Editor’s Note: The phone number for the local Suicide Prevention & Crisis hotline is 607-272-1616.

TOMPKINS COUNTY, N.Y. — Suicide prevention efforts are evolving in Tompkins County, as a local coalition works to bring more organizations on board to implement a “Zero Suicide” model.

The initiative aims to make health care “suicide safe” and acknowledges that many suicidal individuals often fall through the cracks of a “fragmented and sometimes distracted healthcare system,” as the Suicide Prevention Resource Center puts it. It is an initiative with a foundational belief that suicide deaths for people who are under care, whether health or behavioral, are preventable.

At the beginning of a presentation last week diving into how to implement the Zero Suicide model, Sharon MacDougall, Tompkins County deputy commissioner of mental health services, asked the roughly 60 attendees to raise a hand and show the number of people they know who have been lost to suicide. Almost everyone raised a hand.

“We really want to get that number to zero,” MacDougall said.

Two representatives from the New York State Office of Mental Health gave the presentation, discussing in detail the different phases of implementing the suicide prevention model. The audience Monday was mostly made of people who worked in health care, mental health, substance abuse service and schools.

In a previous interview with The Ithaca Voice, Dr. Michael Hogan, former New York State Commissioner of Mental Health and a developer of the “Zero Suicide” movement, said most people who die by suicide were receiving health care, but health care failed to prevent them from dying. The idea is to make health care “suicide safe,” Hogan said.

Q&A: Expert discusses ‘Zero Suicide’ concept and Tompkins prevention efforts

There is currently a statewide effort to address suicide as a public health problem. The New York State Office of Mental Health has received a $3.5 million federal grant to implement the Zero Suicide model in six large health systems across the state. Tompkins County is not part of the grant and is implementing the Zero Suicide model in its own way.

According to OMH, 1,700 people in New York died by suicide in 2014. More people die by suicide in the U.S. each year than from motor vehicle accidents, homicides and breast cancer. And unlike other leading causes of death, like heart disease, cancer, and stroke, the rate of suicide is increasing.

The state’s 2016 report on suicide prevention says trying to find one solution to bring the rate of suicide down, like ensuring access to quality mental health services is necessary but not enough. Instead, well coordinated and collective efforts among health providers, schools and communities are needed.

In Tompkins County, a Suicide Prevention Coalition was formed last year and is leading efforts to implement a countywide Zero Suicide model. Many local providers of mental health and general healthcare are part of the coalition.

At the meeting, MacDougall discussed some of the ways Tompkins County Mental Health services has improved after taking a look at its own practices.

MacDougall said while they were asking clients about depression, they were not using an evidence-based method of screening. So, they instituted the Columbia-Suicide Severity Rating Scale for anyone who comes close to discussing suicide or depression. They also realized staff needed more training, which they provided.

“Early progress from this is that I think we have staff who are far more trained and much better at identifying and engaging clients who have suicide [thoughts],” MacDougall said. “We actually just ask the question now. It’s not just the depression screening. We actually ask ‘Are you feeling suicidal?’ And we actually dig in deeper.”

Last week, the coalition voted in favor of recommending to the Health and Human Services Committee of Tompkins County Legislature that Tompkins County pledges to the Zero Suicide Model. A resolution should make its way to Tompkins County Legislature in the next month.

The Sophie Fund, which sponsored the Watershed Declaration in April 2017, said more needs to be done to prevent suicide in Tompkins County.

“The Zero Suicide Model is an essential approach for saving lives. As the next step, The Sophie Fund renews its call on all the leading community and campus healthcare agencies in Tompkins County to commit to the Zero Suicide Model and to begin the implementation process as expeditiously as possible,” the Sophie Fund said in a statement.

A few organizations have agreed to become Zero Suicide “champions” locally, including Tompkins County Mental Health Services, the Alcohol and Drug Council of Tompkins County and Cornell Health.

Jillian King and Olivia Retallack, representatives giving a presentation from OMH, shared data that showed 80 percent of people who died by suicide had health care visits in the previous year, and 45 percent of people who died by suicide had a primary care visit in the previous month.

“We need to empower our health cares systems to do better prevention,” Retallack said.

The largest healthcare provider in the county, Cayuga Medical Center, is also committed to implementing the Zero Suicide model, Dr. David Evelyn, vice president of medical affairs at Cayuga Medical Center, said.

Evelyn said an in-house team is working on how to implement it. One way to better identify people who are at risk of suicide is by more thorough screening with deeper questions, even if someone is coming in for something seemingly unrelated to depression or mental health. Questions at a regular health exam like, “Are you having trouble sleeping?” or feeling less joy lately or about drug and alcohol use could help start discussions on mental health.

“Part of our issue … is that we’ve separated what I’ll call physical healthcare medicine from mental healthcare medicine and we need to combine them,” Evelyn said.

The greatest risk for patients, Evelyn said, is when they leave the safe environment of the hospital and go back home or back into the community. He said CMC has already started looking at tools to address that risk. He said they will have some sort of Zero Suicide model up within a year. But it’s not something that is implemented and done, Evelyn said. The system will be continually improved.

Anyone with questions about mental health and suicide prevention can contact the local organization Suicide Prevention & Crisis Service 24/7. SPCS provides crisis intervention and counseling services. For more information visit the website here, or call 1-800-273-8255.

Featured image: Sharon MacDougall speaks at the Zero Suicide meeting Monday. (Kelsey O’Connor/The Ithaca Voice)

Kelsey O'Connor

Kelsey O'Connor is the managing editor for the Ithaca Voice. Questions? Story tips? Contact her at koconnor@ithacavoice.com and follow her on Twitter @bykelseyoconnor.