ND Adolescent Suicide ND Adolescent Suicide Prevention ProjectPrevention Project

Mental Health Association of ND Mental Health Association of ND 701-255-3692 701-255-3692

Mark LoMurray, LSW Mark LoMurray, LSW Outreach Services Inc. Outreach Services Inc. 701-223-1650701-223-1650

Quick Facts on ND SuicideQuick Facts on ND Suicide

• #2 Cause of death of 10 - 24 year olds#2 Cause of death of 10 - 24 year olds

• Nation’s 2nd highest suicide rate for 10-Nation’s 2nd highest suicide rate for 10-14 year olds14 year olds

• Nation’s 6th highest suicide rate for 15-Nation’s 6th highest suicide rate for 15-19 year olds. 19 year olds.

• In past year 7% of ND teens report In past year 7% of ND teens report having made a suicide attempthaving made a suicide attempt

.

Age Comparison - Suicide RatesAge Comparison - Suicide Rates

Teen and Young Adult Teen and Young Adult RiskRisk

0 0 020

182

131113

90 98

71

4320

0

50

100

150

200

num

ber o

f dea

ths

<1 1-4 5-9 10-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

age goup

Suicides in North Dakota by Age Group 1987-1996

ND Suicide Prevention ND Suicide Prevention Recent HistoryRecent History• 1991-93 Training of 82 crisis teams

• 1995-97 Local suicide prevention task forces developed in some regions

• 1997 ND Childhood Fatality Review Committee developed

• 1998 1st national suicide prevention plan written with assistance from 12 from ND

• 1999 ND Adolescent Suicide Prevention Task Force develops 1st state plan

Suicide Prevention Suicide Prevention Strategies for Year Strategies for Year 20002000

• Promote five key strategiesPromote five key strategies

• Train in all RCSCC and TSCCC areas.Train in all RCSCC and TSCCC areas.

• Professional organizations - Professional organizations - implement one strategy.implement one strategy.

• Policy maker education and Policy maker education and awareness projectawareness project

Causes of Death Region VII Causes of Death Region VII NDND10-24 Years Old 1992-199610-24 Years Old 1992-1996

26

23

13

18

2 Traffic

Suicide

Accident

Diseases

Homicide

Key Adolescent Risk Key Adolescent Risk FactorsFactors

Impulsive Aggressiveness

Depression

Drug/Alcohol

416 31

151

19

112

19

94

2169

7

91

1358

340

2180

50100150200

num

ber

of

suic

ides

10-14

15-24

25-34

35-44

45-54

55-64

65-74

75-84

85+

age group

ND Suicides 1987-1996 by Gender and Age Group

female

male

0

20

40

60

80

100

120

140de

aths

per

100

,000

all

10-14

15-24

25-34

35-44

45-54

55-64

65-74

75-84

85+

age group

Suicide Rate in North Dakota by Race 1989-1998

white AI

Indian Children in NDIndian Children in ND

• Average age of Northern Plains Indians Average age of Northern Plains Indians is 18 years old compared to ND average is 18 years old compared to ND average of 32 years oldof 32 years old

• 43% of American Indian population is 43% of American Indian population is under the age of 20.under the age of 20.

• 15,500 Indian children in North Dakota15,500 Indian children in North Dakota

• 41% live off reservation in near-by 41% live off reservation in near-by communitiescommunities

Indian Children Health Indian Children Health IssuesIssues• 13 percent of Indian deaths are under 13 percent of Indian deaths are under

age 25 compared to 4% U.S.age 25 compared to 4% U.S.

• Accident death rate for Indian Accident death rate for Indian children ages 5-14 is double the U.S. children ages 5-14 is double the U.S. rate. (20.8)rate. (20.8)

• Diabetes prevelance are 2-3 times Diabetes prevelance are 2-3 times higherhigher

• Suicide for 15-24 years old is 3 times Suicide for 15-24 years old is 3 times the national rate.the national rate.

Indian Children Health Indian Children Health FundingFunding

• Indian Health Services is funded at Indian Health Services is funded at 65% of need.65% of need.

• IHS mental health is funded at 25% IHS mental health is funded at 25% of need.of need.

• IHS per capita expenditure in 1997 IHS per capita expenditure in 1997 was $1,132 compared to U.S. per was $1,132 compared to U.S. per capita expenditure of $3,261.capita expenditure of $3,261.

Monthly Suicide Rate Age 15-24 During 1979-1998

0

5

10

15

20

25

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

month

deat

hs p

er 10

0,000

Suicides Age 15-19 by Region 1989-1998

0

5

10

15

20

25

I II III IV V VI VII VIII TUR SPR FTB STN

region

nu

mb

er

of

su

icid

es

Suicide Rate Age 15-19 by Region 1989-1998

0

20

40

60

80

100

120

140

I II III IV V VI VII VIII TUR SPR FTB STN ND

region

de

ath

s p

er

100,0

00

Suicidal Behavior ND & US Grades 9-12

0

5

10

15

20

25

30

sad considered planned attempted treated

behavior

perc

ent s

tude

nts

grad

es 9-

12

ND 95

ND 99

US 95

US 97

Alcohol Behaviors ND & US Grades 9-12

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

drink <13yrs drink 30d binge 5+ drink school drovedrinking

rode drinking

behavior

perc

ent o

f stu

dent

s ND 95

ND 99

US 95

US 97

Five Key Suicide Five Key Suicide Prevention Strategies Prevention Strategies

• Asset Building/RelationshipsAsset Building/Relationships

• Youth Leadership Youth Leadership

• Community Gatekeeper TrainingCommunity Gatekeeper Training

• Assessment Tool ImplementationAssessment Tool Implementation

• Means Restriction ApproachesMeans Restriction Approaches

UND Mentoring: Drug UND Mentoring: Drug Behavior Results after 8 Behavior Results after 8 monthsmonths

0

10

20

30

40

50

60

70Cig

are

ttes

Beer

Mari

juana

H. Liq

uor

Inhala

nts

PrePostNorm

UND Mentoring: Conflict UND Mentoring: Conflict Behavior after 8 monthsBehavior after 8 months

0

10

20

30

40

50

60

Teased Fight Detention TeacherGrabbed

PrePostNorm

UND Mentoring: Mood UND Mentoring: Mood Changes after 8 months Changes after 8 months

01020304050607080

Depre

ssed

Runaw

ay

Suic

ide

Fam

ily

Did

n't

Care

PrePostNorm

A Circle of ProtectionA Circle of Protection

Healthy Beliefs

Clear

Boundaries

Healthy Relationships

Leadership

Opportunities

““We must promote public awareness We must promote public awareness that suicides are preventable. We that suicides are preventable. We must enhance resources in must enhance resources in communities for suicide prevention communities for suicide prevention programs and mental and substance programs and mental and substance abuse disorder assessment and abuse disorder assessment and treatment. treatment.

Dr. David SatcherDr. David SatcherUnited States Surgeon GeneralUnited States Surgeon GeneralJuly 28, 1999July 28, 1999