Albany Honors The Sophie Fund with Mental Health Advocacy Award

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.

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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 and Tompkins County Mental Health Department nominated The Sophie Fund for the 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

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.

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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…

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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.

Tompkins Coalition: “Yes” to Zero Suicide Model

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.

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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.

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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.

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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.”

“Thank You for Your Work”

New York state officials singled out The Sophie Fund as well as the Suicide Prevention and Crisis Service this week for their leadership and commitment in promoting improved suicide prevention practices in Tompkins County.

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Tompkins County proclamation of suicide prevention month (September 2017): Lee-Ellen Marvin, executive director, Suicide Prevention and Crisis Service; Scott MacLeod, The Sophie Fund; Anna Kelles, Tompkins County legislator

In a March 26 letter addressed to the two Ithaca organizations, Jay Carruthers, director of the state Suicide Prevention Office, and Sigrid Pechenik, director of the state Suicide Prevention Center, also applauded the suicide prevention efforts of city and county officials and local mental health stakeholders.

“We thank you and applaud the efforts that have taken place in Tompkins County over the past year,” wrote Carruthers and Pechenik. “Under your leadership and commitment to make Tompkins County a suicide safer community, you introduced and pushed forward the state’s vision.”

The state officials said they particularly acknowledged “The Sophie Fund’s efforts to bring Zero Suicide into healthcare systems in Tompkins County.” They noted that The Sophie Fund organized a summit to introduce the Zero Suicide Model to county outpatient, inpatient, and college campus leadership; created a website page devoted to Zero Suicide resources; and asked the Tompkins County Suicide Prevention Coalition to form a committee to focus on Zero Suicide Model implementation.

Remarking on the “extraordinary progress” achieved over the past year, Carruthers and Pechenik added: “We consider Tompkins County and its newly formed Suicide Prevention Coalition an exemplary testament to vision, dedication and mobilization of community stakeholders.”

The letter highlighted The Watershed Declaration, a community pledge to intensify suicide prevention efforts; Ithaca Mayor Svante Myrick’s proclamation recognizing suicide as a public health concern; and the Tompkins County legislature’s designation of September as suicide prevention month.

“As the New York State Prevention Plan states, ‘suicide prevention cannot succeed without community involvement and leadership.’ Thank you for your work,” Carruthers and Pechenik concluded.

Read the Full letter

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Download “1,700 Too Many: New York State’s Suicide Prevention Plan 2016–17”

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.

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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.

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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.