building strategies to address youth suicide- louisiana ...presenters: faith boudreaux, med and...
TRANSCRIPT
Building Strategies to Address
Youth Suicide- Louisiana and the
National Child Safety Learning
Collaborative
Louisiana School-Based Health Alliance23rd Annual ConferenceApril 9th, 2019
Presenters: Faith Boudreaux, MEd and Ryann Martinek, MPH
Louisiana Youth and Suicide
• Louisiana suicide rates have been increasing– Especially among youth ages 15-19
• Louisiana suicide rate among youth exceeded the US rate (7.8 vs. 7.2 per 100,000) in 2017 for youth 10-19 years old
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2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Louisiana Suicide Rate Per 100,000Ages 10-19
Source: Vital Records, 2007-2017
Louisiana Youth Suicide
• In 2017, 17.8% of Louisiana’s high school students taking the Youth Risk Behavior Survey (YRBS) seriously considered attempting suicide
– 16.8% attempted suicide
– Nationally, 7.4% of US high school students reported attempting suicide
Source: Centers for Disease Control and Prevention (CDC). 1991-2017 High School Youth Risk Behavior Survey Data.Available at http://nccd.cdc.gov/youthonline/.
• Between 2007 and 2017, 375 Louisiana youth (10-19) died of suicide
– 56% from firearms
– 35% from suffocation
– 5% from self poisoning
Suicide Mechanism
Source: Vital Records, 2007-2017
• Between 2007 and 2017, the majority of violent deaths (suicide, homicide, accidental firearm) among children 10-14 years old in Louisiana were due to suicide
– 57% by firearms
– 34% from suffocation
Suicide Mechanism
Louisiana State Child Death Review and
Suicide Prevention
• Nationally, Child Death Review (CDR) began in 1978
• CDR was established in 1992 in Louisiana with the aim of identifying the causes of unexpected child death and methods for prevention
• Legislatively mandated: Louisiana Revised Statute 40:2019
• 28 member panel of agency directors or Governor appointees
CDR Case Definition:Unexpected deaths of children ages 0-14
An unexpected death is defined within CDR legislation:
“…death which is a result of undiagnosed disease, or trauma in which the surrounding circumstances are suspicious, obscure, or otherwise unexplained, or other death the circumstances of which are suspicious, obscure, or otherwise unexplained. A clinical diagnosis of death due to Sudden Infant Death Syndrome (SIDS) shall be deemed an unexpected death.”
CDR Program Activities
• Identification of cases using state vital records
Bureau of Family Health
• Identification of additional cases through news sources (e.g.. obituaries, newspaper articles, etc.)
• Validation of Cases
• Data abstraction
• Case Review Team (CRT) Meetings
• Community Advisory & Action Team (CAAT) Meetings
Regional
• State CDR Meeting
• Annual Report
• Statewide Preventive Measures (practice changes, programs, system improvements, policies, or state laws)
State
State CDR Suicide Case Review
Recommendations (June 2018)
– Strengthen/identify opportunities to build capacity in:• Suicide prevention programs for children• School-based bullying prevention programs• Support schools in effectively implementing suicide prevention
tools and, should a death occur, support schools in responding to the loss
– Determine if anticipatory guidance in healthcare exists when providers suspect a child is suicidal
– Support follow up care efforts after emergency visits for suicide attempts
– Enforce suicide safety intervention plans as a standard of care for suicidal children
Child Safety Learning Collaborative
Purpose Of CSLC
Focus states on a common agenda for child safety
Actively engage states in collaborative learning and sharing
Increase states’ knowledge and implementation of evidence-based strategies and programs
Enable states to create and use a structured improvement process to achieve child safety results
Demonstrate change over five years
The CSLC will:
Priority Injury Topics
Bullying PreventionMotor Vehicle Traffic
Safety Poisoning Prevention
Sudden Unexpected Infant Death Prevention
Suicide and Self-Harm Prevention
Participating States And Jurisdictions
What Is A Learning Collaborative?
Shared Aims
Application of Quality
Improvement Methods to Inform
and Accelerate Implementation of
Effective Strategies
Effective Strategies and
Measures
Collaborative Data Sharing
Peer Learning
Organizational Level
Collaboration and Targeted Technical
Assistance for Change
Collective National Impact
Suicide and Self-Harm Prevention (SSHP) Common Aim
By April 2023, states and jurisdictions will decrease suicide and self-harm related fatalities, hospitalizations, and emergency department visits by 4% from the November 2018 baselines for children and adolescents ages 10 through 19, through the implementation and spread of evidence-based suicide and self-harm prevention strategies and programs.
Child Safety Network Framework For Quality Improvements And Innovation In Child Safety
Suicide and Self-Harm Topic Teams
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Suicide and Self-Harm Prevention
• Indiana
•Louisiana
•Tennessee
•Texas
•South Carolina
•Vermont
•Wyoming
Benefits of Participation
• Access to national experts and resources and toolkits
• Ability to set individual goals and strategies related to topic and stakeholder interest
• Cross-State Collaboration among Topic Teams
• Contribution to national efforts and a cost-benefit analysis of using evidence-based strategies.
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Change Packages
• Focus on evidence-based and evidence-informed strategies
• Targets the organizational level to increase capacity for implementation and spread
• Informed by Maternal Child Health Bureau state action plans and selected national
performance measures
• Designed to enable Topic Teams to have significant overlap of strategies and
measures
• Informed by the CS CoIIN
• Constantly being tested for effectiveness and potential improvement
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Suicide and Self-Harm Change Packages
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Louisiana Pilot Community- Region 4
• Lafayette’s strong foundation with suicide coalition organized by local stakeholders
• Evidence-based screening in select schools
• Commitment from local stakeholders to the Learning Collaborative
• Region 4 includes the parishes of Evangeline, St. Landry, Acadia, Lafayette, St. Martin, Vermillion and Iberia
• Over the past 3 years the rate of suicide for Region 4 has been increasing for children 10 through 19 years of age. In 2017 the rate per 100,000 was 11 compared to the states rate of 8
Louisiana’s SSHP Team
Pilot is focused in the seven parishes in Region 4 with the goal to spread slowly and deliberately across Louisiana
• Participating Organizations:
• OPH Region 4 Public Health Office
• Louisiana Office of Behavioral Health
• Louisiana Department of Education
• Louisiana Office of Public Health – BFH – Adolescent School Health Program
Child Death Review Team
National Violent Death Reporting System
• Acadian Area Human Services Authority
• The Family Tree
– Suicide Prevention Coordinator
• St. Martin School-Based Health Centers
Louisiana Learning Collaborative Time Frame
Cohort 1 through April 2020
(Regions 4 Pilot)
Cohort 2 through October 2021
(Replication)
Cohort 3 through April 2023
(Replication)
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Thank you!
For more information , please contact:
Faith [email protected]
Acknowledgments:
Lafayette Area Partners• Dr. Tina Stefanski, Debra Perna, Marie Collins, Brad Farmer, Brittney Williams,
Adrienne HuvalLouisiana Office of Behavioral Health:• Danita LeBlancLouisiana Department of Education:• Janice ZubeLouisiana Office of Public Health - Bureau of Family Health• Norah Friar, Jane Herwehe, Amanda Perry, Jia Benno, Rosaria Trichilo,, Ryann
Martinek, Cara McCarthy