1 Juneau Suicide Prevention Coalition 2015 Community Needs Assessment.

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Juneau Suicide Juneau Suicide Prevention Prevention CoalitionCoalition2015 Community 2015 Community

Needs AssessmentNeeds Assessment

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Needs Assessment Needs Assessment CommitteeCommittee

Alice RarigAlice Rarig

Kevin RitchieKevin Ritchie

Julie NeyhartJulie Neyhart

Sam TrivetteSam Trivette

Jennifer CarsonJennifer Carson

Hilary YoungHilary Young

Gus MarxGus Marx

Walter Majoros Walter Majoros

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Community Needs Assessment Community Needs Assessment FrameworkFramework1. General Community Characteristics

2. Community Concerns Regarding Focus Area

3. Examination of Pertinent Data

4. Community Perceptions Regarding Focus Area

5. Identify and Prioritize Intermediate Variables

6. Readiness Assessment (Using Tri-Ethnic Center Model)

7. Resources Assessment

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Community CharacteristicsCommunity Characteristics IsolationIsolation: Small population; land-locked; : Small population; land-locked;

topography limits social and economic topography limits social and economic opportunitiesopportunities

Shifting Population DemographicsShifting Population Demographics: Children and : Children and youth decreasing; seniors increasing rapidlyyouth decreasing; seniors increasing rapidly

Jobs/EconomyJobs/Economy: Low unemployment; reduction in : Low unemployment; reduction in higher paying jobs; increase in lower paying jobs; higher paying jobs; increase in lower paying jobs; increase in non-residents; loss of public sector increase in non-residents; loss of public sector jobsjobs

Student EnrollmentStudent Enrollment: Significant decline in student : Significant decline in student enrollment; trend will continue through 2017enrollment; trend will continue through 2017

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Community Characteristics Community Characteristics (cont.)(cont.)

Cultural CharacteristicsCultural Characteristics: 30% of population is : 30% of population is non-white; need to consider culture and non-white; need to consider culture and ethnicity in servicesethnicity in services

High Cost of LivingHigh Cost of Living: Very expensive to live; : Very expensive to live; significant housing shortage, especially low-significant housing shortage, especially low-income housingincome housing

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General Data AnalysisGeneral Data Analysis Comparison of Juneau to the StateComparison of Juneau to the State: Similar to state : Similar to state

rates and patterns for suicide, alcohol use, rates and patterns for suicide, alcohol use, depression/ emotional distress—despite Juneau’s low depression/ emotional distress—despite Juneau’s low unemployment and relative affluenceunemployment and relative affluence

Ages of Completed Suicides in JuneauAges of Completed Suicides in Juneau: Highest rate : Highest rate for seniors 65+; followed closely by young adults 18-for seniors 65+; followed closely by young adults 18-4444

Alaska NativesAlaska Natives: Higher risk than non-Natives; : Higher risk than non-Natives; statewide rate for Alaska Natives is twice the statewide rate for Alaska Natives is twice the statewide averagestatewide average

Characteristics of Completed SuicidesCharacteristics of Completed Suicides: Most common : Most common characteristics include mental health problems, characteristics include mental health problems, substance abuse and relationship problemssubstance abuse and relationship problems

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General Data Analysis (cont.)General Data Analysis (cont.)

Suicide Means/AttemptsSuicide Means/Attempts: Firearms as leading : Firearms as leading method, followed by strangulation and poisoning. method, followed by strangulation and poisoning. Suicide attempts second only to falls for injury-Suicide attempts second only to falls for injury-related hospitalization in Southeast Alaskarelated hospitalization in Southeast Alaska

Factors Influencing SuicideFactors Influencing Suicide: Preliminary : Preliminary research indicated a strong correlation between research indicated a strong correlation between trauma/violence, behavioral health problems and trauma/violence, behavioral health problems and suicidesuicide

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Community PerceptionsCommunity Perceptions

Importance of SuicideImportance of Suicide: 84.6% of the general public and : 84.6% of the general public and 100% of providers said suicide is a very important 100% of providers said suicide is a very important community issuecommunity issue

Importance of Suicide Prevention EffortsImportance of Suicide Prevention Efforts: 85.3% of the : 85.3% of the general public and 100% of providers thought it was general public and 100% of providers thought it was important to have dedicated suicide prevention effortsimportant to have dedicated suicide prevention efforts

Knowledge of Behavior Health Risk FactorsKnowledge of Behavior Health Risk Factors: The general : The general public and providers saw a strong link between suicide public and providers saw a strong link between suicide and: poor mental health; alcohol/drugs; and isolation and: poor mental health; alcohol/drugs; and isolation (83%-95%)(83%-95%)

Knowledge about Trauma Risk FactorsKnowledge about Trauma Risk Factors: The general : The general public and providers saw a public and providers saw a much smaller correlation much smaller correlation between suicide and traumatic events (trauma when between suicide and traumatic events (trauma when young, violence/sexual assault, bullying). (58%-68%)young, violence/sexual assault, bullying). (58%-68%)

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Community Perceptions (cont.)Community Perceptions (cont.)

Behavioral Health and Primary Care DifferencesBehavioral Health and Primary Care Differences:: Behavioral health agencies reported being much more Behavioral health agencies reported being much more

knowledgeable than primary care providers about knowledgeable than primary care providers about suicide/suicide prevention (100% vs. 42.9%)suicide/suicide prevention (100% vs. 42.9%)

Behavioral health agencies identified a much higher Behavioral health agencies identified a much higher percent of clients with past suicide ideation and attempts percent of clients with past suicide ideation and attempts (71.4% vs. 3.1%)(71.4% vs. 3.1%)

Primary Care Providers Re: Suicide and TraumaPrimary Care Providers Re: Suicide and Trauma:: Primary care providers said only 5.6% of their patients Primary care providers said only 5.6% of their patients

experienced past or current domestic violenceexperienced past or current domestic violence

Only 28.6% of primary care providers screen for current Only 28.6% of primary care providers screen for current suicide risk and only 42.9% screen for past attempts.suicide risk and only 42.9% screen for past attempts.

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Detailed Data AnalysisDetailed Data Analysis Impact of TraumaImpact of Trauma: YRBS and BRFSS data : YRBS and BRFSS data

indicate that:indicate that: There is a strong correlation between childhood There is a strong correlation between childhood

trauma and increased suicide risk for youth and trauma and increased suicide risk for youth and adultsadults

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Detailed Data Analysis (cont.)Detailed Data Analysis (cont.)

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Detailed Data Analysis (cont.)Detailed Data Analysis (cont.) Risky BehaviorRisky Behavior: There is a strong correlation : There is a strong correlation

between risky behavior (smoking, drinking, between risky behavior (smoking, drinking, drugs, risky sex) and suicide for youth and drugs, risky sex) and suicide for youth and adults.adults.

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Detailed Data Analysis (cont.)Detailed Data Analysis (cont.) Alcohol/Drug Abuse and Completed SuicidesAlcohol/Drug Abuse and Completed Suicides: :

Intoxication and alcohol/drug abuse are strongly Intoxication and alcohol/drug abuse are strongly linked with completed suicides in Alaskalinked with completed suicides in Alaska

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Detailed Data Analysis Detailed Data Analysis (cont.)(cont.)

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Detailed Data Analysis (cont.)Detailed Data Analysis (cont.) Mental/Emotional DistressMental/Emotional Distress: :

There is a strong correlation between There is a strong correlation between mental/emotional distress and suicide risk for mental/emotional distress and suicide risk for youth and adults. youth and adults.

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Detailed Data Analysis (cont.)Detailed Data Analysis (cont.) Mental distress and completed suicidesMental distress and completed suicides: Current : Current

mental health problems and history of mental mental health problems and history of mental illness/mental health problems are strongly illness/mental health problems are strongly linked with Alaska suicides.linked with Alaska suicides.

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Detailed Data Analysis Detailed Data Analysis (cont.)(cont.)

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Traumatic Experiences· Child Abuse (sexual,

physical, emotional)· Bullying· Sexual Assault· Interpersonal Violence· Witnessing Violence· Intergenerational

Violence· Historical Trauma

Mental Illness/Severe Emotional Disorders

Risky Behavior· Alcohol Abuse· Tobacco Abuse· Drug Abuse· Risky Sexual Behavior

Emotional Distress· Sadness/Depression· Violence/Fighting· Isolation· Weapon Misuse

Increased Suicide Risk

Factors Increasing Suicide Risk Indicated by Our Needs

Assessment

Red Flags (Contributing Factors)

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Increased Risk for Alaska NativesIncreased Risk for Alaska Natives: Alaska Native : Alaska Native youth and adults are at greater suicide risk than youth and adults are at greater suicide risk than non-Nativesnon-Natives

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Protective FactorsProtective Factors: :

YouthYouth: “Connectedness” was the strongest : “Connectedness” was the strongest protective factor, followed by team sports and protective factor, followed by team sports and adults/parents with whom to talk.adults/parents with whom to talk.

AdultsAdults: Protective factors included: : Protective factors included: moderate/high income; a job; at least a high moderate/high income; a job; at least a high school education; and a current couple school education; and a current couple relationship.relationship.

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Aggravating FactorsAggravating Factors

Culture of silence and tolerance regarding trauma Culture of silence and tolerance regarding trauma and suicideand suicide

Interrelationship of behavioral health conditionsInterrelationship of behavioral health conditions

Disconnected prevention efforts for trauma and Disconnected prevention efforts for trauma and suicidesuicide

Stigma and stereotypes around trauma and Stigma and stereotypes around trauma and suicidesuicide

Intergenerational trauma for Alaska NativesIntergenerational trauma for Alaska Natives

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Mitigating FactorsMitigating Factors

Increasing body of research on ACEsIncreasing body of research on ACEs

Increasing knowledge about trauma and suicide Increasing knowledge about trauma and suicide as individual issuesas individual issues

Relatively robust treatment servicesRelatively robust treatment services

Strong track record of collaborationStrong track record of collaboration

Openness to policy changesOpenness to policy changes

Shifting community norms and values regarding Shifting community norms and values regarding both trauma and suicideboth trauma and suicide

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Community ReadinessCommunity Readiness

Sectors/representative interviewedSectors/representative interviewed:: Youth leaderYouth leader

Alaska Native leaderAlaska Native leader

Primary care providerPrimary care provider

Business leaderBusiness leader

Spiritual leaderSpiritual leader

Law enforcement lieutenantLaw enforcement lieutenant

Behavioral health providerBehavioral health provider

High school principalHigh school principal

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Community Readiness (cont.)Community Readiness (cont.)

Community is relatively aware of individual issues Community is relatively aware of individual issues such as suicide, domestic violence and bullying such as suicide, domestic violence and bullying and prevention efforts in these areas.and prevention efforts in these areas.

Community is only vaguely aware of the Community is only vaguely aware of the relationship between trauma and suicide.relationship between trauma and suicide.

There is high level of passion in the community There is high level of passion in the community surrounding the issue of suicide; the passion surrounding the issue of suicide; the passion needs to be harnessed to address trauma-based needs to be harnessed to address trauma-based suicide.suicide.

Once the community better understands the Once the community better understands the relationship between trauma and suicide, relationship between trauma and suicide, resources will follow.resources will follow.

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Strengths/AssetsStrengths/Assets Past and current JSPC Prevention EffortsPast and current JSPC Prevention Efforts

Signs of SuicideSigns of Suicide Sources of StrengthSources of Strength WebsitesWebsites Advertising/public awareness materials and Advertising/public awareness materials and

activitiesactivities Suicide prevention trainingSuicide prevention training Postvention supportPostvention support

Juneau Violence Prevention Coalition EffortsJuneau Violence Prevention Coalition Efforts Four prevention “pathways”Four prevention “pathways”

Broad-based Stakeholder/Interagency Broad-based Stakeholder/Interagency InvolvementInvolvement

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Gaps/ChallengesGaps/Challenges

Other Sector InvolvementOther Sector Involvement: Alaska Native : Alaska Native community; medical community; domestic community; medical community; domestic violence/sexual assault community; business violence/sexual assault community; business communitycommunity

At-risk PopulationsAt-risk Populations: Young adults; Alaska : Young adults; Alaska Natives; veterans; seniorsNatives; veterans; seniors

Increased Collaboration with Alaska Native Increased Collaboration with Alaska Native CommunityCommunity: Need to recognize tribal : Need to recognize tribal sovereignty and cultural traumasovereignty and cultural trauma

Policy Development ChallengesPolicy Development Challenges: Examples: : Examples: policies to screen youth and adults for trauma policies to screen youth and adults for trauma history/suicide risk; addressing the barrier of history/suicide risk; addressing the barrier of the “positive consent” process for YRBSthe “positive consent” process for YRBS

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RecommendationsRecommendations Overall GoalOverall Goal: To address the relationship between : To address the relationship between

childhood/adolescent trauma and suicide risk in Juneauchildhood/adolescent trauma and suicide risk in Juneau

Interventions

Protective Factors· Friendships/Positive

Relationships· Involvement in

Productive Activities· Religious/Spiritual

Connection· Economic Stability· Feeling that “I Matter”

Universal Interventions· Community Education/

Training· Collaboration between

Agencies· Change Community

Policies/Attitudes

Reduced Suicide Risk

Factors Reducing Suicide Risk Indicated by Our Needs

Assessment

Selective Interventions· Access to Mental health

Services· Access to Physical

Health Services

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Universal Prevention Universal Prevention StrategiesStrategies

Community Education/TrainingCommunity Education/Training. Examples:. Examples: General community education on trauma/suicide link General community education on trauma/suicide link

(audio/video/print media, conference)(audio/video/print media, conference)

Add a trauma piece to Gatekeeper training and Add a trauma piece to Gatekeeper training and present to general public and targeted groupspresent to general public and targeted groups

Universal CollaborationUniversal Collaboration. Examples:. Examples: Coordinated prevention strategies with the Violence Coordinated prevention strategies with the Violence

Prevention Coalition (joint media campaign; unified Prevention Coalition (joint media campaign; unified activities to address protective factors)activities to address protective factors)

Changing Community Policies/AttitudesChanging Community Policies/Attitudes. Examples:. Examples: Legislative advocacy, e.g., Erin’s Law regarding child Legislative advocacy, e.g., Erin’s Law regarding child

sexual assault education and training in schoolssexual assault education and training in schools Stronger policy framework on bullying in Juneau Stronger policy framework on bullying in Juneau

schoolsschools

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SelectiveSelective Prevention StrategiesPrevention Strategies Selective CollaborationSelective Collaboration::

Greater partnership with Alaska Native community, Greater partnership with Alaska Native community, primary care providers and behavioral health providers primary care providers and behavioral health providers (public and private)(public and private)

Access to Primary Care ServicesAccess to Primary Care Services: : Ensuring that those who have experienced childhood Ensuring that those who have experienced childhood

trauma have ready access to primary caretrauma have ready access to primary care Ensuring that primary care providers screen for ACEs, Ensuring that primary care providers screen for ACEs,

suicide attempt history and current suicide suicide attempt history and current suicide ideation/plans/attemptsideation/plans/attempts

Access to Behavioral Health ServicesAccess to Behavioral Health Services:: Developing trauma screening tools for agencies that come Developing trauma screening tools for agencies that come

into contact with children and youthinto contact with children and youth Ensuring that children’s behavioral health agencies Ensuring that children’s behavioral health agencies

screen/assess for trauma and provide trauma-informed screen/assess for trauma and provide trauma-informed carecare

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Strategies to Enhance Protective Strategies to Enhance Protective FactorsFactors

Evidence-based Wellness Promotion Services for Evidence-based Wellness Promotion Services for StudentsStudents: : Sources of StrengthSources of Strength

Anti-bullying Services and ActivitiesAnti-bullying Services and Activities:: School-based anti-bullying activities that School-based anti-bullying activities that

celebrate diversity, and dignity/respect in celebrate diversity, and dignity/respect in interpersonal relationshipsinterpersonal relationships

Community-based ServicesCommunity-based Services:: Working with community-based organizations to Working with community-based organizations to

develop activities that promote positive develop activities that promote positive relationships and connectedness for youthrelationships and connectedness for youth

Activities to promote protective factors for at-Activities to promote protective factors for at-risk populations such as young adults, Alaska risk populations such as young adults, Alaska Natives, veterans and seniorsNatives, veterans and seniors

1 Juneau Suicide Prevention Coalition 2015 Community Needs Assessment.

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Transcript of 1 Juneau Suicide Prevention Coalition 2015 Community Needs Assessment.