The Watershed Declaration

Five Years After The Watershed Declaration

thesophiefund

Five Aprils ago, The Sophie Fund organized a meeting of community mental health stakeholders representing 18 governmental and non-profit organizations from Tompkins County, the City of Ithaca, and the campuses of Cornell University, Ithaca College, and Tompkins Cortland Community College.

Co-Founder Scott MacLeod introduced The Sophie Fund to the community, explaining that it was established in memory of his daughter who died by suicide in Ithaca the previous year, and outlining its mission to support mental health initiatives aiding young people in the greater Ithaca area.

Garra Lloyd-Lester, associate director of the Suicide Prevention Center New York, announced plans to convene a “key stakeholders” with the aim of establishing a suicide prevention coalition in Tompkins County.

At the close of the April 17, 2017 meeting, the assembled stakeholders adopted a solemn resolution. It was dubbed The Watershed Declaration, as the meeting was hosted by The Watershed, a new downtown watering hole owned by Sophie’s friend and former colleague.

The declaration reads:

“We the assembled mental health stakeholders of the greater Ithaca community and Tompkins County recognize suicide as a serious public health concern. Today we renew our commitment to suicide prevention and pledge to intensify efforts toward saving lives and bringing hope to those struggling with suicide thoughts or affected by suicide loss.”

How did that pledge turn out? The results are mixed.

Since The Watershed Declaration was adopted, Tompkins County has averaged 12 suicide deaths per year. There is anecdotal evidence of a spike in local suicides, including those on college campuses, in 2021 and 2022. Suicide is the second leading cause of death among Americans aged 10-34.

GET INVOLVED: Interested to join the cause of suicide prevention? Email The Sophie Fund at thesophiefund2016@gmail.com

In June 2017, then Ithaca Mayor Svante Myrick issued a proclamation in support of The Watershed Declaration, and the Tompkins County Legislature proclaimed September 2017 to be The Watershed Declaration Month.

Led by Tompkins County Mental Health Services, 40 local mental health leaders came together in July 2017 and launched the Tompkins County Suicide Prevention Coalition.

In October 2017, The Sophie Fund organized an expert briefing at the Statler Hotel for senior healthcare administrators throughout Tompkins County; the topic was the Zero Suicide Model, which is designed to improve suicide prevention measures in healthcare systems.

Eight months later, the Suicide Prevention Coalition adopted Zero Suicide as its policy; eight healthcare providers stepped up to declare themselves “Zero Suicide Champions,” pledging to explore implementation of the model. In July 2018, the county legislature unanimously passed a resolution to support Zero Suicide, calling on local healthcare and behavioral healthcare providers to follow the model’s systematic clinical approach to preventing suicides.

Coalition work toward drafting a strategic plan, creating a leadership team, expanding membership, conducting outreach, and following up on Zero Suicide implementation badly drifted in 2020; this was partly due to leadership transitions throughout the county’s healthcare agencies, as well as disruptions caused by the Covid-19 pandemic.

The coalition resumed monthly meetings in February 2021, elected Sally Manning of Racker as convener, and resumed work on a strategic plan.

In February 2022, then coalition unanimously adopted a three-year strategic plan guided by a vision “for a community where no lives are lost to suicide” and using data, science, and collaborations to implement effective strategies.

The five-point plan calls for using data to inform suicide prevention strategies; advancing the Zero Suicide Model in healthcare; reducing suicide in the youth population; reducing access to lethal means; and advocating for policies and practices to prevent suicide. The coalition has formed work groups to drive efforts in all five areas.

For its part, The Sophie Fund re-launched its Zero Suicide Initiative with a series of presentations and trainings to reinvigorate work on the model in Tompkins County.

On November 16 The Sophie Fund hosted “Call to Action: Suicide Prevention in Healthcare,” an expert briefing for top healthcare leaders by Jenna Heise, director of Suicide Prevention Implementation at the Suicide Prevention Center of New York.

This was followed on March 9 with “Understanding, Identifying, and Addressing Suicide Risk: A Clinical Primer for Behavioral Health Providers,” a training with national suicide prevention leaders hosted by The Wellness Institute.

The Sophie Fund on March 24 hosted “Implementation of Zero Suicide,” a suicide prevention presentation for front line managers representing 10 leading healthcare providers in Tompkins County; it was led by Tammy Weppelman, the State Suicide Prevention Coordinator at the Texas Health and Human Services Commission, and Mike Olson, the crisis program manager at My Health My Resources, an agency currently implementing the model in in Tarrant County, Texas.

On June 16, Virna Little, CEO of Concert Health and a leading expert on integrating primary care and behavioral health, will provide a briefing for primary care physicians and their teams on implementing Zero Suicide protocols in primary care practices.

Finally, in June Jenna Heise of the Suicide Prevention Center of New York will return to Ithaca for a roundtable discussion with top healthcare leaders on Zero Suicide implementation progress.

Suicide Prevention Day—What You Can Do

thesophiefund

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.

Albany Honors The Sophie Fund with Mental Health Advocacy Award

thesophiefund

The New York State Office of Mental Health on Thursday presented The Sophie Fund with an Excellence in Suicide Prevention award for its mental health advocacy work in Tompkins County at the state’s 2018 Suicide Prevention Conference held in Albany.

JourneyOfHealingAward092018

The Sophie Fund and its founders, Scott MacLeod and Susan Hack, received the state’s Journey of Healing Award for “exemplary advocacy by a Suicide Attempt or Suicide Loss Survivor.”

MacLeod and Hack established The Sophie Fund to support mental health initiatives aiding young people after the 2016 death by suicide of their 23-year-old daughter, Sophie Hack MacLeod, a Cornell University student.

“The Sophie Fund is a beautiful example of how a tragic loss can transform a community,” said New York State Office of Mental Health Commissioner Dr. Ann Marie T. Sullivan.

“Scott and Susan took their painful loss and channeled it into a passion to save lives in Tompkins County. We thank Scott, Susan and everyone involved in The Sophie Fund for their hard work and commitment to suicide prevention.”

Said Lee-Ellen Marvin, executive director of Ithaca’s Suicide Prevention & Crisis Service (SPCS): “Scott and Susan have transformed their grief in just two years into a powerful force of influence for suicide prevention in Tompkins County.”

SPCS, the Tompkins County Mental Health Department, and Tompkins County Legislator Shawna Black nominated The Sophie Fund for a 2018 Excellence in Suicide Prevention award. State officials cited The Sophie Fund’s “tenacity” in securing the adoption of The Watershed Declaration in 2017, which called for intensified suicide prevention efforts in the county, and in advocating for the Zero Suicide Model to be adopted by local healthcare providers.

The Sophie Fund also has sponsored student mental health programming at Cornell University and Ithaca College; mental health first aid training; a series of bookstore readings by authors of books on mental health; and artists who address mental health and suicide themes. It is working on an initiative to support college students taking a health leave of absence. The Sophie Fund also sponsors the annual Ithaca Cupcake Baking Contest to raise mental health awareness and raise monies for local mental health nonprofits.

MacLeod and Hack thanked the Office of Mental Health and the Tompkins County nominators for Thursday’s recognition.

“In the loss of our precious Sophie in 2016, we witnessed the profound depths of mental illness and the immense tragedy of suicide,” they said in a statement released by the Office of Mental Health. “In establishing The Sophie Fund in her memory, we resolved to do everything possible to support young people battling mental disorders. Suicide is preventable, and we also resolved to do everything we could so that we do not lose one more person, young or old, to suicide in Sophie’s adopted Ithaca–Tompkins County community.”

MacLeod and Hack also paid thanks to “the countless people who have made The Sophie Fund’s work a reality”—supporters and partners in Tompkins County, friends, family, and others in the greater Ithaca area and beyond, and the New York Suicide Prevention Office.

Sophie was born in Johannesburg and spent her childhood living in South Africa, then France, and eventually Egypt. But she adopted Ithaca as her hometown, spending five summers in the violin program of the Suzuki Institutes at Ithaca College and then enrolling at Cornell in 2010. At the time of her death, she was on a health leave of absence from Cornell and working in Ithaca’s vibrant culinary scene.

Photo caption: Sigrid Pechenik, associate director, New York State Suicide Prevention Office; Susan Hack, co-founder, The Sophie Fund; Jay Carruthers, director, New York State Suicide Prevention Office; and Garra Lloyd-Lester, director, New York State Suicide Prevention Community Initiatives

Tompkins County Adopts the Zero Suicide Model

thesophiefund

The Tompkins County Legislature on Tuesday unanimously passed a resolution 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.

IMG_9285

Tompkins County Legislature July 17, 2018

“This is an initiative we can be proud of,” said Shawna Black, chair of the legislature’s Health and Human Services Committee, who sponsored the resolution. “We are going to be one of the first counties in New York State to implement Zero Suicide.”

“We have a lot of work to do as a county to support those that struggle with mental health issues,” Black added. “However, the conversation will continue and our goal of zero suicides will set the standard for our community and it’s providers. As a community we realize the need for honest conversation about suicide prevention and the tools we must implement in order to save lives. I would like to thank the many providers that offer service on a daily basis and for their commitment to the zero suicide initiative.”

The legislative passage of Resolution 7950 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.

Jay Carruthers, director of the New York State Office of Mental Health’s Suicide Prevention Office, commended the county’s efforts to implement Zero Suicide.

“The suicide prevention work done at the community level in Tompkins County over the last two to three years has been extraordinary,” Carruthers said in a statement to The Sophie Fund. “Creating community partnerships, raising awareness, decreasing stigma, forming a coalition, and most recently working to integrate suicide prevention in health and behavior healthcare services—the Zero Suicide Model—it’s a wonderful accomplishment.

“In fact,” Carruthers added, “a big topic of conversation at Governor Andrew Cuomo’s Suicide Prevention Task Force this year has been how to support robust suicide prevention at the local level. No one approach is going to be enough to materially reduce the number of suicides. It takes community-level public health approaches, a commitment to deliver suicide safer healthcare, and the creation a culture of data-informed programming. The partnership between Tompkins County and the state has been truly exemplary in moving in this direction.”

Sharon MacDougall, Tompkins County deputy commissioner of mental health services, said “the support from our community, the Tompkins County Health and Human Services Committee, and the Legislature is inspiring and incredibly meaningful to our behavioral health providers and clients. Tompkins County Mental Health Services is honored to collaborate with our partners to push forward a vision and commitment for Zero Suicide in our community.”

MacDougall noted that including Tompkins County Mental Health Services, a total of seven local healthcare providers have become “Zero Suicide Champions” by committing to implement the model: Cayuga Medical Center; Alcohol & Drug Council of Tompkins County; Suicide Prevention & Crisis Service; Cornell Health of Cornell University; Family & Children’s Service of Ithaca; and CAP Plan/Preferred.

David Shapiro, president and CEO of Family & Children’s Service, commented: “F&CS has for many years been at the forefront of suicide prevention in Tompkins County through the staff training, team support, and clinical supervision that have become hallmarks of our clinical program. F&CS is one of the founding members of the Tompkins County Suicide Prevention Coalition. Along with committing to the Zero Suicide Model, F&CS is also committed to be a Zero Suicide Champion and will share what we learn with the broader community so that we can all be better prepared to help people who may be at risk to commit suicide. Our commitment to the Zero Suicide Model sets a lofty goal with an aspirational challenge.”

Kent Bullis, executive director of Cornell Health, commented to The Sophie Fund: “Cornell Health supports the Zero Suicide model, and is committed to completing the Zero Suicide Organizational Self-Study this summer and reporting out our experience to the Tompkins County Suicide Prevention Coalition in the spring.”

In March, Cayuga Medical Center became the first major healthcare provider in Tompkins County to endorse the Zero Suicide initiative. “Cayuga Medical Center is committed to Zero Suicide and is currently studying what resources we need to implement,” David Evelyn, vice president for medical affairs, told The Sophie Fund. “We are pursuing the self-assessment.”

In comments to the Legislature prior to Tuesday’s vote, Scott MacLeod of The Sophie Fund said that “adopting the Zero Suicide Model is an important step in addressing the public health problem of suicide and the rising suicide rate.” The Sophie Fund sponsored The Watershed Declaration adopted exactly 15 months earlier in which local healthcare providers pledged to intensify suicide prevention efforts in Tompkins County. The Sophie Fund also co-hosted an expert briefing on the Zero Suicide Model last October at The Statler Hotel on the Cornell campus.

MacLeod thanked the Tompkins County Legislature and the Zero Suicide Champions for their support for the Zero Suicide Model. He also thanked and cited the valuable support provided by Jay Carruthers, director of the state Suicide Prevention Office; Associate Director Sigrid Pechenik; Garra Lloyd-Lester, associate director of the Suicide Prevention Center of New York State; and Michael Hogan, a former New York State mental health commissioner and a developer of the Zero Suicide Model.

The Tompkins County resolution reads in part:

WHEREAS, the Tompkins County Suicide Prevention Coalition endorses the Zero Suicide model as a framework for organizational commitment to safer suicide care in health and behavioral health care systems, and

WHEREAS, suicides are preventable, now therefore be it

RESOLVED, on recommendation of the Health and Human Services Committee, That Tompkins County hereby signs onto the Zero Suicide model to reduce the number of people committing suicides, commit to sharing lessons learned with other counties to support a state-wide initiative and encourage all health and behavioral healthcare to participate in the Zero Suicide model…

IMG_9269

Shawna Black (center), chair of the Health and Human Services Committee

The Zero Suicide Model, sometimes called the “Suicide Safer Care Model,” holds 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.

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.

As the Suicide Prevention Resource Center (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.”

The facts make a compelling case that healthcare settings must play a critical role in preventing suicide. 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 New York State 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.”

Zero Suicide is 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.”

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.

[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.]

Tompkins Coalition: “Yes” to Zero Suicide Model

thesophiefund

The Tompkins County Suicide Prevention Coalition on Monday overwhelmingly voted to recommend the Zero Suicide Model for healthcare providers as a countywide suicide prevention initiative. Deputy Mental Health Services Commissioner Sharon MacDougall said the coalition’s recommendation will be sent to the Community Services Board and the Tompkins County Legislature for consideration.

IMG_6978

Deputy Tompkins County Mental Health Services Commissioner Sharon MacDougall (center) with Cornell University students Winnie Ho of Alpha Phi Omega Gamma Chapter and Sophie Jones of The Sophie Fund

Four healthcare organizations attending the meeting also announced their agreement to become Zero Suicide “champions”—Tompkins County Mental Health Services; Alcohol & Drug Council of Tompkins County; Cornell Health, the healthcare center of Cornell University; and Cayuga Area Plan/Preferred, Inc., which represents primary care providers. MacDougall asked the champions to “commit to the model and report back to this coalition next spring in 2019.” In March, the Cayuga Medical Center announced its adoption of the Zero Suicide Model.

Prior to the meeting, about 50 people attended a community presentation on the Zero Suicide Model given by Jillian King and Olivia Retallack of the New York State Office of Mental Health’s Suicide Prevention Office.

IMG_6955

The Zero Suicide Model holds that suicide prevention is 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. The model’s developers argue 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.”

King and Retallack called suicide “an enormous public health problem,” and noted that many people who take their own lives are receiving treatment in healthcare systems. According to data they presented, 80 percent of people who died by suicide had healthcare visits within the prior 12 months. And most had a recent visit: 45 percent had a primary care visit within a month of their deaths; and 19 percent had contact with mental health services within the past month.

IMG_6954

Inadequate training is part of the problem. In a 2014 survey of New York State mental health providers, 64 percent felt they had little or no specialized training for suicide intervention; 33 percent did not feel they had sufficient training to assist suicidal patients.

MacDougall recounted how Tompkins County Mental Health Services improved its suicide prevention efforts when it began adopting the Zero Suicide Model in 2016:

“What I realized was that we weren’t using evidence-based assessments or screening tools to ask the question. We were talking about depression. We were talking about things with our clients. But we didn’t actually use a specific screener, or a specific assessment that’s based on the best research available to ask the questions.

“So immediately we instituted C-SSRS [Columbia-Suicide Severity Rating Scale], it’s an evidence-based screening tool that you can use for everyone. And we use it for everyone who walks in our door for an intake, and we use it on a regular basis for anyone who is even coming close to discussing suicide or depression issues. That was one step we made from that first year.

“We also looked at the fact that we weren’t doing safety plans. We were doing an older version, like a recovery plan, or a plan of care, but not a true safety plan. So we use that on anybody who tests positive after asking the suicide assessment.

“The third thing we realized was that our staff wanted and needed more training. They were asking for more training. All of our staff completed online certification training on online webinars.

“Early progress from this is that I think we have staff who are far more trained and much better at identifying and engaging clients who have suicide [thoughts]. We actually just ask the question now. It’s not just the depression screening. We actually ask ‘Are you feeling suicidal?’ And we actually dig in deeper.”

The Sophie Fund, which sponsored The Watershed Declaration in April 2017 calling for intensified suicide prevention efforts in Tompkins County,  released a statement Monday following the coalition’s meeting:

“The Sophie Fund would like to thank the Tompkins County Suicide Prevention Coalition for supporting the Zero Suicide initiative. There are many agencies and individuals to acknowledge for their leadership, but we’d like to particularly thank Frank Kruppa and Sharon MacDougall of the Tompkins County Mental Health Services; Lee-Ellen Marvin of the Suicide Prevention & Crisis Service; and the Cayuga Medical Center, for its recent adoption of the Zero Suicide Model.

“We must do more to prevent suicide in Tompkins County. The Zero Suicide Model is an essential approach for saving lives. As the next step, The Sophie Fund renews its call on all the leading community and campus healthcare agencies in Tompkins County to commit to the Zero Suicide Model and to begin the implementation process as expeditiously as possible.

“We are experiencing a mental health crisis in the United States—and we must step up to meet that challenge. A terrible part of that crisis is the alarming rise in suicides. Just this month, the Centers for Disease Control and Prevention released a report that the national suicide rate increased 25.4 percent from 1999 to 2016. There are more than 1 million suicide attempts every year. It is the second leading cause of death among young people 15-24 years of age.”

[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.]