By Jessica Varney, Executive Assistant to the Administrator, Pickens County
“Are you thinking about killing yourself?” This question may seem inappropriate or uncomfortable to you (and a shocking way to begin an article in a newsletter); however, asking this difficult question has the potential to save a life. Studies show that the question itself does not increase suicides or suicidal thoughts. Experts in the field of mental health recommend asking directly about suicide. Put another way, if you’ve noticed warning signs, don’t ignore them. Caring enough to ask and being prepared to connect the individual with the proper care can make a big difference. The question is, what care options are available?
Identifying resources, gaps, and opportunities in our crisis care system is one of the objectives of the Crisis Intercept Map process. The Substance Abuse and Mental Health Services Administration (SAMHSA), a federal agency under the U.S. Department of Health and Human Services, and its Service Members, Veterans, and Families (SMVF) Technical Assistance (TA) Center at Policy Research Associates, Inc. designed and developed the Crisis Intercept Mapping process for SMVF Suicide Prevention to help communities strengthen the delivery of evidence-based suicide prevention policies and practices during the time period surrounding an episode of acute care when the risk of suicide is higher. Pickens County has been selected as one of 10 sites from across the country to participate in SAMHSA’s SMVF TA Center’s Crisis Intercept Mapping project this spring and is the first county in South Carolina to be chosen.
The Pickens County team consists of members in leadership at the local, regional, and state level and both military and civilian participants. Individuals on the team represent Prisma Health Baptist Easley, AnMed Health Cannon Hospital, Anderson-Oconee-Pickens Mental Health Clinic, Pickens County Behavioral Health, Samaritan’s Health Clinic, Pickens County Sheriff Office, Pickens County Emergency Services, Pickens County Veterans Affairs, American Legion Post 11, Upstate Warrior Solutions, Mental Health of America Greenville County, Clemson University, Easley First Baptist Church, National Alliance on Mental Illness, SC National Guard, South Carolina Department of Mental Health, and South Carolina Department of Veteran’s Affairs. We are honored to have the SC Secretary of Veterans’ Affairs, Major General William Grimsley, serving on our team. The South Carolina Governor’s Challenge Team to Prevent Suicide among SMVF is also supportive of this initiative, and several individuals serve on both teams. The Pickens County Council passed Resolution #2020-12 in support of suicide prevention among SMVF in September 2020 and is supportive of this process, with our County Council Chairman Chris Bowers serving on the team in a dual capacity since he is also a leader in the medical field.
According to the CDC, suicide is the 11th leading cause of death statewide. It is the third leading cause of death for ages 10-24, second leading cause of death for ages 25-34, and fourth leading cause of death for ages 35-44. We know that the military suicide rate is higher than the non-military suicide rate. The issue of suicide prevention is of high importance for Pickens County in particular. According to the latest data from SCDHEC, Pickens County has the highest combined five-year suicide death rate per 100,000 population in the state. Additional data provided by the South Carolina Violent Death Reporting System for 2003-2018 shows that in Pickens County a physical health problem was identified as the circumstance for 40.8% of the suicides among our military population, while a physical health problem was identified as the circumstance in 20.2% on our non-military population. A mental health problem was identified as the circumstance in 34.7% of military suicides and 38.9% on non-military suicides. Other circumstances identified include depressed mood, alcohol problem, intimate relationship issues, history of or current recipient of behavioral health treatment, non-alcohol-related substance abuse, civil legal problem, or other crisis. Military suicide deaths occurred by firearm in 67.4% of cases, by poisoning in 16.3%, and by hanging in 10.2%, compared to non-military suicide deaths by firearm in 51.6% of cases, by poisoning in 25.4%, and by hanging in 17.1%. Also, 28.6% of suicides with known military status disclosed intent within 30 days prior to injury. Implementing the elements of effective suicide prevention: screening, safety planning, lethal means safety, and supportive contacts, are vital to making a difference.
Within a community crisis system, there are four key “intercept points” that provide opportunities for diverting at-risk SMVF to appropriate and effective prevention and support services: First Contact, Acute Care, Care Transitions, and Ongoing Treatment and Recovery Support. Most military veterans do not receive health care through the VA system and instead seek care in community care settings. Unfortunately, many community providers do not consider themselves culturally competent about military and veteran populations. This program seeks to strengthen the partnerships among military and civilian stakeholders for optimal crisis care coordination between various services. Our CIM team is looking forward to seeing the completed Crisis Intercept Map for our community and how we will collaboratively implement our plan moving forward.
While the Crisis Intercept Map is focused on suicide prevention among SMVF, I am hopeful the progress made through this initiative will make our County even more prepared to address the need for suicide prevention for all of our citizens. Additionally, my very involvement in the SMVF CIM for suicide prevention is a testament to the fact that everyone can be part of the solution to the problem of suicide. I do not have a military background, and I do not have a medical background. Yet, here I am serving as the team lead for this project. I’m just a person who cares, and lots of caring people are needed to bridge these gaps and reach the people who are hurting or lonely. I invite you to access the resources available online from the SCDMH Office of Suicide Prevention, SAMHSA, NAMI, or other trusted sources to educate yourself so that you can also be an advocate for suicide prevention. Everyone has a role to play in preventing suicides. You don’t have to be an expert. You just have to care.