Newsroom

Remarks by
Sybil K. Goldman, M.S.W.
Senior Advisor on Children

Office of the Administrator
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services

"Collaboration Around Youth Suicide Prevention:"
A Workshop for State Public Health and Mental Health Officials

Seattle, Washington
January 23, 2003

Note: Reference to Slides indicates that Ms. Goldman accompanied her speech using a PowerPoint presentation.

Slide 1 (Cover Slide)

Thank you, Sameer/Mr. Abraham.

Good evening, and thank you (Robert/Bob Glover) for that introduction. I can't tell you how pleased I am to be with you here in Seattle.

I bring you greetings from "the other" Washington…and from Charles Curie, the administrator of the Substance Abuse and Mental Health Services Administration.

Mr. Curie stands shoulder-to-shoulder with all of you in your efforts to develop and promote community-based suicide prevention and intervention programs that work…for our young people…and for Americans across the lifespan. A bit later, I will share with you some of what SAMHSA is doing to advance your efforts at the national level.

Before I begin, I would like to extend a special welcome to the first lady of Idaho, Mrs. Patricia Kempthorne.

I would also like to acknowledge the many partners whose collaborative efforts have made this meeting possible, including:

…the Centers for Disease Control and HRSA's Bureau of Maternal and Child Health for providing the Federal funding that gave "wings" to the idea of convening this Workshop.

…Dr. Robert Glover, executive director of the National Association of State Mental Health Program Directors (NASMHPD) and Dr. George Hardy, Jr., executive director of the Association of State and Territorial Health Officials (ASTHO)…for bringing together this diverse group of State health agencies, policymakers and advocates to tackle the topic of youth suicide prevention.

…and my hat is off to all of you in attendance for making the time to lend your voice to the dialogue. Your presence here today speaks volumes about your commitment to the goal: to prevent and reduce the incidence of suicide in the vulnerable populations we serve.

The theme for today's meeting is collaboration. In fact, this meeting—itself, a public/private collaboration—is a testimony to the power of partnerships…the kind that are needed to advance suicide prevention in this country.

This evening I would like to use these keynote remarks to help us begin on one accord as we explore the concept of collaboration around youth suicide prevention.

Like the teacher at a school assembly who hits a key on the piano to give the musicians a starting tone, I am here to help us begin with a clear understanding of the conditions that underlie this meeting and the common concerns and objectives that bring us together.

Each of us may approach the issue of suicide prevention from a slightly different perspective. But in spite of our differences, if we heed each other's voices, I believe we can make harmonious music during this Workshop...and afterward.

This evening I want to talk about how we can use effective, broad-based coalitions to develop solutions around youth suicide prevention.

I will outline some of the contributions SAMHSA has made…and continues to make…to the collaborative process. And I will leave you with a few action items…things that each of you can do…right now…to start to address the complexities of suicide prevention in your communities.

Why is suicide prevention such a complex concept? In part because suicide is such a complex process.

The message I would like to deliver to you tonight is that, collectively, we have the tools and the wisdom to begin to attack the problem of suicide…and to make an impact.

Winston Churchill said, "Out of intense complexities intense simplicities emerge."

I am here today to suggest that there is simplicity in the complexities of suicide prevention, as well.

Simply put, I believe that we will make great strides in suicide prevention when we accept that no single group can do it alone.

Success will come…

…when we tear down the walls that separate us and start building bridges between the Federal, State and community groups that represent the complexities of the problem…

…when we expose the barriers that are keeping us from getting our jobs done…

…when we figure out what we each do best…and then do it…

…when we integrate and coordinate the talents of experts from many disciplines across agencies, across Departments, and across the country.

Easier said than done? Certainly.

Slide 2

But we don't have a choice. The human cost of doing otherwise is too great.

Take a look at the numbers…

Slide 3 / Slide 4

In the year 2000, we lost almost 30,000 American citizens to suicide…one person every 18 minutes…80 Americans per day.

That represents 64% of all the violent deaths in the country. For every two victims of homicide in the U.S., there are three deaths from suicide.

Slide 5

When we focus in on youth, the numbers are similarly alarming. Suicide is the third leading cause of death for young people ages 15 to 24. In 2000, more teenagers and young adults died from suicide than from cancer, heart disease, HIV, birth defects, stroke, pneumonia and influenza, and chronic lung disease combined.

That doesn't take into account the many attempts at suicide. New data from the National Household Survey on Drug Abuse shows that some 3 million youth, ages 12 to 17, thought seriously about suicide or attempted suicide in 2000.

Slide 6

Suicide is a serious public health problem across the lifespan. As you see, suicide is among the top eight leading causes of death for Americans ages 5 to 64.

Slide 7

The graphic shows that the rate of suicide skyrockets in White males after age 65. I know that the focus of this conference is youth suicide prevention, but we must keep the elderly on our radar screen, as well. We know that older people die by suicide more often…and they are more deliberate in their attempts.

Slide 8

The highest rates of suicide are here in the West, where, as you can see, in nearly every case, the rate of suicide is higher than the national average.

Slide 9

These numbers…and the pain and loss behind the numbers…are why we all here today.

I quote Mr. Curie when I say, "One death by suicide is one death too many." Saying "Suicide is a preventable tragedy," Mr. Curie underscores that we must "identify, evaluate and promote community-based suicide prevention programs… systems of services in which every door can be the right door to help."

Slide 10

In the last five years, there has been considerable national attention focused on this issue. HHS has been at the forefront of much of the national effort. The model that HHS has provided for the field of suicide prevention is particularly exemplary.

Slide 11

In 1999, representatives from the Centers for Disease Control, Indian Health Service, HRSA, NIH, SAMHSA and OASH/OSG came together, informally, in an attempt to marshal the resources of the Department around the issues of suicide prevention. In 2000, the group officially convened as the Federal Steering Group for Suicide Prevention with a view to developing a comprehensive national plan for preventing suicide.

The Committee operated—not as a collection of separate individuals working in separate agencies with separate agendas—but in the spirit of one HHS with a single-minded purpose.

Slide 12

That purpose was to oversee development of the National Strategy…a national roadmap for saving lives that represents the first attempt in the United States to prevent suicide through coordination of resources and services at all levels of government…and between government and its private sector partners.

Today, there are 35,000 copies of the National Strategy in print. (I brought along copies for each of you.)

That same spirit of unity and single-minded direction is what it will take to realize the goals and objectives of the National Strategy.

As the Committee implements the activities outlined in the Strategy, each agency is contributing expertise…doing what it does best. For example, the NIH is conducting research into the causes of suicide…the CDC is collecting statistics…the Indian Health Service is working with us to serve tribal communities…and SAMHSA is acting as the link between Federal efforts, the States, and local communities.

Slide 13

SAMHSA is moving the Strategy forward by providing resources, funding programs, and evaluating the results. Many of these activities are built on partnerships across HHS and, in many cases, are also collaborations with community-based programs.

Slide 14

The National Strategy for Suicide Prevention Web site, for example, is a collaborative effort of SAMHSA, NIH, CDC, and HRSA. It is a robust online resource of accurate and up-to-date suicide information.

Slide 15

Through our Indicators of Success initiative, efforts are also underway to gather baseline data for each of the Strategy's 11 goals and 68 objectives. Eventually, we will be able to measure how successful we have been in everything from increasing the number of states with suicide prevention plans to providing training to medical personnel. Tools are also being developed to measure and track the success of the goals in preventing suicide.

Slide 16

SAMHSA is also developing Suicide-Prevention Guidelines for Schools based on a model developed in New Zealand. The guidelines will help teachers and other school personnel identify students at risk for suicide and promote a safe, comfortable environment where students can seek and receive help.

Slide 17

Our Signs of Suicide evaluation project is educating teens about the link between depression and suicide…helping teens learn to identify risk of suicide in a friend…and encouraging teens to tell a responsible adult when they suspect a friend may be at risk.

The initial results are very promising. Phase II Evaluation suggests a reduction in suicidal behaviors at 3 months.

Slide 18 / Slide 19

Another activity that is getting a lot of attention is our Hotline Evaluation and Linkage Project…HELP, for short.

This $9 million, 3-year initiative—a collaboration with the American Association of Suicidology—has three goals:

• To assess and certify the quality of crisis hotline services;
  
• To establish one nationwide number—1 (800) SUICIDE—to connect callers with the hotline nearest them; and
  
• To build in a system of evaluation to see if hotline services are effective.

We hope to have 200-300 hotlines in the network before the end of the grant period. If there are centers in your States that are not certified and networked, please encourage them to participate in this worthwhile opportunity.

Slide 20

Finally, this past fall, SAMHSA awarded a $2.5 million grant to the Education Development Center to collaborate with the American Association of Suicidology, the Suicide Prevention Action Network, and the American Foundation for Suicide Prevention to create a National Suicide Prevention Technical Resource Center.

The Center will help survivors, clinicians, advocates, scientists and Federal, State, local, and tribal organizations plan, implement, evaluate and promote community-based suicide prevention programs that work. It will also be a central resource for technical assistance, training, and information on best practices.

This Center will play an important role in advancing the National Strategy.

The National Strategy and the initiatives that have grown from it are a start. It is a broad agreement on what should be done by public and private partners across many sectors of society. But clearly there is much more to do.

At the Federal level, our role has been to lead…to create a model…to lay out a framework for action that must be set in motion at the community level where we have the best opportunity to make real improvements in real people's lives.

Slide 21

This is where you come in. Collaboration at the State and community level is the vital next step. The National Strategy is your roadmap. Adopt it…modify it…replicate it…as you develop and implement your own local suicide prevention plans.

Collaboration and partnerships have been the recipe for success at the Federal level. Collaboration and partnerships will also be the keys to your success.

Working together with schools, faith-based organizations, healthcare professionals, survivor organizations and other national and community-based public and private partners is a way to ensure that your prevention plans…

• …are comprehensive enough to address the complexities of the problem;
  
• …promote collective ownership of the problem…and engage organizations that may not have considered suicide prevention within their purview;
  
• …incorporate ideas and strategies from other prevention programs…and avoid duplication of efforts; and
  
• …leverage resources to fund projects that will address the greatest need and make the most impact. Now, when increasing fiscal pressures are challenging many States to stretch their resources to the breaking point, collaboration just makes good dollars and sense!

Today, nearly half of the States have implemented suicide prevention programs. Our goal is to have 50 State plans as well as plans for each of the 7 territories.

Implementing the National Strategy at the local level will be a grand undertaking. And no one…not even the Federal Government…has all the answers. But the Strategy provides a place to start…and a logical and organized way to work towards the goal. It clearly outlines the roles that can be played by each partner organization, so that everyone can focus on the activities that they do best.

The good news: by being here today, you have already taken the first step.

Slide 22

In this room, we have the nucleus of a solution. After you come together tomorrow…and share insights and information about how you can work together to tackle the issue of suicide prevention…we need you to go back to your communities…to pull in other partners…and build even wider networks.

We need you to take the success you achieve with youth and apply the lessons learned to create comprehensive programs that speak to the needs of populations across the lifespan.

Let's also use the National Suicide Prevention Resource Center for technical assistance, best practices and training.

Slide 23

Finally, let's ensure that we keep the momentum going. SAMHSA will continue active leadership and support of national and State suicide prevention activities. We will make every effort to stay current…adding more tools as they are developed.

We need your ongoing feedback. We must function as one unit with one goal: to make every door the right door for suicide prevention so that we can save lives.

This evening, let's start off on the same note. No matter what song we might sing individually, let's decide to speak with one voice during this Workshop…and afterward. The stakes are high and the people we serve are counting on us to get this right.

We owe them nothing less.

Thank you.

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