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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 www.suicidepreventionlifeline.org
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 Alert.com 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 www.suicidology.org.
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, www.suicidology.org.
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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.
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Donna and Phillip Satow sit beside
a photograph of their late son, Jed, in their SoHo
apartment and office in New York.
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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 (indianz.com
12/3)
Copyright © 2000-2004 Indianz.com
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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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