Suicide Prevention
Youth Suicide Prevention in Nevada
A Program of the
Nevada Office of Suicide Prevention
1
Suicide Prevention in Nevada

2003
Suicide prevention legislation (SB49, SB36, SCR 3, 4, & 5)
adopted in Nevada

2005
Nevada Coalition for Suicide Prevention established; State of Nevada
receives Cohort 1 Garrett Lee Smith grant $1.2 million;

2005
Nevada Office of Suicide Prevention established;

2007
Nevada Suicide Prevention Plan released;

2008-2011
Three Garrett Lee Smith Awards come to Nevada (ITCN/IHBN, OSP and
Pyramid Lake Paiute Tribe; 4 MSPI grants awarded to NV tribes;

2009
State of Nevada awarded Garrett Lee Smith grant for $1.5 million,
funding ended June 2013;

2013
Fund for a Healthy Nevada funds office and two state positions added;
2
Reducing Access to Lethal Means

Progress of Nevada’s program

Child Fatality Review Awareness Grant

Bringing the program to gun stores and shooting
ranges

Bringing the program to the public through gun shows
in Nevada
3
Facts You Need to Know
About Suicide
1.
Talking about suicide will not cause a person to kill
themselves.
2.
Few suicides happen without warning.
3.
There is no “suicide type.”
4.
Suicidal people can help themselves.
5.
Suicide “secrets” and/or “notes” must be shared
Used with permission from the Maine Resource Book for Gatekeepers
4
Facts You Need to Know
About Suicide
6.
Depression, anxiety, mood disorders, substance
abuse and conduct disorders are the most common
factors found in suicidal individuals.
7.
Suicide is preventable.
8.
Youth most commonly share their thoughts,
problems, and feelings with other youth.
9.
Suicide is not painless…not an “easy way out.”
Used with permission from the Maine Resource Book for Gatekeepers
5
Facts You Need to Know
About Suicide
10.
People who show marked and sudden improvement
after a suicide attempt or depressive period may be
in great danger.
11.
People who talk about suicide may very well attempt
or complete suicide.
12.
Suicide is not inherited.
13.
Suicidal behavior is not just a way to get attention
Used with permission from the Maine Resource Book for Gatekeepers
6
Facts You Need to Know
About Suicide
14.
There is strong evidence that sexual minority
individuals are more likely than their peers to think
about and attempt suicide.
15.
Any concerned, caring friend can be a “gatekeeper”
and may very well make the difference between life
and death.
16.
Not every death is preventable.
Used with permission from the Maine Resource Book for Gatekeepers
7
Suicide in the U.S.

Over 38,600 suicide deaths in 2010

Firearms used in about five of every
ten suicides

3.7 male deaths for every female death

Suicide claims a life every 14 minutes
Source: AFSP, USA Suicide: 2010 Official Final Data
8
Suicide Death Rates by State 2009
Source: National Vital Statistics Reports
(Released Winter 2012)
(1) Montana
(2) Alaska
(3) Wyoming
(4) Idaho
(5) Nevada
Suicide Rates in Nevada and the US --1999-2010
Source: Centers for Disease Control and Prevention and NV Office of Health Statistics and Surveillance
10
Suicide in Nevada
4th highest rate in the nation
6th leading cause of death, 2nd for youth
Elderly rates exceed national average
More suicides than homicides, motor
vehicle accidents, or AIDS
Source: AFSP, USA Suicide: 2010 Official Final Data,
Nevada Bureau of Health Planning and Statistics
11
Leading Causes of Death, Nevada
Age Groups
Ran
k
5-9
65+
All
Ages
Heart
Disease
390
Malignant
Neoplasms
892
Heart
Disease
3,458
Heart
Disease
4,811
Heart
Disease
123
Malignant
Neoplasms
366
Heart
Disease
784
Homicide
36
Suicide
104
Unintentio
nal
Injury
222
Heart
Disease
35
Malignant
Neoplasms
90
Suicide
101
Liver
Disease
28
Liver
Disease
100
Suicide
114
Influenza
&
Pneumonia
359
Cerebrovascular
796
Homicide
22
Cerebrovascular
45
Cerebrovascular
99
Nephritis
359
Suicide
547
Cerebrovascular
19
Diabetes
Mellitus
39
Liver
Disease
90
Influenza
Alzheimer's
&
Disease
Pneumonia
290
471
HIV
16
Viral
Hepatitis
33
Nephritis
75
Unintention
al
Injury
247
Nephritis
471
Diabetes
Mellitus
63
Diabetes
Mellitus
233
Diabetes
Mellitus
350
1
Congenital
Anomalies
60
Unintentio
nal
Injury
12
Malignant
Malignant
Neoplasms Neoplasms
-----
Unintentio
nal
Injury
117
2
Unintentio
nal
Injury
13
Homicide
---
Unintention Unintention
al
al
Injury
Injury
-----
Suicide
48
Suicide
76
3
Maternal
Congenital
Pregnancy
Anomalies
Comp.
--12
Homicide
38
Heart
Disease
14
Homicide
---
Chronic
Low.
Congenital
Respiratory Anomalies
Disease
-----
15-24
55-64
1-4
Congenital
Anomalies
---
10-14
45-54
<1
25-34
35-44
Unintention Unintention
al
al
Injury
Injury
145
177
4
Short
Gestation
12
Heart
Disease
---
5
Diarrhea
---
Malignant
Neoplasms
---
Cerebrovascular
---
Influenza
Malignant
Malignant
&
Neoplasms Neoplasms
Pneumonia
13
19
---
6
Neonatal
Hemorrhag
e
---
Perinatal
Period
---
Heart
Disease
---
Benign
Septicemia
Neoplasms
-----
7
Circulatory
System
Disease
---
Anemias
---
Chronic
Influenza
Influenza
Low.
Congenital
&
&
Respiratory Anomalies
Pneumonia
Pneumonia
Disease
---------
8
Placenta
Cord
Membrane
s
---
Cerebrovascular
---
Septicemia
---
Diabetes
Mellitus
---
Cerebrovascular
---
9
Homicide
---
Chronic
Low.
Respirator
y
Disease
---
Tuberculos
is
---
Suicide
---
Four
Tied
---
10
Respirator
y
Distress
---
---
---
Viral
Encephaliti
s
---
Four
Tied
---
HIV
---
Liver
Disease
---
Influenza
Septicemia
&
Septicemia
--Pneumonia
29
13
Cerebrovascular
---
Diabetes
Mellitus
10
Two
Tied
28
Malignant
Malignant
Neoplasms Neoplasms
3,135
4,529
Chronic
Chronic
Unintention
Low.
Low.
al
Respiratory Respiratory
Injury
Disease
Disease
144
1,019
1,186
Chronic
Unintention
Low.
Cerebroal
Respiratory
vascular
Injury
Disease
621
1,088
131
Influenza
&
Septicemia Septicemia
Pneumonia
230
322
59
Source: CDC WISQAR, 2014 http://www.cdc.gov/injury/wisqars/index.html
NV Suicide Rate: 19/100,000 (vs. 11 for US) Ages 15-24 : NV 16.1 vs. US 9.8
Youth Risk Behavior Survey
13
Risk factors
• Certain mental disorders:
Depression
Bipolar Disorder
Anxiety Disorders
Schizophrenia
Conduct Disorder (in youth)
Psychotic Disorders
Impulsivity and aggression, related to a mental
health diagnosis
American Foundation for Suicide Prevention, 2013
14
Risk factors
•
•
•
•
Alcohol or substance dependence or abuse
Problem gambling
Previous suicide attempt(s)
Family history of attempted or completed
suicide
• Serious medical condition or pain
American Foundation for Suicide Prevention, 2013
National Council on Problem Gambling
15
Risk factors
• A highly stressful life event such as losing
someone close, financial loss, or trouble
with the law
• Prolonged stress due to adversities such
as unemployment, serious relationship
conflict, harassment or bullying
• Exposure to another person’s suicide, or
to graphic or sensationalized accounts of
suicide (contagion)
16
Protective factors
• Receiving effective mental health care
• The skills and abilities to solve problems
• Connectedness – positive connections with
family, peers, community and social
institutions that foster resilience
American Foundation for Suicide Prevention, 2013
17
Warning Signs for Suicide
Adolescents
Volatile mood swings
Evidence of unhealthy relationship
Sudden deterioration in personal appearance
Self-mutilation
Fixation with death or violence
Eating disorders
Gender identity issues
Depression
Source: Suicide Prevention Resource Center website www.sprc.org
18
18
 Access to lethal means
Self-Harm Case Fatality Rates
1-2% fatal
85-90% fatal
98% nonfatal,
ED-treated
15% nonfatal,
ED-treated
Firearms
Cutting & Poisoning
Source: CDC WISQARS <http://www.cdc.gov/ncipc/wisqars/>
Self-Harm Case Fatality Rates
1-2% fatal
85-90% fatal
98% nonfatal,
ED-treated
15% nonfatal,
ED-treated
Firearms
Cutting & Poisoning
Source: CDC WISQARS <http://www.cdc.gov/ncipc/wisqars/>
Methods of Self-Harm, Nevada
Suffocation 14%
Poison
85%
Poison
23%
Jump 2%
Sharp 2%
Other 2%
Firearm
57%
Sharp 8%
Suffocation 2%
Firearm 1%
Other 4%
Nonfatal Inpatient
Suicide
Source: CDC WISQARS www.cdc.gov/ncipc/wisqars (2007 suicides) and State of Nevada
Health Division (2006 hospitalizations)
Another 47% said under an hour.
Only 13% said one day or more.
Means Matter
 People
who attempt suicide are often ambivalent.
 Some are acting impulsively during a short-term
crisis period.
 If a highly lethal method is unavailable and an
attempter substitutes a less lethal method, the odds
are increased that the attempt will be nonfatal.
 90% or more of those making nonfatal attempts
will not go on to die by suicide
What Providers?












School psychologists
Truant officer, coach, teacher, principal, nurse
Pediatricians
ED clinicians
Defense attorneys
Police
Social workers
Rehab clinician
Employee assistance projects
Divorce attorneys, marriage counselors
Clergy
Etc.
Training



New Hampshire’s CALM training (Counseling on
Access to Lethal Means) – offers trainings and
train-the-trainer sessions; on SPRC’s evidencebased registry
CALM-Online – coming soon to SPRC’s free
online training website
Kruesi Emergency Dept. Training – on SPRC’s
evidence-based registry
Building It Into the System
Emergency
Dept. Social
Worker
Building It Into the System
Change policies & information systems
State Hospital
Association
State Social
Work
Association
Hospital
Administration
Emergency
Dept. Social
Worker
Graduate
School
Lethal Means Program in Nevada
2013, Teamed with Rhode Island, Suicide Proofing Your Home
Brochure
Feb 13, State Suicide Prevention Coordinator asked me to look
into New Hampshire's Program
May 13, went to our first Gun Show in Las Vegas
Aug 13, Received $9,000 Grant to purchase Posters, Brochures,
Gun Locks, and DVDs to distribute
Dec 13, Teamed with the Nevada Firearms Coalition
Apr 14, Finalizing materials for distribution
40
Going into Gun Stores and Shooting
Ranges
Offering Materials for their use and being able to
provide them on a DVD for printing or viewing
• Safety and Security Brochures
• Videos for viewing by staff
• Tips for Gun Shops and
Shooting Ranges
Offering Trainings
• safeTALK and ASIST
trainings from
LivingWorks
41
Talking to the public through gun
shows in Nevada
How to get them engaged in the topic of suicide
prevention
• #1, Anti-Suicide, Pro-Firearm, Safety and Security
• The Nevada Coalition for Suicide Prevention raffles off a
Handgun Safe at each show
• Showing different
ways to secure
firearms helps to
start the conversation
• From the grant
funds we give away
locks for securing
firearms
42
Talking to the public through gun
shows in Nevada
Building a Relationship with the Gun Show Promoters
•
Consistent message, Anti-Suicide, Pro-Gun, Safety and
Security
•
Work with your non-profit organization to enable the
promoter to provide the
table space at no cost
•
Being Flexible when free
tables are not available and
also when extra space is
available
43
Talking to the public through gun
shows in Nevada
What to expect from the public when you are there
•
Taboo subject, many people will not talk about Suicide
•
Some will just walk
on by
•
Some will just look
at the materials on
the tables and not talk
about suicide
prevention
44
Talking to the public through gun
shows in Nevada
Nevada's Most Successful Show Reno 22/23 March 14
• 463 people looked at materials or stopped and engaged
in conversation during the 2 day show
•
200 raffle tickets
were purchased
•
19 locks were given
away to individuals
for a specific gun in
their home
45
Lethal Means Counseling Approach





LAST TWO MONTHS - How often in the past couple of
months have you felt like you didn’t want to live? Tell me
about the times it was the worst. Did you want to kill
yourself?
EVER ATTEMPTED - Have you ever attempted suicide in
your life?
TODAY - What about today? Are you thinking about killing
yourself?
IF AT RISK, ask about access to firearms, regardless of
whether any plans are mentioned.
IF AT RISK, ask about plans & access to methods
mentioned.
Lethal Means Counseling Approach


Firearm assessment:
 Ask about all homes the youth spends time in (e.g. joint
custody, grandparents living next door)
 Ask the father/male figure, not just the mother (females often
don’t know about the guns at home)
 Ask the youth
Make a plan
 Best option is to get the guns out of the house until situation
improves





Police may be able to store them
Or ask a friend or relative
Second best option is to unload and securely lock all guns
See www.lokitup.org for locking options
Hiding guns is not recommended; kids often know where to
look
Washoe County Resources
•
Northern Nevada Child and
Adolescent Services
775-688-1600

Washoe County Social Services
775-785-8600

NV Aging and Disability Services
Division
775-688-2964

Renown
775-982-5318

West Hills
775-323-0478

Crisis Call Center
775-784-8090

ReStart
775-324-2622


Information and Referral
(social services)
2-1-1
Mojave Adult, Child and Family
Services
775-324-3300

Northern NV Adult Mental Health
Services
775-688-2001
48
Clark County Resources

Southern NV Adult Mental
Health Services
702-486-6000

University Medical Center
702-383-2000

Spring Mountain
Treatment Center
702-873-2400

Montevista Hospital
702-364-1111

Information and Referral
(social services)
2-1-1

Clark County Social Services
702-455-4270

State of NV Aging and Disability
Services Division
702-486-3545

Community Counseling Center
702-369-8700

Bridge Counseling Center
702-4746450
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How to Help
Family and friends
Pastor
YOU
Social Worker
50
Suicide Prevention Coordinator
Misty Vaughan Allen, MA
445 Apple Street, Ste. 104
Reno, NV 89502
Phone: (775) 443-7843
E-mail: mvallen@dhhs.nv.gov
Suicide Prevention Training
& Outreach Facilitator
Richard Egan
3811 W. Charleston Bl.
Suite 210
Las Vegas, NV 89102
Phone: (702) 486-8225
E-mail: regan@health.nv.gov
Suicide Prevention Training
& Outreach Facilitator
Janett Massolo
445 Apple Street, Ste. 104
Reno, NV 89502
Phone: (775) 688-2964 ext. 261
E-mail: jmassolo@dhhs.nv.gov
Youth Suicide Prevention Assistant
Brandi McConnell
3811 W. Charleston Bl.
Suite 210
Las Vegas, NV 89102
Phone: (702) 486-8225
E-mail: bmmcconnell@health.nv.gov
51