A Public Health Approach to Comprehensive Suicide Prevention in Connecticut - The Connecticut Department of Health (DPH) is applying for the five-year CDC grant entitled Comprehensive Suicide Prevention (CDC-RFA-CE20-2001) which begins September 1, 2020. CT DPH will partner with key staff from the CT Department of Mental Health and Addiction Services (DMHAS) and the CT Department of Children and Families (DCF) to co-Project Direct this prevention initiative, and with local public health and behavioral health partners to advance this prevention effort. Suicide in Connecticut (CT) is a major public health issue. Currently, over 400 people die by suicide each year. From 2015-2019, there were about 2,000 suicides, and 90% of them in persons over 25 years old. Since 2008, the number of suicide decedents has climbed each year, from 308 to 424 (2019), a 37.7% increase. And according to recent CT statistics, about 4,500 persons per year received treatment in a hospital setting for suicide attempt or non-suicidal self-directed violence. A coordinated, multi-tiered, and multi-disciplinary public health approach is needed to curtail the rates of suicide, suicide attempts, and other self-directed violence. Active and robust surveillance and data dissemination activities are needed to inform prevention initiatives on a state and local level. Evidence-based and data-driven prevention strategies, which have an immediate impact in preventing suicide, will be implemented, as will upstream approaches to promote resilience, coping skills, mental health, and wellbeing to protect individuals from considering suicide as an option. Targeted vulnerable populations for which this project will be focused are: 1) persons 35 to 65 years old, who are at a higher risk of suicide and suicide attempts, and have severe mental illness or substance use disorders and 2) adolescents and young adults 10 to 24 years old—the highest risk age group for suicide attempt, other self-directed violence, and suicide ideation. The prevention strategies in this proposed suicide prevention project will be framed to align with the CDC technical package, Preventing Suicide: A Technical Package of Policies, Programs, and Practices (CDC, 2017). Strategies selected will be categorized into a three-tier approach: community-based interventions, healthcare-related interventions, and upstream interventions. Also, chosen strategies are in-line with statewide CT Suicide Advisory Board objectives and with the Connecticut State Suicide Prevention Plan 2020. Tier 1 community-based interventions are: contracting with local health departments and districts (LHDs) to (A.) Create protective environments, by reducing access to lethal means among at-risk adults, (B.) Identify and support people at risk, by offering a gatekeeper training toolbox which includes suicide prevention, awareness, and skills trainings to community stakeholders, and (C.) Lessen harms and prevent future risk, through (1) postvention planning to link survivors to CT’s crisis response teams and (2) safe messaging and reporting. Tier 2 healthcare-related interventions are: (D.) Identify and support people at risk, through expanding capacity for gatekeeper training and education of community health and behavioral health providers in the context of CT’s Zero Suicide work. Tier 3 Upstream interventions are: identify and promote/support upstream interventions, such as programs that (E.) Teach coping and problem-solving skills, through social-emotional learning (SEL) programs, including two CT-developed evidence-based programs that address SEL in K-12 school populations. They are Gizmo’s Pawesome Guide to Mental Health and 4 What’s Next. Implementing these prevention strategies will increase resilience and coping skills, create awareness of signs and symptoms of suicide so appropriate life-saving actions can be taken, link suicide survivors to needed resources, and reduce contagion. Ultimately, the goal is to reduce suicide morbidity and mortality in CT.
