Suicide in Montcalm County

Eric Nelson Tammie McDaniel

Lindy Hilding Venus Johnston

Connie Chrisman Jennifer Vicarie

NURS 340

Suicide in Montcalm County

Suicide:

“Death arising from an act inflicted upon oneself with the intent to kill oneself” (Healthy People 2020).

Definition

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).

Groups Affected

Est. Population 2012: 63,097Land Area per Square Mile: 705.40 Person per Square Mile: 89.8

( U.S. Census Bureau, State & County Quick Facts, 2013)

Montcalm County

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

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)

Suicide Continued

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)

Top 3 Contributing Factors for Montcalm County

Poverty


School District

Number of

Homeless

Students

Total Students

Percent Homeles

s

Students Eligible for free

or reduced

lunch Carson City- Crystal

59 963 6.1% 547

Central Montcalm

60 1770 3.4% 1110

Greenville 163 3545 4.6% 1840 Lakeview 101 1386 7.3% 763 Montabella 90 821 10.9% 611 Tri County 37 2336 1.6% 1130 Vestaburg 24 673 3.6% 418

Poverty Continued


• 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 nurseVestaburg Community School does not have a school nurse

Limited Resources for Adolescents with Mental Illness

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).

Access to Healthcare or No Health Coverage

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)

Theories of Social Support

Essential & Basic Needs

(Bing Images, Maslow's Chart)

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

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 Prevention/Intervention Resources Continued

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


County Awareness & Postvention

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 Available

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


State Resources Continued

• 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

Some National Resources Available

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


Website Information

http://www.suicidology.org/

http://www.afsp.org/

http://www.jedfoundation.org/

http://www.sprc.org/

http://www.yellowribbon.org/

http://www.suicidegrief.com/

http://www.mental-health-today.com/ptsd/boarde.htm

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


Agencies Working Together

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.

Why Suicide is Still an Issue?

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

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

Nursing Diagnosis Continued:

This is a leading Health Indicator for Healthy People 2020

Suicide is the third leading cause of death in Montcalm County’s adolescents

Why Community Nursing Intervention

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

Assistance from Others

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 Levels

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

Prevention/Interventions

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

Strategy/Plan:

Developing a wallet-sized card

Creating a local resource brochure

Providing suicide prevention education for parents, students, and counselors

Community Action Plan Continued

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

Teen Resource Card

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

Local Resource Brochure

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

Community-Wide Education

Funding Volunteers Awareness of Resources Limited school nursing Limited inpatient healthcare facilities Insurance coverage Willingness of participation

Barriers

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

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.

Evaluation Continued

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

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_fi

nal_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/


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


Documents

Suicide in Montcalm County