South County Healthy Bodies, Healthy Minds – one of Rhode Island’s 10 Health Equity Zones – is using $2 million from the Substance Abuse and Mental Health Services Administration for its Zero Suicide in Washington County program to eliminate suicides in the region, which has the state’s highest suicide rate.
Zero Suicide in Washington County will use some of the grant to provide depression care for people in the region. The program will also train all staff at health care facilities, coordinate outreach to patients in need and review suicide attempts to identify trends or opportunities for future prevention efforts.
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Providence Business News spoke about the effort with Susan A. Orban, coordinator for the Washington County Coalition for Children and South County Healthy Bodies, Healthy Minds and director of community health and wellness for South County Health.
PBN: Can you outline how you will apply the recent $2 million grant to efforts to curb suicides in Washington County?
ORBAN: Zero Suicide is just that, an initiative to make suicide a “never event” in Washington County. It’s an ambitious goal for the county with the highest rate in Rhode Island. We will implement the grant in two ways:
- Creating a comprehensive mental health identification and response system among the Washington County major health facilities.
- Spending 65 percent of the funds to ensure that uninsured or underinsured individuals get needed mental health assistance.
Major components will include:
- Working among our health care partners (South County Health, Yale New Haven Health/Westerly Hospital, Thundermist Health Center, Wood River Health Services, WellOne Primary Medical & Dental Care, Block Island Health Services, and URI Health Services) and health care organizational leaders. They have agreed to establish systems to not only identify and assess suicide risk among all patients receiving care but provide referrals and follow-up to assure they receive the care they need.
- Implementing routine depression screening as a regular part of health care … from emergency room settings to primary care offices.
- Increasing the confidence and comfort of staff and patients in talking about mental health concerns as a normal part of their health care.
- Training health care staff how to treat patients presenting with depression and suicidality.
- Developing protocols for tracking individual and system-level progress and facilitate quality improvements as needed.
This may sound bureaucratic, but in fact, our work will be transformative. We will be working together to assure that no one in South County feels so without hope that taking his or her life seems like the only option.
PBN: What progress have you made up until now in this mission? Where have you seen the biggest successes and setbacks?
ORBAN: The effort is just beginning, so we can’t speak to progress or setbacks. I can say that I am thrilled by how quickly our two hospitals, South County Health and Yale New Haven/Westerly Hospital, gave this project their full commitment. This will mean a lot of time and change of paradigm for them. Similarly, our community health centers, which see many, if not most, of our low-income residents, became partners without reservation as well as URI Health Services. That is our first of what I expect to be many successes.
PBN: Please share a common misconception about suicide and suicidal thoughts.
ORBAN: There are so many. The most common [misconception] about suicide is that if you talk about it, you will put the idea in someone’s head. In fact, the opposite is true. It can often be a relief for someone to be able to talk about their suicidal thoughts and feelings. Having the opportunity to talk about their suicidal feelings can be a protective factor as well as a way for you to assess the risk of harm and urgency for treatment.
Suicidal thoughts are much more common than most people think. If we are concerned someone we know may be having these thoughts, we need to ask them directly: “Are you thinking about killing yourself?” and if they say “Yes,” ask the person if they have a plan as to how they would do it. Only then will we know the seriousness of the situation and which steps to help and support them. If we don’t ask, we’ll never know.
Zero Suicide is based on the other key misconception, namely that you can’t stop suicide. In fact, suicide is one of the most preventable deaths there is. If you can give someone hope that his or her situation will improve, you can make the key difference. That’s why we are not only working with health care staff but are training police officers, teachers, coaches, ministers and other key community leaders, though not through this project.
PBN: Do you have any information indicating why the suicide rate in Washington County is so high? Or an educated guess?
ORBAN: First, suicide is a national crisis. It’s currently the 10th leading cause of death in America, and has been rising for 15 years. The figures are more frightening for young people under age 24, for whom suicide is the second leading cause of death.
Of course, suicidal tendencies don’t just appear one day; 1 in 5 nationally has a diagnosable mental health disorder right now. Yet, nationally, we have less than a 50-50 chance of getting the behavioral help we need.
The cultural issues facing Americans are the same that face Rhode Island and the nation as a whole: a greater social disconnect, increasing anxiety and alcohol/drug use, broken families, financial challenges, and so on. 24/7 access to news and the pressures of social media also complicate matters. Isolation and/or feelings of being overwhelmed in the midst of all these stressors may depress someone else to the point where they might consider suicide.
I believe the high suicide rate in Washington County specifically is related to our limited access to behavioral health care. As is typical in many suburban/rural areas, we don’t have access to the full continuum of behavioral health services we need. Washington County is, in fact, a federally designated mental health shortage area. Our major psychiatric facilities are located in Providence, which can pose a transportation challenge. Insurance can also be a key barrier to quality behavioral health care and follow-up. Stigma in our small towns may also prevent many people from reaching out for help.
PBN: What can people in Washington County, and in Rhode Island in general, do to help?
ORBAN: Two things. One, reach out and get to know your neighbors, friends, work colleagues, students, family members, etc. If someone you know appears to be suffering emotionally, connect, reach out, inspire hope and offer help. Show compassion and a willingness to find a solution when the person may not have the will or drive to do it alone. Connect to resources in your community. It may take more than one offer, and you may need to reach out to others who share your concern about the person who is suffering. Take time to learn the five signs of emotional suffering and join the state’s new Change Direction campaign.
In Washington County, we offer free trainings through proven effective programs called Mental Health First Aid and QPR – Question, Persuade, Refer – that teach nonprofessionals how to identify and support someone who might be in mental distress.
Two, end the stigma. Mental illness is a health issue. We need to treat it like any other physical ailment or health condition, i.e. diabetes, heart disease, cancer. Nor should we be embarrassed about our own needs or that of a family member. We need to let people know that seeking help is a sign of strength, not weakness, and that they are not alone.
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.
