In Emotional Distress or a Suicidal Crisis? Dial 9-8-8

National Suicide Prevention Month may be ending on September 30, but the need to support people experiencing a mental health crisis is more urgent than ever.

After a dip in 2019 and 2020, the suicide rate in the United States increased nearly 4 percent in 2021—47,646 deaths, up from 45,979 in 2020, according to a new report from the U.S. Centers for Disease Control. The rate for people age 15-24 rose 7 percent. Overall suicide rates have risen more than 30 percent in the past two decades.

Some good news: Seeking help became easier in 2020, with the introduction of the 988 Suicide & Crisis Lifeline. 988 has been designated as a new three-digit dialing code, similar to the simple-to-remember public safety hotline number 911.

The Lifeline provides free and confidential support to people in suicidal crisis or emotional distress 24 hours a day, seven days a week, across the United States. You can also connect to the Lifeline if you are concerned about a loved one, friend, or colleague.

988 calls go to into a nearby crisis center, one of 200 across the country. When people call or text 988, or connect to chat online, they will be connected to trained counselors that are part of the Lifeline network. Trained counselors listen, understand how the caller’s problems are affecting them, provide support, and connect them to resources if necessary.

NOTE: The previous Lifeline phone number (1-800-273-8255) will always remain available to people in emotional distress or suicidal crisis.

Ithaca’s 53-year-old Suicide Prevention & Crisis Service has long been part of the Lifeline network. Its trained counselors can also be reached by dialing 607-272-1616.

The Lifeline has been proven to be effective. According to its administrator, numerous studies have shown that callers feel less suicidal, less depressed, less overwhelmed, and more hopeful after speaking with a Lifeline counselor. Calls to the Lifeline have soared 45 percent since 988 was introduced in July.

The Lifeline is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered by Vibrant Emotional Health.

Warning Signs for Suicide

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

New Step Toward “Zero Suicide” in Tompkins County

Top healthcare leaders in Tompkins County have agreed to form a steering committee to drive local implementation of the Zero Suicide Model, an emerging standard designed to save lives by closing gaps in the suicide care offered by and across healthcare providers.

Zero Suicide roundtable participants, July 20

The move came during “Zero Suicide Roundtable: A Discussion on Best Practices in Suicide Prevention with Tompkins County Healthcare Leaders,” hosted on July 20 at the Statler Hotel by The Sophie Fund and Tompkins County Mental Health Services.

The two-hour roundtable was moderated by Jenna Heise, director of Suicide Prevention Implementation at the Office of Mental Health’s Suicide Prevention Center of New York.

The 13 roundtable participants represented Cayuga Medical Center, Guthrie Cortland Medical Center, Tompkins County Health Department, Tompkins County Mental Health Services, Family & Children’s Service of Ithaca, Suicide Prevention & Crisis Service, Cornell University, Tompkins Cortland Community College, and The Sophie Fund.

The leaders’ agreement is a step toward fulfilling Goal 2 of the Tompkins County Suicide Prevention Coalition’s 2022-2025 Strategic Plan, adopted last February, which calls for “quality improvement for suicide care in all Tompkins County healthcare and behavioral health settings.”

The strategic plan’s Objective 2.3 calls for the formation of a “Zero Suicide Work Group comprised of leading health and mental health providers to share ideas, experiences, and challenges, and lead collaborative, sustainable efforts to implement the Zero Suicide Model throughout Tompkins County.”

Harmony Ayers-Friedlander, deputy commissioner of Tompkins County Mental Health Services, introduced Heise to the gathering “as we renew our commitment to the implementation of the Zero Suicide Model in our community, within, and across, our healthcare settings.” She noted that the county’s Suicide Prevention Coalition was launched exactly five years earlier with the vision of “a community where no lives are lost to suicide.”

Addressing the healthcare leaders, Ayers-Friedlander added:

“Your presence here today serves as a reminder of just how important this work is. Zero Suicide works. Because it gives us hope that we can make a difference, direction through a systems-based framework when faced with the complexity of human suffering, and real tools that help us at each step of the way. Today is a time to evaluate where we are individually as institutions and collectively as a community in preventing suicide through this model.”

Jenna Heise, director of New York State’s Suicide Prevention Implementation, moderates a Zero Suicide leadership roundtable

Heise opened the roundtable with a brief overview of the Zero Suicide Model and then walked participants through a discussion on the model’s seven elements: leadership, training, screening and assessment, care planning, treatment, transition of care, and quality improvement.

“The foundational belief of Zero Suicide is that individuals in our care, on our watch, need not die by suicide, and that suicide is actually preventable for those in care,” Heise said. “The way that happens is that suicide prevention and suicide care become a core priority for health and behavioral health. We have not done a good job of that, frankly.”

“We need to have that leadership commitment,” Heise said. Under the model, she explained, a leadership commitment creates a “just culture” for suicide care that relies on systemic use of best practices rather than leaving suicide prevention to individual health workers.

“It has to be looked at as a systems problem,” she said. “For too long, we have left it to the crisis team or to one outstanding individual clinician or social worker, and our systems, or the newest person, the greenest person straight out of school, who had no schooling in suicide.”

Citing examples of successful implementation of Zero Suicide, such as in the Henry Ford Health System in Michigan, Heise added: “It is an aspirational goal but it is quite attainable. There are folks that have done this work and committed to it, and followed this framework in implementing the seven elements, and they have shown that you could significantly reduce the suicides, by rate and number, within your healthcare organization.”

Heise commended Tompkins County’s approach to creating a “safer suicide community, wrapped around health and behavioral healthcare, including partners on board like the health department, behavioral health, large health systems, universities, higher ed, and so forth. That’s where you start to really see impact, everybody speaking the same language, using the same tools, the same best practices, the same framework. This is very exciting.”

Participants shared their experiences with various aspects of suicide prevention measures within their systems. They noted the importance of cross-system coordination and integration for suicide care, the challenge of staffing, and a desire for greater suicide-specific training. Several participants noted their continuous quality improvement efforts in suicide care but said they did not follow the Zero Suicide Model per se.

The Sophie Fund provided participants with a packet of materials about the Zero Suicide Model and previous suicide prevention efforts that have been undertaken in Tompkins County. The packet included the following items:

Zero Suicide Organizational Self-Study

Transforming Systems for Safer Care

Quick Start Guide to Getting Started with Zero Suicide

“Vital Signs: Suicide rising across the US,” Centers for Disease Control and Prevention

“Changes in Suicide Rates United States, 2018–2019,” MMWR, Centers for Disease Control and Prevention

Sentinel Event Alert Issue 56: Detecting and treating suicide ideation in all settings, The Joint Commission

National Patient Safety Goal for suicide prevention, The Joint Commission

Three-Year Strategic Plan 2022-2025, Tompkins County Suicide Prevention Coalition

Resolution 2018-155, Suicide Prevention Coalition Zero Suicide Initiative, Tompkins County Legislature

The Watershed Declaration

Mental Health Support and Crisis Services Tompkins County, The Sophie Fund

“Health Care Contacts in the Year Before Suicide Death,” Journal of General Internal Medicine, by Brian K. Ahmedani, et al.

“Suicide Prevention: An Emerging Priority For Health Care,” Health Affairs, by Michael F. Hogan and Julie Goldstein Grumet

The roundtable was the fifth and final session of a Zero Suicide initiative launched by The Sophie Fund last November. 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.

“Understanding, Identifying, and Addressing Suicide Risk: A Clinical Primer for Behavioral Health Providers,” on March 9 by The Wellness Institute

“Implementation of Zero Suicide,” a suicide prevention presentation for front line managers, on March 24 by Tammy Weppelman, State Suicide Prevention Coordinator at the Texas Health and Human Services Commission.

“Zero Suicide: Best Practices for Primary Care,” on June 16 by Virna Little, Co-Founder and CEO of Concert Health.

If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline by dialing 988 (or 1-800-273-8255), or contact the Crisis Text Line by texting HOME to 741-741.

Celebrate Mental Health!

More than a dozen Tompkins County nonprofits participated in the Mental Health and Wellness Fair on May 7 at the Bernie Milton Pavilion in the Ithaca Commons. Thanks to the kind and compassionate souls who are working so hard to support mental health in our community! Gratitude to Josephine Gibson and the Mental Health Association in Tompkins County for hosting this opportunity to celebrate Mental Health Awareness Month 2022.

Mental Health Association in Tompkins County

Racker

Racker’s message board

Suicide Prevention & Crisis Service

Family & Children’s Service of Ithaca

Planned Parenthood of Greater New York

Tompkins Families

Big Brothers Big Sisters of Ithaca & Tompkins County

Village at Ithaca

Lakeview Health Services

The Sophie Fund

Southern Tier AIDS Program

Why We Support the Zero Suicide Model

The Tompkins County Legislature passed a resolution a year ago 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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Members of the Cayuga Health Partners Care Coordination Team

Cayuga Health Partners, a Physician-Hospital Organization comprising more than 40 medical practices and 200 physicians and a leader of healthcare delivery in Tompkins County, pledged to become a “Zero Suicide Champion” with the goal of implementing the suicide prevention model in our local healthcare network.

That pledge was made during a June 2018 meeting of the Tompkins County Suicide Prevention Coalition, formed in 2017 by more than 30 community-based organizations. Others announcing their commitment included Cayuga Medical Center, Tompkins County Mental Health Services, Alcohol & Drug Council of Tompkins County, Suicide Prevention & Crisis Service, Cornell Health of Cornell University, and Family & Children’s Service of Ithaca.

The Zero Suicide Model involves a foundational belief that suicide deaths for those engaged in the healthcare system are preventable. It is clear that safer suicide care is in the best interest of our patient population. I know for myself and my team, we all want to go to bed at night knowing we’ve done everything in our power to support the well being of the communities we serve.

The case for Zero Suicide is compelling. The New York State Office of Mental Health has released data showing that an overwhelming number of those who die by suicide are often already engaged in health systems. More than 80 percent of people who die by suicide have had health care visits in the prior 12 months—often more recently than that. These findings are consistent with national data.

Making the commitment to become a Zero Suicide Champion was the easy part. Now, utilizing the specific strategies and tools available free of charge to practices and providers nationwide through the Zero Suicide framework, Cayuga Health Partners is working to prevent suicides while improving the care for those who seek help.

Cayuga Health Partners is working in collaboration with Ithaca’s Suicide Prevention and Crisis Service in an effort to encourage individual practices and providers to embrace the Zero Suicide Model. In the fall of 2018, we launched a series of Lunch & Learn events featuring presentations about the model by SPCS Executive Director Lee-Ellen Marvin. To date, more than 60 percent of the primary care practices in the network have opened their doors to the presentations and discussions about the role they can play in suicide prevention. Members of Cayuga Health Partners have also played a role in supporting our partner organization, Cayuga Medical Center, in its own implementation of the Zero Suicide Model.

Cayuga Health Partners (formerly called Cayuga Area Plan/Preferred) is a partnership of the Cayuga Area Physicians Alliance (CAPA) and Cayuga Medical Center. Our network mission is to unify member organizations in the pursuit of high quality, accessible, and cost-effective healthcare for the population of patients we serve. In efforts to accomplish this, Cayuga Health Partners is a physician-led, physician-driven effort combining evidence-based best practices and innovative data collection technology in a way that aligns physician incentives and community partnerships to drive improvement in clinical quality.

For more information about the Zero Suicide Model, go to: http://zerosuicide.sprc.org/

—By Emily Mallar

Emily Mallar is the director of Care Management at Cayuga Health Partners

[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 Watershed Declaration

Community mental health stakeholders representing 18 organizations on Monday declared suicide a “serious public health concern” and pledged to intensify suicide prevention efforts in Ithaca and Tompkins County.

GarraLloyd-Lester                       Garra Lloyd-Lester, associate director of the Suicide Prevention Center New York

The call to action, known as The Watershed Declaration, was adopted by acclamation at the close of a meeting of leaders from Tompkins County, the City of Ithaca, non-profit organizations, and the campuses of Cornell University, Ithaca College, and Tompkins Cortland Community College.

The Watershed Declaration stated as follows:

“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.”

Lee-Ellen Marvin, executive director of the Suicide Prevention and Crisis Service in Ithaca, praised the call to action. “I was excited and moved to see leaders from different parts of our social service community together in one room, thinking about and committing to suicide prevention,” she said. “There is indeed a public health crisis, and the way to prevent suicide is with awareness, vigilance, and the willingness of all parts of society to commit to this effort.”

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

Lloyd-Lester explained that suicide is increasingly seen as a public health problem rather than just an issue to be handled by an individual and their therapist.

“Operationally, that means we can all play a role in helping individuals who might be struggling with thoughts of suicide, to help keep them safe,” said Lloyd-Lester. “Seeing the folks here today it is really reflective of this idea that suicide is everybody’s business. That is the mantra that the state talks about: suicide prevention is everybody’s business.”

Sharon MacDougall, Deputy Commissioner of Mental Health Services in Tompkins County, welcomed the state’s initiative. “Suicide prevention efforts in Tompkins County are strong and need collaboration among all our agencies, providers, and groups like The Sophie Fund,” she said. “A Suicide Prevention Coalition will help bring these efforts together in close collaboration—providing a unified and passionate Tompkins County voice advocating zero suicides in our county.”

Monday’s meeting was organized by The Sophie Fund, which advocates for improved mental health for young people in the greater Ithaca area.