Cayuga Health: Advancing Suicide Prevention

Centralus Health is recognizing September as National Suicide Prevention Month, joining organizations and communities across the country in raising awareness, reducing stigma, and encouraging meaningful conversations about mental health and suicide prevention.

Throughout the month, team members are helping bring greater visibility to suicide prevention and the importance of connection. During Suicide Prevention Week, staff across the health system hosted resource tables and shared mental health and suicide prevention resources with patients, visitors, and colleagues.

Centralus Health is a collaborative network uniting Cayuga Health in Ithaca and Arnot Health in Elmira. As part of its focus on strengthening suicide prevention in clinical care, Centralus Health welcomed Dr. Virna Little, a nationally recognized leader in suicide prevention, on September 11 for a Grand Rounds presentation, “Optimizing Suicide Care.”

The presentation focused on evidence-based approaches to suicide risk screening and assessment, strategies for integrating suicide care into clinical workflows, and best practices for improving continuity and follow-up for individuals at risk for suicide.

Our health system has endorsed the Zero Suicide Model, a framework that recognizes suicide prevention as a core responsibility of healthcare. Through this commitment, the health system continues to foster an environment where suicide risk is recognized, concerns are taken seriously and individuals experiencing a mental health crisis receive compassionate, coordinated care.

We have made systemic improvements in suicide care since 2018. We formed a system-wide Zero Suicide Implementation Team, sub-teams for component units, and conducted a Zero Suicide Self-Study and a Workforce Survey. We have implemented core Zero Suicide practices within the Emergency Department, inpatient Behavioral Health Unit, and the Cayuga Integrated Behavioral Health (CIBH) program which embeds behavioral health clinicians within primary care practices.

New York State’s Office of Mental Health recognized our efforts for systemic improvement with a Spotlight Story in “1,700 Too Many: New York State’s Strategy for Suicide Prevention 2026-2030,” announced on September 10 by Governor Kathy Hochul.

Centralus Health is also supporting suicide prevention efforts in the communities it serves, including the American Foundation for Suicide Prevention’s Out of the Darkness Greater Ithaca Walk. The September 12 event in Lansing’s Myers Park brought community members together to raise awareness, honor those affected by suicide and support suicide prevention research, education, and advocacy.

National Suicide Prevention Month is an important reminder that suicide prevention is a shared responsibility. Through education, awareness, compassionate care and community partnership, Centralus Health remains committed to helping create communities where people feel seen, supported and connected to help when they need it.

—By Andreia de Lima, MD

Andreia de Lima is Chief Medical Officer and Vice President of Medical Affairs at Centralus Health’s Cayuga Medical Center and Schuyler Hospital

If you or someone you know feels the need to speak with a mental health professional, you can call or text the 988 Suicide and Crisis Lifeline at 9-8-8, or contact the Crisis Text Line by texting HOME to 741-741.

Preventing Suicides in Tompkins County

To mark National Suicide Prevention Month in September, The Sophie Fund is publishing a booklet highlighting the considerable efforts taken to save lives in Tompkins County over the past decade.

Healthcare leaders speaking at a suicide prevention town hall, 2023

Leaders from healthcare, behavioral health, government agencies, and concerned nonprofits have come together to upgrade suicide prevention practices, train practitioners, and educate the public about suicide risk factors and warning signs. It is a sustained, community-wide mission.

The booklet will be distributed at “Rooted in Action: Innovative Approaches for Rural Suicide Prevention,” the annual New York State Suicide Prevention Conference being held this year in Ithaca on September 29-30.

If you or someone you know feels the need to speak with a mental health professional, you can call or text the 988 Suicide and Crisis Lifeline at 9-8-8, or contact the Crisis Text Line by texting HOME to 741-741.

Among the steps taken in Tompkins County:

—In the 2017 Watershed Declaration, healthcare leaders pledged to “intensify efforts toward saving lives and bringing hope to those struggling with suicide thoughts or affected by suicide loss.”

—Stakeholders formed the Tompkins County Suicide Prevention Coalition in 2018, adopting a 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.

Formation of the Tompkins County Suicide Prevention Coalition, 2017

—The Coalition hosted two community town halls, “How Healthcare Helps Prevent Suicides,” and “Youth Mental Health & Wellness.”

—The Coalition launched the “Tompkins County Suicide Care Pathway Initiative” in 2025, bringing together hospitals, campus health centers, behavioral health clinics, and crisis responders to map and improve support and continuity of care across health sectors.

—Community nonprofits created the annual “Mental Health Support and Suicide Prevention for Schools in Tompkins County,” a booklet of information and resources, and distributed more than 200 copies to school personnel.

—The American Foundation for Suicide Prevention Central New York chapter organized annual “Out of the Darkness” walks in the community and on the campus of Cornell University.

Out of the Darkness” Walk at Cornell University, 2024

—AFSP, NAMI Finger Lakes, Mental Health Association, Suicide Prevention and Crisis Service, and The Sophie Fund provided a robust array of suicide and mental health care trainings and support services including help hotlines.

—The Coalition launched an initiative to promote the Zero Suicide Model in the community’s healthcare systems; and top healthcare leaders formed the Tompkins County Zero Suicide Steering Committee in to implement the model within and across healthcare systems.

Launch of the Tompkins County Zero Suicide Steering Committee, 2022

—Cayuga Health and Tompkins County Whole Health embarked on Zero Suicide implementation plans.

—The Suicide Prevention & Crisis Service expanded its 988 call center staff from five to 42, expanded its coverage area to a total of 17 counties, and added call lines for LGBTQ+ and non-crisis emotional support.

DOWNLOAD Tompkins County Suicide Prevention

Scott MacLeod, co-founder of The Sophie Fund, said that his organization was grateful for Tompkins County’s advances in suicide prevention, but added that there was no room for complacency.

“People of all ages, including students on local college campuses, are dying by suicide in Tompkins County,” he said. “Nationwide, suicide remains the second leading cause of death among people aged 10-24.” He noted that the Coalition’s Suicide Care Pathway Initiative in 2025 showed numerous gaps in local suicide care, a need for more training in suicide prevention treatment protocols, and greater fidelity in the use of those protocols.

“We need continuous efforts to educate ourselves about risk factors and warning signs, to encourage people who are struggling to seek help, and to see suicide prevention best practices implemented by all providers. National Suicide Prevention Month is a call to action to step up the mission,” he added.

The Sophie Fund is a nonprofit organization advocating for improved mental health in Tompkins County. It was formed in 2016 in memory of Sophie Hack MacLeod, a Cornell University student who died by suicide that year.

If you or someone you know feels the need to speak with a mental health professional, you can call or text the 988 Suicide and Crisis Lifeline at 9-8-8, or contact the Crisis Text Line by texting HOME to 741-741.

For Tompkins Clinicians: Free Training in Suicide Care

The Sophie Fund is sponsoring free registration—and free continuing education credits (CEUs)—for healthcare professionals in Tompkins County to attend a two-day online training in suicide prevention featuring many leading experts.

The training program, “Suicide Safer Care in Clinical Practice,” takes place on the afternoons of Tuesday March 10 and Wednesday March 11.

It is organized by The Wellness Institute, which says attendees “will receive direct guidance from intervention developers, current updates into emerging suicide prevention challenges, and concrete steps to work with clients at risk with greater confidence, competence, and clarity.”

The training will cover primary treatments for suicidality such as Cognitive Behavior Therapy for Suicide Prevention (CBT-SP) and Dialectal Behavior Therapy (DBT) as well as brief interventions including Attempted Suicide Short Intervention Program (ASSIP) and Collaborative Assessment and Management of Suicidality (CAMS). The program includes a session devoted to treating suicidality in youth. (See full program, below.)

The training is also sponsored by the American Foundation for Suicide Prevention, The Jed Foundation, the Education Development Center, Zero Suicide Institute, Suicide Prevention Resource Center, EveryMind, SAVE, and CAMS-care.

Free registration with free continuing education credits for physicians, primary care clinicians, health and mental health clinicians, and clinical social workers serving Tompkins County is supported by a grant from The Sophie Fund.

To request a registration code for free registration, healthcare professionals can email The Sophie Fund at thesophiefund2016@gmail.com providing their 1) name, 2) email address, 3) degree level, and 4) place of employment (or name and address of practice, if self-employed).

Scott MacLeod, co-founder of The Sophie Fund, said his organization’s sponsorship of the Wellness Institute program for the fifth year in a row is intended to advance suicide prevention with local healthcare providers. Thus far, The Sophie Fund has provided the free training for 220 clinicians in Tompkins County, including the counseling center staffs of Cornell University and Ithaca College.

Zero Suicide is an emerging standard designed to save lives by closing gaps in the suicide care offered by healthcare providers. The model provides a practical framework for system-wide quality improvement in areas including training staff in current best practices, identifying at-risk individuals through comprehensive screening and assessment, engaging at-risk patients with effective care management, evidence-based treatments, and safe care transition.

Suicide is the second leading cause of death among Americans aged 10-14 and 25-34. Recently, Tompkins County has averaged 12 suicide deaths per year. Another 1,600 parents, children, siblings, friends, and spouses may be impacted by the resulting psychological, spiritual, and/or financial loss.

An estimated 300 people in Tompkins County may attempt suicide every year. While rates for other causes of death have remained steady or declined, the U.S. suicide rate increased 35.2% from 1999 to 2018.

Suicide Safer Care in Clinical Practice

TUESDAY, MARCH 10, 1-5 P.M. EST

Suicide Theories

Thomas Joiner, PhD; David Rudd, PhD

Primary Interventions: CT-SP vs. DBT

Kate Comtois, PhD, MPH; Kelly Green, PhD

Brief Interventions: ASSIP vs. BCBT vs. CAMS

Anja Gysin-Maillar, PhD; Craig Bryan, PsyD, ABPP; Raymond Tucker, PhD

Youth Interventions: ABFT vs. IPT-A vs. DBT-A

Guy Diamond, PhD; Alec Miller, PsyD; Anat Brunstein-Klomek, PhD’ Jonathan Singer, PhD, LCSW

WEDNESDAY, MARCH 11, 1-5 P.M. EST

Joining the Client in the Dark: Leaning into Empathy Rather than Fear

Stacey Freedenthal, PhD

The Silent Partner: Addressing Substance Use in Suicide Prevention

Arwen Podesta, MD

AI, Chatbots, and Apps: Implications in Clinical Care

John Torous, MD, MBI

Self Care is Not a Luxury: Techniques for Protecting Against Vicarious Trauma

Jeffrey Barnett, PhD

Trigger Warning: Re-framing Firearm Counseling from “Restriction” to “Safety”

Emmy Betz, MD, MPH

Crisis-Ready: Preparing a Suicide-Safe Practice

Jill Harkavy-Friedman, PhD

In Practice: Effective Solutions to Unique Situations (Bridging the Gap between Theory and Implementation)

Jill Harkavy-Friedman, PhD; Jennifer Hartstein, PsyD

Learning Objectives

  • Describe two research-based models for understanding suicide, identify motivations for suicide and their implications in clinical treatment.
  • Describe evidence-based interventions DBT and CBT-SP for suicide ideation and behaviors and how to apply each approach to clinical cases.
  • Describe evidence-based brief suicide interventions, ASSIP, CAMS, and BCBT and how to apply each approach to clinical cases.
  • Describe evidence-based suicide interventions for youth, ABFT, DBT, and IPT-A and how to apply each approach to clinical cases.
  • Differentiate client-centered care from defensive practice in treating individuals with suicide ideation and/or behavior.
  • Describe how mental health apps and AI-enabled chatbots are currently being used in clinical care. Review their evidence base, limitations, and risks related to safety, bias, and clinical validity.
  • Apply practical frameworks to assess digital tools and suggest ways to communicate the risks and benefits to patients.
  • Describe a screening process that detects substance use disorders and co-morbid risk for suicide.
  • Explain the importance of ongoing self-care to maintain clinical effectiveness when treating suicidal patients and outline an effective self-care plan.
  •  Describe how language impacts delivery of firearm suicide prevention messaging or counseling and three preferred terms relevant to firearm suicide prevention.
  • Identify suicide risk factors and warning signs and describe key steps for preparing one’s clinical practice to respond effectively to individuals expressing suicidal ideation.
  • Analyze complex cases and apply practical, evidence-informed strategies to effectively manage suicide ideation and behaviors in clinical practice

Please, Don’t Ignore Signs of Suicide

So many people struggle with a mental illness in silence. Suicidal thoughts are actually not that uncommon. But people who experience them are too often ashamed or embarrassed to speak about it. Or some figure, “I can handle it,” and put on a happy face. Loved ones or friends may be concerned about someone’s well-being. But stigma prevents them from asking if they are thinking of harming themselves.

September is National Suicide Prevention Month, a time to spread greater awareness about suicide and support those who may be struggling.

Suicide is preventable, and researchers and practitioners have made important strides in the past 20 years to improve way to assess suicidality and provide treatment for the condition.

The Tompkins County Suicide Prevention Coalition is urging local healthcare and behavioral health providers to adopt a framework of best practices known as the Zero Suicide Model.

This involves better screening tools for identifying people at risk of suicide. When suicidal ideation is a concern, Zero Suicide calls for creating safety plans to deescalate a suicidal crisis and lethal means counseling to ensure that weapons or medications are kept at a safe distance. Suicide-specific treatments include Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) and Dialectical Behavior Therapy (DBT).

Another major advance is the introduction in 2022 of the 988 Suicide & Crisis Lifeline, which provides free and confidential emotional support to people in suicidal crisis or emotional distress 24/7. You can also call 988 if you are concerned about a loved one, friend, or colleague. Veterans and/or their loved ones and friends can call 988 and then press 1 to reach the Veterans Crisis Line

Locally, 988 calls go to the Suicide Prevention & Crisis Service of Tompkins County (SPCS), one of 200 call centers across the country.

When people call or text 988, or connect to chat online, they connect to trained counselors that are part of the Lifeline network. They listen, understand how the caller’s problems are affecting them, provide support, and connect them to resources if necessary.

SPCS maintains a “warm line” for people who are not in crisis yet may be feeling lonely and need someone to talk to without judgement. The Ithaca Warm Line number is (607) 210 8328.

SPCS also operates Ithaca LGBTQ+ Peer Support, designed to be a safe space to engage in casual conversations, share experiences, or get support for crisis situations or thoughts of suicide. The Ithaca LGBTQ+ Peer Support number is (607) 276 1771.

The Lifeline is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered by Vibrant Emotional Health. SAMSHA provides a Partner Toolkit to help promote the 988 number and other suicide prevention services.

According to the 988 administrator, numerous studies have shown that callers feel less suicidal, less depressed, less overwhelmed, and more hopeful after speaking with a Lifeline counselor. 

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

According to AFSP, 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

For local, state, and national resources, visit The Sophie Fund’s suicide prevention page.

Free Training in Suicide Care: Sign Up Now!

The Sophie Fund is sponsoring free registration—and free continuing education credits (CEUs)—for healthcare professionals in Tompkins County to attend a two-day online training in suicide prevention featuring some of the nation’s leading experts.

The training program, “Suicide Safer Care in Clinical Practice Incorporating Current Best Practices,” takes place in the afternoons of Wednesday March 19 and Thursday March 20. It is organized by The Wellness Institute, which says the conference designed “to strengthen confidence and competence in providing caring, evidence-based services to clients with suicide risk.”

The training, which covers treating youth suicidality, lethal means counseling, brief interventions, treatment pathways, and other topics, is also sponsored American Foundation for Suicide Prevention, The Jed Foundation, the Education Development Center, Zero Suicide Institute, American Association of Suicidology, and CAMS-care. (See full program, below.)

Free registration and free continuing education credits for physicians, primary care clinicians, health and mental health clinicians, and clinical social workers serving Tompkins County is supported by a grant from The Sophie Fund.

To request a registration code for free registration, healthcare professionals can email The Sophie Fund at thesophiefund2016@gmail.com providing their 1) name, 2) email address, 3) degree level, and 4) place of employment (or name and address of practice, if self-employed).

Scott MacLeod, co-founder of The Sophie Fund, said his organization’s sponsorship of the Wellness Institute program for the fourth year in a row is intended to advance the Zero Suicide Model with healthcare providers. Thus far, The Sophie Fund has provided the free training for 180 clinicians in Tompkins County, including the counseling center staffs of Cornell University and Ithaca College.

Zero Suicide is an emerging standard designed to save lives by closing gaps in the suicide care offered by healthcare providers. The model provides a practical framework for system-wide quality improvement in areas including training staff in current best practices, identifying at-risk individuals through comprehensive screening and assessment, engaging at-risk patients with effective care management, evidence-based treatments, and safe care transition.

Suicide is the second leading cause of death among Americans aged 10-14 and 25-34. Recently, Tompkins County has averaged 12 suicide deaths per year. Another 1,600 parents, children, siblings, friends, and spouses may be impacted by the resulting psychological, spiritual, and/or financial loss.

An estimated 300 people in Tompkins County may attempt suicide every year. While rates for other causes of death have remained steady or declined, the U.S. suicide rate increased 35.2% from 1999 to 2018.

Suicide Safer Care in Clinical Practice: Incorporating Current Best Practices

Wednesday, March 19, 1-5 p.m.

Understanding Suicide to Prevent Suicide: A Clinical Framework

E. David Klonsky, PhD, Professor in the Department of Psychology, University of British Columbia

Jill Harkavy-Friedman, PhD, Senior Vice President of Research, American Foundation for Suicide Prevention

New-Generation Treatments (CRP, BCBT, etc.)

Craig Bryan, PsyD, ABPP, Trott Gebhardt Philips Endowed Professor and Professor of Psychiatry and Behavioral Health, Ohio State University College of Medicine

Assessment, Safety Planning, and Treatment Pathways

Gillian Murphy, PhD, New York-based psychotherapist; former Assistant Deputy Director for the National Suicide Prevention Lifeline (now 988)

Integrating Firearm Safety Discussions in Clinical Practice

Christopher Knoepke, PhD, MSW, LCSW, Research Assistant Professor, University of Colorado Anschutz Medical Campus.

Clients with Suicide Bereavement

Noam M. Schneck, PhD, Assistant Professor of Clinical Medical Psychology (in Psychiatry), Columbia University’s Department of Psychiatry and the New York State Psychiatric Institute

Thursday, March 20, 1-5 p.m.

The Human Element: Engaging Suicidal Clients

Jonathan Singer, PhD, LCSW, Professor, Loyola University Chicago School of Social Work

Creating Safe Spaces for Suicidality Disclosure

Lindsay Sheehan, PhD, Assistant Professor of Psychology and Associate Director of the Center on Health Equity, Education, and Research, Illinois Institute of Technology

Post-Crisis Reintegration

Marisa Marraccini, PhD, Tarbet Faculty Scholar in Education and an Associate Professor of School Psychology, University of North Carolina at Chapel Hill’s School of Education

Adapting Suicide Prevention for Telehealth

Lauren Khazem, PhD, Research Assistant Professor and clinical psychologist in the Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center

Addressing Substance Use in Suicide Prevention

Christina M. Sellers, PhD, LCSW, Associate Professor and Director of the Center for Innovation in Behavioral Health Education and Research, School of Social Work, Simmons University

Sleep-Focused Approaches to Youth Suicide Prevention

Sally Weinstein, PhD, Associate Professor of Clinical Psychiatry and Associate Director of the Center on Depression and Resilience, University of Illinois College of Medicine

Ask the Experts: What Works in Suicide Care (Q&A Session)

David Jobes, PhD, ABPP, Professor of Psychology and Associate Director of Clinical Training, Catholic University of America; Creator and Developer, Collaborative Assessment and Management of Suicidality (CAMS)

David A. Brent, MD, academic chief of child and adolescent psychiatry, UPMC Western Psychiatric Hospital

Jill Harkavy-Friedman, PhD, Senior Vice President of Research, American Foundation for Suicide Prevention

Learning Objectives:

Describe a model for understanding suicide and list factors that contribute to increased suicide risk.

Discuss how clinicians can engage in suicide prevention in their clinical practice.

Describe the suicidal mode and identify the mechanisms targeted by newly developed treatments in suicide prevention.

Identify core principles that can guide the suicide assessment process and brief interventions to implement to maintain client safety.

Articulate the role of firearms in suicide and how to integrate firearm safety conversations into suicide prevention efforts.

Explain the unique emotions that typify suicide bereavement and an approach to facilitate emotional acceptance.

Identify suicide-focused care models that fit a clinician’s clinical approach best and ways they can utilize their emotional reactions while working with suicidal individuals.

Describe client perspectives on disclosure of suicidality and strategies to increase comfort in disclosure.

Explain considerations for supporting students returning to school following suicide-related crises and how best practices for student reintegration may be generalized for community reintegration of individuals in all life stages.

Identify telehealth adaptations of suicide prevention strategies and how they may be implemented. (Describe imminent suicide risk assessment and responses.)

Explain the relationship between substance use and suicide and how substance use is a risk factor for suicide.

Describe developmental changes in sleep in adolescence, how to assess sleep quality in youth, and intervention strategies to improve sleep in adolescents that may be relevant for suicide prevention.

Demonstrate how to ask a client if they are experiencing suicidal thoughts, incorporate one new practice for suicide prevention, and develop a practice plan to put in effect when a person states they have been thinking about suicide.