Connecticut Department of Public Health receives five-year, $3.5M grant from CDC to fund suicide prevention efforts

The Connecticut Department of Public Health has received a five-year, $3.5 million grant from the Centers for Disease Control and Prevention to enhance statewide suicide prevention efforts, Gov. Ned Lamont announced at St. Francis Hospital and Medical Center in Hartford Thursday morning.

The grant, which runs through Aug. 31, 2025, will be a joint effort between DPH, the Connecticut Department of Mental Health and Addiction Services, the Connecticut Department of Children and Families and UConn Health. The prevention efforts will concentrate on populations that are disproportionately impacted by suicide or attempted suicide, including middle-aged adults, particularly men with mental illness or substance use disorder, and adolescents and young adults (ages 10-24).

State officials at the news conference spoke about the intense mental health toll the COVID-19 pandemic has taken on Connecticut residents.

With COVID-19 cases increasing and the winter approaching, “I can feel the stress building again,” Lamont said. He described a “witches’ brew” of health concerns, economic distress and social isolation.

“I hear a lot of, ‘I thought we had a light at the end of the COVID tunnel and it looks like it’s receding,’ ” Lamont said. “I hear the economic anxiety every day.”

Dr. Steven Wolf, chairman of emergency medicine at St. Francis, said that social isolation has exacerbated local residents’ experiences of mental illness and substance use disorder.

Seven people under the age of 18 have died by suicide in Connecticut this year, including four since October, according to Miriam Delphin-Rittmon, the commissioner of the state Department of Mental Health and Addiction Services.

Connecticut averages about eight suicides of children under the age of 18 annually, Vannessa Dorantes, the commissioner of the state’s Department of Children and Families, said. She emphasized that the state must “work together to get that number to zero.”

On average, 403 Connecticut residents died annually of suicide between 2015 and 2019, a 14% increase from the annual average of 351 residents between 2010 and 2014, according to state officials.

“Though Connecticut has one of the lowest suicide rates in the United States, we know even one death is too much,” Delphin-Rittmon said.

Karen Jarmoc, president & CEO of the Connecticut Coalition Against Domestic Violence, said that calls to CTSafeConnect, the organization’s domestic violence hotline, rose by 30% due to the COVID-19 pandemic and domestic violence advocacy groups across the state faced increased demand for their services.

“When the pandemic hit in March in our state, understandably there were shut-in orders to keep people safe from a public health standpoint,” Jarmoc said. “From our perspective, it created a precarious situation where victims of domestic violence were shut in with their abusive partner.”

Early in the pandemic, 18 sites across the state that house victims of domestic violence had to send some people to hotels in order to reduce capacity and the risk of a COVID-19 outbreak, she said. That resulted in more than $390,000 in unexpected fees to house about 200 adults and 200 children in hotels, from March through

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US suicide rate fell last year after decade of steady rise

The U.S. suicide rate fell slightly last year, the first annual decline in more than a decade

NEW YORK — The U.S. suicide rate fell slightly last year, the first annual decline in more than a decade, according to new government data.

It’s a small decrease and the data is preliminary, but the decline is “really exciting,” said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention.

The fall may be partly due to years of suicide prevention efforts, like increasing mental health screenings, she said. Other factors, like the pre-pandemic economy, might also have played a role, she added.

Suicides had been on the rise since 2005. In 2018, the national suicide rate hit its highest level since 1941 — 14.2 per 100,000 people. The Centers for Disease Control and Prevention posted new death rate data this week showing that for 2019, it dropped to 13.9.

Drug overdoses rose in 2019, and deaths from falls were up, too. But death rates for the nation’s two biggest killers — heart disease and cancer — were down, as were death rates for flu, chronic lung disease and Alzheimer’s disease. The firearm death rate was flat, probably because the small decline in suicides was offset by a slight uptick in gun homicides.

When all that is factored together, the U.S. life expectancy calculation for 2019 should stay the same as it was in 2018 or maybe even increase slightly, said Robert Anderson, who oversees death data for the CDC’s National Center for Health Statistics.

“I think 2019 will turn out to be a pretty good year for mortality, relatively speaking,” Anderson said. “2020 will not.”

There have been at least 300,000 more deaths this year than expected, the CDC said this week in a separate report. About two-thirds of those are being attributed directly to COVID-19, but many of the others are believed to be related to the pandemic.

It’s not yet clear whether suicides are up this year.

The pandemic sparked a wave of business closures, some temporary and some permanent. Millions of people were forced to stay at home, many of them alone. Surveys suggest more Americans are reporting depression, anxiety and drug and alcohol use. Adding to that dangerous mix, firearm purchases rose 85% in March, when the virus was first surging.

“There are clear forces pressing suicide risk factors in a negative direction,” Moutier said, but that’s doesn’t mean suicide rates will automatically rise.

There are some “silver linings” to the pandemic, she added. One is increasing acceptance that mental health distress is normal, and that it’s OK to seek counseling. Another is increasing availability of telemedicine.

Anderson noted many COVID-19 deaths have been in the same set of late-middle-aged white people who are considered at high risk for

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COVID-19 a New Opportunity for Suicide Prevention

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The ongoing COVID-19 pandemic poses clear threats to mental well-being, but an increase in suicide is not inevitable if appropriate action is taken, one expert says.

“Increases in suicide rates should not be a foregone conclusion, even with the negative effects of the pandemic. If the lessons of suicide prevention research are heeded during and after the pandemic, this potential for increased risk could be substantially mitigated,” writes Christine Moutier, MD, chief medical officer of the American Foundation for Suicide Prevention, in an invited communication in JAMA Psychiatry.

“This is a moment in history when suicide prevention must be prioritized as a serious public health concern,” she writes.

Mitigating Suicide Risk

Although evidence from the first 6 months of the pandemic reveal specific effects on suicide risk, real-time data on suicide deaths are not available in most regions of the world. From emerging data from several countries, there is no evidence of increased suicide rates during the pandemic thus far, Moutier notes.

Still, a number of pandemic-related risk factors could increase individual and population suicide risk.

They include deterioration or recurrence of serious mental illness; increased isolation, loneliness, and bereavement; increased use of drugs and alcohol; job loss and other financial stressors; and increases in domestic violence.

There are mitigating strategies for each of these “threats to suicide risk.” The science is “very clear,” Moutier told Medscape Medical News.

“Suicide risk is never a situation of inevitability. It’s dynamic, with multiple forces at play in each individual and in the population. Lives can be saved simply by making people feel more connected to each other, that they are part of a larger community,” she added.

The Political Will

Moutier notes that prior to the pandemic, four countries ― Finland, Norway, Sweden, and Australia ― had fully implemented national suicide prevention plans and had achieved reductions in their national suicide rates. However, in the United States, the suicide rate has been steadily increasing since 1999.

A Centers for Disease Control and Prevention survey released in August 2020 found that 40% of US adults reported symptoms of depression, anxiety, or increased substance use during COVID-19 and that about 11% reported suicidal ideation in the past month, all increases from prior surveys.

COVID-19 presents a “new and urgent opportunity” to focus political will, federal investments, and the global community on suicide prevention, Moutier writes.

“The political will to address suicide has actually moved in the right direction during COVID, as evidenced by a number of pieces of legislation that have suddenly found their way to passing that we’ve been working on for years,” she said in an interview.

One example, she said, is the National Suicide Hotline Designation Act, signed into law earlier this month by President Donald Trump.

As previously reported, under the law, beginning in July 2022, Americans experiencing a mental health crisis will be able to dial 9-8-8 and be connected to the services

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Virus shutdowns took a grim toll on amputee veterans who died by suicide, families say

His life became a blur of surgeries and recovery, and in moments of darkness, he had contemplated ending it all, he later said.

But Hamill renewed his spirits as a motivational speaker and advocate for other veterans, many of whom became part of a legion of social media followers drawn to his gritty determination.

His post on April 19 had a different tone.

“My own personal hell has been reignited,” Hamill wrote on Instagram. “This pandemic, although viral in nature; alludes to what happens to us as human beings, when we are stripped of our outlets, and are deprived of our ability to socialize.”

Hamill died two weeks later of an apparent suicide at the age of 31.

View this post on Instagram

Part 1 of 3. “These are the times, that try men’s souls.” • For the past month or so, I’ve sat back and watched human beings make sense of the world’s current predicament; and how it correlates to, and affects, their daily lives. I have watched many attempt to make sense of all of this. Inspire their peers across a variety of platforms, justify everything they perceive as they see fit. I’ve watched multi-million dollar earning business owners blast their inspirational speeches, and give their tools for motivation. I’ve watched actual entrepreneurs, to include some of my closest and dearest friends, suffer, as they watch their dreams get suffocated by the current state of affairs and all of its ironies. I’ve observed and listened to all the ‘loudest (men/women) in the room’, tout their recipe for success, only to succumb to the gravity of our current hardships with a parting whisper. There is a harsh reality that most of us have finally realized, that transcends our current socioeconomic environment. One that many, though still afflicted, shrug off because of stubbornness. That they ignore. That they pretend doesn’t exist outside their small bubble, in their day to day lives. Yes, we’ve all been stymied during what should be a period of growth; springtime, a source of new beginnings and hope. Coming out of the ever inevitable depression and seclusion of winter, this following season seems to be some cruel universal joke played upon us as a species. Compounding these present set of circumstances, there are those of us who live in the grips of mental illness or injury. Living in a veritable prison of sadness, fear, devastation, and utter agony. Day in, and day out. I began writing this at 03:46 in the morning, on April 19th, 2020. I’ve been drunk on red wine since the previous night. I haven’t slept. I haven’t stopped suffering. My own personal hell has been reignited, in light of present circumstances affecting us all. This pandemic, although viral in nature; alludes to what happens to us as human beings, when we are stripped of our outlets, and are deprived of our ability to socialize.

A post shared by Rory Hamill (@rory.hamill) on

As coronavirus restrictions unfurled

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Suicide Prevention Still a Daunting Challenge

Suicide screening protocols implemented in veteran and general populations reduced suicides, but making such screening tools more efficient remains a challenge, according to a pair of studies.

After the Veterans Health Administration implemented the Veterans Affairs Suicide Risk Identification Strategy (Risk ID) in 2018, results were positive in outpatient visits for 3.5% and 0.4% of primary and secondary screenings, respectively, and results were positive in emergency settings for 3.6% and 2.1% of primary and secondary screenings, respectively, reported Nazanin Bahraini, PhD, Rocky Mountain Regional VA Medical Center in Aurora, Colorado, and colleagues.

Compared to patients in ambulatory care, patients screened in the emergency department were more likely to endorse suicidal ideation with intent (odds ratio 4.55, 95% CI 4.37-4.74, P<0.001), have a specific plan (OR 3.16, 95% CI 3.04-3.29, P<0.001), and report recent suicidal behavior (OR 1.95, 95% CI 1.87-2.03, P<0.001) during secondary screening, Bahraini’s group wrote in JAMA Network Open.

Risk ID includes three tiers of screening starting with the nine-item Patient Health Questionnaire, followed by the Columbia Suicide Severity Rating Scale Screener and the VHA’s Comprehensive Suicide Risk Evaluation.

“The greater acuity of suicide risk among patients in the ED or [urgent care clinics] cohort compared with those in the [ambulatory care] cohort supports national implementation of evidence-based suicide prevention programs, such as Safety Planning in the ED,” Bahraini and co-authors wrote.

Suicide screening is recommended for all veterans, who have a 21% higher risk of dying by suicide than the general population.

However, close to two-thirds of veterans who die by suicide do not seek healthcare from the VA, indicating that many suicides will still be missed in VA screening initiatives, noted Roy H. Perlis, MD, MSc, of Massachusetts General Hospital and Harvard Medical School in Boston, and Stephan D. Fihn, MD, MPH, of the University of Washington in Seattle, in an accompanying editorial.

“Although the VA is not representative of general clinical practice, these numbers provide a useful reference for estimating the yield of routine screening in these settings,” Perlis and Fihn wrote.

Another study published in JAMA Network Open, from the Kaiser Permanente system in California and Washington, examined the practicality of a risk-based alert system to identify patients who may attempt suicide.

The tool was developed from electronic health records and included characteristics such as depression symptoms, mental health visits, and past suicide attempts to estimate suicide risk. When patients entered a certain adjustable risk threshold, the tool would deploy an alert to physicians.

Using the 95th percentile threshold, the tool yielded 162 daily alerts and demonstrated a positive predictive value of 6.4%. (That works out to a number-needed-to-screen of 17 to prevent one suicide attempt, Perlis and Fihn calculated.) In contrast, the system sent out four alerts per day at the 99.5th risk percentile.

“While this provides useful estimates for planning, many key effectiveness, clinical, operational, ethical and legal questions remain,” the study’s lead author Andrea H. Kline-Simon, MS, of Kaiser’s research division in Oakland, California, told MedPage Today

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Nation’s Largest Suicide Prevention Organization Celebrates National Suicide Hotline Designation Act (S.2661) Becoming Law

Nation’s Largest Suicide Prevention Organization Celebrates National Suicide Hotline Designation Act (S.2661) Becoming Law

PR Newswire

WASHINGTON, Oct. 19, 2020

WASHINGTON, Oct. 19, 2020 /PRNewswire/ — On Saturday, October 17, the National Suicide Hotline Designation Act (S.2661), legislation that will support the implementation of the future 9-8-8 crisis hotline, was signed into law. Robert Gebbia, CEO of the American Foundation for Suicide Prevention (AFSP), the nation’s largest suicide prevention organization, released the following statement:

AFSP.org
AFSP.org

“In July, the Federal Communications Commission announced that 9-8-8 would be the new universal hotline number for the National Suicide Prevention Lifeline by July 2022. This easy-to-remember number will increase public access to mental health and suicide prevention crisis resources, encourage help-seeking for individuals in need, and is a crucial entry point for establishing a continuum of crisis care.

“This is why AFSP applauds the U.S. Congress for prioritizing suicide prevention through unanimous passage of the National Suicide Hotline Designation Act. This historic legislation, now law, will bring our mental health crisis response system into the 21st century. We are encouraged by the federal government’s dedication to preventing this leading cause of death and showing all Americans that mental health is just as important as physical health.

“It should be noted however that the United States’ mental health crisis response system is woefully underfunded and undervalued. It is crucial that local crisis call centers are adequately equipped to respond to what we expect will be an increased call volume and provide effective crisis services to those in need when 9-8-8 is made available in July 2022.

“We would like to especially thank the legislation’s sponsors in the U.S. Senate, Sens. Cory Gardner (R-CO), Tammy Baldwin (D-WI), Jerry Moran (R-KS), and Jack Reed (D-RI), and the U.S. House, Reps. Chris Stewart (R-UT), Seth Moulton (D-MA), Greg Gianforte (R-MT), and Eddie Bernice Johnson (D-TX), as well as their staff. We would also like to thank the Committee members, Congressional leadership, and staff who have supported these efforts on Capitol Hill.

“AFSP’s nearly 30,000 volunteer Field Advocates engaged their members of Congress for years in support of the National Suicide Hotline Designation Act. They made their voices heard through thousands of letters, phone calls, and emails. They have pushed the suicide prevention movement forward, and their efforts will save lives.”

The National Suicide Prevention Lifeline’s 9-8-8 number will be active nationwide by July 2022. Until that point, those in crisis should continue to call the Lifeline at 1-800-273-TALK (8255).

For guidelines on how to report safely on suicide: https://afsp.org/for-journalists/.

The American Foundation for Suicide Prevention is dedicated to saving lives and bringing hope to those affected by suicide. AFSP creates a culture that’s smart about mental health through education and community programs, develops suicide prevention through research and advocacy, and provides support for those affected by suicide. Led by CEO Robert Gebbia and headquartered in New York, and with a public policy office in Washington, D.C.

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