USPHS Scientific and Training Symposium June 21, 2011 LT Jason Hymer, REHS Reno District Injury Prevention Coordinator

1. Gain a basic understanding of the IHS Injury Prevention Program and the burden of unintentional and intentional injuries on American Indians/Alaska Natives. 2. Describe the role of IHS Environmental Health Officers in community based suicide prevention efforts. 3. Identify the contributions of IHS Environmental Health Officers to the field of suicide prevention.

 Unintentional  Motor vehicle  Falls  Fire/Burn  Drowning  ATV  Intentional  Suicide  Homicide  Assault

 Injuries are the leading cause of death for American Indians and Alaska Natives (AI/AN) ages 1-44  3 rd leading cause of death overall 5 Leading Causes of Death AI/AN , ages 1-44 Unintentional Injuries (8,671) Suicide (2,518) Homicide (1,687) Heart Disease (1,626) Liver Disease (1,494)

 Mission: “To raise the health status of American Indians and Alaska Natives to the highest possible level by decreasing the incidence of severe injuries and death to the lowest possible level and increasing the ability of tribes to address their injury problems.”

 IP began in the late 1970’s/early 1980’s in response to the high rate of motor vehicle crashes (MVCs)  EHOs identified MVCs as a leading cause of injury using injury surveillance systems  EHOs took the lead in injury prevention activities  The majority of early IP work focused on unintentional injury prevention  EHO/IPS work in intentional injury prevention has not been as wide spread

 Community-based prevention  Reliable surveillance data  Capacity building  Partnerships and collaboration

 Between 1999 and 2007, suicide was the 2 nd leading cause of death for AI/AN ages  78% of completed suicides were between the ages of  The suicide rate for AI/AN ages is 1.7 times the national average.  Rates are much higher in some regions/Tribes

 Suicide occurs in predictable patterns  Utilize the same public health models used in unintentional injury prevention

 Many of the key elements in unintentional injury prevention also apply to suicide prevention:  Identifying effective strategies  Technical assistance  Data collection  Partnerships

 EHOs/IPS have assisted tribes in identifying and implementing effective strategies for suicide prevention  Effective strategies include:  American Indian Life Skills Development Curriculum  Applied Suicide Intervention Skills Training (ASIST)  Suicide Alertness for Everyone (safeTALK)  Safe firearm storage projects

 Assistance with proposal writing  MSPI, IHS IP Grants, SAMHSA  Developing goals and objectives for coalitions  Training

 EHOs/IPS have taken the lead on injury surveillance for years  Suicide data is typically included in injury surveillance  EHOs/IPS have worked with Tribes to improve suicide data

 Partnerships are key in suicide prevention!  No one agency or entity has the resources to fully address the issue of suicide  EHOs/IPS have extensive experience in coalition building

 Strong foundation in public health  Focus on prevention vs. treatment  EHOs work “in the trenches”  Advanced training in injury prevention

 Safe firearm storage projects  Implementation of gatekeeper training program  Members of suicide prevention coalitions  Assistance with grant writing  Data collection

 Lack of knowledge in suicide prevention  View suicide as a behavioral health issue  Fear of the subject  Lack supervisory support

 Attend gatekeeper training  Incorporate suicide prevention into IHS IP Short Courses  Review online training modules

Questions?