Five Years After The Watershed Declaration

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.

Meet Ithaca’s Mr. Kindness

To paraphrase his wife Jacque, Darrell Harrington is Ithaca’s Mr. Kindness. He is certainly a man with a big heart—actually, hundreds of them. Harrington is the one who came up with Be Kind Ithaca, whose bright red “Be Kind” hearts adorn lawns and porches throughout Tompkins County and beyond.

Darrell Harrington featured in a Spectrum News 1 segment in 2021

“Spreading kindness and paying it forward,” as Harrington puts it, is Be Kind Ithaca’s mission.

It started with the outbreak of the Covid-19 pandemic and the related lockdowns in March 2020. Harrington became concerned about the spike in anxiety that he was witnessing in the world around him. Jacque, a nursing student he describes as “just solid,” blew through two red lights in Ithaca one day. “There was this fear, this panic,” Harrington recalled. “The whole world was scared. Our age hasn’t been through something like this.”

Harrington, 48, a lifelong musician who is originally from Groton, has a long history with anxiety disorder. He still lives with some of the trauma he developed from being bullied as a kid with “buck teeth” and “coke-bottle eyeglasses.” After seeing a lot of stressed folks arguing on social media, Harrington did something he never imagined he could do.

He decided to publish a post about his personal experience with anxiety, and invited people to reach out to him if they wanted to talk about their own anxiety with someone. He says he was shocked to discover all the positive responses, including from people he had been afraid would “judge” him.

Harrington wanted to do more. Having recently started a small construction business, he knows his way around a tool shed. Drawing from his mother’s enjoyment of crafting, he used some scrap wood to create a red heart standing six feet high and four feet wide painted with the words “Be Kind.” Just before Easter that year, he trimmed the giant heart with colorful lights and planted it on the edge of his property along a busy road on Ithaca’s South Hill. “I’m just gonna put that there, if it can help someone decompress their stress, their anger, or just make them smile,” Harrington recalled.

Maria Salino, the owner of the nearby Dolce Delight bakery, saw Harrington’s heart and asked he if would make her one, too. Then at her request, Harrington went back to his basement work shop to saw, sand, drill, and paint away and produce 10 more hearts for her friends. He made a few extras and offered them to his own friends on social media, who scooped them up. Harrington reckons that he gave away the first few hundred hearts, but then with lumber prices rising he reluctantly started charging for them basically at cost so he wouldn’t go in the hole financially.

The orders kept coming in. With an extra hand in the work shop from his brother Dale, Harrington began offering two sizes, two by two feet and a miniature, for $27 and $14, respectively. The hearts are in plain site outside countless homes locally, but he has now shipped the Be Kind placards to nearly every state (and documented on Be Kind Ithaca’s Facebook page). Besides the hearts he constructs by hand, Harrington has created a line of Be Kind merch with everything from key chains and employee badge clips to t-shirts and fridge and car bumper magnets.

Nor has Harrington stopped at symbolic expressions of kindness. Inspired by Ronald McDonald House Charities, Be Kind Ithaca has begun donating a portion of its proceeds to the community. It has raised funds for T-Burg Takes on Pediatric Cancer, the Mickey Gallagher Memorial Scholarship Fund, the SPCA of Tompkins County, and The Lost Dogs of the Finger Lakes. Harrington has also sent donations to help victims of severe weather incidents in Texas and Kentucky.

(Full disclosure: Be Kind Ithaca recently made a donation to The Sophie Fund from its sales of Christmas ornaments, hand crafted by Harrington’s retired parents.)

Be Kind’s mission also involves undertaking random acts of kindness. For example, after hearing that many people had succumbed to Covid-19 at an Ithaca area nursing home, Harrington sprung into action by delivering gift bags to all its custodial workers to thank them for their selfless service. Partly supported by a donor, the bags were stuffed with Be Kind key chains, Dolce Delight gift cards, and New York lottery tickets.

Sometimes when Harrington encounters a total stranger who looks overwhelmed, he’ll pull out and present them with a Be Kind sticker. “You just see them smile,” he said.

To some, Harrington may seem like an unlikely ambassador of kindness. They would be wrong. For 30 years—since becoming a teenage fan of Guns N’ Roses—he has played bass guitar in heavy metal and rock bands, like Bone Jar and The New York Rock. With dreadlocks and tattoos up and down his left arm, he toured the country and played venues including CBGB in New York and Whiskey a Go Go in LA. Back home, he augmented his income bartending, and managed The Haunt, Ithaca’s largest band venue.

Through his rough and tumble music career and his mental health struggles, Harrington maintained a belief in the goodness of his fellow men and women. “For every bad person you hear about, there’re nine other amazing and kind people,” he said.

Darrell Harrington himself is one of those amazing and kind people.

NOTE: Follow Be Kind Ithaca on Facebook and Instagram, or email darrelljharrington@gmail.com, to order Be Kind products.

Advancing “Zero Suicide” in Tompkins County

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.

Tammy Weppelman, the State Suicide Prevention Coordinator at the Texas Health and Human Services Commission, outlined the seven elements involved in implementing the Zero Suicide Model. Weppelman was joined in her presentation by Mike Olson, the crisis program manager at My Health My Resources, an agency currently implementing the model in in Tarrant County, Texas.

The Zero Suicide Model is designed to eliminate gaps in systems of care for treating patients experiencing suicidal behaviors; research has shown that more than 80 percent of people who died by suicide had seen a healthcare provider in the previous 12 months, almost 50 percent within a month of their death, and more than 20 percent within their final week of life.

“Suicide prevention is a core function of the organization, it’s everybody’s business,” Weppelman said. “Suicide is preventable. The culture in your organization is a just culture, which means that you look at suicide as a system failure rather than an individual failure. It’s not an issue with a specific clinician or something that one person did that led to someone dying by suicide. But, collectively, as a organization, or as a system, what can we do better to prevent suicide.”

LEARN MORE: The Zero Suicide Model in Tompkins County

Weppelman said that leadership, the first element of the model, entails a healthcare provider creating an implementation team. She said it was essential that the team include top leadership decision-makers as well as individuals within the organization who are personally passionate about preventing suicide.

“Leaders are easily drawn to other priorities,” she explained. “But the passion on your implementation team, they’re not going to be drawn to other priorities. They’re going to keep that team driving forward.”

Olson discussed evidence-based training as a second element of Zero Suicide, “making sure that especially your direct care staff, or your front line staff, is competent in suicide prevention, but also confident in their ability to identify suicide risk and respond to that risk appropriately.”

He said that training provides skills for universal screening for suicide risk, assessment of treatment needs, and safety planning. A tangible first step, he added, calls for healthcare organizations to administer a workforce survey about suicide prevention capabilities at least every two to three years.

Weppelman reviewed a third element, identifying suicide risk. In all healthcare settings, she explained, “we want to do universal screening, screening every person, every visit, every time.” A recommended tangible first step, she said, is choosing a screening tool, such as C-SSRS or ASQ.

“In my experience, people don’t come out and say they’re having thoughts of suicide without somebody asking them,” she explained. “If you do ask, most of the time they’re honest, because they know that it’s a safe place or a safe person to talk to. So the the benefit of universal screening is that if you ask, you’re going to catch people. And if you don’t ask, you’re not.”

“I’ve heard somebody say, ‘It seems like a lot. What if somebody comes in every week? You ask them every week about suicide?’ Yes, it’s kind of like every time you go to the doctor you get your blood pressure taken, you get your temperature taken. Asking about suicide is like a mental health vital sign.”

The next element of Zero Suicide is to engage people who screen for high risk in a care management plan, a clinical pathway, Olson said. He said that this involves developing an individual safety plan with the patient, such as one using the Brown-Stanley Safety Plan template, that provides quick tips for self-care in a crisis, emergency contact information, and a reminder to remove access to any lethal means. Care management will also entail ongoing risk assessment and procedures for follow up care, he said.

Weppelman said that another element is using evidence-based treatment interventions. She explained that Zero Suicide calls for interventions that are specific to reducing suicide risk, as opposed to treatments for illnesses such as depression that are thought to be related to suicide. She said that recognized suicide-specific interventions include Collaborative Assessment and Management of Suicidality (CAMS); Dialectical Behavioral Therapy (DBT); and Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP).

Olson said that a sixth element focuses on the healthcare organization’s capacity to manage suicide risk during transitions in care. He said this includes supporting individuals transitioning from the emergency department or psychiatric hospitals; those who miss appointments or withdraw from care; and individuals transitioning to a new service provider.

He said that the transition element has been the trickiest for his agency. “Services are optional, we can’t force patients to to engage in services if they don’t want to,” he said.

Yet, Olson said, Zero Suicide calls for reengaging patients through “caring contacts”—“very basic correspondence just saying, ‘Hey, we haven’t seen you at the clinic in a while, you know we’re here for you if you need us.’” He said it also calls for “warm handoffs” to onward providers, so the patient “doesn’t fall through the cracks during that transition period.” He said his agency utilizes the Care Coordination Agreements and Care Transitions model for “making sure there’s timely follow up after any type of discharge from the hospital.”

“Individuals are 273 percent more likely to die by suicide within 30 days of a care transition, so these times are so super important,” Weppelman added.

Weppelman recalled her experience working in crisis services at a Dallas-Fort Worth area community mental health center that implemented Zero Suicide. She said that the center established memorandums of understanding with local hospitals so that when they discharged a patient in need of psychiatric follow-up for outpatient services, “they would be direct dropped to our door—within an hour of discharge, we would be seeing them.” When somebody presented at the emergency department after a suicide attempt, the center would dispatch a mobile crisis team to follow up, she said.

The seventh Zero Suicide element is continuous quality improvement. Weppelman said that this entails the use of data, keeping track of suicide deaths and suicide attempts within a provider’s system. She said that another aspect of improvement is developing a Zero Suicide implementation plan, starting with small goals that can be more easily achieved. She suggested doing one thing to drive efforts forward in the next 30 days, and then setting three goals for the next 90 days, and three goals for the next year.

“It’s not an initiative that you start today, and you end next week,” she explained. “It’s always a continuous quality improvement project.”

The presentation for front line managers was the third in a series of presentations and trainings on Zero Suicide hosted by The Sophie Fund.

It was attended by representatives from leading healthcare providers, including: Tompkins County Mental Health Services; Cayuga Medical Center; Cayuga Health Partners; Suicide Prevention and Crisis Service; Family & Children’s Service of Ithaca; Guthrie Cortland Medical Center; Alcohol & Drug Council of Tompkins County; Cornell Health and its Counseling & Psychological Services; Center for Counseling and Psychiatric Services at Ithaca College; and Health and Wellness Services and Mental Health Counseling at Tompkins Cortland Community College. The presentation was also attended by Sally Manning, convener of the Tompkins County Suicide Prevention Coalition.

Previous events included “Call to Action: Suicide Prevention in Healthcare,” an expert briefing on the Zero Suicide Model for Tompkins County healthcare leaders on November 16 by Jenna Heise, Director of Suicide Prevention Implementation at the Suicide Prevention Center of New York; and “Understanding, Identifying, and Addressing Suicide Risk: A Clinical Primer for Behavioral Health Providers” on March 9 by The Wellness Institute.

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.

The Tompkins County Suicide Prevention Coalition on February 24 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; implementation of the Zero Suicide Model is one of the plan’s main objectives.

Zero Suicide is the healthcare pillar of “1,700 Too Many: New York State’s Suicide Prevention Plan 2016–17,” as well as of the 2021 “Surgeon General’s Call to Action to Implement the National Strategy for Suicide Prevention.”

Next Steps for Cornell Addiction and Recovery

Cornell Sober Housing, Inc. has changed its name to Cornell Collegiate Recovery, Inc. (CCR) to reflect its overall mission of advocacy to the Cornell University community about college student alcoholism, addiction, and recovery.

CCR is an independent nonprofit organization. Its board and supporters include faculty, alumni, and students committed to collegiate recovery. Since its founding in 2015, our mission has been multifaceted. We provide a clean and sober living environment for Cornell students, support their sobriety and recovery, and cultivate understanding throughout the broader Cornell community about substance abuse and addiction recovery.

At the end of the 2021-22 academic year, we will be closing our Sober House residence temporarily. This is an unfortunate consequence of Covid-19 and constraints on social gatherings, which have reduced the number of students associated with the Sober@Cornell student organization and who are interested in living in the house. In this context, we are shifting our focus to educating the Cornell University community—students, faculty, and administrators—about alcoholism, drug addiction, and recovery, and working with Sober@Cornell to rebuild its organization and programming.

Another in an occasional series of articles about student mentaOne in an occasional series of articles about student mental health. For more information, go to The Sophie Fund’s Student Mental Health Page

According to the Association of Recovery in Higher Education, approximately 160 colleges have recovery programs for students. Earlier college alcohol and drug programs focused on students drinking to excess (i.e., binge drinking) and gave little attention to students addicted to alcohol and other drugs because it was thought that alcoholics and addicts were primarily middle age adults. Alcohol is the dominant drug of choice among college students and most students drink moderately or are abstinent. National research finds that approximately 6 percent of college students are dependent upon alcohol and approximately 12 percent abuse alcohol. While students abusing alcohol can change their behavior and drink responsibly, either on their own or with professional help, students dependent upon alcohol and other drugs require alcoholism and addiction treatment to abstain and gain long-term sobriety.

The primary barrier to helping students recover from alcoholism and drug addiction is stigma. Cornell Collegiate Recovery, Inc. will work to reduce stigma and promote student access to treatment and long-term recovery through a variety of efforts:

  • Working with the Cornell University administration and Cornell Health to develop a comprehensive collegiate recovery program. We will seek to work with the Skorton Center for Health Initiatives to develop education efforts focused on teaching students about alcoholism, drug addiction, and recovery and how to seek help for themselves or fellow students suffering from alcoholism and drug addiction. We will seek to work with Counseling and Psychological Services (CAPS) to cross-train its clinicians in the diagnosis and treatment of mental health disorders and substance use disorders, particularly alcohol and other drug addictions.
  • Working with Sober@Cornell to revitalize its organization and rebuild its membership. We will work to promote a positive identity for students in recovery and a community of support through public relations campaigns and sponsoring sober events on campus.  
  • Working with student service professionals across campus to facilitate their ability to identify students who may be suffering from alcoholism and addiction and refer them to Cornell Health for appropriate diagnosis and treatment. Student service professionals also provide a critical role in supporting students in recovery to maintain their sobriety, achieve their full potential as Cornellians, and pursue successful careers after graduation.
  • Working with student organizations to promote an understanding of alcoholism, drug addiction, and recovery. For several years, we have brought Cornell alumni in recovery to campus to talk with fraternities and sororities. These FAST Talks have been well received, helping students to distinguish between responsible drinking and alcohol dependence and providing them with information on seeking help for themselves or friends. We will be promoting FAST Talks to other student organizations this year. We believe that peers helping peers is one of the best ways to help students suffering from alcoholism, and drug addiction and to support them in their recovery.

By William J. Sonnenstuhl, Alison Young, Tim Vanini, and Shawn Meyer

William J. Sonnenstuhl, Alison Young, Tim Vanini, and Shawn Meyer are officers of Cornell Collegiate Recovery, Inc.