Local health officials and medical professionals made a pledge to recommit to a Zero Suicide method of suicide prevention at a community town hall Sept. 28 at Greater Ithaca Activities Center.
“We, at Tompkins County Whole Health, believe that every suicide is preventable,” Frank Kruppa, commissioner of Tompkins County Whole Health, said at the forum. “And we need to say that out loud and more often, and begin to figure out how to make that a reality.”
The Zero Suicide approach is a framework for health and behavioral health care systems to prevent death by suicide.
“It’s about asking everyone, and not just assuming,” said Dr. Laura Sidari, M.D., director of Cayuga Health Integrated Behavioral Health, on Oct. 5.
“You can’t just assume that those who are strong and seem just fine are OK,” Sidari said. “You have to ask.”
There was a 35% increase in the American suicide rate from 1999 to 2018, according to statistics shared in a presentation at the panel discussion.
Thirty-three percent of American adults experienced mental health illness in 2021.
For Sidari, the death of a mentor who died by suicide was a devastating reminder that anyone can struggle with suicidal thoughts while showing no outward signs.
The mentor’s name was Christine Petrich, and she was an accomplished psychiatrist and professor who had two young children at the time of her death.
“She was one of the 40% [of those who die by suicide] who never told anyone and had no history of mental illness prior that would make it readily known,” Sidari said. “We found out when she didn’t show up for work the next day.”
“If this can happen to a psychiatrist, to people who we would think should be protected from it, it can happen to anyone,” Sidari said. “That’s why it’s important we keep sharing these stories, like Scott—he does this as a living legacy to his daughter Sophie.”
Sidari is referring to Scott MacLeod, who started The Sophie Fund after his daughter died by suicide in 2016.
“We established The Sophie Fund to support mental health initiatives aiding young people in Tompkins County, including the college campuses,” MacLeod said at the panel discussion, which he and The Sophie Fund organized in an effort to bring together medical caregivers, policy makers and community members for an open dialogue about employing suicide prevention strategies within Tompkins County.
The Zero Suicide Initiative was a main topic of conversation.
Since 2018, the Tompkins County Suicide Prevention Coalition has advocated for implementing the Zero Suicide model in all health care and behavioral health settings. In 2022, Tompkins County health care leaders formed the Zero Suicide Steering Committee to advance the model.
During the COVID-19 pandemic, the effort to implement the strategy stalled. At the forum, Dr. Andreia de Lima, M.D., chief medical officer of Cayuga Medical Center (CMC) and Schuyler Hospital, spoke of her recommitment to the Zero Suicide model.
“We have many moving pieces, and part of the work right now is to coordinate how we can all move together towards the same goal,” de Lima said. “Because we are all — and not just in the system, but everyone here — we are all taking care of the same patients. We are taking care of the community. If they get admitted to CMC, and after discharge they will be seen at Cornell Health. Someone was discharged from Guthrie Cortland, and then they come to our [Emergency Department]. So in a way, we are all taking care of the same community.”
“Our goal is to get [the Zero Suicide model] in every space of the health system, but before that we need to work with them on training so that everyone knows what to do,” Sidari said.
Sidari said that participating as a panelist was “wonderful,” and that she enjoyed participating as someone who is working in the community. She was heartened by the community’s interest, as well.
“The room was filled with not just health care and mental health professionals but also interested community members,” she said, adding that suicide prevention is about bringing people together. “Part of it, ultimately, is about taking care of one another because suicide touches us all.”
The goal is to have universal depression screenings employed as routinely as a check for heart rate or blood pressure for any patient receiving medical care, not just for those who are seeking mental health care or who are perceived to be at risk.
“Because many people who die by a suicide have seen a heath care professional but not a mental health professional, it is really important that our health care providers are aware of the need of universal screening,” Sally Manning, convener of Tompkins County Suicide Prevention Coalition, said Oct. 4.
“It doesn’t matter if you have a stuffy nose or it’s just a routine visit,” Sidari agrees. She believes mental wellness is a vital sign, too, and a universal questionnaire can identify red flags and start a discussion. Depending on the severity of the situation, based on the assessment, medical care professionals can apply the results to a framework of procedures that tells them how to proceed to ensure the patient receives appropriate mental health care.
Sidari also places a great deal of importance on educating the general public. There are ways intervene and prevent suicide, she said. For instance, there are telltale behaviors that can be effectively hidden from friends and family or commonly overlooked.
“There are warning signs, like withdrawing from others, giving belongings away, seeking access to weapons, writing goodbye letters and not planning for the future,” Sidari said. “If you know what someone’s baseline is and they are looking off that day, do not be afraid to ask, ‘How are you doing?’ Sometimes we don’t ask because we are afraid of the answer, and the key piece that came up at the town hall is that it is a good thing when people let us know they’re suffering. We should have hope and gratitude and say, ‘Thank you for sharing that with me.’”
One of the biggest risk factors surrounding suicide is access to a firearm.
“This is something that is a touchy subject,” Sidari said. “It’s not that we have an interest in taking people’s guns away, but having trigger locks, the ability to remove ammunition or the firearm from the home if you have a friend or neighbor who is at risk — that you can tell them you’re going to put them in a safe place for now. Not that it’s forever, but to tell them, ‘This is what I can do right now.’”
The three biggest risk factors for death by suicide, according to Sidari, are lack of meaning, lack of purpose and lack of connection. Even just having a conversation with someone who is struggling can be healing for them.
“Just being present with someone who is sharing something difficult can save a life,” she said.