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Zero Suicide program called a success
Portsmouth Herald - 12/10/2017
EXETER - Exeter Health Resources hosted a two-day training at the end of November, bringing together a multitude of organizations as part of their continuing five-year commitment to suicide prevention.
Zero Suicide is a national movement, which staff members of Exeter Hospital have not only adopted for their own use, but are spreading the word about, hoping for a statewide initiative to address suicide prevention.
At the Zero Suicide Academy training, Exeter brought together stakeholders that can be involved in suicide prevention. In addition to primary and mental health personnel, staff members invited law enforcement, community groups, Department of Corrections, Veterans Administration, Department of Safety and even members of the National Guard.
Deb Vasapolli, communications director for Exeter Health Systems, said the hospital's Zero Suicide efforts began in 2013.
"In 2013, we did a needs assessment and identified death by suicide as a significant problem especially among youth," said Vasapolli. "We wanted to see where we could make a significant difference in one area, and suicide rose to the top. Our board committed to a five-year plan to improve the statistics surrounding youth suicide."
In the first year, Vasapolli said they organized their efforts and chose a direction with the help of many people involved in the topic. In the second year, they awarded grants to five organization working to help prevent suicide, Arts in Reach, Austin17 House, Big Brothers/Big Sisters of New Hampshire, The Carriage Barn Equestrian Center, and the Chase Home for Children.
"Along the way, we learned that up to 60 percent of those who commit suicide had seen their provider within a year, or even within 30 days," said Vasapolli. "If health care providers could screen each interaction for suicidal thoughts or tendencies, and have a warm pathway for hand-off care, we believe we can eliminate much of this."
So, EHS funded bringing in Zero Suicide and trained 90 people in the practice.
Elaine de Mello, supervisor of training and prevention services for NAMI NH (National Alliance on Mental Illness), said the Zero Suicide model shows that when health services, and behavioral health services come together to better screen and approach patients who may have suicidal thoughts, there are better outcomes.
"If there is early detection, there is a much better chance that we can see a reduction in suicide," said de Mello. "The Henry Ford Health System showed a while ago that with the right approaches and best practices we can reduce the stigma. We learned that it takes a comprehensive approach, involving everyone, law enforcement, mental health workers, schools, primary care and families to enhance cooperation and the continuity of care. We need to keep people from falling through the cracks."
The key to success, said de Mello, is the hand off of care.
"When a person is in crisis and treated in the emergency room, they are given an appointment for follow-up care," said de Mello. "What we have found is as much as 90 percent do not keep the appointment. By doing something as simple as making a phone call, asking how the person is doing and reminding them of their appointment, we can improve those odds."
The simple act of showing that someone cares can make a huge difference without costing the state a lot of money.
"Of course, there are better practices we need to put in place," said de Mello. "We need to ensure that our records and our communications are thorough. We need to ensure the proper training is there, to recognize the signs. This is what Exeter began with their training last month. We need integrated models of care. It can be as simple as having a social worker available to a primary care doctor."
There is already a state suicide prevention plan in place, but de Mello said Zero Suicide could take it a step further and she commended Exeter for bringing the model to the state.
Vasapolli said she believes New Hampshire could become a model program for the rest of the country, and Becky Stoll, who came to the state to educate professionals about Zero Suicide, agreed.
Stoll, who is the vice president of crisis and disaster management at CenterStone in Tennessee, said that agency has adopted Zero Suicide practices and she now teaches the concept across the globe.
"I am not saying this because I was just there, but this group was so completely engaged and wanting to learn this, maybe the most engaged group I have seen yet," said Stoll. "Everyone was listening. No one was talking or looking down at their phones. It was impressive. I think there is real meat behind their effort and I believe from what I have seen that Zero Suicide is effective."
Stoll said the program is a marathon, not a sprint. She said it is an investment, not so much as of money as of "human capital."
"It takes time to embed this in all the state's systems," said Stoll. "We rolled it out in 2014, and within two years had seen a 64 percent reduction in suicide. I think New Hampshire can see similar results because it seemed like they were all over this concept, all in and ready to get started."
- Talking about wanting to die.
- Looking for a way to kill oneself.
- Talking about feeling hopeless or having no purpose.
- Talking about feeling trapped or in unbearable pain.
- Talking about being a burden to others.
- Increasing the use of alcohol or drugs.
- Acting anxious, agitated or recklessly.
- Sleeping too little or too much.
- Withdrawing or feeling isolated.
- Showing rage or talking about seeking revenge.
- Displaying extreme mood swings.
The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide but may not be what causes a suicide.
What to do:
If someone you know exhibits warning signs of suicide:
- Do not leave the person alone.
- Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt.
- Take the person to an emergency room or seek help from a medical or mental health professional.
- Call the U.S. National Suicide Prevention Lifeline at (800) 273-TALK.