Our Goal: Zero Suicide for Tompkins County

The Sophie Fund recently organized a small conference with a big purpose: to introduce and implement the Zero Suicide Model in Tompkins County. Together with Ithaca’s Suicide Prevention & Crisis Service and the New York State Suicide Prevention Office, we invited the most senior healthcare leaders from local government, medical centers, and college campuses to attend an expert briefing on October 16 at The Statler Hotel.

Zero Suicide briefing 101617

Healthcare leaders from Ithaca and Tompkins County

The presenters were two of the nation’s leading authorities on suicide prevention:

—Michael Hogan, a developer of the Zero Suicide Model, who served as New York State Mental Health Commissioner (2007–2012), Ohio Department of Mental Health Director (1991–2007) and Connecticut Mental Health Commissioner (1987–1991).

—Sigrid Pechenik, Associate Director of the New York State Suicide Prevention Office.

Turnout for the briefing was excellent. Attendees included: Tompkins County Public Health Director Frank Kruppa, who also serves as the county’s Mental Health Commissioner; Deputy Mental Health Commissioner Sharon MacDougall; senior administrators from Cayuga Medical Center and Family & Children’s Service of Ithaca; and health directors from Cornell University, Ithaca College, and Tompkins Cortland Community College.

Suicide is absolutely not an inevitable outcome for people struggling with suicide ideation related to mental illness or other factors. The Suicide Prevention Resource Center argues that “we all have a role to play” in preventing suicide.

The American Foundation for Suicide Prevention explains that “suicide most often occurs when stressors exceed current coping abilities of someone suffering from a mental health condition”—and part of the problem is that conditions like depression often go undiagnosed or untreated.

AFSP outlines the risk factors and warning signs for suicide, and the critical steps that suicidal individuals and their families and friends can take when such factors and signs are present. Risk factors include mental health conditions, stressful life events, and a family history of suicide. Warning signs include talking about pain and suicide, increased alcohol or drug use, withdrawing from family and friends, and exhibiting anxiety or loss of interest.

The Zero Suicide Model, sometimes called the “Suicide Safer Care Model,” goes further. Zero Suicide argues that suicides can be prevented by closing cracks in healthcare systems—that “suicide deaths for individuals under care within health and behavioral health systems are preventable.”

As Hogan and Pechenik emphasized in their Statler presentations, Zero Suicide means making suicide prevention a core responsibility of healthcare. Specifically, this entails a systematic clinical approach in healthcare systems—training staff, screening for suicide ideation, utilizing evidence-based interventions, mandating continuous quality improvement, treating suicidality as a presenting problem—and not simply relying on the heroic efforts of crisis staff and individual clinicians.

PechenikHogan

Sigrid Pechenik, Associate Director, New York State Suicide Prevention Office, and Michael Hogan, former New York State Mental Health Commissioner

As SPRC puts it: “The programmatic approach of Zero Suicide is based on the realization that suicidal individuals often fall through multiple cracks in a fragmented and sometimes distracted healthcare system, and on the premise that a systematic approach to quality improvement is necessary.”

Certainly, the facts make a compelling case that healthcare settings must play a critical role in preventing suicide. According to Pechenik, a review of New York State data of 3,564 suicides in 2013–2014 identified that 25 percent of the individuals who took their own lives had been discharged from emergency departments or inpatient facilities within just seven days prior to their suicide deaths.

The data also indicates a strong need to better train clinicians in suicide screening, assessment, intervention, and follow-up. Of 1,585 mental health providers surveyed by the NYS Office of Mental Health in 2014, 64 percent reported little or no specialized training in suicide-specific interventions. Moreover, about 33 percent reported that they did not feel they had sufficient training to assist suicidal patients.

Zero Suicide is at the heart of the 2012 National Strategy for Suicide Prevention, released by the U.S. Surgeon General and the National Action Alliance for Suicide Prevention. The NSSP’s Goal 8 is to “promote suicide prevention as a core component of healthcare services.” Goal 9 is to “promote and implement effective clinical and professional practices for assessing and treating those at risk for suicidal behaviors.”

As Pechenik noted, Zero Suicide is also explicitly embraced by the NYS Suicide Prevention Plan 2016–17, entitled 1,700 Too Many. Implementing Zero Suicide in health and behavioral healthcare settings is the first pillar of the suicide prevention strategy outlined in the plan. The second pillar is to “create and strengthen suicide safer communities.”

According to the U.S. Substance Abuse and Mental Health Services Administration, “There is strong evidence that a comprehensive public health approach is effective in reducing suicide rates.”

Hogan pointed out that the Zero Suicide Model builds on breakthroughs such as the Perfect Depression Care Initiative implemented in 2001 by the Henry Ford Health System in Michigan. Its comprehensive approach to mental and behavioral healthcare—incorporating suicide prevention as an explicit goal—demonstrated a 75 percent reduction in the suicide rate among Henry Ford health plan members.

More recently, Hogan highlighted, The Joint Commission issued a Sentinel Event Alert on the imperative of improving suicide prevention in healthcare settings. The Alert is important because the commission is a body that accredits and certifies nearly 21,000 healthcare organizations and programs (including Cayuga Medical Center) across the country—such accreditation and certification is a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.

The Joint Commission’s February 24, 2016 Sentinel Event Alert Issue 56, entitled “Detecting and Treating Suicide Ideation in All Settings,” stated:

“The Joint Commission urges all healthcare organizations to develop clinical environment readiness by identifying, developing and integrating comprehensive behavioral health, primary care and community resources to assure continuity of care for individuals at risk for suicide.”

The Sentinel Event Alert recommended detailed actions for suicide ideation detection; the screening, risk assessment, safety, treatment, discharge, and follow-up care of at-risk individuals; educating all staff about suicide risk; keeping health care environments safe for individuals at risk for suicide; and documenting their care.

The commission’s focus on suicide prevention in healthcare settings stems from the belief that while being alert to risk factors and warning signs is important, it is not sufficient. There is no typical suicide victim: most people with risk factors don’t attempt suicide, and others without risk factors do. Thus, the Alert stated:

“It’s imperative for healthcare providers in all settings to better detect suicide ideation in patients, and to take appropriate steps for their safety and/or refer these patients to an appropriate provider for screening, risk assessment, and treatment.”

The Alert reported that many communities and healthcare organizations presently do not have adequate suicide prevention resources, leading to the low detection and treatment rate of those at risk. It noted that although most people who die by suicide receive healthcare services in the year prior to their deaths, healthcare providers often do not detect their suicidal thoughts. “Supportive continuity of care for those identified as at risk for suicide is crucial,” the Alert said.

The Joint Commission reported that in 2014 many commission-accredited organizations were actually rated non-compliant with its National Patient Safety Goal 15.01.01 Element of Performance 1: “Conduct a risk assessment that identifies specific patient characteristics and environmental features that may increase or decrease the risk for suicide.”

The commission said its database recorded 1,089 suicides occurring from 2010 to 2014 among patients receiving care, treatment, and services in a staffed, around-the clock care setting or within 72 hours of discharge, including from a hospital’s emergency department. According to the Alert, “The most common root cause documented during this time period was shortcomings in assessment, most commonly psychiatric assessment.”

The Joint Commission said its Sentinel Event Alert aimed “to assist all healthcare organizations providing both inpatient and outpatient care to better identify and treat individuals with suicide ideation.” The Alert listed areas for improvement:

—Clinicians in emergency, primary, and behavioral healthcare settings particularly have a crucial role in detecting suicide ideation and assuring appropriate evaluation.

—Behavioral health professionals play an additional important role in providing evidence-based treatment and follow-up care.

—For all clinicians working with patients with suicide ideation, care transitions are very important. Many patients at risk for suicide do not receive outpatient behavioral treatment in a timely fashion following discharge from emergency departments and inpatient psychiatric settings.

The Sentinel Event Alert noted that suicide is the 10th leading cause of death in the United States, taking “more lives than traffic accidents and more than twice as many as homicides.” In 2011, according to data published by the U.S. Centers for Disease Control, suicide became the second leading cause of death for Americans aged 15-24.

In April 2016, the National Center for Health Statistics reported a 24 percent increase in the suicide rate in the United States from 1999 to 2014. While age-adjusted death rates for heart disease and cancer have dramatically declined in the last two decades thanks to improved detection and treatment strategies, the suicide rate has skyrocketed.

On September 15, 2017, the U.S. National Institute of Mental Health reported that three interventions, which were designed for follow-up of patients identified with suicide risk in hospital emergency departments, save lives and are even more cost effective than usual care. The interventions were sending postcards to patients at risk; calling discharged patients to offer support and encourage follow-up treatment; and connecting patients to suicide-focused cognitive behavioral therapy programs.

“In the face of a gradually rising suicide rate, the need for effective prevention strategies is urgent,” said NIMH Director Joshua Gordon. “These findings of cost-effectiveness add to the impetus for implementing these life-saving approaches. Importantly, they also make a strong case for expanding screening, which would allow us to reaching many more of those at risk with life-saving interventions.”

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It is the hope of The Sophie Fund that the October 16 briefing at The Statler Hotel is the start of a process of garnering commitments from local healthcare leaders to develop implementation plans that bring the Zero Suicide Model to Tompkins County.

To achieve ultimate success, “buy-ins” will be needed from major healthcare systems including psychiatric units, emergency departments, and college health centers, as well as from primary care providers and substance use disorder treatment centers.

To assist healthcare organizations in implementing the seven fundamentals of Zero Suicide, SPRC established the Zero Suicide project offering online resources such as an organizational self-study, implementation toolkits, readings, and webinars, and an offline Zero Suicide Academy providing two-day trainings for healthcare leadership.

The NYS Office of Mental Health operates the New York Academy for Suicide Safer Care, which offers a 9-12 month program of webinars and coaching calls for organizations seeking to raise their standard of suicide care.

The Statler briefing follows several encouraging local developments in suicide prevention during 2017.

On April 17, community mental health stakeholders representing 18 organizations adopted The Watershed Declaration, calling suicide a “serious public health concern” and pledging to intensify suicide prevention efforts in Ithaca and Tompkins County.

On June 7, 2017, Ithaca Mayor Svante Myrick issued a proclamation supporting The Watershed Declaration and calling for “an all-out effort to prevent suicide.” The Tompkins County Legislature issued a similar proclamation on September 5, 2017.

On July 31, led by the Tompkins County Department of Mental Health, local mental health leaders launched the Tompkins County Suicide Prevention Coalition representing 32 organizations including health, behavioral health and substance use disorder treatment facilities, schools, and county departments.

—By Scott MacLeod and Susan Hack

Scott MacLeod and Susan Hack are officers of The Sophie Fund, Inc., a nonprofit charitable corporation supporting mental health initiatives aiding young people in greater Ithaca and Tompkins County.

Music for the Mind

On November 14 at Ithaca College’s Whalen School of Music, come join students, faculty, and community in the effort to raise awareness for mental health, spread resourceful information, and send a message of hope and inspiration.

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Click Here to Download the Poster

Last spring semester, I was in my dorm building when a floor-mate of mine needed a call to public safety due to self-harm and attempted suicide. Luckily, she got the help she needed, is back at school, and now one of my dear friends.

After being a part of that experience, I felt the need to do something about it. I came up with an idea of putting together a “Mental Health Awareness Concert.” I know very well that music has the power to bring people together, raise awareness, and comfort anyone around to hear it.

The Music for the Mind concert takes place Tuesday, November 14 at 8:15 p.m. in Ford Hall in Whalen School of Music. It will include performances from Marc Webster, Ivy Walz, and Patrice Pastore, Ithaca College Choir, Voicestream, ICUnbound, Rock Hard Dance Company, and many other IC students.

Prior to the concert, Ithaca College and local mental health organizations will set up in the lobby outside Ford Hall. Active Minds, Mental Health for Musicians, The Sophie Fund, and IC’s Center for Counseling, Health and Wellness will have tables with their representatives, goals, and information.

After the concert, in Hockett Green Room, everyone is invited for a panel discussion led by Active Minds, a representative from the IC Center for Counseling, Health and Wellness, and a voice faculty representative. Audience members are welcome to listen to personal stories as well as share their own.

Concert attendees will be invited to consider donations to The Sophie Fund to support mental health initiatives aiding young people in the Ithaca area.

Our goal for this evening is to support and inspire. By addressing an issue at hand with care, helpful information, and music, we are unstoppable!

—By Megan Jones

Megan Jones is a voice major at Ithaca College

Students and The Sophie Fund

It’s Mental Health Awareness Week at Cornell University, but for some college students in Ithaca, it’s seems like every week is mental health week. In a good way!

The Sophie Fund is privileged to partner on a host of projects with student organizations at Cornell and Ithaca College. Active Minds at Ithaca College, and Cornell Minds Matter, Alpha Phi Omega–Gamma Chapter and Phi Sigma Pi at Cornell all played vital roles in the 2017 Ithaca Cupcake Baking Contest in the Commons on October 14.

APO-PSPVolunteers from Cornell University’s Alpha Phi Omega–Gamma Chapter and Phi Sigma Pi

Besides volunteering to register contestants, inventory the cupcake entries, participate in preliminary judging (okay, hard work!), and clean up the Bernie Milton Pavilion afterwards, students participated in a related fundraising effort for suicide prevention. In one week alone in September, APO Gamma collected more than $500 in donations. APO Gamma also delivered excess cupcake entries to the Friendship Center at the Ithaca Rescue Mission for the homeless.

Speaking at the cupcake awards ceremony, Winnie Ho, vice president of service for APO Gamma, said that working for mental health causes was one of her fraternity’s top priorities. Here’s what she had to say:

“I’d like to take this time to talk about the partnership that we have developed with The Sophie Fund over the past year. It’s been one of the most rewarding experiences of our chapter to get involved in all the mental health opportunities that exist in this town.

“For us, service remains one of our most important cardinal principles. We’ve seen an overwhelming response from many of our brothers to support for opportunities within APO and other opportunities outside of APO to serve and support their friends, their loved ones, and their community.

“At Cornell it is Mental Health Awareness Week, and APO Gamma is hosting many events, and so are many other student organizations. Which helps prove the point: anyone can get involved in mental health. You can start by asking yourself, asking your friends, taking care of the people around you. You don’t need to organize anything enormous to start improving the mental health of other people. Thank you so much for coming out today. Happy cupcakes!”

DSC_8712 copyWinnie Ho of Cornell University’s APO Gamma Chapter

Cooper Walter, president of Cornell Minds Matter, staffed a table at the cupcake contest to engage contestants and passersby on mental health issues. During the awards ceremony, he issued a special appeal to young people in Ithaca. Here’s what he had to say:

“In the couple minutes we have here today, I want to talk about mental health and young people. College age—18 to 24—is a pivotal turning point for everyone’s lives. It is at that age that most of the mental health disorders onset. And it is the age that we build the life skills and the coping strategies that set us up for success.

“At Cornell, 25 percent of all students have a mental health disorder, but only 30 percent [of those] seek help. I want to challenge every one here—especially the young people—to take a moment to engage with mental health. Ask yourself, ‘What does mental health mean to you?’ ‘What is your mental health?’ ‘How can you improve it?’ ‘And what are you going to do—today—to advance mental health and make your life better.’

“I also challenge you to take a moment to engage with your peers. Many friends are struggling with their mental health, or can improve their mental health, but aren’t thinking about it. Today, when you talk to your friends, ask them: ‘How are you doing?’ But don’t just take ‘Oh, I’m good,’ or ‘I’m fine,’ at face value. Ask them, ‘Are you struggling with anything?’ ‘Can I help you in any way?’ ‘Is there anything you’d like to discuss?’

“If we take these small steps, considering what mental health is to us, and reach out to our friends to help them engage with mental health, we can set ourselves up for a successful life, and successful health.”

DSC_8709 copyCooper Walter of Cornell Minds Matter

CMMCornell Minds Matter at the Ithaca Cupcake Baking Contest in the Commons

PSPVolunteers from Phi Sigma Pi

APOWinnie Ho and Ivan Rios of APO–Gamma

APO Buttons 092517APO–Gamma brothers collecting donations for suicide prevention in Ho Plaza

AM-greenstar2Members of Active Minds at Ithaca College collecting donations for suicide prevention at GreenStar Natural Foods Market

 

Cupcake Joy, 2017 Edition

Enjoy a photo gallery from the 2nd Annual Ithaca Cupcake Baking Contest, held in the Commons on October 14, 2017.

bannerBernie Milton Pavilion, October 14, 2017

 

registrationLet the Contest Begin: Angela registers Tamarynde Cacciotti’s entry, cream puff cupcakes with Earl Grey pastry filling that went on to win the Grand Prize.

 

alistrongwaterHappy Halloween: Ali Strongwater’s 2nd Prize-winning pumpkin and ginger cupcakes haunted by sugar ghosts.

 

alexanderRaspberries and Butterflies: Alexander Quilty’s 3rd prize-winning chocolate raspberry-filled cupcakes with raspberry buttercream frosting.

 

monicacottoEmerging Brightness: Monica Cotto’s vegan blood orange dark chocolate cupcakes topped with edible crystal geodes (Honorable Mention).

 

Beth Goelzer LyonsForest of Cupcakes: Beth Goelzer Lyons’s chocolate chip cookie dough-filled vegan chocolate cupcakes topped with chocolate trees.

 

melaniehardyFall Foilage: Melanie Hardy’s Campfire S’more Cupcakes with marshmallow fluff frosting topped with a Hershey bar (Honorable Mention).

 

robynschmittWinter Wonderland: Robin Schmitt’s vanilla cupcake topped by an edible peanut butter and nutella pine cone (Honorable Mention).

 

Lianna White“Healthiest Cupcake” Award: Lianna White’s gluten-free carrot raisin walnut cupcake.

 

nataliemccaskellLand of Unicorns: Natalie McCaskill-Meyers’s unicorn cupcakes won an Honorable Mention Award and “Best Youth Cupcake” Award.

 

judgesThe Hard Part: The judging begins!

 

judging2Tastes and Scents: The judging continues!

 

debbielazinskyCupcake Joy: Debbie Lazinsky of GreenStar Natural Foods Market samples the cupcake submissions.

 

alternativesfcuColoring Contest: Volunteers from Alternatives Federal Credit Union run the Coloring Contest for Under-8’s.

 

jacobparkercarverJacob Parker Carver of the Mental Health Association in Tompkins County sets up an interactive mental health quiz for attendees.

 

amyleviereAmy LeViere of the Community Foundation of Tompkins County welcomes the contestants.

 

IMG_9981Lee-Ellen Marvin, executive director of the Suicide Prevention & Crisis Service, thanks The Sophie Fund for being a catalyst for change in suicide prevention in Tompkins County.

 

yukojinguMeet the VIP Judges: Yuko Jingu (friend and co-worker of Sophie)

 

deleilanormanMeet the VIP Judges: Daleila Norman of GreenStar Natural Foods Market

 

ameliasauterMeet the VIP Judges: Amelia Sauter of Felicia’s Atomic Brewhouse and Bakery

 

Mary Sever Schoonmaker“Richest Cupcake” Award: Mary Sever Schoonmaker receives a GreenStar gift certificate for her chocolate zucchini cupcakes with meringue frosting garnished with cashew toffee bark.

 

tamaryndecacciotti copyShe’s No. 1: Tamarynde Cacciotti with her Grand Prize award for her cream puff cupcakes with Earl Grey pastry filling and mocha buttercream frosting.

 

mickiequinnThe Maestro: Event Producer Mickie Quinn

Cupcakes: Special Awards

Contestants in the 2nd Annual Ithaca Cupcake Baking Contest on Saturday came up with innovative and fun designs and tastes—congratulations to these winners of Special Awards!

Best Youth Cupcake

Natalie McCaskill-Myers

 

Can’t Believe It’s Vegan!

Erica Brath

 

Most Unique Frosting

Amy Fuhr

 

Most Inspiring Cupcake

Beth Goelzer Lyons

 

Brightest Flavor

Star Utter

 

Best Theme

Patti Meyers (and Hudson)

 

Classiest Cupcake

Aušra Milano

 

Most International Cupcake

Maggie Chutter

 

Most Creative Flavor

Kim Englehart

 

Richest Cupcake

Mary Sever Schoonmaker

 

Fluffiest Cupcake

Lynn Sokolowski

 

Healthiest Cupcake

Lianna White

 

Most Locally Inspired Cupcake

Sadie Hays

 

Pretty in Pink

Hannah Cohn-Manik

 

Cutest Cupcake

Jessica Adams

 

Best Dressed Cupcake

Geneva Moreland

 

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Natalie McCaskill-Myers’s entry: “Unicorn cupcake with an “S” for Sophie”—caramel coffee pumpkin with a cardamom cream cheese frosting

 

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Erica Brath’s entry: Kirsch-flavored black forest cupcake with chocolate and cherry topping

 

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Amy Fuhr’s entry: Vanilla cupcake filled with key lime pie on a graham cracker crust topped with meringue and a raspberry

 

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Beth Goelzer Lyons’s entry: Chocolate chip cookie dough-filled vegan chocolate cupcake with cookie dough frosting and topped with a chocolate tree

 

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Star Utter’s entry: Lemon cupcake with buttercream frosting

 

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Patti Meyers’s entry: My Father’s Dragon Tangerina Cupcakes—tangerine-flavored cupcake with blue and white striped dragon decoration

 

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Aušra Milano’s entry: Chocolate cupcakes with cocoa nibs, chocolate ganache filling, and rose-scented vanilla cream cheese frosting

 

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Maggie Chutter’s entry: Baklava cupcakes—phyllo dough cupcake with honey cinnamon frosting

 

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Kim Englehart’s entry: Chocolate bourbon cupcake with smoked coconut bacon, maple frosting and caramel bourbon sauce

 

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Mary Sever-Schoonmaker’s entry: sea salt caramel-filled chocolate zucchini cupcake with chocolate meringue buttercream frosting garnished with cashew toffee bark

 

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Lynn Sokolowski’s entry: White chocolate macadamia cupcake with raspberries and white chocolate buttercream frosting

 

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Lianna White’s entry: Gluten-free carrot raisin walnut cupcake with a frosting made from cashews, cream cheese, vanilla and maple syrup

 

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Sadie Hays’s entry: The Black Diamond—cabernet franc and raspberry ganache-filled chocolate cake with vanilla chevre frosting, topped with Indian Creek raspberries and a white chocolate “Cayuga Lake” sail

 

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Hannah Cohn-Manik’s entry: Vanilla cupcake with raspberry meringue buttercream frosting

 

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Jessica Adams’s entry: Chocolate cupcake with Oreo frosting

 

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Geneva Moreland’s entry: Blackberry-filled chocolate cupcake with vegan cream cheese chocolate sage frosting topped with fresh sage