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State of Alaska

Health Indicator Report of Suicide Mortality Rate - All Ages

The rate of suicide is increasing in America. Now the 10th leading cause of death, suicide claims more lives than traffic accidents and more than twice as many homicides.^1^ The economic and human cost of suicidal behavior to individuals, families, communities and society makes suicide a serious public health problem. Alaska had the second highest age-adjusted suicide rate in the nation in 2014 at 22.3, the most recent year for which national data are currently available.^2^ Suicide cost Alaska a total of $226,875,000 of combined lifetime medical and work lost cost in 2010, or an average of $1,383,382 per suicide death.^3^[[br]] [[br]] ---- {{class .SmallerFont 1. The Joint Commission. Detecting and treating suicide ideation in all settings. Sentinel Alert Event. Issue 56, February 24, 2016. https://www.jointcommission.org/sea_issue_56/ Accessed October 11, 2016. 2. Stats of the States - Suicide Mortality. Suicide Mortality by State: 2014. http://www.cdc.gov/nchs/pressroom/sosmap/suicide-mortality/suicide.htm Accessed October 5, 2016. 3. American Foundation for Suicide Prevention. State Fact Sheet. https://afsp.org/about-suicide/state-fact-sheets/#Alaska. Accessed October 5, 2016. }}

Notes

Data provided by the [http://dhss.alaska.gov/dph/VitalStats/Pages/data/default.aspx Alaska Bureau of Vital Statistics (BVS)] in May 2016.   Alaska Native people refers to any mention of American Indian or Alaska Native heritage when enumerating racial and ethnic background. Individuals of multiple races incorporating American Indian/Alaska Native are moved into the Alaska Native group. When race and ethnicity are consider concurrently, Hispanic individuals with American Indian/Alaska Native heritage are combined into the Alaska Native (any mention) group and removed from the Hispanic class. The definition of the Alaska Native group is intended to conform to the eligibility requirements for access to Alaska Native Tribal Health Consortium.

Data Sources

  • [http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Alaska Health Analytics and Vital Records], Division of Public Health, Alaska Department of Health and Social Services
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention

Data Interpretation Issues

Alaska populations are from the [http://laborstats.alaska.gov/pop/popest.htm Alaska Department of Labor and Workforce Development, Research and Analysis].

Definition

The rate of deaths resulting from the intentional use of force against oneself. Suicides are reported as the number of resident deaths resulting from the intentional use of force against oneself per 100,000 population. The definition of suicide is "death arising from an act inflicted upon oneself with the intent to kill oneself." ICD-9 codes: E950-E959. ICD-10 codes: *U03, X60-X84, Y87.0.

Numerator

Number of deaths resulting from the intentional use of force against oneself in the resident population in a reporting period.

Denominator

Mid-year resident population estimate in the reporting period.

Healthy People Objective: Reduce the suicide rate

U.S. Target: 10.2 suicides per 100,000

Other Objectives

'''Who is at risk for suicide?''' Much of what we know about the profile of individuals who have died by suicide and those who have attempted suicide comes from looking in the rearview mirror - at data compiled about suicide victims and attempts. Suicide may affect certain demographics - such as military veterans and men over age 45 - more than others. It's important to identify the risk factors, rather than membership in a group, when considering suicide risk. Paying attention to risk factors matters because patients may not disclose suicide ideation voluntarily. Risk factors for suicide include: * Mental or emotional disorders, particularly depression and bipolar disorder. Up to 90 percent of suicide victims suffer from a mental or emotional disorder at the time of death. * Previous suicide attempts or self-inflicted injury; the risk of suicide is twice as high (100 percent higher) than general suicide rates for one year following a suicide attempt and the higher risk continues beyond that. The risk is even higher the first few weeks immediately following a suicide attempt. * History of trauma or loss, such as abuse as a child, a family history of suicide, bereavement or economic loss. * Serious illness, or physical or chronic pain or impairment. * Alcohol and drug abuse. * Social isolation or a pattern/history of aggressive or antisocial behavior. * Discharge from inpatient psychiatric care, within the first year after and particularly within the first weeks and months after discharge. While some depressed patients who attempt or die by suicide after inpatient psychiatric hospitalization express suicide ideation before or during hospitalization, other depressed patients who have received inpatient psychiatric treatment develop suicide ideation after discharge. * Access to lethal means coupled with suicidal thoughts. However, there is no typical suicide victim. Most individuals having these risk factors do not attempt suicide, and others without these conditions sometimes do. Therefore, there is a danger in considering only individuals with certain conditions or experiences in certain settings as being at risk for suicide. It's imperative for everyone in all settings to better detect suicide ideation in others, and to take appropriate steps for their safety and/or refer these individuals to an appropriate provider for screening, risk assessment, and treatment.^1^[[br]] [[br]] ---- {{class .SmallerFont 1. The Joint Commission. Detecting and treating suicide ideation in all settings. Sentinel Alert Event. Issue 56, February 24, 2016. https://www.jointcommission.org/sea_issue_56/ Accessed October 11, 2016. }}

How Are We Doing?

Alaska had the second highest age-adjusted suicide rate in the nation in 2014 at 22.3 per 100,000.^2^ In 2015, the rate was 27.1 per 100,000. Intentional self-harm, or suicide, is the fifth leading cause of death in Alaska. In 2015, suicide claimed the lives of 200 Alaskans. Firearms were the leading mechanism of death by suicide, making up 61 percent of all suicide deaths; 98 males and 24 females. Among the leading causes of death in Alaska, suicide ranked third in total years of potential life lost with 7,510 years lost. On average 37.5 years of life were lost prematurely for each suicide death.^3^ Since 2006, the age-adjusted rate has increased 38.3 percent.^3^ On average, one person dies of suicide every two days in the state. Suicide was the leading cause of death for 15-24 year olds and the 2nd leading cause of death for ages 25-44.^4^ Alaska's suicide rates continued to be the highest among males, young adults (18-24 year olds), American Indian/Alaska Native people, and persons living the rural regions of the state. Residents in Northern and Southwest Alaska are at significantly higher risk for suicide. There is extreme annual variability in the suicide mortality rate for Alaska Native people. Since 2000, the annual suicide mortality rate has fluctuated between extremes of 50.4 per 100,000 in 2015 to the recent low of 29.5 per 100,000 in 2014. [[br]] [[br]] ---- {{class .SmallerFont 2. U.S. Centers for Disease Control and Prevention (CDC). Suicide mortality by state: 2014. [http://www.cdc.gov/nchs/pressroom/sosmap/suicide-mortality/suicide.htm]. Accessed October 5, 2016. 3. Alaska Department of Health and Social Services, Division of Public Health, Health Analytics and Vital Records Section. Alaska Vital Statistics 2015 Annual Report. [http://dhss.alaska.gov/dph/VitalStats/Documents/PDFs/VitalStatistics_Annualreport_2015.pdf]. Accessed February 7, 2017. 4. American Foundation for Suicide Prevention. State fact sheets: suicide: Alaska 2016 facts & figures. [https://afsp.org/aboutsuicide/ state-fact-sheets/#Alaska]. Accessed October 5, 2016. }}

How Do We Compare With the U.S.?

In 2014 (the most recent year for which national data are available), the national suicide rate was 13.0 per 100,000. The suicide rate in the U.S. has been increasing since 2000, when the rate was 10.4 per 100,000. The rate of suicide among all Alaskans in 2014 was 72% higher than the national rate. For Alaska Native people, the rate was 126% higher than the national rate. Since 2006, the national suicide rate has been increasing by 2% per year. Between 1999 and 2014, suicide rates were higher in all age groups under 75 years. After a period of nearly consistent decline in suicide rates in the United States from 1986 through 1999, suicide rates have increased almost steadily from 1999 through 2014. While suicide among adolescents and young adults is increasing and among the leading causes of death for those demographic groups, suicide among middle-aged adults is also rising.^5^[[br]] [[br]] {{class .SmallerFont 5. Curtin SC, Warner M, Hedegaard H. Increase in suicide in the United States, 1999-2014. NCHS data brief, no 241. Hyattsville, MD: National Center for Health Statistics. 2016. [http://www.cdc.gov/nchs/products/databriefs/db241.htm]. Accessed October 11, 2016. }}

What Is Being Done?

The Statewide Suicide Prevention Council [http://dhss.alaska.gov/suicideprevention/Pages/default.aspx ] advises the governor and legislature on issues relating to suicide. In collaboration with communities, faith-based organizations, and public-private entities, the Council works to improve the health and wellness of Alaskans by reducing suicide and its effect on individuals and communities.

Evidence-based Practices

Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs. Below are the strategies identified for enhancing mental health support systems. '''Strategy 1:''' [[br]]Create supportive environments that promote resilient, healthy, and empowered individuals, families, schools, and communities (universal prevention). '''Evidence Base:''' [[br]]The World Health Organization holds that "a supportive environment is of paramount importance for health. The two are interdependent and inseparable" (Sundsvall Statement on Supportive Environments for Health, 1991). Supportive environments can help protect people from risk factors for poor health, encourage participation in health care and health promotion, expand individuals' health competencies and self-reliance, and support person-centered health care. Stigma and attitudes about help-seeking (specifically seeking treatment or services for mental health conditions) are key barriers to promoting mental and emotional health and preventing mental illness. Creating communities that de-stigmatize depression and mental illness and encourage people to seek mental health services when needed can increase the number of people accessing services. '''Sources:''' [[br]]Segal DL, Coolidge FL, Mincic MS, O'Riley A. Beliefs about mental illness and willingness to seek help: a cross-sectional study. Aging Ment Health 2005;9(4):363-7. Reynders A, Kerkhof AJFM, Molenberghs G, Van Audenhove C. Attitudes and stigma in relation to help-seeking intentions for psychological problems in low and high suicide rate regions. Social Psychiatry and Psychiatric Epidemiology 2014;49(2): 231-9. '''Strategy 2:''' [[br]]Enhance clinical and community preventive services to ensure availability of timely treatment and support services (indicated prevention). '''Evidence Base:''' [[br]]Nearly half of individuals who die by suicide had a diagnosable mental health disorder. Timely access to appropriate mental health and substance use disorder treatment services as close to home as possible is essential to preventing suicide. Not all behavioral health professions provide or require suicide-specific education for licensure. Yet, outpatient and community behavioral health providers often provide services to individuals at risk of suicide and so are in a position to help prevent suicide. Evidence-based training that strengthens clinical competencies to address suicide risk and ideation can reduce suicide among people receiving behavioral health services. Primary and specialty health care providers also have a role to play in suicide prevention. Appropriate assessment and referral for services is needed in a variety of health care settings. Integrating behavioral health care with primary care can help ensure timely access to appropriate services, especially for patients experiencing mental health disorders. For example, the Community Preventive Services Task Force, DHHS recommends collaborative care for the management of depressive disorders. '''Sources:''' [[br]]National Research Council. Reducing Suicide: A National Imperative. Washington, DC: The National Academies Press, 2002. Recommendation from the Community Preventive Services Task Force for Use of Collaborative Care for the Management of Depressive Disorders[http://www.thecommunityguide.org/mentalhealth/CollabCare_Recommendation.pdf] '''Strategy 3:''' [[br]]Allocate resources to suicide prevention efforts proven effective through evidence based on surveillance, research, and evaluation. '''Evidence Base:''' [[br]]Prioritizing funding for evidence-based suicide prevention practices helps to ensure that limited public resources are used to the maximum benefit of communities. '''Source:''' [[br]] National Registry of Evidence Based Programs and Practices (NREPP) [http://www.nrepp.samhsa.gov]

Available Services

'''Alaska:''' [[br]]Careline Alaska [[br]][http://carelinealaska.com/] [[br]]Call anytime, toll-free: 1-877-266-4357 (HELP) SouthEast Alaska Regional Health Consortium (SEARHC) [[br]]1-877-294-0074 24/7 help line Identity, Inc. [[br]]907-258-4777 (ANC) GLBTQ help line [[br]]1-888-901-9876 (statewide) '''National:''' [[br]]National Suicide Prevention Hotline [[br]][http://www.suicidepreventionlifeline.org/] [[br]]Call 24/7: 1-800-273-8255 The Trevor Project [[br]][http://www.thetrevorproject.org] [[br]]1-866-488-7386 GLBTQ crisis hotline

Health Program Information

Casting the Net Upstream Goals^6^: [[br]]Goal 1. Alaskans accept responsibility for preventing suicide. [[br]]Goal 2. Alaskans effectively and appropriately respond to people at risk of suicide. [[br]]Goal 3. Alaskans communicate, cooperate, and coordinate suicide prevention efforts. [[br]]Goal 4. Alaskans have immediate access to the prevention, treatment, and recovery services they need. [[br]]Goal 5. Alaskans support survivors in healing. [[br]]Goal 6. Quality data and research is available and used for planning, implementation, and evaluation of suicide prevention efforts. The Joint Commission urges all health care organizations to develop clinical environment readiness by identifying, developing, and integrating comprehensive behavioral health, primary care, and community resources to assure continuity of care for individuals at risk for suicide. Many communities and health care organizations presently do not have adequate suicide prevention resources, leading to the low detection and treatment rate of those at risk. As a result, providers who do identify patients at risk for suicide often must interrupt their workflow and disrupt their schedule for the day to find treatment and assure safety for these patients.^1^ '''Detecting suicide ideation in non-acute or acute care setting''' 1. Review each patient's personal and family medical history for suicide risk factors. 2. Screen all patients for suicide ideation, using a brief, standardized, evidence-based screening tool. 3. Review screening questionnaires before the patient leaves the appointment or is discharged. '''Taking immediate action and safety planning''' 4. Take the following actions, using assessment results to inform the level of safety measures needed. '''Behavioral health treatment and discharge''' 5. Establish a collaborative, ongoing, and systematic assessment and treatment process with the patient involving the patient's other providers, family and friends as appropriate. 6. To improve outcomes for at-risk patients, develop treatment and discharge plans that directly target suicidality. '''Education and documentation''' 7. Educate all staff in patient care settings about how to identify and respond to patients with suicide ideation. 8. Document decisions regarding the care and referral of patients with suicide risk. [[br]] [[br]] ---- {{class .SmallerFont 1. The Joint Commission. Detecting and treating suicide ideation in all settings. [https://www.jointcommission.org/sea_issue_56/]. Published February 24, 2016. Accessed October 11, 2016. 6. Casting the net upstream: promoting wellness to prevent suicide. Alaska State Suicide Prevention Plan, 2012-2017. Annual Implementation Report 2014. [http://dhss.alaska.gov/SuicidePrevention/Documents/pdfs_sspc/CTN2014-Implementation.pdf]. Accessed October 11, 2016. }}
Page Content Updated On 04/18/2017, Published on 04/18/2017
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 24 September 2017 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Tue, 18 Apr 2017 14:17:48 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 24 September 2017 2:13:59 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Tue, 18 Apr 2017 14:17:48 AKDT