Suicide Prevention and COVID-19 Early Warning System Sara Kohlbeck - - PDF document

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Suicide Prevention and COVID-19 Early 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 Storm

INCREASING Risk Factors:

Isolation & disconnection Loss of natural supports Financial instability / Job loss Relationship stress Limited access to healthcare Alcohol use (up 60%) Feeling hopeless/burdensome Access to lethal means (guns, prescription medication, etc.) Uncertainty

DECREASING Protective Factors:

Connectedness & relationships Access to preventive healthcare Social supports Sense of purpose/meaningfulness (job or hobby) Resilience / Distress Tolerance Engagement in faith community Empowerment Healthy Coping Skills Routine

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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 Despair

Alongside 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 more people 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 775 more Americans to suicide, 1,200 to overdose and increase by 10,000 those experiencing 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, 2020 Calumet, 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

10 20 30 40 50 60 70 80

Completed Suicide Suicide Attempt Suicidal Ideation Mental Health

Female 45% Male 54% Transgender F- M 1% Transgender M-f 0% Other 1%

Percent Calls by Gender

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Percent Mechanism of Injury Gender

20 40 60 80 100 120

Female Male Transgender F-M Transgender M-F Firearm Sharp Object Hanging Poisoning Fall Other/Unknown Poisoning (Prescription Drug) 21% Sharp Object 20% Firearm 14% Poisoning (Non- Prescription Drug) 7% Hanging 7% Fall from Heights 4% Jumping in Front of Vehicle 4% Other/Unkno wn 23%

Percent Calls by Mechanism of Injury

Top 3 1. Poisoning-Rx Drug 2. Sharp Object 3. Firearm

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Percent by Day of Week/time of Day

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Midnight to 5:59 a.m. 6:00 a.m. to 11:59 a.m. Noon to 5:59 p.m. 6:00 p.m. to 11:59 p.m.

Calls by age group over time

2 4 6 8 10 12 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 Issue 27% Substance Use 12% Financial Issue 5% Physical Health 5% Unknown 5% Other 3% Death of a Loved One 3%

Percent by Primary Triggering Event

(41% had more than one event listed)

Top 3 1. Mental Health 2. Relationship Issues 3. Substance Use

Outagamie and Winnebago County Suicides

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March April May June

2018 2019 2020

2 4 6 8 10 12

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 you

Sarah Bassing-Sutton sarah@newmentalhealthconnection.com 920-420-4903 Sara Kohlbeck skohlbeck@mcw.edu Beth Clay beth@newmentalhealthconnection.com 920-202-0117

This project is funded by the Advancing a Healthier Wisconsin Endowment at the Medical College

• f Wisconsin

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