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VA and SAMHSA hear counties on suicide prevention strategy

March 10, 2011
by Dennis Grantham, Editor-in-Chief
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Hyde joins National Action Alliance for Suicide Prevention leaders to listen at NACO conference

To counter increasingly troubling statistics—34,000 suicides annually, the result of over a million attempts—the Veterans’ Administration and the Substance Abuse and Mental Health Administration (SAMHSA) have joined under the umbrella of the National Action Alliance for Suicide Prevention in an effort to expand national awareness and take coordinated steps to revise the nation’s decade-old suicide prevention strategy.

At a recent meeting in Washington, D.C., associated with the National Association of Counties (NACO) conference, the National Action Alliance reached out to county officials and service providers for input.
The Alliance, which was launched on Sept. 10, 2010, as a public-private partnership, was represented by Ira Katz, MD, PhD, who directs Mental Health Services for the Veterans’ Administration and Richard McKeon, MD, MPH, of SAMHSA, who, along with SAMHSA Director Pamela Hyde, set aside their prepared remarks to listen to suggestions about community-based suicide prevention initiatives from some 40 county-level officials and providers. Leon Evans, President and CEO of The Center for Health Services in Bexar County, Tex. (whose efforts were featured last month in an Online Exclusive by Ron Manderscheid), noted the effectiveness of early intervention approaches, including crisis intervention training for local safety forces, which his county conducted for police, fire, dispatchers and others in 2010.
Each was taught to ask, “Are you a veteran?” in the early stages of a crisis call. Evans also suggested that local public health resources, including hotlines and crisis intervention help, be opened up to veterans, since some are at risk for suicide yet are reluctant to use VA resources due to the fear of stigma and damage to their careers.

A Sonoma County, Calif., supervisor, Shirlee Zane, urged greater candor and openness about the issue of suicide, saying, “We cannot be ashamed to talk about our pain.” Zane, a psychologist, stated that her own candor following the suicide death of her husband in early 2011 “unlocked many stories” among community leaders and local citizens who had been affected by suicide. “Because I spoke, they didn’t feel ashamed any more,” she said.

For her, the situation highlighted ‘what happens when you lose your job in this economy? And what does that mean if you already suffer from anxiety or depression, as he did.” While many communities are considering how to create new jobs, Zane cautioned that “one of the things we [county officials] haven’t done well is understand, when a company or organization closes, the incredible emotional impact on people’s lives, their need for understanding and support about what happened.”

Zane added another concern: “We did a feasibility study in Sonoma County and found that there are five people every day—out of 15 ‘911’ calls—that get into the criminal justice system due to a substance use or mental health issue.”

Based on the fact that pre-trial incarceration of these individuals can cost an average of $25,000, Zane says her county is investing $300,000 in a mobile behavioral treatment unit, staffed by a licensed therapist and substance abuse expert. “They’ll be first responder on 911 calls when there is not a critical risk of harm,” she says, noting that the goal “is to give law enforcement a tool that to prevent incarcerations, save the county money, and get the person the services they desperately need.”

Jim Colvin, administrator of the Chelan-Douglas Regional Support Network of East Wenatchee, Wash., spoke of the “remarkable outcomes” of veteran-to-veteran peer outreach. He suggested that if counties could partner with the VA to locate and train veterans as peer counselors, these individuals could reach out to current returning veterans to proactively address concerns about transitioning back into civilian life, PTSD, substance abuse, or other behavioral health issues that could lead to suicide.

“This kind of intervention is very powerful and could be done at very low cost,” said Colvin, noting that local VA officials set an earlier proposal aside due to a lack of funding. “We’re just scratching the surface of this incredible resource.”

Jim McDermott, of Tarrant County, Tex., noted that like other counties, “We don’t have a lot of money.” But the county has recruited volunteers—and the Arlington, Tex., police department—to pilot a team approach for suicide prevention. He cited a 2005 American Medical Association study that highlighted the importance of enabling local primary care providers to “recognize the impact of life changes, signals of depression, and increased suicide potential.” Citing local results, he added, “the approach can work very well if the behavioral health and primary care communities are working together.”

To submit recommendations to the task force that is updating the National Strategy for Suicide Prevention, visit www.surveymonkey.com/s/nssptaskforce.

To follow the progress of the National Action Alliance for Suicide Prevention, visit their new website at http://actionallianceforsuicideprevention.org.

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