Summit for Hope, Portland, Oregon 2015
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Washington County Mental Health conference on developing a Zero Suicide community
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Summit for Hope, Portland, Oregon 2015
- 1. #zerosuicide Zero Suicide in Healthcare: 4 Bold Ideas DAVID COVINGTON, LPC, MBA— RECOVERY INNOVATIONS, INC.
- 2. #zerosuicide 2 Looking at Suicide Differently
- 3. #zerosuicide 3 The Forgotten Patient
- 5. #zerosuicide 5 Four Bold New Ideas 1. Include individuals with lived experience in your leadership and design 2. Start your goal from the other end 3. Your goal must emanate from the leader (CEO, etc.) 4. Believe differently. Aspire for Zero.
- 7. #zerosuicide 7 “Suicide prevention has not been informed by peers who have experienced the agony and decision- making. They can provide support that can be magic” Eduardo Vega, MHA of San Francisco
- 8. #zerosuicide 8 Disease Transmission R Nought Measles Airborne 12 – 18 HIV/AIDS Sexual Contact 2 - 5 SARS Airborne Droplet 2 – 5 Influenza Airborne Droplet 2 – 3 Ebola Bodily Fluids 1.5 – 2.5
- 10. #zerosuicide 10 Four Bold New Ideas 1. Include individuals with lived experience in your leadership and design 2. Start your goal from the other end 3. Your goal must emanate from the leader (CEO, etc.) 4. Believe differently. Aspire for Zero.
- 11. #zerosuicide 11
- 12. #zerosuicide 12
- 13. #zerosuicide 13 6380 Computer/web services
- 14. #zerosuicide 14 Four Bold New Ideas 1. Include individuals with lived experience in your leadership and design 2. Start your goal from the other end 3. Your goal must emanate from the leader (CEO, etc.) 4. Believe differently. Aspire for Zero.
- 15. #zerosuicide 15 “Over the decades, individual [mental health] clinicians have made heroic efforts to save lives… but systems of care have done very little.” Richard McKeon, SAMHSA
- 16. #zerosuicide 16
- 17. #zerosuicide 17 Four Bold New Ideas 1. Include individuals with lived experience in your leadership and design 2. Start your goal from the other end 3. Your goal must emanate from the leader (CEO, etc.) 4. Reject myths. Aspire for Zero.
- 18. #zerosuicide 18 “Suicide represents a worst case failure in mental health care. We must work to make it a ‘never event’ in our programs and systems of care.” Mike Hogan, Former State MH Commissioner
- 19. #zerosuicide 19 Polling Question #1 Someone who died by hanging with their hands bound behind their back and feet tied together was probably a murder, not a suicide. A. True B. False
- 20. #zerosuicide 20
- 21. #zerosuicide 21
- 22. #zerosuicide 22
- 23. #zerosuicide 23
- 24. #zerosuicide 24
- 25. #zerosuicide 25 Group A Group B
- 26. #zerosuicide 26 Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self — to the mediating intellect– as to verge close to being beyond description. It thus remains nearly incomprehensible to those who have not experienced it in its extreme mode. - William Styron
- 27. #zerosuicide 27 I finally succumbed when all my strength was fully, completely gone…
- 28. #zerosuicide 28 Suicide Can Be Prevented. A. Never in Those Truly Intent on Suicide B. Sometimes, but Only in Advance of Acute Risk C. Always, but Only in Advance of Acute Risk D. Always, Even Up to the Last Moment
- 29. #zerosuicide 29 Four Bold New Ideas 1. Include individuals with lived experience in your leadership and design 2. Start your goal from the other end 3. Your goal must emanate from the leader (CEO, etc.) 4. Reject myths. Aspire for Zero.
- 30. #zerosuicide 30 572,000 Hospitalizations** 752,000 Attempts Requiring Medical Attention** 1,100,000 Suicide Attempts** 8,700,000 Seriously Considered Suicide** 38,364 Suicides* Pyramid of Suicidal Behaviors
- 31. #zerosuicide 31 6.8 to 10.5 10.6 to 13.9 14 to 16.9 17 to 23 23.2 20.1 14.0 14.5 10.6 13.9 16.9 10.5 6.8 Suicide Rates (2010 National Average Rate 12.4)
- 32. #zerosuicide 32 0 5 10 15 20 25 30 35 40 45 50 5-9 10- 14 15- 19 20- 24 25- 29 30- 34 35- 39 40- 44 45- 49 50- 54 55- 59 60- 64 65- 69 70- 74 75- 79 80- 84 85+ Rate/100,000 Age Group (Years) White Male AI/AN Male Black Male White Female AI/AN Female Black Female Suicide Rates by Age, Race, & Gender
- 33. #zerosuicide 33
- 34. #zerosuicide 34 Learning Collaborative, Julie Goldstein-Grumet Learning Collaborative, Meena Dayak ZS Advisory Board (Mike Hogan & David Covington) 3,802 2,507 1,123 6,292 1,562 6,816 771 6588,344 National Survey of 30,000 MH Professionals Across Nine States
- 35. Question 16 of 16. (Behavioral Health) 35
- 36. Question 13. TRAINING (Behavioral Health) 36
- 37. Question 14. SKILLS (Behavioral Health) 37
- 38. Question 15. SUPPORT (Behavioral Health) 38
- 39. #zerosuicide 39 The Air Force Did It
- 40. #zerosuicide 40 Henry Ford Also Did It
- 41. #zerosuicide 41 Magellan Health (Arizona)
- 42. #zerosuicide 42 Magellan Health (Arizona)
- 43. #zerosuicide 43
Editor's Notes
- Forbes Magazine, 2010 “The Forgotten Patient”
- But, fear is not always based upon facts. What seemed to get lost in all this was the actual risk of contagion. Disease researchers use a basic metric to estimate how many people on average each sick person will infect. “[The basic reproductive rate (R nought)] is calculated by estimating the chances of exposure, number of susceptible persons, length of contagious period, how the disease spreads, and how much time passes between exposure and becoming contagious.” Using this scale, one of the most infectious diseases we know is measles, which is airborne and leads to infection on average of 12 to 18 people for every infected person. The December 2014 event at Disneyland is just now coming to a close, after it infected nearly 150 people in California and five other states. HIV/AIDS typically spreads to 2 to 5 other persons through sexual contact. The 2003 outbreak of SARS had a similar R nought impact. By contrast, Ebola, which is communicated only through bodily fluids and only while a person is showing symptoms, is much more difficult to spread, with an estimated reproduction of 1 to 2 persons on average. The goal of public health is to drive the rate of spread for any disease to below 1, which is the difference between it dying out or it becoming more widespread. These are simply the facts that we Americans missed- Ebola is not less serious than SARS, measles or influenza – it just doesn’t spread as easily as they do. In fact, it’s the least communicable of all well-known infectious diseases. Despite all the hysteria, only four individuals actually contracted Ebola on American soil.
- “Me too” – Brene Brown has suggested that these are some of the most powerful words known to humanity. But, because of the silence… the courage that has most often been shared in our world around suicide has had to do with ending one’s life. But what about if? WHAT IF the stories people heard were about those who lived… about those who found a way to hold on a little longer… until the pain subsided… The Suicide Prevention field has invested a significant amount of time and effort attempting to eliminate negative messages and control media stories after someone dies. Maybe the strongest answer is to instead focus more on those who live. What if those examples were the ones more readily accessible to those in desperate pain? Ten years ago, those stories did not seem to exist at all… but courage has emerged! It happened at this conference with: - Dese’Rae Stage and livethroughthis.org - Craig Miller and Thisishowitfeels.com - DeQuincy Lezine and The Way Forward Report Eric Hipple, Heidi Bryan, Kevin Hines, Kita Curry, Cheryl Sharp, Cara Anna, Siloan Green, William Styron, Terry Wise, Sabrina Strong, Tom Kelly, CW Tillman, Leah Harris, Katie Ayotte, Ursula Whiteside, Marsha Linehan, Eduardo Vega and many others…
- Sadly, the answer is False. According to Dr. Thomas Joiner, it is not uncommon for individuals who are attempting to end their life to bind their feet, then their hands and attempt to end their life by hanging. While this is extremely difficult for those of us who have not experienced debilitating psychic pain and suicidal thoughts, we are going to discuss in this presentation what motivates this behavior. http://www.foxnews.com/us/2011/07/15/body-millionaires-girlfriend-found-hanging-at-mansion-may-be-suicide/
- My example references an acute pain, but extend that into a chronic day-over-day anguish that blinds the person to the possibility of a better day tomorrow. Perhaps people do not choose suicide so much as they finally succumb because they just don’t have the strength, supports, resources, hope, etc. to hold on any longer. My hands were sweaty, slipping on the bar. My muscles began to hurt, intense pain that became stronger and stronger as the seconds passed. I closed my eyes, relaxed my breathing, and repeated to myself, “One more second, one more second.” I wanted to hang on. That was my choice. Yet gravity and fatigue worked against me and I fell, forced to succumb to the pain — but even then, falling was not what I chose to do. I fell a split second after another competitor; he was eliminated, I was not. I had hung on long enough.
- Recently, I have been offering a multiple choice question to audiences. Suicide is preventable: The idea that “suicide is a choice” is central to our disbelief that we could actually save everyone. But, we know we can extend and strengthen a person to hold on, even in spite of desperate pain.