 in the first month of his freshman year at Rutgers University. Among the foundation’s programs is the Million Upstander Movement, in which enlistees pledge to stand up to bullying and treat others with kindness, respect, and compassion. The Sophie Fund’s Anna Moura spoke to Jane Clementi via Zoom on October 28, 2020.

Tyler and Jane Clementi [Courtesy Jane Clementi]

THE SOPHIE FUND: What drove you to create the Tyler Clementi Foundation?

JANE CLEMENTI: It was in the wake of my son’s death. He died by suicide in the fall of 2010 after he had been just started his freshman year. His roommate live-streamed him in a sexual encounter with another man. And then, as he read the comments and quotes on social media, his reality became twisted and distorted, and he made that permanent decision to a very temporary situation, and he died by suicide. It was to honor his legacy.

There were several high-profile deaths in the fall of 2010, but Tyler’s seemed to rise even up to the top of those and his story held national headlines for several weeks after that. Several noted celebrities continued to talk about Tyler over the course of time. As my fog lifted from the extreme distress that I was in after Tyler’s death, I realized that there was a lot of good positive conversation that was happening, and that those conversations were helping to create change, to make life better for other LGBTQ youth as well as just other marginalized youth that were being targeted.

I wanted to make sure that the world knew more about Tyler and the kind, caring, resourceful young man that he actually was. I also have come in years since to realize how distressed he truly was as well. I recently moved, within the last six months, and I came across more writings that Tyler had documented some of his pain and sadness and anger. It was someone I didn’t even recognize. I had no idea. So not everyone exhibits symptoms of their pain.

THE SOPHIE FUND: How do you define the problem of bullying?

JANE CLEMENTI: I think it’s a complex issue with a complex array of solutions. I think it’s helpful for us to share our stories so that people are aware of the great consequences and harm that can be caused from bullying behavior. I like to make sure people know that not all bullying situations end in the same devastating way that Tyler’s story ended. But with that said, all bullying hurts when it is happening, and it often leaves lifelong scars, whether physical or emotional, psychological scars.

I also think it is an issue that needs our constant attention and immediate attention. I don’t think it’s “kids just being kids.” I don’t think it magically disappears when someone turns 18. It’s behavior that goes on uncorrected and unchallenged. We have to identify that behavior early—the earlier, the better—to make change. Legislation is important, but I think it’s just a small component of creating change. I think most legislation sets the boundaries, which I think is key and important, but after that once the boundaries are crossed, it is very punitive. It mostly deals with punishment or suspension. I don’t think that that changes the behavior. I think we need to implement more behavior modification, and maybe reward positive behavior and call out positive behavior as part of the solution.

We are working preventing bullying online and off, as well as in schools, workplaces, and faith communities. Because I think it happens not only to youth, and not only in schools, but also through legislative inequalities as well as religious dogma that targets especially those in the LGBTQ community. We can go further down to the root of the cause and that will help prevent it for other people.

THE SOPHIE FUND: What can we really do to make an impact on bullying behavior?

JANE CLEMENTI: We have a few initiatives ourselves with the Tyler Clementi Foundation that we think will impact that behavior. First of all, we think it’s important to realize that there’s more than just the target and the aggressor in a bullying situation. But there are bystanders. Almost all situations have bystanders, people who see what’s happening. And those are bystanders because they’re passive and remain silent. That is like condoning and supporting the aggressive behavior. So, we want to empower those bystanders, and we call them “upstanders” once they become empowered. We think that there are many ways to do that.

You can intervene and interrupt a situation if you feel comfortable and if you know the people involved. Because we never ever want anyone else to come into harm’s way. Sometimes it’s as easy as, if you know the people and maybe think they are using racial slurs or homophobic slurs as jest or some type of humor—which they are not—and calling it out and saying that this isn’t funny.

It might even be as simple as coming beside the person being targeted and calling them away and pulling them physically out of the situation, saying, “Come with me, I want to show you something I saw outside, or down the hall,” or whatever.

If you don’t feel comfortable in that situation, or if the behavior doesn’t get changed, it’s about reporting it to a trusted adult or a youth. Or reporting it to the proper people if it’s happening in the workplace, up your ladder, your chain of command, your human resources department, something to that effect.

If you have someone’s best interest at heart, it is not tattling, or telling on someone. It’s about finding them the right support, which takes us to the third easiest way. That is to reach out to the target. I think that that is important. I think if someone had reached out to Tyler, it would have made all the difference for him. Making sure they know where their resources are. Tyler had resources at Rutgers, and he had resources at home. But no one made sure he knew how to reach out. And when you’re in a really dark place, and I learned personally, you don’t often see your resources. You just see the pain and the bleakness. So reaching out to the target, making sure, sometimes it’s just about making sure they know you’re there, you’re a friend. I think those are key elements of being an upstander.

We also believe that its more than just a one-on-one but about creating safe communities as well. We believe that someone, if they say on a first day of a group meeting together, whether it’s a sports team, or a club, or a classroom, or an entire school, having a person of authority set the boundaries, and say that we value everyone here, we will not accept anybody being targeted or humiliated for any reason. And then calling out and enumerating the reasons. Such as body shape and size, or abilities, or what language they speak at home, or their sexual orientation, or their gender identity, or whatever else makes somebody special and precious.

We do think people are targeted because of their differences, and we need to enumerate those differences so people understand that, and then get an acknowledgement back from the group that, yes, they understand. It is not a magic wand. The aggressor needs to hear where the boundaries are sometimes. It is also a huge message for someone who is marginalized to hear, to know that they are welcome and included in this space regardless of whatever makes them special.

THE SOPHIE FUND: Tell us about the “Upstander Pledge”?

JANE CLEMENTI: We started it several years ago. We wanted to reach a million people with our upstander pledge by October of 2020, and I’m pleased to say that we did just reach a million people. We’re really thrilled about that announcement, but we also know that a million people sounds like a lot, but it still needs to reach more. So we are going to continue our message.  It is also a message that needs to be heard over and over again.

Every time you are faced with a situation, it’s not like, “Oh, I signed the pledge, I’m good.” You have to really think about it. One of the things I’ve learned is that there is something called the bystander phenomenon. The more people that see an incident happening the less likely that somebody is to stand up to that incident. That’s why we need to have it fresh on our mind: “Wait a minute, nobody is saying anything. That’s me. I need to be that person that stands in the gap. I need to be the person to be empowered enough, and to have the courage enough, to stand up here.” And then hopefully you’ll be the leader to create a wave of people that will stand up to that.

THE SOPHIE FUND: How does the foundation’s work specifically impact LGBTQ youth?

JANE CLEMENTI: Our mission is broad in that it speaks to anyone’s difference. With that said, I think that allows us to speak specifically where we go and where we are invited in to talk. We are not quite as problematic for some schools or for some businesses that might not be able to or want to invite, say, GLSEN, or GLAAD, or HRC. And yet, for us, that is a huge focus of our work because that is part of Tyler’s story. Tyler was a gay youth, so we can speak to that. We have a gentle way of bringing that conversation to the organization that we are speaking in.

THE SOPHIE FUND: How do you view the problem of cyberbullying?

JANE CLEMENTI: With Covid we are spending so much more of our time in the digital cyber world, so the incidences of cyber-attack or bullying are so much greater. We have to be sure and think about the words that we’re using, and say the words that are building other people up and not attacking their character. I think it’s important that we see the humanity behind something and being willing to back up whatever we say by saying it to someone’s face, not saying it just through words on a screen.

THE SOPHIE FUND: Can you talk about the Tyler Clementi Higher Education Anti-Harassment Act?

JANE CLEMENTI: A little history. It was created and introduced into the Senate initially by the New Jersey’s senator at the time, which was Senator Frank Lautenberg. He realized a truth which I still see today, that there is no federal anti-bullying legislation at all. Since Tyler was a college student, he initiated the bill to speak to colleges and universities, higher education institutions, to create policies and programs to protect all their students.

In 2010, in the fall, there were very few state laws for anti-bullying. I think New Jersey instituted one of the first. New Jersey’s law is called HIB—Harassment, Intimidation, and Bullying. That passed shortly after Tyler’s death. At this point, all 50 states have some form of anti-bullying legislation. Which also means each state has a different definition of what bullying is. There are 50 different definitions out there. And so I do think we do need a federal law.

There are several that are out there. The two that are most known are the Safe Schools Act, which would be K-12, and that is supported by the Human Rights Campaign, and several other organizations. And then there’s theTyler Clementi Higher Education Anti-Harassment Act. That is also supported by HRC and a few less organizations than the Safe Schools Act. But it does not seem to get passed legislatively. Maybe with the new Congress we can get that moving forward.

THE SOPHIE FUND: What do you think is needed specifically in higher education?

JANE CLEMENTI: One of the things with LGBTQ support is that many colleges and higher education institutions do not have a resource person or an LGBTQ center on their college campuses. Out of 6,000 institutions, only less than 10 percent had a resource person, one FTE employee who was in charge of the resource center. So, I think that there needs to be more resource availability available through a center through a place where people can gather together and receive the support that they need.

Most institutions also need policies in place to protect all students and calling out and enumerating classes including LGBTQI+ students as well. With those policies they should have trainings for staff as well as for students. Those are components of Tyler’s bill also. Having not only policies in place but trainings for staff and students.

THE SOPHIE FUND: Can you talk a little bit about the Tyler Clementi Center at Rutgers University?

JANE CLEMENTI: We have a Memorandum of Understanding with Rutgers that created the Tyler Clementi Center at Rutgers. It falls under the inclusion and diversity chancellor. They are working towards having research and symposiums. For all marginalized students, but the last two symposiums have been specific to LGBTQ, creating safe LGBTQ spaces on the college campus. They just did a web conference, the topic was “Out of The Closet.” It was discussing the safety aspect of being in the closet against the harm of being in the closet, which usually outweighs the safety. It was about not forcing people to come out before they were ready to come out. But how to rather encourage people to see the positive aspect of being out, and the better emotional mental health of it.

The Clementi Family at Tyler’s high school graduation 2010 [Courtesy Jane Clementi]

THE SOPHIE FUND: How do you view bullying in the context of today’s divisive political scene?

JANE CLEMENTI: We never will agree with everyone completely on solutions. But I do think it is key that we learn how to have those conversations respectfully and to talk about the issues and solutions to the problems without attacking someone’s character or the person. I think that’s one of the things that we haven’t achieved very well in our political system right now. As a nonprofit, we don’t endorse any candidate at all, but we certainly need leaders that will exemplify and model good behavior for us and not call out and target and attack a person’s character but have those respectful conversations.

 Until we do, I think it definitely affects youth today. You might dismiss it, but there was a research project out of the University of Virginia that talked about the last political campaign for the last election. It showed that bullying behavior increased among youth after certain political leaders exhibited it on the television screen or their news media screen, and visualizing someone calling out news reporters for their disabilities, or calling out other people and attacking their personality.

THE SOPHIE FUND: Why did the foundation reach out to the 2020 presidential candidates to take the upstander pledge?

JANE CLEMENTI: They were going to occupy so much of our time through news, we thought it was important that the candidates, all of the candidates, would take our pledge and to live out our pledge in their campaign. We reached out in a bipartisan way to everyone running at the time, and we posted them on our website.

It is multi-faceted the answer as to why some people did not take the pledge. Obviously, it was interesting to me that all the candidates were from the Democratic Party that did sign our pledge. But even within that Democratic Party, there were some that did not take it. Some responded that they don’t sign pledges, and they don’t put their name to things that they don’t have control over. And I accept that. But we got most of the top contenders who were running which I think speaks volumes. If someone actually engages in bullying behavior, I would imagine that they wouldn’t want to sign the pledge.

THE SOPHIE FUND: How do you assess the “Be Best” initiative of First Lady Melania Trump? People have accused President Trump of engaging in bullying and not setting a “Be Best” example.

JANE CLEMENTI: I concur. I don’t think he would be the best example. I don’t think her initiative is as robust as it should be either. I see very little about it. Maybe I’m just missing it in my news area. I do know that she had one conference and I know some people who attended the conference. I didn’t even know that it was happening until after the fact. I think it was shallow at best, and I think she could have had a larger and stronger voice in this area. Although it’s very difficult when you are trying to reap change for good and one of the people involved on the other side and is occupying so much media attention is actually being the aggressor in many situations. and being the aggressor without knowing that he even is the aggressor. I have to have a good view of everyone. I can’t imagine someone wants to be an aggressor or wants to inflict cruel pain on someone else. I think sometimes it is just not even in their consciousness that they are being that type of an aggressor.

—By Anna Moura

Anna Moura, an intern at The Sophie Fund, is a Class of 2021 Writing major and Psychology minor at Ithaca College

[To learn more, check out local, state, and national resources on bullying at https://thesophiefund.org/bullying]

Suicide Prevention Day—What You Can Do

September 10 is World Suicide Prevention Day. It falls within Suicide Prevention Awareness Week. September is Suicide Prevention Awareness Month. The American Foundation for Suicide Prevention provides many helpful resources—to help yourself, support others, promote best practices, and advance better public health policies. Check out AFSP’s #KeepGoing page to see what you personally can do to prevent suicide.

If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.

The Sophie Fund is dedicated to preventing suicide in the greater Ithaca community. Our nonprofit organization is named for Sophie Hack MacLeod, a Cornell University student who died by suicide in Ithaca in March 2016. Working with partners, we work to promote mental health awareness and advocate for specific best practices such as the Zero Suicide Model in the Ithaca community as well as on the local college campuses.

In 2017, The Sophie Fund led the adoption of the Watershed Declaration in which 18 community mental health stakeholders pledged to intensify efforts toward saving lives and bringing hope to those struggling with suicide thoughts or affected by suicide loss. The Sophie Fund is a founding member of the Tompkins County Suicide Prevention Coalition. In 2018, the Tompkins County Legislature called on local healthcare and behavioral healthcare providers to follow the Zero Suicide Model’s systematic clinical approach to preventing suicide.

Please contact us at thesophiefund2016@gmail.com for questions about our mission or to partner in our efforts.

Know the Suicide Warning Signs

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

If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.

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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

Aggression

Fatigue

Warning sign: Mood

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

Depression

Anxiety

Loss of interest

Irritability

Humiliation/Shame

Agitation/Anger

Relief/Sudden Improvement

Support Team Hope!

The Sophie Fund expresses its gratitude to Crystal Howser, one of our area’s greatest suicide prevention champions. Please consider donating to Crystal’s team of volunteers to raise funds for the American Foundation for Suicide Prevention by clicking HERE.

teamhope

Crystal Howser (far left) and her 2020 team

We’re proud to share Crystal’s message:

I’m walking in the Out of the Darkness Greater Ithaca Walk to fight suicide and support AFSP’s bold goal to reduce the suicide rate 20 percent by 2025.

It has been 22 years since we lost my Dad to suicide and not a day goes by that I don’t think about him and miss him dearly. It is my goal to work hard, educate, erase stigma, and help fight to prevent suicide losses from happening.

This is our ninth walk in Tompkins County. I co-chair the walk each year along with many other annual events we bring to our local communities (in Tompkins, Cortland, and Cayuga counties). We need to let others know they are not alone!

All donations are 100 percent tax deductible and fund research, education, advocacy, and support for those affected by suicide.

Thank you for your support!

Click here HERE to donate today.

[If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.]