Suicide in Montcalm County . Eric Nelson Tammie McDaniel Lindy Hilding Venus Johnston Connie Chrisman Jennifer Vicarie NURS 340. Definition. Suicide:
Suicide in Montcalm County Eric Nelson Tammie McDaniel Lindy Hilding Venus Johnston Connie Chrisman Jennifer Vicarie NURS 340
Definition • Suicide: • “Death arising from an act inflicted upon oneself with the intent to kill oneself” (Healthy People 2020).
Groups Affected • All people are affected by suicide. According to Healthy People 2020 (2013), “Suicide is the 11th leading cause of death in the United States, accounting for the deaths of approximately 30,000 Americans” (U.S. Department of Health and Human Services, 2013). Although these are alarming statistics, it is the 3rd leading cause of death among Montcalm County adolescents. • (Mid-Michigan Health Department, 2011, p 36).
Montcalm County • Est. Population 2012: 63,097 • Land Area per Square Mile: 705.40 Person per Square Mile: 89.8 • ( U.S. Census Bureau, State & County Quick Facts, 2013)
Suicide • Suicide is the third leading cause of death in Montcalm County for adolescents ages 15-24 years old. • The Montcalm County suicide mortality rate has consistently been higher than that of Michigan and the U.S. during the period 1996-2009. • The Montcalm County suicide mortality rate has increased 29% over the period 1996-2009, and was 36% higher than that of Michigan during the most recent 5-year period (2005-09) in which data is available. • (Mid-Michigan Health Department, 2011, p 36)
Suicide Continued • The goal set by Healthy People 2020 was to reduce suicide attempts by adolescences. This is listed under the leading health indicator for mental health and mental disorders. • The baseline was 1.9 suicide attempts per 100 occurring in 2009. The target was to decrease that number to 1.7 attempts per 100. Instead it increased to 2.4 per 100. • (U.S. Department of Health and Human Services, 2013)
Top 3 Contributing Factors for Montcalm County • Poverty • The poverty rate in 2011 for children under 18 was 21.9% in the U.S. (U.S. Department of Commerce, 2013) • As of 2009, child poverty in Montcalm County had climbed to 29.1% (MI at 22.1%) an increase of approximately 85% from 2000 to 2009. (Mid-Michigan Health Department, 2011)
Poverty (Mid-Michigan Health Department, 2011, p 10)
Poverty Continued (Mid-Michigan Health Department, 2011, p 11)
Limited Resources for Adolescents with Mental Illness • No facilities in Montcalm County with inpatient care for adolescents. • The only facility within the county with inpatient care for adults is closing their doors. • Limited school nursing and they are grant based. Greenville Public Schools has only one nurse for the whole school district • Carson City-Crystal School does not have a school nurse • Vestaburg Community School does not have a school nurse
Access to Healthcare or No Health Coverage • In 2011, 9.4% of children under age of 18 (7.0 million) were without health insurance. • The uninsured rate for children in poverty, 13.8% was higher than the uninsured rate for all children, 9.4% for the U.S. • (U.S. Department of Commerce, 2012, pp 21-23) • Montcalm County 7.3% and Michigan 6.8% youth under 18 years of age are without insurance coverage. • (Mid-Michigan Health Department, 2011, p 14).
Theories of Social Support • Addressed with family, friends, neighbors, and communities to influence change by offering social support with: • Instrumental Assistance • Informational Support • Emotional Support • Appraising Support • Social Support • (Harkness & DeMarco, 2012)
Essential & Basic Needs (Bing Images, Maslow's Chart)
County Prevention/Intervention Resources • Counseling Resources • Carson Behavioral Health Center (outpatient) • Catholic Charities West Michigan • Community Hope Christian Counseling • Montcalm Center for Behavioral Health • Montcalm Area Health Center-a Cherry Street Health Services Clinic • North Kent Guidance Services • Pine Rest Christian Mental Health Services (Greenville) • Substance Abuse Treatment Resources • Life Guidance Wellness and Prevention Services • Riverhaven Coordinating Agency • ( Montcalm County Suicide Prevention Coalition, 2009)
County Prevention/Intervention Resources Continued • Faith Community Resources • Central Montcalm Area Ministerial Association • East Montcalm Ministerial Association • Greenville Ministerial Association • Lakeview Ministerial Association • Ministerial Association of Tri-County • Montabella Ministerial Association • Vestaburg Ministers Association • (Montcalm Suicide Prevention Coalition, 2009)
County Awareness & Postvention • Awareness • Montcalm County Suicide Prevention Coalition • Postvention(directed toward surviving family/friends) • Mid Michigan Home Care & Hospice • Hospice of Michigan • Sparrow Hospice Services • Survivors Outreach Program (Montcalm Suicide Prevention Coalition, 2009)
State Resources Available • Michigan Association for Suicide Prevention (MASP) • Awareness , Education, Survivor support, Conferences, Workshops, Youth suicide prevention, & Advocacy • Michigan Suicide Prevention Coalition • Advocacy & Policy Implementation • Mid-Michigan District Health Department • Clinical Services, Primary prevention, Public awareness /education, Advocacy & Surveillance (Montcalm Suicide Prevention Coalition, 2009)
State Resources Continued • The MINDS Program, Inc. • Primary prevention, Research, Advocacy, Public awareness/education & School-based programming • Yellow Ribbon Suicide Prevention Program of Michigan • Crisis intervention, Survivor support, Depression screening, Primary prevention, Advocacy, Public awareness/education & School-based programming • (Montcalm Suicide Prevention Coalition, 2009)
Some National Resources Available • American Foundation for Suicide Prevention • Research, Education, Training & Public awareness • A New Day, Inc. • Primary prevention, Public awareness/education & Advocacy • Suicide Prevention Resource Center • Primary prevention, Survivor support, Coordination, Training, Technical assistance & Public awareness/education
Website Information • Website Support • American Association of Suicidology (AAS) www.suicidology.org • American Foundation for Suicide Prevention (AFSP) www.afsp.org • The Jed Foundation www.jedfoundation.org • Suicide Prevention Resource Center (SPRC) www.sprc.org • Yellow Ribbon International www.yellowribbon.org • Internet Suicide Grief Support Forums www.suicidegrief.com & www.mental-health-today.com/ptsd/boarde.htm (Montcalm Suicide Prevention Coalition, 2009)
Agencies Working Together • The National Strategy for Suicide Prevention & National Prevention Strategy • Michigan Association for Suicide Prevention (MASP) has an informal affiliation with the American Association of Suicidology and also participates in the Michigan Suicide Prevention Coalition. • MASP collaborates with the American Foundation for Suicide Prevention (Ann Arbor Chapter). • Oakland County Community Mental Health & University of Michigan Depression Center • Montcalm Center for Behavioral Health works with all the hospitals in the county. • Mid-Michigan District Health Department with police/law enforcement, mental health, courts, schools, and health care providers (Montcalm Suicide Prevention Coalition, 2009)
Why Suicide is Still an Issue? • Although many suicide prevention programs have been developed and implemented, few are evidence-based in their effectiveness in decreasing suicide rates. • There has been limited research on how to comprehensively predict, treat, and prevent suicide among youth.
Nursing Diagnosis • Risk for suicide among adolescents ages 15-24 in Montcalm County related to: • Limited assistance programs for mental illnesses • Access to healthcare or no health coverage • Poverty/homelessness • Alcohol/drug abuse • Obesity • Lack of parental/teacher awareness of suicide risk factors • School violence/bullying/cyber bullying
Nursing Diagnosis Continued: • As demonstrated by: • Increase in suicide percentages from 2009 of 1.9 to 2.4 in 2011 • Third leading cause of death in 15-24 year olds in Montcalm County
Why Community Nursing Intervention • This is a leading Health Indicator for Healthy People 2020 • Suicide is the third leading cause of death in Montcalm County’s adolescents
Assistance from Others • Other Disciplines that could be involved • Teachers, physicians, psychiatrists, mental health workers, social workers, clergy, and school counselors • Community Groups that could be involved • Church groups with youth programs individual townships could provide a suicide prevention program for parents
Prevention Levels • Primary prevention: Maximizing health and wellness through strategies that are set in place before illness or injury are present. • Secondary Prevention: Maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury.
Prevention/Interventions • Recognize warning signs: verbal comments, non-verbal behaviors, and situations • Improve access to mental health care and services • Increase awareness to community resources • Reduce Substance abuse • Address Mental Health • Address volunteers, fundraisers, grants, and/or donations for those in need of care/services
Community Action Plan • Goals: • Elimination of adolescent suicide as measured by a zero adolescent suicide rate on the annual coroner’s report. • Improved community agency collaboration • Increased community awareness about identifying at-risk and high-risk youth. • Enhanced awareness about accessible crisis response and referral sources.
Community Action Plan Continued • Strategy/Plan: • Developing a wallet-sized card • Creating a local resource brochure • Providing suicide prevention education for parents, students, and counselors
Teen Resource Card • Designed by local teenagers • Wallet-sized & attractive to encourage teens to carry it • Simplicity of use • 24-hour crisis telephone numbers • Immediate access to crisis resources • Low cost-$1.50 per card to make: no cost to the youth
Local Resource Brochure • Tri-fold brochure containing over 100 local resources & their phone numbers • National 24-hour crisis hot-line telephone numbers for immediate response • Provides many services • Low cost to make-$1.20 per brochure: no cost to public & youth
Community-Wide Education • Lectures include information on evidence-based prevention strategies and referral resources in the community. • Mental health professionals with expertise in youth suicide behavior present to speak • Meetings held in schools, churches, community halls
Barriers • Funding • Volunteers • Awareness of Resources • Limited school nursing • Limited inpatient healthcare facilities • Insurance coverage • Willingness of participation
Evaluation • Desired Outcomes • Meet or exceed the goal of Healthy People 2020 • Suicide would no longer be within the top three causes of death in Montcalm County adolescents • Increased awareness and publication of available resources • When to expect changes • According to Montcalm County, statistics are obtained every two years • The Montcalm County Suicide Prevention Coalition has statistics listed for every year between 2001 and 2006 but were not published until 2009. • When putting the interventions to work in the first year, we would hope to see viable statistics three years after they are provided by Michigan Department of Community Health (MDCH) Division for vital records and health statistics.
Evaluation Continued • Tracking • Evaluate and track participation of schools providing suicide prevention and risk factor awareness to staff. • Track the Montcalm County suicide mortality rate from the Mid-Michigan Health Department. • Evaluate the participation of local townships providing suicide prevention and awareness programs for parents. • Track the publication and access of community resources available for mental health services.
References • Dood, F. (2013).Community Process. Power point slides nursing 340, Ferris State University, Big Rapids, MI. • Harkness, G. A., & DeMarco, R., F., (2012). Community and Public Health Nursing Evidence for Practice. Philadelphia, PA: Lippincott Williams & Wilkins
References Continued Korzeniewski, S. J., Meade, L., & Smith, P. (2006). Michigan Suicide Prevention Resource Directory. In Michigan Department of Community Health. Retrieved from http://michigan.gov/documents/Michigan_Suicide_Prevention_Directory_final_1 65276_7. pdf • Mid-Michigan District Health Department. (2011). Community Health Assessment. In Mid-Michigan District Health Department. Retrieved from http://www.mmdhd.org/cha/montcalm/CHA_Montcalm_Co_Profile.pdf
References Continued • Montcalm County Suicide Prevention Coalition, (2009). Community Response Plan. Retrieved from • http://mcspc.info/wp-content/uploads/Suicide-Prevention-Plan.pdf • U.S. Department of Commerce, U. S. Census Bureau.(2012). Income, Poverty, and Health Insurance Coverage in the United States: 2011 (Report Number P60-243). Retrieved from http://www.census.gov/prod/2012pubs/p60-243.pdf • U.S. Department of Commerce. (2013). In United States Census Bureau. Retrieved from http://www.census.gov/
References Continued U.S. Department of Commerce. (2013). In U.S. Census Bureau State & County Quick Facts. Retrieved from http://quickfacts.census.gov/qfd/states/26/26117.html U. S. Department of Health and Human Services. (2013). In Healthy People 2020. Retrieved from http://www.healthypeople.gov/2020/default.aspx