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Suicide Prevention and COVID-19Early Warning System
Sarah Bassing-Sutton
Community Suicide Prevention Coordinator
N.E.W. Mental Health Connection
Sara Kohlbeck
Assistant Director
Comprehensive Injury Center
COVID-19 & Mental Health: A “Perfect StormINCREASING Risk Factors:Isolation & disconnection Loss of natural supportsFinancial instability / Job lossRelationship stressLimited access to healthcareAlcohol use (up 60%)Feeling hopeless/burdensomeAccess to lethal means (guns, prescription medication, etc.)Uncertainty
DECREASING Protective Factors:Connectedness & relationshipsAccess to preventive healthcareSocial supportsSense of purpose/meaningfulness (job or hobby)Resilience / Distress ToleranceEngagement in faith communityEmpowermentHealthy Coping SkillsRoutine
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Impact of COVID-19 on Mental Health & Suicide(Kaiser Family Foundation Poll)
• 45% of adults say the crisis has had a “negative impact” on their mental health
• 19% say it has had a “major impact” on their mental health• 65% of adults who lost income report worsened mental
health• 50% increase in local police contacts for mental health
crisis and suicide-related behaviors • 891% increase in calls to SAMHSA’s Disaster Distress Hotline
https://suicidology.org/2020/05/05/ai-healthcare-professionals-mental-health/
Wellbeing has declined significantly(General Public and Healthcare Professionals)
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Projected Deaths of DespairAlongside the thousands of deaths from COVID-19, the growing epidemic of“deaths of despair” is increasing due to the pandemic—as many as 75,000 morepeople will die from drug or alcohol misuse and suicide
(Well Being Trust (WBT) and Robert Graham Center for Policy Studies in Primary Care)
For every 1% increase in unemployment rate, over a year, we would lose 775more Americans to suicide, 1,200 to overdose and increase by 10,000 thoseexperiencing depression, anxiety and addiction
WI Unemployment Rate in April 2020:
14.1%
Assessing Need in Your Community
Risk Factors:• What are they and how are they changing?
Protective Factors• What are they and how are they changing?
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Partnership and Collaboration
Formation of the Partnerships• Northeast Wisconsin Mental Health Connection
• Backbone agency• Value added• Trust built• “All oars rowing in the same direction”
• Other community collaborations preceding this • Project Zero: Every 1 Matters/Medical College of WI
• Tri-County initiative• Coroners• Law Enforcement• County Mental Health Crisis providers
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The Work of the Early Warning System
• Law Enforcement
• Mental Health Crisis Divisions
• Coroners Office
• Entering data from law enforcement incident calls into a spreadsheet
• Gender, Age, Race, Time, Date, Mechanism, Primary and Secondary Triggers, Location
• Regular contact with Coroners regarding suicides
• Regular monitoring of Crisis Call volume
Bumps along the way….
• Community Partners have their own work to do
• Capacity
• System to collect and share data agreed upon by all partners
• Confidentiality of information collected
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New System Response for Suicide Related Behavior (5/22/20)
GOALS:• Less “hot potato”• Law Enforcement more time to enforcing laws and less time evaluating• Consumers experience a more humane and less transactional process• Fewer Ch. 51’s• Educating the partners who regularly interact in the system response a
clear understanding of the criteria they each use to make the decisions they do-ED/LE/Crisis
Building the Coalition
• Current Suicide Prevention partners and roles in this effort?
• Who NEEDS to be engaged and what will their role be?
• Data Collection and analysis
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Real Time Data on Suicide Related Behavior
Data: March 13 – July8, 2020Calumet, Outagamie and Winnebago Counties
Daily calls over time (n = 869)Shows a 32.8% increase over time
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Percent by Call Type
0 10 20 30 40 50 60 70 80
Completed Suicide
Suicide Attempt
Suicidal Ideation
Mental Health
Female45%
Male54%
Transgender F-M1%
Transgender M-f0%
Other1%
Percent Calls by Gender
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Percent Mechanism of Injury Gender
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40
60
80
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Female Male Transgender F-M Transgender M-F
Firearm Sharp Object Hanging Poisoning Fall Other/Unknown
Poisoning (Prescription
Drug)21%
Sharp Object20%
Firearm14%
Poisoning (Non-
Prescription Drug)
7%
Hanging7%
Fall from Heights
4%
Jumping in Front of Vehicle
4%
Other/Unknown
23%
Percent Calls by Mechanism of Injury
Top 31. Poisoning-Rx Drug
2. Sharp Object
3. Firearm
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Percent by Day of Week/time of Day
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12.5
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14.5
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15.5
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Midnight to5:59 a.m.
6:00 a.m. to11:59 a.m.
Noon to 5:59p.m.
6:00 p.m. to11:59 p.m.
Calls by age group over time
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13-Mar 20-Mar 27-Mar 3-Apr 10-Apr 17-Apr 24-Apr 1-May 8-May 15-May 22-May 29-May 5-Jun 12-Jun 19-Jun 26-Jun 3-Jul
Ages 25-54 Ages 10-24 Ages 55+
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Mental Health
40%
Relationship Issue27%
Substance Use12%
Financial Issue5%
Physical Health
5%
Unknown5%
Other3%
Death of a Loved
One3%
Percent by Primary Triggering Event (41% had more than one event listed)
Top 31. Mental Health
2. Relationship Issues
3. Substance Use
Outagamie and Winnebago County Suicides
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March April May June
2018 2019 2020
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2018 2019 2020
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Data Considerations
• Rates of suicide deaths and attempts in your community?
• How do you access information on suicide ideation and attempts in your community
• What other types of data do you need to implement and evaluate this effort?
• How will you access that?
“Dream” Team
Multi-disciplinary team • Law Enforcement• Mental Health Provider• County Crisis • Lived Experience• Academic Partners• Representation of communities at highest risk
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Opportunities for System Innovation
Ideal System Response- First Responders
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Ideal System Response: Emergency Department
Ideal System Response: Completed Suicide
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Barriers and Facilitators
• What forces will facilitate this effort in your community? How might you leverage those?
• What forces will present a barrier to this effort in your community? How might you work to dismantle those?
Q & A /Thank youSarah [email protected]
Sara [email protected]
Beth [email protected]
This project is funded by the Advancing a Healthier Wisconsin Endowment at the Medical College of Wisconsin
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