Suicide Prevention goals and investments
Vermont's rates of suicide, calculated as the number of deaths by suicide per 100,000 people, are higher than the national averages. Vermont rates of suicide are also higher than the rates of neighboring states and the New England Region. The overall rate for the past 10 years has been increasing. In the most recent years more than a 100 Vermonters have died by suicide. More men die by suicide than women. Firearms are the method used for nearly two-thirds of the deaths by suicide. The Agency of Human Services is currently using the score card to keep track of key data elements to guide our efforts at reducing the rate of suicide in Vermont. It can be accessed at Agency of Human Services Scorecard.
The Leadership Group in alliance with the Vermont Suicide Prevention Center (VTSPC) has created a broader group entitled the Vermont Suicide Prevention Coalition where there is representation from provider groups (inpatient and outpatient) suicide survivors, family members, Agency of Human Services, Agency of Education, schools and higher educational institutions, Veterans Affairs, legislators as well as the Centers for Health and Learning. The coalition guides and informs the statewide prevention efforts.
Vermont’s suicide prevention plan aligns closely with the World Health Organization’s (WHO) suggested strategy. The plan categorizes actions into three broad categories; Universal Prevention, Selective Prevention and Indicated Strategies essentially signifying primary, secondary and tertiary prevention strategies. These are broad and take a population health approach to this problem.
The Vermont Department of Mental Health (DMH) will work in partnership with the Agency of Human Services Leadership Group as well as the Center for Health and Learning (CHL) will promote interventions in all three categories i.e. Universal, Selective and Indicated.
Universal Strategies: These are initiatives that are designed to reach the entire population.
- Increase access to healthcare
- Promote positive mental health campaign plans to accomplish the following:
- UMAtter campaign plans to accomplish the following;
- Promote the message that suicide is preventable
- Equip gatekeepers with the knowledge and skills to respond effectively to those in distress
- Increase public awareness of the importance of addressing mental health issues
- Establish a broad-based suicide prevention and intervention strategy throughout Vermont
- Sponsor a media campaign to reduce the stigma associated with being a consumer of mental health, substance abuse and suicide prevention services
- Promote positive youth development
- Put into place long-term, sustainable approaches to prevention and early intervention
Vermont Gun Shop Project: Since nearly two-thirds of all deaths by suicide in Vermont use firearms as the means, Department of Mental Health has partnered with the Center for Health & Learning, Vermont Sportsmen’s club, Gun Owners of Vermont along with Suicide prevention coalition to increase the knowledge and awareness of gun shop owners in Vermont about the use of guns for suicide. In addition resources and helpline information will be made available to gun shops to post in their shops to give those who may go to a gun shop the information they need to get timely help
Selective Prevention:These are initiatives that are meant to reach groups or populations at higher risk for any number of reasons.
- Targeted services for people at higher risk:This will include gatekeeper training as well as Mental Health First Aid training for those in key positions to identify people at higher risk.These gate keepers will be trained in screening for depression as well as trained in screening for suicidality.
- Crisis services at Designated Agencies
- 211 - National Suicide Prevention hotline
- Peer run warm line
- Domestic violence hotline
- Sexual violence hotline
Crisis Text Line:
- FREE SUPPORT AT YOUR FINGERTIPS, 24/7
- Crisis Text Line serves anyone, in any type of crisis, providing access to free, 24/7 support and information via the medium people already use and trust: text. Here’s how it works: Text START to 741741 from anywhere in the USA, anytime, about any type of crisis. A live, trained Crisis Counselor receives the text and responds quickly. The volunteer Crisis Counselor will help you move from a hot moment to a cool moment
Zero Suicide project: is a collection of intervention designed to improve care for those identified with needing help with suicidal thoughts and other related problems.
Zero Suicide Project: Vermont has adopted the Nation Action Alliance for Suicide Prevention’s platform called Zero Suicide. The alliance defines Zero Suicide as:
Zero Suicide: is a commitment to suicide prevention in health and behavioral health care systems, and also a specific set of tools and strategies. It is both a concept and a practice
The four areas of intervention under this project are as follows:
- Screening: Embed widespread screening of depression and suicidality in healthcare settings including primary care practices. The Blueprint for Health Medical Home practices to enhance their screening re suicidality by using Patient Health Questionnaire (PHQ) questions about depression and suicidal thoughts in Primary care settings.
- Assessment: For those patients who screen positive to then do an enhanced screening/severity assessments regarding severity of suicidality e.g. Columbia Suicide Severity Rating Scale (CSSRS). Support Blueprint’s community health teams to help patients access appropriate treatment with the local DAs for individuals who screen as needing an intervention
- Suicide focused/ competent treatment: Support Designated Agency (DA) pilot sites to access trainings in modalities specifically about care for the suicidal person:
- Counselling about Access to Lethal Means (CALM)
- Assist DA pilot sites to train clinicians in using Collaborative Assessment and Management of Suicide (CAMS) which includes an online initial training followed by a learning collaborative style continuous education on CAMS.Build capacity for ongoing training in Vermont by developing a Train the Trainer model
- Reinforce use of Cognitive Behavioral Therapy and Dialectical Behavioral Therapy as the best treatment practices for problems commonly associated with suicidality such as depressive disorders, anxiety disorders and personality disorders.The CAMS methodology is complimentary to these treatments methods.
- Roll training out to providers outside of the DAs: Community Health Teams, therapists embedded in Medical Homes, etc. Partner with the inpatient psychiatric units as well as emergency rooms at hospitals to develop and send caring letters after a person, who has had suicidal thoughts, is discharged from their facility. Designated Agency Crisis Centers to develop and send caring letters after a person who had suicidal thoughts is discharged from the hospital.