1. Health Care Policy
Catherine Bauer
Jacksonville University
Organization, Delivery, and Policy in Healthcare
NUR512
Virginia Suicide Prevention Program

2. Objectives
• Describe the extent and severity of problem
• Review Program outcomes, results and
sustainability
• List accreditation requirements
• Review resources needed

3. Severity of Problem
• In Virginia, suicide ranked 11th for cause of
death among residents and was the third
leading cause among 10- to 24-year-olds.
• 1,047 Virginians died by suicide in 2013
("State Suicide Prevention Initiatives and
Plans," 2015)

4. Suicide Rates, By State
("State Suicide Prevention Initiatives and
Plans," 2015)

5. Suicide Rates, By Region
("State Suicide Prevention Initiatives and
Plans," 2015)

6. Severity of Problem in Virginia
• 4,401 suicide attempts; 30% (n=1,294) occurred among
youth and adolescents aged 10-24.
• Females were more likely to attempt suicide than
males.
• Whites were more likely to attempt suicide than any
other race.
• 82% of suicide attempts involved poisonings.
• These suicide attempts resulted in hospitalization
charges of more than $43 million, and a median charge
of $6,192 per episode of care.
("State Suicide Prevention Initiatives and Plans," 2015)

7. Program Overview
• The Suicide Prevention Program coordinates statewide
training for school personnel, human service providers,
faith communities and others on suicide prevention
and intervention, including identification of persons at-
risk of suicide, screening, counseling and referral.
• The suicide prevention programs are currently funded
through the Substance abuse and Mental Health
Services Administration, pursuant to the Garrett Lee
Smith Memorial Act, and the Preventive Health and
Health Services Block Grant
("Strategizing for suicide prevention," 2015)

8. Factors influence suicide rates
• History of mental disorder, particularly depression
• History of alcohol and substance abuse
• Family history of suicide and child maltreatment
• Feelings of hopelessness
• Impulsive or aggressive tendencies
• Barriers to accessing mental health treatment
• Physical illness
• Easy access to lethal methods
• Unwillingness to seek help because of the stigma attached to suicidal
thoughts or to mental health and substance abuse disorders
• Cultural and religious beliefs -- for instance, the belief that suicide is a
noble resolution of a personal dilemma
• Local epidemics of suicide
• Isolation, a feeling of being cut off from other people
• Previous suicide attempt(s)
("Strategizing for suicide prevention," 2015)

9. Prevention Tips
• Begins by knowing the signs that may indicate depression:
– Low self-esteem
– Anger management problems
– Irritability
– Getting into trouble with the law
– Becoming pregnant early in life
– Abusing alcohol or drugs
– Threatening suicide or homicide
– Significant change in appetite or weight
– Feelings of worthlessness or excess guilt
– Fatigue or loss of energy
("Public Health Approach to Suicide Prevention," 2015)

10. ("Public Health Approach to Suicide Prevention," 2015)

11. What You Can Do....
• If you think a person is at risk for depression or
suicide, the next step is to actively intervene and
refer the person to proper help.
• Take immediate and sufficient steps to ensure
safety including eliminating access to firearms.
• Explore individual/family/group therapy
• Enlist family and community support.
• Do not hesitate to involve mental health
professionals trained to recognize and treat
depression and related disorders.

12. Sustainability of Program
• National Strategy for Suicide Prevention (NSSP)
NSSP emphasizes the role all Americans can play in protecting their friends,
family members, and colleagues from suicide. It provides guidance for
schools, businesses, health systems, clinicians, and others based on nearly a
decade of research and advancements in the field.
• National Action Alliance for Suicide Prevention
This public-private partnership advances the NSSP (see above) in pursuit of
their vision of a nation free from suicide. The Alliance champions suicide
prevention as a national priority, catalyzing efforts to implement high priority
objectives of the NSSP, and cultivating the resources needed to sustain
progress. AFSP supports the Action Alliance and AFSP leadership sits on the
Alliance’s Research Prioritization Taskforce.
("State Suicide Prevention Initiatives and Plans," 2015)

13. Resources Needed
• Scientific research grants
• Developing a growing network of researchers
dedicated to reducing the loss of life from suicide
• Significant contributions as a member of the
Research Priorities Task Force of the National
Alliance for Suicide Prevention, and by consulting
with organizations such as the National Institutes
of Health to support implementation of these
priorities.

14. Accredidation
• The National Violent Death Reporting System
(NVDRS) collects detailed information on
violent deaths and suicides from 17 states;
including Virginia. This information can
provide valuable insight into the
circumstances surrounding youth suicide. For
example, a recent study conducted by Harvard
University using NVDRS data found that 35%
of youth suicide deaths occurred the same day
the youth experienced a crisis.
("State Suicide Prevention Initiatives and Plans," 2015)

15. Outcomes
Effective clinical care for mental, physical and substance use disorders
Easy access to a variety of clinical interventions and support for help
seeking
Strong connections to family and community support
Support through ongoing medical and mental health care relationships
Skills in problem solving, conflict resolution and nonviolent handling of
disputes

16. Unintended Effects
• While we understand that suicide is personal and
complicated, we also know that thoughtful public
policies can reduce the number of suicides.
• The U.S. Senate has passed the Harkin/Alexander
amendment, the Mental Health Awareness and
Improvement Act (S. 689), by a vote of 95-2.
• This amendment is the first significant mental health
legislation passed by the Senate since 2008
• This act reauthorizes important federal youth suicide
prevention programs for states and college campuses
under the Garrett Lee Smith Memorial Act
("Public Health Approach to Suicide Prevention," 2015)

17. Program Revision
• The Mental Health Awareness and Improvement Act will
help advance suicide prevention through:
• Mental health awareness training for school and
emergency services personnel so they can recognize the
signs and symptoms of mental illness, become familiar with
resources in the community for individuals with mental
illnesses, and learn how to safely de-escalate crisis
situations involving individuals at risk for self-harm
• Expansion of the National Violent Death Reporting System
(NVDRS) to all 50 states, which would ensure the
availability of complete, accurate, and timely information
used to design effective suicide prevention strategies.
("Public Health Approach to Suicide Prevention," 2015)

18. Program Revision
• In 2014-2015, Suicide Prevention Advocates
have inspired positive state policy changes by
Supporting legislation that now mandates regular
suicide prevention training for school personnel.
• Supporting pioneering legislation in Washington
state and Kentucky that now mandates regular
suicide prevention training for certain health and
mental health professionals.
("Public Health Approach to Suicide Prevention," 2015)

19. References
• State Suicide Prevention Initiatives and Plans.
(2015). Retrieved from www.afsp.org/advocacy-
public-policy/state-policy/state-suicide-
prevention-initiatives-plans
• Suicide: Prevention Strategies. (2015). Retrieved
from
www.cdc.gov/violencePrevention/suicide/preven
tion.html
• Suicide Prevention in the 21st Century: A
Framework. (2015). Retrieved from
www.sprc.org/basic/about-suicide-prevention