Youth Suicide Prevention Efforts in Vermont

This presentation discusses the importance of understanding suicide as a public health concern, focusing on youth suicide trends in Vermont. It emphasizes the need for increased awareness, identification of available resources, and actionable steps in suicide prevention. The content covers language guidelines, an ecological model of prevention, the Zero Suicide framework, and data on suicide death rates in Vermont and the US. Variations in suicide deaths based on geography and demographics within Vermont are also highlighted.

• Youth Suicide
• Prevention
• Vermont
• Public Health Concern
• Zero Suicide

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1. YOUTH SUICIDE PREVENTION IN VERMONT Thomas Delaney, PhD Vermont Child Health Improvement Program, UVM Larner College of Medicine Charlotte McCorkel, LICSW Howard Center 1

2. OBJECTIVES Increase understanding of suicide as a public health concern Deepen awareness of youth suicide and self-harm trends with Vermont youth Identify resources and action steps 2

3. The S word

4. LANGUAGE Terms to Avoid: Successful suicide Committed suicide Chose to kill himself Completed suicide Terms to Use: Took his/her own life Died as a result of a self-inflicted injury Died by suicide

5. ECOLOGICAL MODEL OF PREVENTION Community Individual Peer/Family Society

6. ZERO SUICIDE An evidence-supported framework for changing how care is provided for people at risk for suicide (https://zerosuicide.sprc.org/) In Vermont, being implemented in communities served by three Designated Agencies Workforce training on effective, collaborative treatment Creating a suicide safer pathway of care within and across mental health and related services 6

7. VERMONT AND US SUICIDE DEATH RATES 2005-2016 (PER 100,000 PEOPLE) 22 19.8 20 19.2 18.9 17.9 18 Deaths per 100,000 of population 16.9 16.5 16 15.1 14.3 13.9 13.9 13.0 14 12.6 13.9 13.8 13.4 13.0 12 12.9 12.7 12.4 12.0 11.9 11.5 11.2 11.0 10 8 Over the past 5 years, Vermont's suicide death rate has averaged about 30% higher than the US rate. 6 4 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Source: CDC WISQARS VT US Linear (VT) Linear (US)

8. VERMONT SUICIDE DEATHS VARY WITH GEOGRAPHY AND DEMOGRAPHICS 2012 - 2014 Death Rates per 100,000 residents, by VT County Lamoille Orange Windham Washington Bennington Caledonia Franklin Rutland Windsor Chittenden Addison Essex Orleans GrandIsle 0.0 5.0 10.0 15.0 20.0 25.0

9. SUICIDE IN THE UNITED STATES

10. US Non-Fatal Self Injury Rates per 100,000 People 500 461 441 450 400 387 400 386 370 350 329 325 Events per 100,000 314 313 290 300 275 319 301 300 300 294 286 285 250 271 264 269 274 260 178 200 178 177 166 160 157 153 150 133 132 127 125 124 160 160 163 152 100 119 112 101 96 94 88 50 74 67 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 All Ages Age 10-14 Age 15-19 Age 20-24

11. SUICIDE AND YOUNG VERMONTERS WHO IDENTIFY AS LGBTQ+ Compared to non-LGBTQ youth: 3x more likely to have felt sad or hopeless every day for at least 2 weeks (during the past year) 4x more likely to have hurt themselves on purpose in the past 12 months than non-LGBTQ students More than 4x more likely to have made a suicide plan in the past year 4.5x more likely to have made a suicide attempt

12. TRENDS IN RISK FACTORS: VERMONT YOUTH RISK BEHAVIOR SURVEY, 2009-2017 50% 40% 30% 24% 25% 21% 21% 16% 19% 20% 17% 16% 15% 13% 12% 11% 11% 9% 8% 10% 5% 6% 5% 4% 4% 2011 0% 2009 2013 2015 2017 Felt sad or hopeless 2+ weeks Purposely hurt self without wanting to die Made a suicide plan, past year Attempted suicide, past year

13. SUICIDE ATTEMPTS IN YOUTH AND YOUNG ADULTS CDC estimates 12 self-injury ED/hospital visits for every death by suicide. Many attempts do not receive medical attention. 25 : 1 attempts to deaths in young people 4 : 1 attempts to deaths in elderly Not currently capturing data on many youth suicide attempts: giant disparity between YRBS data and what s available from treatment providers Opportunity to improve Vermont s coding of attempts in EDs and other settings inconsistent coding across different settings / providers Stigma and resistance to labelling Estimate of medically serious youth person attempts in VT: 375 annually

14. HIGHER RISK IN VT YOUTH: TRENDS

15. SO, WHAT ARE WE LEARNING? Vermont suicide death rates still higher than overall US rates Highest VT death rates seen in middle age and older, and males. Nationally, youth and young adult non-fatal self injury has increased substantially; VT rates are likely increasing too. What are some ways we might be able to make progress? Prevention efforts targeting specific ages and risk factors (emerging adults, middle age and older adults, older males) Providing suicide safer care (primary care, EDs, community mental health centers, etc.) Strengthening and expanding training for suicide gatekeeping, screening/assessment and use of evidence based treatments Continue improving surveillance of suicide attempts and deaths, including increasing use of NVDRS and hospital data Investigate what successes other states/communities are having Grant writing / more resources!

16. UMATTER 2009-2016, SAMHSA supported statewide youth suicide prevention gatekeeper trainings Development of Umatter model gatekeeper training and training for trainers Adapted from pre-existing models Frameworks and Connect 193 VT middle and high schools trained to date

17. IMPACT: POST-VENTION

18. RESOURCES