The U.S. Department of Health and Human Services¹ Substance Abuse and Mental Health Services Administration (SAMHSA) today announced the launch of the National Suicide Prevention Lifeline


SAMHSA has announced the launch of the National Suicide Prevention Lifeline 1-800-273-TALK. The national hotline is part of the National Suicide Prevention Initiative (NSPI)*a collaborative effort led by SAMHSA that incorporates the best practices and research findings in suicide prevention and intervention with the goal of reducing the incidence of suicide nationwide. In addition to the national hotline, a new website is being launched

In the United States, suicide currently is the 11th leading cause of death among all age groups, accounting for approximately 30,000 deaths annually. More than 100 crisis centers in 39 states currently participate in the National Suicide Prevention Lifeline. SAMHSA is committed to working with state and local organizations, such as the Mental Health Association of New York City, the National Association of State Mental Health Program Directors, and community crisis centers, to expand the availability of suicide prevention and intervention services.

The National Suicide Prevention Lifeline is funded by a 3-year $6.6 million grant from SAMHSA¹s Center for Mental Health Services, which has been awarded to the Mental Health Association of New York City and its partners*the National Association of State Mental Health Program Directors, Columbia University and Rutgers University. The National Suicide Prevention Lifeline is a network of local crisis centers located in communities across the country that are committed to suicide prevention. Callers to the hotline will receive suicide prevention counseling from trained staff at the closest certified crisis center in the network. A nation-wide public education campaign to raise awareness about suicide and the national hotline is under development.

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New Reports Available.
The following two reports are now available on the Arizona Department of Health Servises (ADHS) web site:

Additional reports on drowning deaths, assault (homicide), drug-related deaths, firearm-related deaths, etc. are in preparation.

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Arizona Suicide Prevention Alert Teams Up with Suicidology Association to Offer Online Prevention Training

The American Association of Suicidology will offer for the first time, through our website, an on-line suicide prevention course for health care professionals which can be taken for continuing education credit. In addition, Arizona Suicide Prevention also has partnered with this national organization to develop and offer a training program for health care workers who deal with American Indians, who carry a higher than average suicide risk. The programs should be available in the near future, according to Lanny Berman, AAS executive director. For more information about AAS, go to


More Suicide Prevention Training Urgently Needed To Reduce Arizona Suicide Deaths

Arizona ranks 10th in the U.S. in number of suicide deaths, and suicide prevention advocates are urging the state to require additional training by health professionals in risk assessment and patient management as a way to reduce this death toll.

A large percentage of suicide victims visit their health care provider in the month prior to their deaths, according to suicide experts. If physicians had better training in identifying these patients, they could likely prevent many deaths by helping them get treatment. Some 90% of suicide victims suffer from some treatable mental illness, such as depression, according to national experts.

Mental health professionals normally receive only two hours of training in suicide prevention in school and therefore often feel ill-equipped to deal with suicidal patients, according to the American Association of Suicidologists, an organization that deals with suicide. States should require or provide incentives for taking Continuing Education courses in suicide risk assessment and patient treatment to mental health professionals as one practical method of reducing death rates, the AAS suggests.

This recommendation is echoed by the Institute of Medicine in its 2002 report "Reducing Suicide: A National Imperative." According to the IOM: " Because primary care providers are often the first and only medical contact of suicidal patients, tools for recognition and screening of patients should be developed and disseminated. Furthermore, since over half of suicides occur in populations receiving treatment for mental disorders, it is critical to enhance the capacity of mental health professionals to recognize and address both chronic and acute suicide risk factors.

For example, the State of Arizona currently requires psychologists to obtain 60 hours of continuing education every two years. The AAS suggests clinical psychologists and other mental health professionals, especially social workers and licensed professional counselors, be required or encouraged to take six hours of training in suicide prevention every two years. This could be offered in one three-hour module covering risk assessment, with another three-hour module dedicated to patient treatment methodology.

This training would make professionals more comfortable with dealing with the topic of suicide, and able to identify and deal with patients more effectively, thus saving lives. Another benefit is that by knowing and following best practices, these professionals will also reduce their legal liability for medical malpractice related to a suicidal patient, the AAS points out.

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Phoenix Attorney David Wenner Named To American Association of Suicidology's First Trustee Council

Phoenix, Arizona, attorney and trial consultant David A. Wenner, J.D., has been named to the first Trustee Council of the American Association of Suicidology (AAS).

"We are thrilled to have someone of David's capability join AAS, and we are looking forward to his contributions to the association in helping us advance the cause of suicide prevention," said Dr. David Rudd, AAS Board President.

"David brings passion and expertise to our efforts that will help save lives," added Lanny Berman, Executive Director of the Washington D.C.-based organization.

A partner in the Phoenix law firm of Snyder and Wenner, P.C., Wenner is a nationally recognized authority and lecturer on juror bias and decision-making. He has spent the past 20 years litigating catastrophic injury and death cases, lecturing across the country and developing a successful juror bias model. Wenner and his partner Howard Snyder are both listed among the Best Lawyers in America. They founded their law firm in Phoenix in 1982.

Wenner didn't begin his career in law, however, but in social work, where he developed an appreciation for the challenges and the importance of working to improve people's lives. As a result, he is often sought out nationally to consult in cases involving mental health issues.

"I have been involved in a number of suicide cases over the years," said Wenner. "Each one of them represented a death that was unnecessary and preventable, had the appropriate information and professional help been available. As a member of the Trustee Council, I will have the opportunity to make positive contributions to help curb the rising number of suicide tragedies in our country."

Those interested in AAS and its programs can obtain more information at the organization's web site,


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Campuses Expand Suicide Prevention

Friday, November 21, 2003

Devastated by their son's suicide during his sophomore year in college, Donna and Phillip Satow channeled their grief into reaching other students who have contemplated taking their own lives.

Donna and Phillip Satow sit beside a photograph of their late son, Jed, in their SoHo apartment and office in New York.

Now, three years later, the Jed Foundation is working with 120 colleges and universities around the country, providing resources that include Ulifeline, a free Web site linking students to mental health centers and confidential help. It's one sign, some experts say, that colleges are becoming more attuned to the issue -- even if it's just one step.

"A Web site doesn't solve the problem," said Donna Satow, whose son, Jed Satow, was at the University of Arizona when he died in 1998. "But it might help one or two kids."

Second only to automobile accidents, suicide is the leading killer of college students -- claiming the lives of an estimated 1,100 each year, according to the Jed Foundation. The American Association of Suicidology reports on its Web site that the suicide rate for 15-to-25 year olds is 300 percent higher than it was in the 1950s.

In the aftermath of three apparent suicides this fall at New York University, nearly 100 colleges and universities contacted the Jed Foundation about offering the non-profit's services to their students.

The Jed Foundation also recently joined with Columbia, Harvard, Yale and the Massachusetts Institute of Technology to begin developing more effective suicide prevention programs on campuses.

Ron Gibori, the executive director of Ulifeline, credits schools for recognizing the problem. Colleges often have campaigns urging students not to binge drink, or to protect themselves from sexually transmitted diseases. But suicide gets less attention, he says.

Some schools are focusing on the causes of suicidal tendencies. Counselors say perfectionism -- in combination with the long-recognized problems such as depression, bipolar disorder and drug abuse -- is starting to play a larger role in college-age suicides.

'Normal failures can be viewed as disasters'

"The good sign is that (students are) driven, they're motivated and they're highly conscientious," said Connie Horton, the director of counseling and consultation services at Illinois Wesleyan University in Bloomington.

"But the downside is that they can be really hard on themselves and normal failures can be viewed as disasters."

An unprecedented pressure to excel -- often beginning in early childhood -- may contribute to an apparent increase in suicidal tendencies among today's college students, said Kansas State University psychologist Sherry Benton.

"There's a culture of perfectionism that really wasn't there before," said Benton, the co-author of a study on college suicides released earlier this year.

"Students were just as high-achieving a generation ago. But they didn't have this sense of perfectionism at this level."

Based on 13,257 consultations at the Kansas State counseling center over a 13-year period, Benton and other KSU researchers determined that the number of students at the school with suicidal tendencies tripled between 1988 and 2001.

Last year, Illinois Wesleyan began offering "perfectionistic thinking seminars" to teach students that a less-than-flawless academic effort doesn't equal failure.

"We try to help them put things in perspective," said Horton. "That this is just one exam in one class in one semester of their lives."

Communication is the real key to prevention, said Ross Szabo.

In appearances before high school and college students on behalf of the National Mental Health Awareness Campaign, Szabo relates how his battles with bipolar disorder, depression and anger resulted in a failed suicide attempt when he was in high school.

He encourages students not to suppress their problems but to share them with friends, family or counselors.

"One of the things I see is that young people feel alone and don't know that they can talk about it," said Szabo, 25, a graduate of American University in Washington, D.C. "A lot of times they don't have the words to start talking about it. And their form of expression is to wind up taking their own lives."

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Doctors Urged to Monitor Teens Using Antidepressant Drugs

The Food and Drug Administration is urging doctors to keep a closer watch for signs of worsening depression and suicidal behavior in both adults and children taking some of the most popular antidepressants, even though no direct link between the drugs and suicide has been established.

While the advisory does not mandate stronger cautions, officials said they hoped the makers of 10 drugs would update labels voluntarily while the FDA continues to investigate a possible suicide risk from the drugs.

"We're basically telling physicians that depression may become worse and may lead to suicidal thinking or behaviors," said Dr. Russell Katz, director of neuropharmacological drug products for the FDA. "We do not know if the drugs are causative; it may be a natural course of disease, but they should be aware that changes might occur."

The new advisory came six weeks after a panel of FDA experts urged closer monitoring of patients being treated with certain antidepressants, particularly those that regulate the brain hormone seratonin.

Warnings with the drugs already advise that side effects from the drugs may include agitation, anxiety and hostility.

But the new advisory aims to make those warnings more prominent, while underscoring the need for better monitoring of patients, particularly when they first start taking the drugs or when the dosage is changed.

The drugs are all relatively new antidepressants: Prozac, Paxil, Zoloft, Effexor, Celexa, Remeron, Lexapro, Luvox, Serzone and Wellbutrin.

Katz stressed, "We're not indicting any drug for its ability to induce suicidal behavior."

British regulators first raised doubts about the drugs last year, contending that internal studies by drug companies suggested certain antidepressants increase the risk of suicidal behavior in children and teens.

The FDA echoed that concern for suicide risk in children last October, but the new advisory urges closer watch over both youths and adults, particularly since the drugs are increasingly prescribed not just by psychiatrists but also by pediatricians and family doctors, for not just depression, but other conditions like attention-deficit disorder and anxiety.

The agency said that in 2002, nearly 11 million antidepressant prescriptions were written for children.

In January, a committee set up by the American College of Neuropsychopharmacology to review the suicide risks from the drugs concluded that they do not pose a risk, based on clinical trials involving about 2,000 youths.

"The most likely explanation for the episodes of attempted suicide while taking selective serotonin reuptake inhibitors is the underlying depression, not the SSRIs," said Graham Emslie, a psychiatrist at the University of Texas Southwestern Medical Center at Dallas who co-chaired the committee. The study got no drug-industry support, but several members of the panel have ties to manufacturers.

Proponents of the drugs argue that suicide is the third-leading cause of death among youth, and that untreated depression is the major cause of suicide. They note that the teen suicide rate has actually declined over the past decade, the same time period that prescription rates for antidepressants in youths have gone up.

There are numerous individual reports of preteens and teenagers who killed themselves, or tried to, shortly after they started taking antidepressants, and dozens of parents of those youngsters testified before the FDA advisory committee last month.

But in controlled trials of the drugs, the results are less clear. The FDA says it has seen 25 studies involving about 4,000 children and teens. There were no completed suicides, but 109 patients experienced one or more possibly suicide-related behaviors or attempts.

Critics of the drugs say those results don't reflect the danger, because teens considered at high risk of suicide are excluded from the studies, and definitions of what constitutes suicidal behavior as opposed to some other disorder, such as self-mutilation, have not been consistent.

Copyright © 2004 Scripps Howard News Service

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American Indian Suicide
The American Indian Suicide Rate in Arizona almost 300% higher than other groups

Suicide is an even greater problem for American Indians and Alaska Natives. The suicide rate for this group of U.S. citizens is about 1.7 times the rate for all races in the U.S. The suicide rate for males 15 to 34 years of age is more than twice the national rate. Factors such as poverty and substance abuse contribute to this crisis.

For example, the poverty rate for American Indians and Alaska Natives in 2001 was 24.5 percent, as compared to 7.8 percent for non-Hispanic Whites. The 2002 National Household Survey on Drug Abuse found that among youths aged 12 or older, the AI/AN population had the highest rate of substance abuse or dependence of any major racial and ethnic group (14.1 percent). Studies have shown that 70 percent of all suicidal acts (completions and attempts) in AI/AN country involved alcohol.

There is a critical need for a Suicide Prevention Center to develop programs which can focus on education, screening, and improved treatment for this at-risk group.

Indian Health Service Special Report on Suicide (PDF)

For the past 15 years, suicide has been the second leading cause of death for 15 to 24- year- old American Indians and Alaska Natives. The suicide rate for this age group is 31.7 per 100,000, as compared to a rate of 13.0 per 100,000 for persons in this age group for all races in the U.S. population. In addition, completed suicide for AI/AN occurs at a higher rate than in the general population (Middlebrook, LeMaster, Beals, Novins & Manson, 1998). However, suicide rates are not uniform across all AI/AN. Two communities that have experienced a significantly high rate of suicide are the Zuni Pueblo reservation in Arizona and the Standing Rock Indian reservation in the Dakotas.

Suicide is often the result of the failure to treat such problems as depression, alcoholism, and domestic violence, all of which are pervasive in the AI/AN population. A suicide attempt requiring hospitalization commonly costs $5,000 or more. These costs can escalate to exceed $100,000 in some AI/AN communities because of geographic isolation and high transportation costs. Such costs could be dramatically reduced with effective prevention programs.


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Arizona Tribe Sees Alarming Rate of Suicide Attempts
Tuesday, March 9, 2004

After 20 suicides and more than 1,000 attempts in less than three years, the White Mountain Apache Tribe of Arizona and the Indian Health Service say the suicide crisis on the reservation is over. The tribe and IHS set up a task force to deal with the problem. They reached out to at-risk youth, developed policies for suicide prevention and worked to educate the community. The task force will continue its work. The tribe continues to see high numbers of suicide and suicide attempts. In 2002, there were 545 suicide attempts reported and six completed suicides.

For more information and related stories:

IHS Tackles Apache Suicide Crisis (US Medicine 12/4)
Montana Reservation Experiences Rash of Suicides ( 12/3)
Copyright © 2000-2004


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Suicide-Med Link in Kids is Not Found

REUTERS WASHINGTON - Anti-depressants such as Prozac and Paxil do not raise the risk of suicide in children and teen-agers, a group of pharmacologists said Wednesday in a preliminary report released amid a review by U.S. regulators.

Health officials in the United States and Britain are probing a possible link between anti-depressants and suicide. A U.S. Food and Drug Administration advisory panel is scheduled to discuss the topic at a public meeting on Feb. 2.

British drug safety experts said in December that most selective serotonin re-uptake inhibitor anti-depressants should not be used by children or adolescents.

In response to the concerns, the American College of Neuropsychopharmacology said it evaluated all published clinical trials on treatment of children with SSRIs. The group acknowledged, however, that it did not have access to "a substantial amount of data" available to regulators and pharmaceutical companies.

The pharmacologists group said research it reviewed showed evidence of a connection was "weak."

"We don't see this as a compelling problem" based on current data, said Dr. J. John Mann, chief of neuroscience at the New York State Psychiatric Institute and co-chairman of the College of Neuropsychopharmacology task force that studied the issue.

"The evidence, if anything, favors of positive effect," Mann said, noting that those treated with the anti-depressants were less likely to voice suicidal thoughts or exhibit suicidal behavior.

Drug makers say millions of patients have taken SSRIs - Paxil, Prozac, Zoloft and others - without problems and that any suicidal thoughts are the result of depression rather than treatment.

The task force reviewed clinical trials involving more than 2,000 youths and found no significant increases in suicide attempts or suicidal thinking related to the anti-depressants. No deaths by suicide were reported in the trials.

One shortcoming, however, was that people most likely to commit suicide generally were not included in the studies, Mann said.


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Attorneys are Suicide Prevention Advocates

Howard Snyder and David Wenner, partners in the law firm of Snyder and Wenner, Phoenix, recently joined the board of the Arizona Suicide Coalition. The board, made up of representatives of various state and private agencies and individuals, meets monthly to oversee development and implementation of a coordinated plan to implement the state's suicide prevention plan.

Link to Reducing Suicide: A National Imperative
Link to Suicide Prevention Program Annual Report

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Also, the National Hopeline Network at 1-800-784-2433 provides access to trained telephone counselors 24 hours a day, 7 days a week.

For events, happenings and more information on the Arizona Suicide Prevention Coalition

Matthew Couto was neglected and victimized by two doctors, who took no decisive action to help him, despite numerous red flags.
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