1. Northwoods Coalition Annual Meeting and Training
Substance Abuse Prevention Is
Suicide Prevention
June 15, 2016

2. Community Behavioral Health Liaison
Presenter
Debi Traeder
Community Behavioral Health Liaison

3. Overview Connection between substance abuse and suicide
Building partnerships in suicide and substance abuse prevention coalitions
Why should we talk about suicide

4. Substance Abuse and Suicide: Where the Two Intersect
Intersection

5. Substance Abuse and Suicide: The Facts
Nationally:
Suicide is the leading cause of death among people with substance use disorders.1
People treated for alcohol abuse or dependence are at about ten times greater risk for suicide.2
Alcohol is present in about 30 to 40 percent of suicides and suicide attempts.1

6. Substance Abuse and Suicide: The Facts
Wisconsin:
Of suicides with known circumstances -
26% had an alcohol problem
13% had another substance abuse problem
Toxicology reports showed:
37% tested positive for alcohol
19% were positive for opiates

7. Substance Abuse and Suicide
Why should we care?
How can we work together toward prevention?

8. More Facts:
From 2010 – 2014, over 3,870 people died by suicide in Wisconsin, a rate higher than the national average (14.4 as compared to 12.9)
Nationally, suicide outnumbers homicide nearly 2:1
In Wisconsin, that ratio is 4:1
Someone dies by suicide in this country every 12 minutes – 117 people die by suicide every day

9. 2010-2014 Suicides in Wisconsin
Ages
Deaths
3871
Rate
14.4
Men
3050
22.9
Women
821
6.1
5-14 40
1.1 27
1.4 13
.07
15-24
538
13.7
432
21.6
106
5.5
25-34
621
17.0
491
26.5
130
7.3
35-44
606
17.2
467
26.3
139
8.0
45-54
899
21.2
681
32.2
218
10.3
55-64
633
496
26.8
137
65-74
271
12.3
22o
20.9 51
4.5
75-84
183
14.1
165
29.4 18
2.4
85+ 80
12.9 71
35.2 9
2.2

10. Suicidal Thoughts Among Adults Who Used Substances SAMHSA, 2014

11. People Die by Suicide Because they can Because they want to
Because they have developed the desire and capability to do so
Due to the fear, pain and stigma associated with suicide, few people are able to complete – but experiences may help develop that capacity

12. Two Major Factors Perceived Burdensomeness Failed Belongingness
Add in acquired capability for self harm

13. People Abuse Drugs: Because they can Because they want to
Because they don’t think they will be the one to get “hooked”
Because they think it will help them deal with problems(burdensomeness)
Because they want to fit in (belongingness)

14. Coalitions Partnership with suicide prevention coalitions
share resources – funding, collaboration
share information – the co-occurrence dual diagnoses
share the media – collaborative projects get noticed
strategies for building these collaborative relationships
common barriers and how to overcome
examples of successful partnerships]

15. Build the Relationships
Join each other’s coalitions
Share information that pertains to both or even just theirs
Plan joint events and/or press releases

16. Common Challenges Turf issues Reputations
Education and awareness of each other’s issues and their effect on the community
Marathon County example - collaboration

17. Courageous Conversations
Too many

18. We must talk about the elephant in the room.
In AODA treatment we often hear

19. Courageous Conversations
What makes them courageous?
Fear of:
Saying the wrong thing
What if they say yes
Not knowing what to say or do
See additional sheet

20. What gets in the way… Is it the stigma? Is it fear?
Is it not knowing what to do?
All of the above?

21. What we are not taught: Signs of suicide, mental illness or addiction
What to do about them or how to find help for self and others
When asked in a survey about some of their biggest fears in their field of work:
97% mentioned the fear of losing a client to SUICIDE

22. Workforce/Community Competency
Train
Just as “CPR” skills make physical first aid possible, training in suicide intervention develops the skills used in suicide first aid.
Behavioral Workforce Preparedness Survey
½ of the staff were uncertain or felt they did not have the skills, training, or supports to engage or assist those who are suicidal.
Do the survey…

23. Training and Tools QPR – Question, Persuade, Refer
Suicide Risk and Assessment
Mental Health First Aid
AMSR – Assessing and Managing Suicide Risk
CAMS– Collaborative Assessment And Management of Suicide
Trauma-Informed Care and ACE’s
Our personal therapeutic approaches
Our relationship
Our gut feelings
Use of suicide risk assessment frameworks
Prove a structured method to assess current and more long-standing risk
Determines which signs and symptoms to assess, which questions to ask
How to combine that information to determine current risk
Determines what actions may need to be taken
There are different matrixes available CAMS, CASE, AMSR, QPR-T, C-SSR and others
The tool you use just needs to consistent and staff needs to be trained, supported

24. Ask… Ask… Ask…. Ask To assess suicide, we must first detect it.
We have to ask the questions–

25. Ask… Ask… Ask…. Ask
By asking the question, there is opportunity…

26. Ask… Ask… Ask…. Ask
Generally, the more direct and honest the approach, the better.
You seem to be very unhappy, Have you had thoughts of suicide?
With all you are going through, have you experienced thoughts of harming or even killing yourself?
Are you thinking of ending your life?
Are you thinking about suicide?
You’re not thinking about killing yourself, are you? or
You aren’t serious when you talk about suicide, right?

27. A word about… Zero Suicide
A grand goal
An opportunity
A statewide initiative
A just system
If Zero is not the right target, what is?

28. For More Information…
Debi Traeder North Central Health Care Thank you!