Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 74 of 136 Strategy Three ‐ Continued
Work with social networking companies.
Continue work on development and implementation of PSAs, news releases, web‐based information, and other media/materials.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 75 of 136 Strategy Four ‐ Implement Policy and Governance Advocacy to Promote Systems Change in Suicide Awareness and Prevention Desired Outcomes
While specific measurable outcomes need to be developed for this strategy, in general terms, goals of this strategy are to:
1. Increase public awareness of suicide as a public health problem within an organization by promoting adoption of policies and programs that either work to prevent suicide or respond to emotional crises.
2. Promote local, state, and federal policies and programs that prevent suicide.
3. Disseminate information to individuals in the community regarding the Santa Clara County Suicide Prevention Plan and its recommended activities.
4. Build partnerships with other local suicide prevention and mental health agencies, governments, media, and other organizations with a stake in public health.
5. Help remove the stigma associated with suicide by bringing the subject out in the open and discussing what can be done to prevent it.
6. Recruit individuals and organizations to advocate for policy change and/or adoption in their workplace or community site.
7. Change laws—see Recommended Actions below.
8. Advocate for prevention funding.
Target Populations
The committee’s recommended strategies in this category include advocacy on behalf of:
Partnerships between primary care and mental health professionals; Partnerships with support organizations and service providers (e.g., churches, employee assistance programs, schools, National Alliance on Mental Illness, etc.) to raise awareness and create a welcoming environment for those at risk of suicide; Strong networks of support organizations and service groups (e.g., a network of youth‐ supporting organizations and service groups);
Active participation across sectors, industries, and groups in implementing strategies (e.g., education, healthcare, non‐profit, for‐profit, government); Legislative or policy changes in government and institutions, with a goal of convincing as many systems as possible to play key roles in suicide prevention; Broad adoption of policies mandating cultural and linguistic competency; Standardization of reporting requirements across sectors and agencies; and Possible certification of a countywide hotline with National Suicide Prevention Center’s Lifeline.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 76 of 136 Strategy Four‐ Continued
Current Activities and Recent Gains
Palo Alto Unified School District Board of Education adopted a policy for suicide prevention in their school district at their meeting June 1, 2010, and Los Gatos Union High School District is working on a similar policy.
Palo Alto Unified School District has shared their policy and Articles of Regulations implementation guidelines. All districts have been requested to create a comparable policy. Partnered with the County Medical Examiner‐Coroner’s Office to improve data collection for future psychological profiling activities of those identified as dead by suicide. County Medical Examiner‐Coroner’s Office provided the first‐ever comprehensive investigative reports for all suicides that occurred in 2009 to be able to begin to analyze and possibly use in future psychological profiling efforts. County Medical Examiner‐Coroner’s Office is considering the adoption of a new policy that they annually prepare investigative reports for all suicides that occurred in the previous year for subsequent analysis of the data.
Revamped training for involuntary suicide prevention holds—5150/ 5250. In partnership with law enforcement agencies, the Mental Health Department is continuing to enhance law enforcement officers’ abilities to manage crises involving mentally ill residents through Police Crisis Intervention Training (CIT). In addition to reducing the need for using deadly force, this 40‐hour program can save lives by giving officers tools they can use when encountering individuals who intend to lose their lives by intentionally threatening police officers (i.e., suicide by police). Recommendation: 1) Advocate for more required mental health training for cadets, and 2) advocate for law enforcement agencies to require that more officers receive Crisis Intervention Training (CIT). Our county’s school districts have been actively involved in the effort to reduce youth suicide and to raise awareness among their staff on how to recognize students in emotional distress or crisis and how to intervene and provide support. Recommendation: Advocate and monitor adoption until all school districts adopt and implement a policy. PEI Project 5 ‐ Suicide Prevention. The Interim Suicide Prevention Oversight Committee will write PEI Project 5 ‐ Suicide Prevention Proposal for submission to the Oversight and Administration Committee (OAC) for approval. This proposal will include funding for a Suicide Prevention Coordinator. Anticipated submission date for the new project is August to September 2010. Approval for the new project is expected by July 2011. The Mental Health Department will request joining the California Mental Health Services Authority (CalMHSA) in August 2010, with acceptance anticipated for October 2010, at which time the Mental Health Department will be able to represent Santa Clara County in the California Mental Health Services Act discussions and deliberations concerning the:
• Student Mental Health Initiative
• State suicide prevention efforts and programming, and • Ethnic specific programs.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 77 of 136 Strategy Four‐ Continued
Recommended Actions
We will identify and work with local organizations, including schools and school districts, to support suicide prevention efforts. This will be part of an ongoing effort to identify, share and leverage resources, to provide other forms of assistance as feasible and desirable, and to move toward the objective of comprehensive adoption and implementation of effective suicide prevention measures in all key venues.
The American Foundation for Suicide Prevention (AFSP) suggests several tools for learning more about effective advocacy. The SPAC recommends that these tools be considered when detailing the specific activities of this strategy. The references include:
National Mental Health Association’s Advocacy Primer
Grassroots Tool Kit: A manual on event planning, coalition building, and grassroots advocacy from the Leadership Conference on Civil Rights Advocate’s Guide to Grassroots Organizing During a Congressional Recess from the Leadership Conference on Civil rights, and
Speak, Out! A Guide to Advocacy regarding Mental Health Policy from the Mental Health Association of Westchester County.
Some specific actions suggested by the AFSP in the area of advocacy include, but are not limited to, the following:
1. Strengthening legislation on veteran and military suicide prevention to promote longitudinal research on the rates and develop anti‐stigma campaigns and continue to expand suicide prevention programs to assist members, returning veterans and their family members.
2. Adoption of legislation and other policy directives to encourage the National Institutes of Health Agencies to invest more substantially in research related to suicide, suicide prevention, and survivors of suicide loss or suicide attempts.
3. Appropriations at the maximum attainable level for the National Violent Death Reporting System.
4. Implementation of Mental Health Parity and Health Insurance Reform.
5. Reauthorization of and appropriations for the Substance Abuse and Mental Health Services Administration (SAMHSA).
6. Adoption of legislation to allow the Golden Gate Bridge Authority (and other local jurisdictions) to use federal funds for bridge suicide prevention barriers.
7. Adoption of legislation that aims to reduce bullying and cyber‐bullying.
8. Adoption of legislation to establish Depression Centers of Excellence.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 78 of 136
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 79 of 136 Strategy Five ‐ Establish a Robust Data Collection and Monitoring System to Increase the Scope and Availability of Suicide‐Related Data and to Evaluate Suicide Prevention Efforts
This strategy develops and sustains processes for collecting and analyzing state and local data that will help establish local program priorities and evaluate the impact of suicide prevention strategies.
Desired Outcomes
Proving that this plan is making a difference by reducing the number of deaths by suicide can only be accomplished by collecting data and monitoring the activities of the plan and its outcomes. In order to do this the following goals must be met:
1. Expand reporting on suicide attempts and deaths;
2. Increase accuracy in reporting of data related to suicide and prevention activities;
3. Increase the convergence of data reported by various entities;
4. Increase availability of comprehensive data on suicide‐related activities in Santa Clara County; and
5. Establish and define a centralized monitoring body of suicide prevention activities and outcomes.
Target Population
1. General public
2. Policy makers and funding entities
3. Local public health monitoring system
4. Implementation entities
Current Activities and Recent Gains
Partnered with County Medical Examiner‐Coroner’s Office to improve data collection for future psychological profiling activities of those identified as dead by suicide. County Medical Examiner‐Coroner’s Office provides to the committee a compilation of the routine investigation reports for all reported suicide deaths on a yearly basis, beginning with 2009 deaths.
Collected and conducted a preliminary review of suicide data for Santa Clara County including by zip code, city, and a variety of social factors. Conducted preliminary needs assessment of high risk population groups.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 80 of 136 Strategy Five ‐ Continued
Recommended Actions
Local efforts, as recommended by the SPAC, will be defined more specifically and completed during the implementation phase. They include:
1. Identify a Monitoring Team to
a. Oversee plan implementation,
b. Identify resources and funds,
c. Produce an implementation schedule,
d. Select and begin meetings of a Suicide Prevention Oversight Committee (SPOC),
e. Devise plan for continuous data collection and analysis, f. Develop and report standards for monitoring and measuring plan outcomes, and
g. Elicit public input on strategies and funding priorities;
2. Determine specifically what additional data are needed to accurately monitor the number of lives lost to suicide;
3. Define baselines for strategies in existence at that time;
4. Conduct a review of all suicide prevention resources in County;
5. Define or refine planning and process metrics to track prevention and intervention strategies;
6. Review and interpret data on lives lost to suicide;
7. Work for the creation of a Santa Clara County Suicide Death Review Committee; and
8. Monitor the Plan’s implementation to ensure that efforts continue across various systems as part of a countywide approach to reduce suicide.
The committee recommends achieving the desired outcomes by establishing a monitoring system as described by “National Strategy for Suicide Prevention, Goals and Objectives for Action,” an outline adopted by the U.S. Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration and the National Mental Health Information Center, which includes the following:
Track trends in rates,
Identify new problems or additional data required,
Provide evidence to support activities and initiatives, Identify risk and protective factors,
Target high risk populations for interventions, and
Assess the impact of prevention efforts.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 81 of 136 Strategy Five ‐ Continued
Additionally, the committee recommends:
Establishing a Death Review Panel and process to review reports of all deaths by suicide, and possibly suspected suicide in order to create psychological profiles of those at risk. Create an annual report based on psychological profile findings to contribute to the knowledge of suicide in Santa Clara County.
Learn from past suicides and suicide attempts to prevent similar situations in the future. Conduct a comprehensive assessment of mental health services and standards in the county.
Identify what additional data is required for our county’s suicide prevention efforts. Identify leading causes of suicide in Santa Clara County to assist in identifying priorities for means restriction, as appropriate.
Develop and maintain a current database of academic articles, data, and other resources on suicide.
Monitor high‐traffic, youth‐oriented websites to assess suicide‐related content and take action where needed. (Examples of online sites include: YouTube, Facebook, and Twitter.) Inventory existing social and medical service centers, such as hospitals and medical clinics, to determine gaps and best practices in the mental health system. Monitor outreach activities offering support for previous suicide attempters. Conduct a comprehensive assessment and determine methods to reach and provide for those at‐risk of suicide.
Potential sources for data
Nationally, suicide surveillance data come from death certificates. This vital statistics information is available from the National Center for Health Statistics, Centers for Disease Control and Prevention. Medical examiner databases also provide some information related to suicide. The information on rates available from vital statistics databases obviously does not include those deaths misclassified as homicides or accidents, and an unknown number of others misclassified as natural causes but which may actually be suicides. Information available from death certificates is limited and is not always complete. Prevention efforts would be enhanced by more comprehensive information. However, such information is not now systematically collected. Data on suicide attempts must come from sources designed for other purposes, such as trauma registries and uniform hospital discharge data sets. Trauma registries provide detailed information about the nature and severity of an injury, the treatment provided, and the status of the patient on discharge from the hospital. However, most trauma registries include only "major" trauma cases, those that require at least a three‐day hospital stay. Moreover, many suicide attempts do not lead to traumatic injuries (e.g.,
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 82 of 136 Strategy Five ‐ Continued
overdoses of medicines). Thus, trauma registries have only limited information on suicide attempts.
A uniform hospital discharge data set is another potential source of information on suicide attempts. As suggested by its name, a hospital discharge data set provides information only about those suicide attempts that resulted in hospital treatment. Not all states require either trauma registries or uniform hospital discharge data.
The State of Oregon is unique in that a 1987 law requires hospitals treating a child under the age of 18 for injuries resulting from a suicide attempt to report the attempt to the Oregon Health Division. This data source provides important information for youth suicide prevention programming in Oregon.
Other possible sources of data on suicide attempts include mental health agencies, psychiatric hospitals, poison control centers, universities and colleges, child death review team reports, emergency departments, and surveys. Limitations exist for all of these data sources, such as lack of detail on the circumstances surrounding the suicide attempt. Detailed information is important because it may lead to increased knowledge of how suicides can be prevented in the future.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 83 of 136 VI. Next Steps
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 84 of 136 VI. Next Steps
The desired outcomes for each of the five recommended strategies in the Suicide Prevention Strategic Plan (the Plan) cannot be achieved through isolated actions or services. The scope of the problem and the need for community‐wide support necessitates long‐term, sustained and coordinated effort by many stakeholders. There is no time to waste. The goal of this section is to commit Santa Clara County to concrete actions that will tangibly improve suicide prevention activities in the County by December 31, 2010. These actions will lay the foundation for full implementation of the Plan.
Infrastructure. These actions are intended to create the requisite infrastructure to implement, coordinate and report on suicide prevention efforts throughout the county. 1) Establish a Suicide Prevention Oversight Committee (SPOC). The SPOC will advise the Board of Supervisors on the implementation of the Plan and will submit semi‐annual progress reports to the Board of Supervisors’ Health and Hospital Committee (HHC). The SPOC will work closely with the Mental Health Department (MHD), which will serve as the lead agency in coordinating suicide prevention services/activities throughout the county. 2) Hire a Suicide Prevention Coordinator. To ensure timely facilitation and ongoing support for implementation of the Plan, the MHD will designate one full‐time staffperson as the County’s Suicide Prevention Coordinator.1
This staff person also will serve as the County’s
liaison to the California Office of Suicide Prevention. 3) Form Four Work Groups. As indicated in the Plan, the SPOC will form four work groups, each of which will plan for, oversee, and report on the implementation and effectiveness of its assigned strategies. The following four work groups will develop implementation plans for each strategy:
a) An Intervention Strategies work group (Strategy 1) will compile a comprehensive overview of existing and needed intervention strategies. It will coordinate a system of suicide prevention services.
b) A Communications Practice work group (Strategies 2 and 3) will have oversight over all resulting communication projects and activities related to suicide prevention, both locally and regionally, including a Community Education Campaign. c) A Policy and Governance work group (Strategy 4) will advocate for the adoption of suicide prevention policies and protocols among agencies, systems and organizations throughout the County.
d) A Data Committee (Strategy 5) will define the Plan’s data requirements, sources and reporting processes.
1 This assumes that the Board of Supervisors and the State will approve a fifth MHSA Prevention & Early Intervention project.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 85 of 136 Early Implementation. Upon approval from the Board of Supervisors, the MHD will proceed with the following actions which will either immediately reduce suicides or develop new funding sources for suicide prevention activities.
1) Develop Formal MHSA PEI Project for Suicide Prevention. The MHD will develop a fifth Prevention and Early Intervention (PEI) Project for Suicide Prevention and hire a full time (1.0 FTE) Suicide Prevention Coordinator. If approved by the State, “PEI Project 5” will fund approximately $800,000 in new suicide prevention activities annually for three to four years. Funding from this project will support activities in each of the Plan’s five strategies, laying the foundation for new services and resource development. The SPOC will devise a process to apportion available funding to each of the five strategies. 2) Implement Listening Campaigns. The Suicide Prevention Coordinator will begin implementing “Listening Campaigns” to promote mental health and suicide prevention awareness. The Listening Campaigns also will serve as an ongoing vehicle for incorporating residents’ input into the Plan’s implementation.
3) Make Formal Connections to Statewide Suicide Prevention Efforts. The MHD will actively coordinate with and leverage existing statewide suicide prevention efforts, including the activities of the California Mental Health Services Authority (CalMHSA). The MHD’s goals are to influence the development of statewide programs and to ensure that local funds— which have been assigned to support statewide PEI projects—have an impact on local efforts.
4) Implement Approved Suicide Prevention‐Related PEI Plans. a) “First Break” Treatment Programs. Under PEI Project 3, the MHD will initiate services to help individuals, especially for adolescents and Transitional Age Youth (16‐25), address the onset of serious psychiatric illness (with psychotic features). b) Community Education and Training. Under PEI Project 1, the MHD will increase mental health literacy and reduce stigma and discrimination within underserved cultural communities by implementing Mental Health First Aid programs. c) Integrated Behavioral Health. The MHD will implement early intervention services in community‐based, primary care clinics to serve approximately 4,200 patients annually (once fully operational).
d) Gatekeeper Training. The MHD will implement “gatekeeper” programs for older adults.
The above concrete actions will augment current suicide prevention efforts. Modifications or expansion of the aforementioned programs will be influenced by the SPOC as it implements the Plan’s five strategies.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 86 of 136
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 87 of 136 VII. Appendix
Attachment 1: Suicide in Santa Clara County by Zip Code, 2000‐2006 Suicide‐Homicide Comparison Table
Attachment 2: Santa Clara County Community Agencies and Programs that Interface with Suicide Attempters, Victims, and Loved Ones
Attachment 3: Best Practices Recommendations
Attachment 4: Summary of Public Forum Input
Attachment 5: Palo Alto Unified School District Suicide Prevention and Mental Health Promotion Policy
Attachment 6: References
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 88 of 136
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 89 of 136 Attachment 1. Suicides in Santa Clara County by Zip Code, 2000‐2006, and Suicide‐Homicide Comparison Table
ZIP CITY 2000 2001 2002 2003 2004 2005 2006
SUI HOM SUI HOM SUI HOM SUI HOM SUI HOM SUI HOM
SU
I HOM
94022
Los
Altos 1 0 3 0 0 0 0 0 0 0 0 0 3 0
94024
Los
Altos 0 0 3 0 4 0 6 0 2 0 1 0 5 0
L.A. &
L.A.
Hills
Totals 1 6 4 6 2 1 8
94040
Mountain
View 2 0 6 0 2 0 5 1 4 1 1 0 3 0
94041
Mountain
View 4 0 0 0 1 0 0 0 2 1 0 0 1 0
94043
Mountain
View 1 0 5 1 4 1 4 0 2 0 2 0 0 1
M.V.
Totals 7 11 7 9 8 3 4
94085
Sunnyvale 0 0 0 0 0 0 4 0 0 0 0 0 3 0
94086
Sunnyvale 9 2 8 0 11 2 7 3 7 1 3 2 4 0
94087
Sunnyvale 4 0 4 0 3 1 2 0 9 0 4 1 1 0
94089
Sunnyvale 0 0 5 0 2 0 0 0 2 1 3 0 2 1
Sunnyvale
Totals 13 17 16 13 18 10 10
94301
Palo
Alto 2 0 2 0 2 0 3 2 7 0 1 0 2 0
94303
Palo
Alto 2 5 5 5 2 4 1 9 4 4 4 11 0 7
94304
Palo
Alto 0 0 0 0 0 0 0 0 0 1 0 0 0 0
94305 Stan-ford 0 0 1 0 0 0 0 0 0 0 1 0 0 0
94306
Palo
Alto 0 1 2 0 2 0 2 0 4 2 2 0 6 1
95002 Alviso 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 90 of 136 ZIP CITY 2000 2001 2002 2003 2004 2005 2006
SUI HOM SUI HOM SUI HOM SUI HOM SUI HOM SUI HOM SUI HOM 95008
Campbell 1 0 2 0 4 0 4 1 4 0 1 3 7 0
95014
Cupertino 4 0 2 0 1 2 0 2 0 2 0 4 0
95020 Gilroy 5 7 5 3 5 1 2 2 3 0 4 2 3 1
95030
Los
Gatos 0 0 2 0 1 0 3 0 1 1 2 0 3 0
95032
Los
Gatos 4 0 2 0 0 0 3 0 4 0 5 0 1 0
95035
Milpitas 3 1 2 1 3 0 4 3 6 2 6 3 1 1
95037
Mor-gan
Hill 0 1 3 0 7 0 6 0 4 1 3 1 3 0
95046
San
Martin 0 0 0 2 1 0 1 0 0 0 0 0 1 0
95050
Santa
Clara 2 2 3 0 1 2 5 0 1 2 2 2 1 2
95051
Santa
Clara 6 0 2 0 4 3 1 4 0 2 3 6 0
95054
Santa
Clara 0 0 1 1 0 0 1 1 1 2 0 0
S.C.
Totals 8 6 5 6 6 5 7
95070
Saratoga 3 1 2 0 3 0 3 1 9 5 1 1 0 1
95110 San Jose 3 0 0 2 0 0 3 1 0 1 0 2 0 0
95111 San Jose 5 3 4 0 1 2 6 2 3 2 8 1 3 2
95112 San Jose 3 3 2 3 9 1 5 4 3 3 3 0 5 1
95113 San Jose 0 0 0 1 0 0 0 0 1 0 2 0 1 0
95116 San Jose 1 3 1 3 3 5 1 2 3 4 2 4 6 1
95117 San Jose 5 0 1 0 2 0 2 0 3 1 1 0 2 4
95118 San Jose 0 2 2 1 2 0 0 2 4 4 1 1 2 0
95119 San Jose 0 0 0 0 0 0 1 1 0 0 0 0 2 1
95120 San Jose 2 0 2 0 7 3 0 0 2 1 0 0 6 0
95121 San Jose 3 0 3 1 1 0 1 1 1 1 0 0 0 1
95122 San Jose 3 1 1 2 1 3 1 4 1 5 4 3 1 6
95123 San Jose 7 2 3 2 5 1 3 1 10 0 8 0 2 0
95124 San Jose 4 0 4 0 3 0 8 0 6 0 8 1 3 1
95125 San Jose 9 1 3 1 2 1 5 1 8 1 4 0 2 1
95126 San Jose 1 1 1 4 2 0 3 1 4 1 2 0 1 0
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 91 of 136 ZIP CITY 2000 2001 2002 2003 2004 2005 2006
SUI HOM SUI HOM SUI HOM SUI HOM SUI HOM SUI HOM SUI HOM 95127 San Jose 1 2 4 3 3 7 6 5 5 1 5 3 1 4
95128 San Jose 4 1 3 1 1 1 5 1 0 1 2 0 2 0
95129 San Jose 0 0 1 1 6 0 1 0 2 0 2 3 0 0
95130 San Jose 2 0 1 0 0 0 1 0 1 1 0 0 1 0
95131 San Jose 2 1 3 0 0 0 0 1 1 0 0 0 0 0
95132 San Jose 3 1 2 0 5 2 3 1 4 0 1 1 3 1
95133 San Jose 1 1 0 1 1 1 1 0 1 2 1 3 1 2
95134 San Jose 0 0 0 0 1 0 1 1 3 0 1 0 0 1
95135 San Jose 2 0 1 0 1 0 2 0 1 0 0 0 0 0
95136 San Jose 1 1 3 0 1 0 3 0 1 1 2 0 1 1
95138 San Jose 0 0 0 0 0 0 1 0 2 0 0 0 0 0
S.J.
Totals 65 47 61 65 73 60 47
TOTAL 120 120 125 133 156 112 109
1 - 3
4 - 6
7 - 10
California Department of Finance, Demographic Research Unit, Estimates of Population of California Cities, 2006:
Campbell 36,984
Cupertino 55,000
Gilroy 48,448
Los Altos and Los Altos Hills 36,065
Los Gatos 28,971
Milpitas 65,235
Monte Sereno 3,511
Morgan Hill 37,066
Mountain View 71,947
Palo Alto 62,108
San Jose 953,058
Santa Clara 110,700
Saratoga 30,815
Sunnyvale 133,458
Unincorporated 98,244
Total County-2006 Estimate 1,771,610
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 92 of 136
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 93 of 136 Attachment 2. Santa Clara County Community Agencies and Programs that Interface with Suicide Attempters, Victims, and Loved ones Program Name Description
Suicide and Crisis
Services (SACS)
Operated by: County
Mental Health
Department
This county program provides residents with access to a 24‐hour telephone hotline.
Operated primarily by 100 volunteers and with less than $90,000 in annual funding, the program fields over 35,000 calls annually from suicidal clients, concerned family members and other residents in crisis. Approximately 10% of calls are from individuals with suicide ideation. SACS also supports grieving families and friends through its Survivors of Suicide Group and partners with grief /loss support programs operated by Kara and the Bill Wilson Center's Centre for Living with Dying. Several times each year, SACS staff members provide training to various community organizations on suicide assessments and crisis intervention.
County Mental Health
Services
Operated by: County
Mental Health
Department
This county program provides an array of mental health services to primarily Medi‐Cal beneficiaries and those who are uninsured. Approximately 22,000 children, adolescents, young adults, adults and seniors receive services annually through a network of County‐operated and contracted programs.105 Services range from outreach, peer advocacy, and case management to clinical care and support in a variety of community, outpatient, residential and day programs.
Community‐based
organizations (CBOs)
Operated by: County
Mental Health
Department
CBOs account for approximately half of the public mental health system’s capacity, and they are a key component of the entire public safety net. These CBOs address county residents’ behavioral health needs, including mental health concerns that involve the risk of suicide. The CBOs also leverage other funding sources and operate a variety of programs that address behavioral health needs that are not funded by the County Mental Health Department, such as the Status Offender Services network.
EMQ's Families First
Child and Adolescent
Mobile Crisis Program
Operated by: County
Mental Health
Department
This program responds to the acute psychological crises of minors, offering services in the home, at school and in the community. The EMQ Team responds 24/7 and often facilitates hospitalization and/or crisis intervention services to children and youth who are suicidal.
Emergency Psychiatric
Services (EPS)
Operated by: County
Mental Health
Department
Operated at Valley Medical Center, EPS is the single psychiatric emergency receiving center in the county. The program is key in responding to acute mental health crises that often involve risk of suicide. The 24/7 EPS program provides intervention services to individuals experiencing acute psychiatric episodes and who may be a danger to themselves or others. Annually, approximately 7,500 individuals arrive at EPS on “5150 holds,” brought by law enforcement officers and others. The large majority of involuntary holds specify the “danger to self” criteria.
Mental Health Urgent
Care (MHUC)
Operated by: County
Mental Health
Department
This voluntary unlocked county‐run program also provides residents with crisis intervention services. Services at MHUC, which are available to walk‐ins, are available daily from 8 am to 10 pm. Clients, family members, law enforcement agencies and other first responders are encouraged to use MHUC to meet the needs of individuals experiencing severe emotional or psychological distress, including thoughts of self‐ harm.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 94 of 136 Police Crisis
Intervention Training
(CIT)
Operated by: County
Mental Health
Department
In partnership with law enforcement agencies, the MHD is continuing to enhance law enforcement officers’ abilities to manage crises involving mentally ill residents. In addition to advocating for more required mental health training for cadets, the MHD is working to ensure that all officers receive Crisis Intervention Training (CIT). In addition to reducing the need for using deadly force, this 40‐hour program can save lives by giving officers tools they can use when encountering individuals who intend to lose their lives by intentionally threatening police officers (i.e., suicide by police).
Golden Gateway
Operated by: County
Catholic Charities
In addition to providing intensive case management and therapy to severely mentally ill older adults, this program conducts extensive outreach to and mobile assessments of homebound or shut‐in seniors who would benefit from mental health services. Golden Gateway’s services are important for preventing suicides in California. Adults aged 75 and over have the highest rates of suicide (California Strategic Plan on Suicide Prevention, June 2008).
Self‐Help Centers
Operated by: County
Mental Health
Department
These county programs offer drop‐in self‐help and peer support for mental health consumers. Three programs provided in North, Central and South county locations offer the unique opportunity for consumers to find support and compassion within a supportive peer‐run setting.
Ethnic and Cultural
Community Advisory
Committees (ECCACs)
Operated by: County
Mental Health
Department
Similar to the philosophy of self‐help centers, the ECCACs are family and consumer support teams from eight ethnic and cultural communities who offer support and linkage to services.
Toll Free Veterans’
Suicide Prevention
Hotline
Operated by:
Department of
Veterans’ Affairs
1‐800‐273‐TALK (8255), and press "1". The Department of Veterans Affairs' (VA) The Veterans Health Administration (VHA) has founded a national suicide prevention hotline to ensure veterans in emotional crisis have free, 24/7 access to trained counselors. To operate the Veterans Hotline, the VA partnered with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Suicide Prevention Lifeline. Veterans can call the Lifeline number, 1‐800‐273‐TALK (8255), and press "1" to be routed to the Veterans Suicide Prevention Hotline.
Veteran Suicide Chat
Service
Operated by: Veterans
Administration
www.suicidepreventionlifeline.org. Veterans may use Veterans Chat without identifying themselves or revealing any personal information unless the person chooses to do so. Mental health clinicians on the Veterans Chat do not provide treatment or care. The clinicians will only provide information on services, guidance and assistance, and helpful online resources via Veterans Chat. If the VA mental health clinician with whom you are chatting decides that you are a danger to yourself and crisis intervention is needed, we will ask you to provide a phone number where VHA Suicide Hotline staff may make contact you. However, even at this time, you do not have to provide that information.
VA Palo Alto and Menlo
Park Division
Operated by: Veterans
The Veterans Administration, while not organized by counties, provides a comprehensive array of medical and mental health services for veterans through the VA Palo Alto Health Care System. Available mental health services include 80 acute psychiatric beds; mental health emergency services; voluntary residential rehabilitation programs for PTSD, substance abuse, and homeless services; outpatient mental health treatment including specialty services designed for women veterans and OIF/OEF recent returnees, intensive case management, and specialized evidenced‐based
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 95 of 136 Administration interventions for family therapy, PTSD, and addiction treatment. Suicide Prevention Coordinators at the Palo Alto VA track and coordinate intervention and care services for veterans who are at high risk for suicide. Services are provided at a number of VA sites including Palo Alto, Menlo Park, San Jose, Monterey, Capitola, as well as at Vet Centers located in Redwood City and San Jose.
Suicide Prevention Lifeline 1‐800‐273‐8255 (TALK) press 1 for veterans Veteran Suicide Chat Service www.suicidepreventionlifeline.org VA Palo Alto Telephone Care Line 800‐455‐0057
VA Palo Alto Main Number650‐493‐5000
Outpatient Care Clinic
Operated by: Veterans
Administration
Community‐based outpatient clinic in San Jose and local Vet Centers. The suicide coordinators at the Palo Alto VA track and coordinate intervention and care services for veterans who are at high risk for suicide.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 96 of 136
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 97 of 136 Attachment 3. Best Practices Recommendations
National Strategy for Suicide Prevention Ten Prevention Programs Program Name Description
1) American Indian Life
Skills Development/Zuni
Life Skills Development
The curriculum includes anywhere from 28 to 56 lesson plans covering topics such as building self‐esteem, identifying emotions and stress, increasing communication and problem‐solving skills, recognizing and eliminating self‐destructive behavior, learning about suicide, role‐playing around suicide prevention, and setting personal and community goals. The curriculum typically is delivered over 30 weeks during the school year, with students participating in lessons 3 times per week.
Lessons are interactive and incorporate situations and experiences relevant to American Indian adolescent life, such as dating, rejection, divorce, separation, unemployment, and problems with health and the law. Most of the lessons include brief, scripted scenarios that provide a chance for students to employ problem solving and apply the suicide‐related knowledge they have learned. 2) CARE (Care, Assess,
Respond, Empower)
CARE (Care, Assess, Respond, Empower)‐‐formerly called Counselors CARE (C‐ CARE) and Measure of Adolescent Potential for Suicide (MAPS)‐‐is a high school‐ based suicide prevention program targeting high‐risk youth. Includes a 2‐hour, one‐on‐one computer‐assisted suicide assessment interview followed by a 2‐hour motivational counseling and social support intervention. The counseling session is designed to deliver empathy and support, provide a safe context for sharing personal information, and reinforce positive coping skills and help‐seeking behaviors. CARE expedites access to help by connecting each high‐risk youth to a school‐based caseworker or a favorite teacher and establishing contact with a parent or guardian chosen by the youth. The program also includes a follow‐up reassessment of broad suicide risk and protective factors and a booster motivational counseling session 9 weeks after the initial counseling session. The goals of CARE are threefold: to decrease suicidal behaviors, to decrease related risk factors, and to increase personal and social assets. CARE assesses the adolescent's needs, provides immediate support, and then serves as the adolescent's crucial communication bridge with school personnel and the parent or guardian of choice. The CARE program is typically delivered by school or advanced‐practice nurses, counselors, psychologists, or social workers who have completed the CARE implementation training program and certification process.
Although CARE was originally developed to target high‐risk youth in high school‐‐ particularly those at risk of school dropout or abusing substances‐‐its scope has been expanded to include young adults (ages 20 to 24) in settings outside of schools, such as health care clinics.
3) CAST (Coping and
Support Training)
CAST (Coping And Support Training) is a high school‐based suicide prevention program targeting youth 14 to 19 years old. CAST delivers life‐skills training and social support in a small‐group format (6‐8 students per group). The program consists of 12 55‐minute group sessions administered over 6 weeks by trained high school teachers, counselors, or nurses with considerable school‐based experience.
CAST serves as a follow‐up program for youth who have been identified through screening as being at significant risk for suicide. In the original trials, identification of youth was done through a program known as CARE (Care, Assess, Respond, Empower), but other evidence‐based suicide risk screening instruments can be used. CAST's skills training sessions target three overall goals: increased mood
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 98 of 136 management (depression and anger), improved school performance, and decreased drug involvement. Group sessions incorporate key concepts, objectives, and skills that inform a group‐generated implementation plan for the CAST leader.
Sessions focus on group support, goal setting and monitoring, self‐esteem, decision‐making skills, better management of anger and depression, "school smarts," control of drug use with relapse prevention, and self‐recognition of progress through the program. Each session helps youth apply newly acquired skills and increase support from family and other trusted adults. Detailed lesson plans specify the type of motivational preparation, teaching, skills practice, and coaching activities appropriate for at‐risk youth. Every session ends with "Lifework" assignments that call for the youth to practice the session's skills with a specific person in their school, home, or peer‐group environment. 4) Columbia University
TeenScreen
The Columbia University TeenScreen Program identifies middle school and high school‐aged youth in need of mental health services due to risk for suicide and undetected mental illness. The program's main objective is to assist in the early identification of problems that might not otherwise come to the attention of professionals. TeenScreen can be implemented in schools, clinics, doctors' offices, juvenile justice settings, shelters, or any other youth‐serving setting. Typically, all youth in the target age group(s) at a setting are invited to participate.
The screening involves the following stages:
1. Before any screening is conducted, parents' active written consent is required for school‐based screening sites and strongly recommended for non‐school‐ based sites. Teens must also agree to the screening. Both the teens and their parents receive information about the process of the screening, confidentiality rights, and the teens' rights to refuse to answer any questions they do not want to answer.
2. Each teen completes a 10‐minute paper‐and‐pencil or computerized questionnaire covering anxiety, depression, substance and alcohol abuse, and suicidal thoughts and behavior.
3. Teens whose responses indicate risk for suicide or other mental health needs participate in a brief clinical interview with an on‐site mental health professional. If the clinician determines the symptoms warrant a referral for an in‐depth mental health evaluation, parents are notified and offered assistance with finding appropriate services in the community. Teens whose responses do not indicate need for clinical services receive an individualized debriefing. The debriefing reduces the stigma associated with scores indicating risk and provides an opportunity for the youth to express any concerns not reflected in their questionnaire responses.
5) Emergency Room
Intervention for
Adolescent Females
Emergency Room Intervention for Adolescent Females is a program for teenage girls 12 to 18 years old who are admitted to the emergency room after attempting suicide. The intervention, which involves the girl and one or more family members who accompany her to the emergency room, aims to increase attendance in outpatient treatment following discharge from the emergency room and to reduce future suicide attempts. A review of the literature suggests that factors related to treatment noncompliance following a suicide attempt include family discord, maternal psychopathology, attempter depression, and negative experiences with emergency room staff. The intervention consists of three components designed to improve the emergency room experience for the adolescent and family, thereby changing the family's conceptualization of the suicidal behavior and expectations about therapy. First, a two‐hour training is conducted separately with each of the
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 99 of 136 six groups of staff working with adolescents who have attempted suicide. Second, the adolescents and their families watch a 20‐minute videotape, filmed in Spanish and dubbed in English, that portrays the emergency room experience of two adolescents who have attempted suicide. Last, a bilingual crisis therapist delivers a brief family treatment in the emergency room.
6) Lifelines Curriculum Lifelines is a comprehensive, school‐wide suicide prevention program for middle and high school students. The goal of Lifelines is to promote a caring, competent school community in which help seeking is encouraged and modeled and suicidal behavior is recognized as an issue that cannot be kept secret. Lifelines seeks to increase the likelihood that school staff and students will know how to identify at‐ risk youth when they encounter them, provide an appropriate initial response, and obtain help, as well as be inclined to take such action.
Lifelines includes a set of components to be implemented sequentially: a review of resources and establishment of administrative guidelines and procedures for responding to a student at risk; training for school faculty and staff to enhance suicide awareness and an understanding of the role they can play in identifying and responding to a student with suicidal behavior; a workshop and informational materials for parents; and implementation of a curriculum for students, the Lifelines Curriculum, to inform students about suicidal behavior and discuss their role in suicide prevention.
The research reviewed for this summary assessed only the Lifelines Curriculum, the last component to be implemented in the larger Lifelines program. It consists of four 45‐minute or two 90‐minute lessons that incorporate elements of the social development model and employ interactive teaching techniques, including role‐play. Health teachers and/or guidance counselors teach the lessons within the regular school health curriculum. The Lifelines Curriculum was developed specifically for students in grades 8‐10 but can be used with students through 12th grade.
7) PROSPECT (Prevention
of Suicide in Primary
Care Elderly:
Collaborative Trial)
PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) aims to prevent suicide among older primary care patients by reducing suicidal ideation and depression. The intervention components are: (1) recognition of depression and suicide ideation by primary care physicians, (2) application of a treatment algorithm for geriatric depression in the primary care setting, and (3) treatment management by health specialists (e.g., nurses, social workers, and psychologists).
The treatment algorithm assists primary care physicians in making appropriate care choices during the acute, continuation, and maintenance phases of treatment. Health specialists collaborate with physicians to monitor patients and encourage patient adherence to recommended treatments. Patients are treated and monitored for 24 months.
Implementation of the program relies on educating primary care physicians to recognize symptoms and apply a clinical algorithm based on depression treatment guidelines for older patients from the American Psychiatric Association, the Agency for Healthcare Research and Quality, and the Texas Department of Mental Health. The recommended first line of treatment is citalopram, a selective serotonin reuptake inhibitor (SSRI). If citalopram does not achieve the desired result, other medications may be added or substituted. Interpersonal psychotherapy may also be used in addition to or instead of pharmacological treatment.
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8) Reconnecting Youth Reconnecting Youth: A Peer Group Approach to Building Life Skills (RY) is a school‐ based prevention program for students ages 14‐19 years that teaches skills to build resiliency against risk factors and control early signs of substance abuse and emotional distress. RY targets youth who demonstrate poor school achievement and high potential for school dropout. Eligible students must have either (1) fewer than the average number of credits earned for all students in their grade level at their school, high absenteeism, and a significant drop in grades during the prior semester or (2) a record of dropping out of school. Potential participants are identified using a school's computer records or are referred by school personnel if they show signs of any of the above risk factors. Eligible students may show signs of multiple problem behaviors, such as substance abuse, aggression, depression, or suicidal ideation.
RY also incorporates several social support mechanisms for participating youth:
social and school bonding activities to improve teens' relationships and increase their repertoire of safe, healthy activities; development of a crisis response plan detailing the school system's suicide prevention approaches; and parent involvement, including active parental consent for their teen's participation and ongoing support of their teen's RY goals.
The course curriculum is taught by an RY Leader, a member of the school staff or partnering agency who has abilities as a "natural helper," has healthy self‐esteem, is motivated to work with high‐risk youth, and is willing to comply with implementation requirements.
9) SOS Signs of Suicide SOS Signs of Suicide is a 2‐day secondary school‐based intervention that includes screening and education. Students are screened for depression and suicide risk and referred for professional help as indicated. Students also view a video that teaches them to recognize signs of depression and suicide in others. They are taught that the appropriate response to these signs is to acknowledge them, let the person know you care, and tell a responsible adult (either with the person or on that person's behalf). Students also participate in guided classroom discussions about suicide and depression. The intervention attempts to prevent suicide attempts, increase knowledge about suicide and depression, develop desirable attitudes toward suicide and depression, and increase help‐seeking behavior. 10) United States Air Force
Suicide Prevention
Program
The United States Air Force Suicide Prevention Program (AFSPP) is a population‐ oriented approach to reducing the risk of suicide. The Air Force has implemented 11 initiatives aimed at strengthening social support, promoting development of social skills, and changing policies and norms to encourage effective help‐seeking behaviors. AFSPP's 11 initiatives include:
Leadership Involvement
Suicide Prevention in Professional Military Education Guidelines for Use of Mental Health Services
Community Preventive Services
Community Education and Training
Investigative Interview Policy
Critical Incident Stress Management
Integrated Delivery System (IDS)
Limited Privilege Suicide Prevention Program
Behavioral Health Survey
Suicide Event Surveillance System
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American Foundation for Suicide Prevention: Suicide Prevention Resource Center’s Evidence‐Based Practices
Program Name Description
1. Reduced Analgesic
Packaging
In response to an increasing number of self‐poisonings with analgesics (acetaminophens and salicylates) in the United Kingdom, Parliament passed legislation in 1998 limiting the pack sizes of these drugs. Before the legislation, pharmacies could sell unlimited amounts of analgesic tablets. After legislation, pharmacies were limited to 32 tablets per sale and non‐pharmacy outlets were limited to 16 tablets per sale. In addition to packaging limits, specific printed warnings about the dangers of overdose with these analgesics were included with all sales.
2. Emergency Room
(ER) Means
Restriction
Education for
Parents
The goal of this intervention is to educate parents of youth at high risk for suicide about limiting access to lethal means for suicide.
Education takes place in emergency departments and is conducted by department staff (an unevaluated model has been developed for use in schools). Emergency department staffs are trained to provide the education to parents of child who are assessed to be at risk for suicide. Lethal means covered include firearms, medications (over‐ the‐counter and prescribed), and alcohol. To help with the safe disposal of firearms, collaboration with local law enforcement or other appropriate organizations is advised. The content of parent instruction includes:
1. Informing parent(s), apart from the child, that the child was at increased suicide risk and why the staff believed so;
2. Informing parents that they can reduce risk by limiting access to lethal means, especially firearms; and,
3. Educating parents and problem solving with them about how to limit access to lethal means.
Additional Evidence‐Based Practices from literature review A Model Community
Education Program on
Depression and Suicide
in Later Life
A Model Community Education Program on Depression and Suicide in Later Life, developed by Clara Pratt, PhD, Vicki Schmall, PhD, Willetta Wilson, PhD, and Alida Benthin, MA, Oregon State University Gerontology Department. This is a 3‐hour multimedia program on depression and suicide in later life. Designed for families, older adults, and service providers, the program provides information and teaches skills needed to recognize and respond to depression and suicidal behavior in the elderly. Compared with a
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control group, program participants had significant gains in knowledge and in their intent to take appropriate action in support of a depressed person.
Gatekeeper Training The QPR Institute offers comprehensive suicide prevention training programs, educational and clinical materials for the general public, professionals, and institutions. (QPR stands for how to Question, Persuade and Refer someone emitting suicide warning signs.) QPR is taught by certified instructors in a minimum of one hour, but often extended to two hours for role‐play and practice. The adult learning program teaches lay and professional gatekeepers how to recognize a mental health/suicide emergency, how to Question the validity of suicidal communications, and how to Persuade and Refer someone at‐risk to the next level of intervention. The goal of gatekeeper training is to enhance the probability that a potentially suicidal person is identified and referred for assessment and care before an adverse event occurs. Across our county there are several institutions already providing this training such as Foothill College.
Somewhat related to this is ACT, which also was recommended by committee members. Initiated in 2007, a Navy suicide prevention campaign asks sailors to "ACT" now to save a life. ACT is a three‐step process designed to help determine if someone is suicidal and to prevent them from hurting themselves. It stands for: Ask‐ ask the person if they are thinking of hurting themselves, Care‐ listen and let the person know they are not alone, and Treatment‐ get your shipmate to help as quickly as possible; such as the duty officer, chaplain, friend, medical personnel, or others who can help.
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Attachment 4. Input from Public Forum
Summary of Public Forum Comments and Input:
On April 28, 2010, the Santa Clara County Suicide Prevention Public Forum drew 108 community participants, 6 of whom were monolingual Vietnamese speakers, and 2 were bilingual Mandarin/English and requested the use of interpreters. The purpose of this forum was to provide an opportunity for the community to provide feedback on the work completed by the Suicide Prevention Advisory Committee and to have their comments inform the Plan.
Participants were offered multiple methods to provide their feedback:
Writing comments on Post‐It notes which were placed directly onto the posters of the work completed to date,
Comment Cards, and
Small discussion groups facilitated by Advisory Committee members.
While not every comment was able to be included in the plan, all comments are recorded verbatim below.
The vast majority of the comments fall into one of the six themes summarized below:
Youth who are transitioning from dependent minor status to independent young adult status—regardless of being enrolled in secondary education or in the workforce. Parental education. The public recommended trainings geared to parents and foster parents to recognize their child’s inner turmoil, address the issue of youth who are raised more by nannies and have low parental involvement in their lives. Geographic isolation. Some strategies should address the issue of geographic isolation for youth as well as older adults already included in the plan. Sharing stories. Participants recommended that individuals who had survived their own attempted suicide share their stories to educate and inspire people. Public recognition of life savers. Participants recommended that individuals who help bring people in crisis to an intervention resource be publicly recognized with a certificate or award as a means to raise the profile of suicide prevention and encourage others to consider doing the same.
Stress and stressors, transitions and dysfunction in personal relationship skills. Several individuals commented on homicide/suicides preceded by stressors combined with poor coping and anger management skills. Some stressors discussed were the pressure to achieve and succeed; divorce; loss of job; racism; all prejudicial behaviors; reentry into
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society after criminal justice involvement. This issue/need should be framed as, for lack of a better description a “tipping point.”
Below is a transcript of the small group discussions based on notes taken by Advisory Committee members. Before each comment/question an empty box means we have not identified or addressed the main point of the comment. A black “X” indicates that the comment submitted had already been discussed and included in the Suicide Prevention Plan prior to the Public Forum. A blue “X” underlined indicates inclusion in the plan after the public forum. Those comments without an “X” and not included in the plan at this point may be considered again during the implementation phase of the process.
Santa Clara County’s Mental Health Department hired consulting group MIG to draw a 12’ wide, 4’ tall summary of the night’s input that is referred to in the notes below as a Wall Summary.
This graphic illustration is included on the Santa Clara County Mental Health Department’s Suicide Prevention website—www.sccgov.org/spac .
Addressed
by
committee?
Comment or question
Group 1
X Encourage the community to talk about suicide and for those who have experienced or attempted suicide to be able to share their stories.
X [We need] a systematic approach for all ages.
One that connects the steps, address all ages, honors those who died through suicide with the gift of their stories.
X Need an instrument that would enable the community to understand the journey one takes in even contemplating suicide ‐ let alone attempting or even completing suicide
X Be creative and use social network sites
X have the
category
Prevention strategies should be a separate category ‐ not placed under intervention
Missing best practices in state of California like Healthy Start‐ offer education at a younger age.
X‐ PEI,
Integration
efforts
Multidisciplinary [approach] is key, look at [what] already exisit[s] i.e. student study teams like the Education Model SST (student study teams) utilizing multi‐disciplinary experts
X Stories [are] very powerful, they can touch the heart; stories [can be used] to prevent/ intervene as a means [of] outreach community is a real experiences/ nurture the story and honor an individual.
X‐ Requested
data
Is there research specific to cluster/ “copycat” suicides? X Alcohol/ substance use, meth[amphetamine] [induces a] morbid way of
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thinking and [morbid] emotions, but [they are] not always connected. It may entail body chemistry.
X Working in jails‐ the Mercury News is not on the front page. (Scribe’s not sure‐Suppose is that suicide in jails is not given much media attention but that it’s a real issue) Jail is high risk population
X Regarding the elderly, most see their doctor. How many doctors ask directly questions of life and death and refer [them to mental health].
X Use of community centers to provide a safe environment where youth are able to discuss, talk about the topic of suicide and support discussion with those who’ve experienced traumatic events‐ [they can] speak about how they coped.
X PTSD [is] connected to suicide
X Positive aspect‐ social networking sites or dollars, resources are cost effective ways of reaching out and educating after an event. Questions [can be] asked, [ie.] how is this affecting you?, etc.
X Problems [can] be worked out via [public] health model rather [than] a disease model.
X‐ Listening
Campaign
P[alo] A[lto] [is] using creative strategy ‐ talking to youth. [They have organized] 3 youth focus sessions and asked and learned from the youth.
Listen to the wisdom of the youth.
X PA hosted a youth gathering ‐ youth were invited via social network sites ‐ youth showed up and openly talked about the crisis of suicide and the reality of suicide from a young person's point of view
X Los Gatos [is an] isolated community. Folks [are] worried about [their] children because of the isolation. [There is no] outreach and they’re hurting. Outreach in geographically isolated areas
X Strategy: School Districts with physically isolated students dealing with trauma (i.e. suicide or cluster of suicides) can connect with other districts to share what is being done re: outreach to geographically isolated community members, students who live in the isolated area of the Loma Prieta School District.
X Violence‐ Domestic Violence [and] homicide [are] linked to suicide:
ie. Vietnamese families killed by father who in turn kills himself.
X Companies are utilizing experts to provide workshops for employees who are to be laid off ‐ coping strategies, stress release techniques, etc. so that laid off employees will have the ability and tools to cope with the anger and transition instead of having the rage prompting the laid‐off employee return to their former place of employment with weapons, killing co‐workers and possibly themselves. Recommend policy and governance with for‐profit training and awareness
X‐ Communi‐
cation
practices
[This requires a] paradigm shift. [Suicide is a] public health issue. [We need] understanding. The need for propaganda (mass public awareness campaigns) [like were used for] child seats in cars, smoking, etc. [This requires a] long term
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approach. Paradigm shift may take time but in time suicide will not be seen as an option.
X Bring youth and adults together. Use fishbowls (held in a safe environment).
Develop [a] dialogue, share honestly and be heard.
Adults [need to] listen when there’s an opportunity to provide feedback after the youth have shared‐ [this applies to] numerous topics [like] identity, sexuality, substance use, Mental health, depression, stress. Allow [the youth] freedom to give [their] voice.
Provide tools for communication utilizing fishbowl strategy, community centers, and social networking sites.
X [Adults need to] remember back to [their] youth [when we were asking] what’s the meaning of life? Where’s the spirit? Is there no value in one’s life? Where is this going? [All the] outside influences [that affect them] economy, the government, people’s spirit is dying. Neighborhoods, racial groups, a lot of faiths, are not valued anymore. Where’s one’s [own] identity? [Do you] Find meaning in your work? [All of this needs to be] attached to the spiritual component. Allow the spirit of life (faith) to penetrate.
X [Suicide prevention/ everything] starts with policy. In Santa Clara County [we] need to declare the value of life. All groups [are] affected. Need to be grounded‐ all of life is valuable. Perhaps [we’re] afraid to talk about the spirit.
Talk[ing] to those who are hopeless or [in a] hopeless state is not that helpful (is that what was said?). [People] need the connection, reflective relationships, need to be valued and appreciated. All endeavors [should] come out of that.
X Workers who are just collecting a paycheck vs. workers who are engaged, happy, vivacious. Such agencies/ institutes are welcoming, warm and those who use the facilities are in turn happy, passionate, i.e. teachers who have a passion that spirit shows.. The opposite is true as well, Vivacious work force X Students do not have tools to deal with life. Adults need to come in and hopefully they possess the tools needed. Kids gravitate to exciting teachers.
X Police Department in Los Altos (kids) parents [are] very disengaged, kids [are] being raised by nannies. [Parents don’t know that their] kids are suffering from a tragic event, using drugs, mentally ill. Parents connect with our children.
Police: Speaker shared feeling sad, compassion and sympathy when responding to a suicide call that involves a youth. However police often have little or no compassion and often even feel anger when responding to a suicide or attempted suicide call of an adult. Behaving this way is used as a means of getting a reaction from family members, spouse, significant other.
Differentiated police response to suicide (of youth versus adult) Group 2‐ This group (comments below) consisted of representatives from Redwood Middle School, the Director of Health Services from West Valley College, representatives from an Independent Living Program, a representative from Elmwood Correctional Facility, and a few community members. The group mainly discussed building a common language, educating on
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 107 of 136
all levels, better training volunteers, and providing more resource centers.
Addressed
by
committee?
Comment or question
X One resident feels that parents do not have tools for prevention. We need to have early education, awareness, and focus on mental health. Suggestion: Offer information once the mother gives birth at the hospital.
X We need to develop a method to help the community understand that mental health is OK. Promote help seeking behavior
X Elmwood representative feels that we need to educate within the correctional facility and help women cope with their emotions as they readapt into society.
X A local feels many (community members) believe that more awareness would lead to more suicidal cases—we must somehow lower the stigma, and we need more educators to be involved to help increase awareness. “Silence is killing them”. Stigma reduction
X Another local would like to see more involvement with survivors. Professionals have great knowledge about the subject, but having a resource with the same experience will have a larger impact and understanding. Sharing stories, peer programs
X We need to train more volunteers who want to prevent, educate, and aid mental health.
A representative from independent Living Program states that there is a lack in financial aid. We have resources outreaching to schools. However, we have forgotten about those who are not in schools. Perhaps, we should build resources in Juvenile facilities too.
• Where are other resource centers other than schools?
• Can we provide financial aid to help those with mental health issues? X We have sex education, drivers’ education, etc. But we don’t have a program for mental health? Awareness and education
X We do have a program called Mental Health First Aid—perhaps we need more promotion.
Group 3‐ Participants (comments below): Community Member (wife of a man who committed suicide); Doctor; LACY Member (Social Worker); Council Member, Palo Alto (son had mental health issues); Community member (son committed suicide); Community Member‐2nd Harvest Food Bank; Mental Health Social Worker; School Psychologist; School Counselor X The group discussed the need to have forums that include not only psychologists and social workers but also family members of suicide victims and those who have attempted suicide to discuss their personal experiences, system failures and warning signs. Listening Campaigns X/ X / X Many of our group discussed the need to have a strong prevention strategy and to have discussions with children when they are young and the need to have talking points for pre‐teens.
X Our group also discussed the importance of sharing personal experiences and
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warning signs. Share personal stories
X Our group discussed the lack of availability of services/resources at schools and the need to have a 24 hour telephone number to call to access mental health services.
X We also discussed the need to have teens understand when they have to make a call to someone when they suspect that their friend is having difficulty. This might put adolescents in a bad position however when someone’s life is in jeopardy it is critical to call someone who can slow things down and make an assessment (adult, law enforcement, teacher, counselor, mental health professional, clergy). So an education strategy designed to educate young people about getting their friend help would be an asset and would be a valuable asset for our youth.
X One group member was very complimentary of the QPR.
X The Doctor wanted to hear more about how we can communicate within the various communities to ensure that people are not slipping through cracks.
X
X
The matter of de‐stigmatizing mental health was discussed widely. We also talked about how we need to have a paradigm shift‐much like how our community has changed its views on drunk‐driving. We thought that we could learn some lessons from MADD and that they could be a model for changing the discussion on mental health in the community.
Addressed
by
committee?
Comment or question
Group 4
X Some of our group was surprised about the data on the frequency of suicide among seniors.
X A couple of group members remarked that there was a need to have post‐ incident care or post 5150 care to ensure that family members and the patient were aware of the resources available and that they were not experiencing destructive tendencies.
X Our entire group agreed about the importance of the community ownership and that we all have a responsibility.
X One of the Community members announced that Stanford University Medical School has a Bi‐Polar Education Forum involving families, educators and researchers.
X Another community member recommended the City of Palo Alto’s Family Resource Center which offers monthly meetings to discuss resources available to the community.
Webinar
X‐ CIT
Fremont Unified School District in Sunnyvale has done a Webinar on Suicide Prevention, approximately 20 minutes long and it discusses how resources can be accessed. They have also developed a Crisis Intervention Team at the schools with multi‐discipline resources available.
X A community member recommended that there should be specialized training for counselors at schools when there is denial amongst parents regarding the
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mental health issues involving their children.
We had a lively discussion about respecting the privacy of children while being concerned about their mental well‐being.
X A group member recommended having a guest speaker named Kevin Hines come and talk about his experiences being bi‐polar. Share personal stories X One community member recommended that there be training given to physicians about the type of medications that they prescribe to their patients and how some could have adverse effects on them and even promote suicidal thoughts. Training would recommend that spouses/family members would receive information about certain types of medication and the warning signs.
Provide support to Primary Care for mental health issues.
X We also discussed the need for additional information, awareness and training for Parents, Teachers, Firefighters and the clergy to identify those at‐risk and how to access services.
X
Plan is well written. I came to see how [such a plan] can be effectively implemented in ethnic/ cultural communities. [The] rec[ommendation]s are summaries, but [the] specifics needed (sic) to take back to [the] communities.
X Emotions and emotional awareness aren’t taught. [We need to] teach emotional awareness/ intelligence. [The] education system can teach emotional awareness; and should be] supporting [youth] exposed to suicides.
Youth sometimes suicide through drug abuse or car crashes. Kids now feel more helpless and hopeless. Don’t know how to fit in. Drug and alcohol use is up. Prevention dream: Health Education would be taught in schools and address emotions. Kids need tools.
X Fo[ster] Parents aren’t mandated to take MH awareness and it’s needed.
Foster parents [in] (her experience) [are] in it for [the] money. ([She is a] former foster child) Depression, self mutilation [is] ignored. Focus on foster parents. Lots of training on MH awareness. Public media messages on where to get help.
X *NAMI Member‐ Parents and Teachers [should work together as] allies. ‐Teach teachers about [the] onset of mental illness in youth. –[Has trained] 1 school thus far. Raise awareness among educators
X Stigma to suicide. People don’t want to talk about [it], even within groups that should be comfortable with it. *Suicide [is] “taboo” within mental health.
Mental health professionals, consumers, and their family members should be more willing to talk about suicide, with the ease they have discussing a diagnosis.
Challenge to confidentiality and talking to family members, [HIPPA] creates barriers. Can doctors inform family members? How do they address [the] risk? X Suicide cross[es] economic barriers. Suicide [Has a] huge impact on families. office of Human Relations Commission will be focusing [on] disseminating prevention information.
X [I] Became involved because of Palo Alto Suicides. Effectiveness of means
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restriction as [a] prevention strategy. Focus [should be on] bridge barriers, train track monitors. Peopl e today lack emotional connections, need to connect with people. Increased caring, increased communication X Schools have a huge role to play [in] [re‐defining] norms, de‐stigmatizing help seeking.
X Latino community does not want to acknowledge or talk about [suicide]. [Latinos] need more information in community. Culturally appropriate prevention information is needed.
X Lot of education [is] missing. Don’t use the word “commit” suicide because using “committed” [makes it seem like a] crime and [reinforces] stigma. Should use “died by suicide”. Change terminology
X Kids don’t feel there’s a stigma, they talk about it. Adults don’t want to talk about [suicide]. De‐stigmatize
X Schools have cut student support staff. Teachers have no training and are not equipped. Educate all teachers. Don’t just [train] special education [teachers], support staff need to know [and] recognize the signs.
X The entire community must be trained, neighbors, shops, families. [This should be framed as a] public health approach.
X Media should always inform where to get help.
Addressed
by
committee?
Comment or question
Group 5
X
Q: What are the political benefits to bringing the issues to people’s awareness?
A: There’s believed to be an awareness problem there’s a belief there’s a lot of stigma connected to suicide though people are reluctant to speak out about what they are feelings.
X
Q: What are the political benefits to bringing the issues to people’s awareness?
A: There’s believed to be an awareness problem there’s a belief there’s a lot of stigma connected to suicide though people are reluctant to speak out about what they are feelings.
X
Q: Everyone has limited budgets, is there good information about efforts that save the most lives…?
A: The committee has taken the position that it’s a public health problem in all communities. It’s tactics/ design is to raise awareness and address what
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strategies are most effective to prevent suicide.
X C: There are various components to address the problem but we as a community need to gather all the various components to address the problem; people need to be able to talk about it.
X C: Loved ones need to sacrifice the time to share; with their family members; time to express concern; loved; etc. to let the individuals know that “they care about them” they will be missed.
X C: Concerns around teenagers because of programs being cut; kids not being able to access counselors or help due to the cuts. Age appropriate access to care
X C: Due to oversized classes and lack of funding teachers can not address the problems at hand. Schools united in awareness‐ budget and time limitations X C: General overall consensus on expansion of community led services and programs and/ or peer‐led programs.
X
C: Communication seems the overarching gap like with education; desensitizing stigma make it easy for people to talk about. The media needs to be used as an outlet or resource; we need to build relationships with media people and they need education and sensitivity developing relationships with media.
X C: School age kids‐ Offer Mental Health First Aid to be able to train the school staff to help deal with these issues.
X C: Parents can take simple steps; do little things like having dinner with a child that will make a difference.
X C: Several members felt that strengthening and using "natural" community resources such as church, clubs, etc would be helpful so people could get help there either instead of MH providers or in addition to MH provider help.
X C: We have around us everyday access to people who have attempted suicide.
Why aren’t they the “go to” people leading our efforts to finding the answers of where things broke down and what would have helped them to “not” follow through with an attempt. Attempters Sharing their Stories Addressed
by
committee?
Comment or question
Group 6
Policy and Governance Advocacy
X Partnership between primary care and mental health care professionals is critical.
Policy and governance advocacy may put too many regulations in place. This regulation’s category is too broad. This may inhibit individuals from seeking care.
X More support of primary care is needed. Individuals may not reach out to MH professionals.
X Doctors and mental health care is not working together which is detrimental.
HIPPA [due to HIPPA/ or has HIPPA become a barrier to care]. They are
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currently two separate entities that need to be one. Concern that HIPPA inhibits MH Professionals from other providers; mandated which would impact policy procedure. Division on whether would be a good thing or negative.
Concern to maintain confidentiality while maximizing collaborative care.
X Public Policy takes away the humanity. [We need to] always go back to [the reality] that it’s about people. Regulations and policy should not become barriers in and of themselves.
X Protection of the individual [is a] double‐edged sword. [Need to] Open up communication. Becomes less private and less people will seek help. Policies such as mandates for reporting or asking questions may increase concern for confidentiality and may discourage people from seeking help. [Need to find a policy that is] more open [in sharing patient’s information with loved ones] but still protecting privacy.
X Hospitals don’t report suicide attempts. Should be mandated that hospitals report suicide attempts and that those individuals receive follow up care that is standard protocol.
X Root causes [for suicide] need to be looked at.
Community Education & Implementation
X Outreach‐ Paramedics, EMS, and EMTs have no idea of [the] existing hotlines.
Law Enforcement and firefighters receive little education on these issues. May benefit from in service‐type training.
X [EMS are] taught [to] treat the injury, not the person. Felt that the SACS training was very helpful. By recognizing potential mental illness, helps to interact.
X Law enforcement/ EMT/ Fire fighters, (first responders) [need to have] condensed in‐service type training [and] in‐depth [trainings] Intervention
X Caltrain needs to evaluate entrances where [people] in duress can enter [the train tracks]Means Restriction
X [Schools need to] Address bullying at schools. Parents need to be responsible as well. [Need] outreach for child [or youth] who is being bullied to let them know [what] resources [are in] place.
[Need] a call box at the tracks.
Addressed
by
committee?
Comment or question‐ Monolingual Vietnamese Group 7
X One member shared he attempted suicide when, after being diagnosed of MH, his family insisted that he stayed in an institution and not come home. stigma X One member shared he attempted while using drugs substance use X One member shared she thought seriously about suicide when she came to this country, without family members, lost her job and was evicted. Social isolation, refugee/ immigrant experience
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X One member shared her husband attempted suicide due to family situation (divorce) and is now paralyzed on one arm. Loss of loved one Cultural issues
X Recognition that Vietnamese families put a lot of pressure/expectation on family members for achievement levels, education levels, marriage social roles and pressure
X Severe stigma around Mental Health issues due to cultural belief that Mental Illness is shameful, punishment, karma; we do not get services for loved ones but hide the condition.
Policy and Governance advocacy
We ask for more compassion from the legal system, that people who commit crimes and admit fault be forgiven, or they are led to suicide X Strict immigration laws causes distress in individuals and families, some are led to self‐sacrifice/sacrifice
X Unemployment have caused to families to die in group. Drop in economic level X There is a lot of stress in the workplace which can lead to suicide Practical suggestions
An easy‐to‐remember short hotline number such as 5‐1‐1
X Recognize, give award to people who have prevented another person from attempting suicide.
Addressed
by
committee?
Comment or question
Group 8
X Gathering Data‐ [It] really struck [a] cord about finding out the why. If we know [the] why we may be able to figure out why not.
X Stigma applies to mental illness. Hope to change viewpoint and educate [the] public about [the] crisis of suicide; bring it out of the closet. Important for gaining political and institutional support.
X TV advertising for prevention.
X Actuarial costs of suicide in dollars and cents. Young people are worth $1.5 million dollars for [the] economy. Talk about the money saved by providing prevention programs. If we can sell products we should be able to sell something good like suicide prevention.
X Cultures‐ [In many cultures] mental health [is] taboo. Advertise [messages promoting] seeking mental health [services] would reduce suicide.
X Prevention is not broken out sufficiently in the plan. Would like to focus on
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suicide prevention rather than intervention. How do we make children feel connected and supported? [ie. Examples of ways to connect youth] Service Learning, Building friendships, asset building‐ like Project Cornerstone.
Prevention beyond Intervention.
X To do this, educate parents in families where mental health taboo exists.
School may be [the] best place to introduce this. Suggested 15‐20 minutes as part of curriculum.
X We talked about what we are doing to talk positively and supportive. What are we doing to empower them [youth], to give them [youth] voice, make them [youth] feel supported, develop friendships. Need to positively message this to the community. We are teaching kids about eating healthy, exercising, we should be teaching them about how to take care of their emotional needs.
X Decrease isolation for older communities.
X Gangs, family issues, drugs, prison
X Concern regarding how medical establishment passes out antidepressants without education and [these] can increase [risk of] suicide. We need to get to medical establishment[‘s buy‐in].
Concern regarding drug company advertisements that suggest that pills fix everything.
X [Older Adults struggle with the] Feeling of [their] being a burden. [Suicide should not be considered as a] selfish act.
X [Older Adults struggle with the] Feeling of overcoming death and pain.
X Middle aged: Poor economy, lost jobs.
Strategies
X Workplace education to provide education [on mental health issues and suicide awareness], similar to Air Force Academy efforts‐ getting MH services is not a bad thing. Identity may be wrapped up in job and if one loses job, [people experience a] feeling of lost identity. [Stress is magnified by being] Combined with loss of insurance. [Advocate for a] Law on [requiring businesses to issue a] page of contacts and information regarding insurance options and resources. This could also be available as posters in unemployment offices.
X Support groups for people feeling suicidal.
Offer trainings for Senior Management – services available and general awareness on issues like domestic violence (to avoid homicide/ suicide); depression, etc.
X Train critical professions on suicide prevention and awareness: Cops, Teachers, Clergy. They Need to understand when to turn folks over to other services.
Cultural Issues:
X Difficult to seek outside help for mental health. [Culture dictates that people are] supposed to be able to treat [themselves] within the family. Cultural values, stigma
X [It is] Essential to have someone from the same culture reach out within a
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culture. Culturally appropriate outreach/ inreach within a community X Spread the word in mosques, churches, temples, etc. Clergy would likely welcome resources.
Comment Cards
Comment
Card
In
Plan?
Comment/ Question
A. Everything was very good information and how to help other to live better and happy.
Communication Practices: Communications and more resources and work shops like this is (sic) very outstanding.
X Intervention Strategies: [Offer] Programs after school and more counseling.
Other Comments: Very good.
B. X Policy & Governance: Mental Health, Domestic Violence, Alcohol and Other Drugs, Violence in the workplace/ school all share common prevention themes. Address issues of general community well‐being that would be the foundation of community well‐being in the media campaign.
X Community Education: Need to include [the] entire community[,] so that means engaging workplace/ employers, like HP, IBM, Bank of America et al.
Their issue is workplace violence/ suicide. What does Employee Assistance Program (EAP) do?
X Communication Practices: If IBM says being a good parent is a corporate value and supports that, parents [employed there] will listen.
C. X Policy & Governance: Leaders must be first educated about what needs to be & how they can help.
X Community Education: Information should be reliable where people can get it & in multiple places‐ all media forms, schools, etc.
X Communication Practices: Educate & advocate not using the word “commit” in context of suicide (negative).
X Data Collection and Monitoring Activities: Mental autopsies of victims & attempters. Psychological profiles
X Intervention: Access to means to self harm should be restricted as much as possible. Teachers & schools should help is de‐stigmatizing mental health.
Means Restriction
Other comments: Thanks for your work on this.
D. X A big effort, but not new and effective plans. From now on, cigarette smokes (sic) is pushed into death end. No more place for them to smoke.
Non‐smokers take advantages and harassed cigarette addicts a lots (sic) Be careful!!!! (sic) Paradigm Shift
X Community Education: To educate people is not effective is to give people awards, even though it’s just a letter from authority or a certificate.
Communication Practices: Authorities and specially psychiatrists & case
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manager act according to work rules, but not help consumers with all their hearts. Please educate them first.
X Data Collection and Monitoring Activities: [Is] Needed but don’t go into personal detailed information.
X Intervention: Prevention is more priority. Need hotline personnelle (sic) to be able to help people in trouble some suggestion to get out of it practically. Don’t ignored. (sic) And remember to follow up. It may recur.
X Other comments: I has (sic) some problems myself that can’t be told.
Please think about some ways to detect or discovered (sic) a person’s suicidal thought. Public Awareness and Empowerment
E. Other comments (0‐15, 16‐24): We need emergency phones that connect to suicide prevention at the [train] tracks in Palo Alto. Kids would not want to use their own cell phones for that because they do not want to leave any trace.
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Santa Clara County Suicide Prevention Public Forum
POST‐IT NOTES
From Poster Boards
I. Policy and Governance Advocacy
1. New Strategies
Consider putting (real) phones on hot spots so people can call for help when feeling suicidal.
X Additional idea: National Suicide Hotline. Consider idea to create a national number such as 1‐800‐CHOOSE LIFE (or local city number that transfers to hotline #).
Preserve continuity of services: exclude County‐contracted services from the General Fund.
X Really focus on schools – even at the elementary school level.
X Consider an advocacy day (SACS) during May or other suicide awareness month X Need to build bridges with law enforcement and other first responders.
X Bring a victim to share a story (if possible). It will help to change and enforce positive change.
a) Edits to Strategies
X Raising awareness and educating everyone of all systems and partners of their key roles and explaining what the key note is.
b) Additional Comments
X Countywide hotline is not new. In fact, it can’t exist (sic‐ function well) when the receivers or staff on the other side are not necessarily culturally and/or linguistically competent!!! It would be more practical or personal to contract out with community‐ based ethnic group or entity to do it. To be model friendly, use grassroots not just contract agencies or county employee hotline, etc.
c) Wall Graphic
There are pros and cons of all policies
X Look at the root cause of individuals who die by suicide X There are political benefits of increased awareness
X Suicide is a public health problem
X Partnership with primary health care professionals – this is critical Government shouldn’t be too heavy handed
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X Hospitals must report suicide attempts
X Leverage funding and get the “best bang for our buck” Immigration rules are tremendous on the individuals – need to integrate more compassion
II. Community Education and Information
a) New Strategies
Right focus re: recreation centers after school. Not try to shut them down, no money for the education.
Have a forum of “experts” of people who committed suicide. Tell what went wrong.
Ask therapists to attend, but the first speakers should be survivors.
X Have special programs that worked in the past. Ask community what will work.
X Have special programs that target youth families.
X Make prevention and intervention strategies more accessible to concerned friends and relatives. (Aggressive campaign – poster boards, community presentation) X More volunteer program, keep them [youth] busy and out of gangs X Include community education workers that speak the many languages spoken in this community.
X Training and police officers responding to 5150 calls.
X Have more training to target youth.
X Sounds good the plan will work out well. Encourage the loved one to talk about it. b) Edits to Strategies
For grief counseling, lower the requirements to be helped. Educate people that crisis line is also for mental health support.
c) Additional Comments
X Your suggested strategies for community education and information are excellent.
People need to be desensitized to the subject to feel empowered.
SACS does outreach we used to do more than now. Volunteers for this are difficult to keep the same 2 or 3 people were doing all the outreach talks.
X Make sure you publicize as much as possible. Get support from City Councils and get the word out to the public.
d) Wall Graphic
X 24‐hour telephone service, center
X Educate peers to take next step, training
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o Parents
o Teens, pre‐teens
o Teachers
o Firefighters
X Access points for resources, schools
X Tools for communication
o Fishbowl technique
o Social networking sites
X Heighten awareness
X Need to repair communication break down
X Normalize conversation around suicide
X Advertising for prevention
III. Communication Practices
a) New Strategies
Reassuring the victim that everything is confidential.
X Have forum with suicide attempters. Talk about their experiences.
X Better educate foster parents particularly. Social workers, teachers on how to spot ones in trouble.
X Have talks and trainings in the schools. Involve the youth in trying to define messages.
Everyone who wants a job in the County Psychology Department needs to go through SACS training first.
X Your strategies for communication practices are excellent. I would only add developing strategic relationships with the media – otherwise it’s “whatever bleeds, leads!” X Use communication resources that connect with youth.
Respecting the privacy of the victims of suicide is key, especially for minors.
X It’s good! I think to use authentic community leaders who are much familiar to the residents and cultural groups of their own communities would be much more effective judge than the county.
X Encourage the attempts to talk about his/her crisis.
X Every 1st responder: police, fire, EMT – gets SACS training.
X Use communication resources that connect with specific communities. b) Additional Comments
Perhaps obituaries or death notices might say: “was so depressed he committed suicide” (and did it by….)
c) Wall Graphic
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X Change paradigm – DUI, smoking
X Gift of story
X Welcoming, vivacious spirit
X Media is a resource
Needs to be educated, how to communicate message
X Churches and temples – places other than schools
X Hotline number is too long – need a 3 digit number!
X Public health issue
X Develop common language
IV. Data Collection and Monitoring
a) New Strategies
List failures of the treating therapists and doctors. List anti‐depression medication the person was taking. List medications on which the person suicided.
Use things that work/didn’t work. Then find solutions.
X Collect statistics on suicide attempts. Especially teens.
X Ensure continuum of data collection and analysis cross systems.
X From the current data, you had online I noticed specific zip codes with high rates of suicide this information is critical to developing targeted messages for each community.
X Encourage the attempter to talk about his/her crisis.
Start keeping data on how many suicides were taking Paxol and other SSU medications for bi‐polar
b) Additional Comments
X Psych[ological] autopsy.
c) Wall Graphic
X [Monitor?] Caltrain entrance sites
X Examine, study group deaths
V. Intervention Strategies
a) All Ages
Resist the effort to medicate[.] [Mental Health?] centers closely monitored X Make it not‐taboo to talk about
b) Wall Graphic
X Community ownership
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X Take time with the individual
X Cultural differences – severe stigma against mental health Same cultures need to support each other
E.g. Vietnamese culture
X Honor, aware people for work with suicide prevention
X Stigma in discussing suicide even in mental health profession.
Children and Youth Ages 0 to 15
a) New Strategies
X Listen to them and need to respond to bullying
X Bullying at schools by peers on (sic‐ to) a teachers and administrators.
X Training with at‐risk to hear their concerns and how they would like to be listened to.
X Developmental Asset Building for youth – Project Cornerstone Teen support groups for survivors of teen suicide.
Youth involved in community service.
X Involve schools in planning prevention pre K through Grade 12 Additional idea – introduce the season(s) for non‐violence (begun by Gandhi’s grandson in 1997 at the United Nations to schools. Give teens and teachers idea to incorporate suicide prevention into the nonviolence curriculum. Utilize PSA’s radio and television.
X Advertise, advertise, advertise. Foster parents especially.
X Racism leads to feelings of low self‐esteem, depression, helplessness, etc. This continues for all ages.
X Increase curriculum involving self‐esteem and ethics or “telling” someone older about a potential problem, encourage. Also teach “responsibility age‐specific level” X Important not to “single out” at risk kids. Better to make broad strokes.
Have teachers compliment students example: “Good question, Joe!” Developmental Assets: Project Cornerstone.
X Use social networking potential.
b) Edits to Strategies
X You forgot prevention: should be a separate category.
X Include reaching out to students experiencing academic difficulties Prevention strategies should be formulated:
Youth Developmental Assets; Caring school environment; Service Learning c) Additional Comments
X Racism against Latinos is high!
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X I think the most important thing is a societal shift to isolating individuals less. This is a cultural issue. E.g. computer culture.
X Listen to youth! Be a friend not a stranger!
d) Wall Graphic
X Parents need to connect with kids, youth, teens
X Bullying in schools: outreach, parent support needed
X Dinner with your children
X Educate – healthy foods, exercise
X Empower kids, youth, teens
Youth and Young Adults Ages 16 to 24
a) New Strategies
X Moving, family relations, unsatisfying work – pressure once returned to house of origin X Parent‐child communication training workshops including teens and parents X Internet
X Youth forums: to hear our youth – what do they day they need? X Peer counselors opportunities to get trained in age‐specific ways in crisis intervention and discussing the “ethic” or “telling”
Community service for youth
X Training and police officers responding to 5150 calls X Services list of therapists – hospital with adolescent units Peer to peer college student training and education – early detectional screening in college health services
X Making resources, help lines more obvious and culturally sensitive X Strong need for prevention strategies. Should be called out! X Include bullying issues
X Educate parents about how to address mental health issues – that may emerge when their students are away at college
To finish the high school and get the diploma or GED
Tell teachers to compliment students, e/g/ “Hey Joe, that was a good question!” Like peer stipend program – may listen to them more than adult X Treating suicide as a medical issue it could be argued is culturally biased already…However, I think if you look at your whole program you do not focus on the medical side only.
X If screen people, where are the therapists/hospital beds to put them if needed? X Comprehensive health, curriculum including social, emotional health School nurses should be involved!
X Education! Training of educators, community leaders, parents, youth about signs and calls for help!
X Individuals with physical disabilities – including but not limited to injuries that changes an individuals life? Exp – head injury, parapalegic, quadrapalegic, stroke, etc.
X Immigration or refugee concerns acculturation stress linguistic cultural riff X More information on suicide prevention is needed in Spanish
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X Training targeting high school/community college (administrators, discipline, guidance counselors, staff)
X More sensitive and compassionate media coverage needed b) Edits to Strategies
We need prevention! Separate category
c) Additional Comments
X Listen to youth! Make connections, be a friend.
d) Wall Graphic
Budget cuts in schools impact counseling. Need community‐based counselors/peers Adults Ages 25 to 59
12‐step model
X No cost counseling or crisis services
X Intervention strategy for adults – tie your intervention with de‐stimatizing desensitizing to subject normalizing seeking help and providing hope
Class versus counseling – and counseling when needed
X Peer to peer college student training
X Provide training for family members
X Include adults experiencing job loss and time period out of work X College faculty training (higher education)
X Work place problems – may be the 1st place where problems are noticed. Include training supervisors, etc.
X Single, middle‐age me
X Need to provide targeted resources to returning serve members who are at high risk for suicide. Their families are also at high risk for violence, depression and suicide.
Wall Graphic
X Job loss
Provide unemployed with resources, information
Mandate provision of information
Parent’s impact on entire family
X Foster parents
X Parents need resources, tools to help prevent suicide Older Adults Ages 60+
X Add priority populations. Health or family health of suicide identification or attempts.
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Additional idea – fundraisers such as a wing into life golf tournament for schools, community organizations, or contract agencies.
X Make homebound services/disabled a priority!! For outreach and address isolation issue.
X I like the idea of a mobile unit(s). I think advertising in all forms of media (TV, radio, newspapers, magazines, etc.) is necessary.
a) Additional Comments
The “forgotten” population. I’ve heard it said that they are underserved by the new PEI Plan.
b) Wall Graphic
X Community ownership of plan is important!
X Connect with people
X Reality affects society, people
X Stigma of seeking help, change this!
X Separate prevention and intervention
Medicine side effects impact suicide risk
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Attachment 5. Palo Alto Unified School District Suicide Prevention and Mental Health Promotion Policy
Students BP 5141.52
SUICIDE PREVENTION AND RELATED MENTAL HEALTH PROMOTION
The Board of Education recognizes that suicide is a major cause of death among youth and should be taken seriously. In order to attempt to reduce suicidal behavior and its impact on students and families, the Superintendent or designee shall develop preventive strategies and intervention procedures.
The Superintendent or designee shall involve school health professionals, school counselors, administrators, other staff, parents/guardians, students, local health agencies and professionals, and community organizations in planning, implementing, and evaluating the district’s strategies for suicide prevention and intervention.
Prevention and Instruction
Suicide prevention strategies shall include, but not be limited to, efforts to promote a positive school climate that enhances students’ feelings of connectedness with the school and is characterized by caring staff and harmonious interrelationships among students.
The district’s instructional and student support program shall promote the healthy mental, emotional, and social development of students including, but not limited to, the development of problem-solving skills, coping skills, and resilience.
The Superintendent or designee may offer parents/guardians education or information which describes the severity of the youth suicide problem, the district’s suicide prevention efforts, risk factors and warning signs of suicide, basic steps for helping suicidal youth, reducing the stigma of mental illness, and/or school and community resources that can help youth in crisis.
Staff Development
Suicide prevention training for staff shall be designed to help staff identify and find help for students at risk of suicide. The training shall be offered under the direction of district staff and/or in cooperation with one or more community mental health agencies and may include information on:
1. Research identifying risk factors, such as previous suicide attempt(s), history of depression or mental illness, substance use problems, family history of suicide or violence, feelings of isolation, interpersonal conflicts, a recent severe stressor or loss, family instability, and other factors.
2. Warning signs that may indicate suicidal intentions, including changes in students’ appearance, personality, or behavior.
3. Research-based instructional strategies for teaching the suicide prevention curriculum and promoting mental and emotional health.
4. School and community resources and services for students and families in crisis and ways to access them.
5. District procedures for intervening when a student attempts, threatens, or discloses the desire to die by suicide.
BP 5141.52
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 126 of 136
SUICIDE PREVENTION AND RELATED MENTAL HEALTH PROMOTION (continued) Intervention
Whenever a staff member suspects or has knowledge of a student’s suicidal intentions, he/she shall promptly notify the principal, another school administrator, psychologist, or school counselor. The principal, another school administrator, psychologist, or counselor shall then notify the student’s parents/guardians as soon as possible and may refer the student to mental health resources in the school or community.
Students shall be encouraged through the education program and in school activities to notify a teacher, principal, another school administrator, counselor, or other adult when they are experiencing thoughts of suicide or when they suspect or have knowledge of another student’s suicidal intentions.
The Superintendent or designee shall establish crisis intervention procedures to ensure student safety and appropriate communications in the event that a suicide occurs or an attempt is made by a member of the student body or staff on campus or at a school-sponsored activity.
Also see:
cf. 4131 – Staff Development
cf. 5022 – Student and Family Privacy Rights
cf. 5125 – Student Records
cf. 5030 - Student Wellness
cf. 5141 – Health Care and Emergencies
cf. 5137 – Positive School Climate
cf. 5143 – Nondiscrimination/Harassment
cf. 6142.8 - Comprehensive Health Education
cf. 6164.2 – Guidance/Counseling Services
Policy PALO ALTO UNIFIED SCHOOL DISTRICT
adopted: June 1, 2010 Palo Alto, California
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 127 of 136
Students AR 5141.52
SUICIDE PREVENTION AND RELATED MENTAL HEALTH PROMOTION
Prevention and Instruction
The District’s suicide prevention curriculum shall be designed to help students to:
1. Identify and analyze signs of depression and self-destructive behaviors and understand how feelings of depression, loss, isolation, inadequacy, and anxiety can lead to thoughts of suicide.
2. Identify alternatives to suicide and develop coping and resiliency skills.
3. Learn to share feelings and get help when friends are showing signs of suicidal intent.
4. Identify community crisis intervention resources where help is available and recognize that there is no stigma associated with seeking mental health, substance abuse, gender identity, or other support services.
Staff Development
1. Annual in-service suicide prevention training will be conducted in order for the district staff to learn to recognize the warning signs of suicidal crisis, to understand how to help suicidal youths, and to identify community resources. All staff will learn to identify potentially suicidal students, to take preventative precautions, and to report suicide threats to the appropriate authorities. Training will be offered under the direction of trained district counselors/psychologists.
2. Staff shall promptly report suicidal threats or statements to the principal or to a trained district counselor/psychologist, who shall promptly report threats or statements to the student’s parents/guardians and take appropriate action until the parent or guardian arrives.
Intervention
Immediate Intervention for a Suicide Threat or Attempt
When a suicide attempt or threat is reported, the principal or designee shall:
1. Ensure the student’s physical safety by one of the following, as appropriate:
a. Securing immediate medical treatment if a suicide attempt has occurred. b. Securing law enforcement and/or other emergency assistance if a suicidal act is being actively threatened.
c. Keeping the student under continuous adult supervision until the parent/guardian and/or appropriate support agent or agency can be contacted and has the opportunity to intervene.
THE STUDENT MUST NOT BE LEFT ALONE.
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AR 5141.52
SUICIDE PREVENTION AND RELATED MENTAL HEALTH PROMOTION (continued)
2. Designate specific individuals to be promptly contacted, including the school counselor, psychologist, nurse, superintendent, and/or the student’s parent/guardian, and as necessary, local law enforcement or mental health agencies.
3. Document the incident in writing as soon as feasible.
4. Follow up with the parent/guardian and student in a timely manner to provide referrals to appropriate services as needed.
5. Provide access to counselors or other appropriate personnel to listen to and support students and staff who are directly or indirectly involved with the incident at the school.
6. Provide an opportunity for all who respond to the incident to debrief, evaluate the effectiveness of the strategies used, and make recommendations for future actions.
7. Document the steps taken in the student’s record.
8. Develop an effective plan for reintegration of the student into school following the crisis.
Intervention after a Death Suggested to be Suicide
When a tragedy occurs and a student dies, the principal or designee shall:
1. Contact the Superintendent. District Office staff will contact other schools and remind them to identify and provide counseling to any student who might have known or been connected in any way with the student who died.
2. Call an emergency staff meeting to relay known information and formulate appropriate procedures for supporting students, staff, and parents. The death should not be called a suicide. This is a legal determination that can only be made by the coroner’s office. It should be referred to as a death or a tragic death.
3. Talk with students who were in class with the student by going to that classroom.
4. Contact other students who might know the student in direct, one-to-one conversations.
5. Provide counseling support to students. Contact additional psychologists/counselors to increase the available support. Have a place available for students to go to (Support Room) and walk around campus to be available for any student needing support. Counselors should follow the student’s schedule and be available to assist the students and teachers in those classes. Students must be allowed to grieve, but there should be no large group gatherings such as an assembly. Students should not be allowed to congregate in groups without adult supervision. Identify any students who might be at risk and call them in to talk.
6. Contact the family to express condolences and to let them know what the school is doing. Ask when the family would like the student’s personal items returned to them. The student’s locker should be cleaned out and contents returned to the parents at an appropriate time.
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 129 of 136
AR 5141.52
SUICIDE PREVENTION AND RELATED MENTAL HEALTH PROMOTION (continued)
7. Designate a spokesperson who will respond to questions and inquiries from the media and work with the media to assure responsible reporting (see American Foundation for Suicide Prevention guidelines).
8. School will be conducted as usual to the greatest extent possible. In no case should school be canceled.
9. Prepare a note to send home to parents indicating that a tragic death has occurred and that post intervention procedures and counseling has begun.
10. Schedule a parent meeting as soon as possible to help parents deal with the issue and to advise them how to help students.
Also see:
cf. 4131 – Staff Development
cf. 5022 – Student and Family Privacy Rights
cf. 5125 – Student Records
cf. 5030 - Student Wellness
cf. 5141 – Health Care and Emergencies
cf. 5137 – Positive School Climate
cf. 5143 – Nondiscrimination/Harassment
cf. 6142.8 - Comprehensive Health Education
cf. 6164.2 – Guidance/Counseling Services
PALO ALTO UNIFIED SCHOOL DISTRICT
Approved: June 1, 2010 Palo Alto, California
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 130 of 136 Page 215 of 240
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 131 of 136
Attachment 6. References
1 Behavioral Risk Factor Survey, Santa Clara County 2004 Chartbook, Santa Clara County Public Health Department, 2004
2 California Department of Health: Epic Data
3 http://www.sprc.org/grantees/statetribe/2010/7B%20Inspire%20USA%20handout.pdf 4 Ibid
5 Center for Health Statistics—Vital Statistics Query System. http://www.applications.dhs.ca.gov/vsq/screen4a.asp?cnty_cd=43&YEAR_DATA=2007&Criteria =1&Res_occ=Residence&Birth_Death=Death&stats=2&cod_cd=424 Retrieved 3/4/10. 6 California Department of Public Health, County Health Status Profiles 2009, retrieved 3/9/10 7 Number is based on the above‐established rate.
8 Center for Health Statistics—Vital Statistics Query System. http://www.applications.dhs.ca.gov/vsq/screen4a.asp?cnty_cd=43&YEAR_DATA=2007&Criteria =1&Res_occ=Residence&Birth_Death=Death&stats=2&cod_cd=424 Retrieved 3/4/10. 9 Ibid
10 California Department of Public Health, Center for Health Statistics, Vital Statistics Query System. http://www.applications.dhs.ca.gov/vsq/default.asp.
Retrieved 3/3/10 through kidsdata.org
11 The Trust about Suicide: Real Stories of Depression in College. http://www.afsp.org/files/College_Film//factsheets.pdf Retrieved 3/4/10 12 Mental Health America Suicide Fact Sheet. http://www.mentalhealthamerica.net/go/suicide Retrieved 3/4/10
13 Ray Hodgson, Tina Abbasi, Johanna Clarkson. 1996. Effective mental health promotion.
Health Education Journal, 55, 55‐74
14 National Strategy for Suicide Prevention, US Dept. of Health and Human Services, 2001, p 41 15 Sanford C and Hedegaard H (editors). Deaths from Violence: A Look at 17 States ‐‐ Data from the National Violent Death Reporting System. December 2008. 16 Youth Suicide Fact Sheet. www.suicidology.org. Retrieved 4/22/10. 17 CDC. Suicide among children, adolescents and young adults—United States, 1980‐1992.
MMWR Morbidity Mortality Weekly Report 1995; 44(15):289‐91 18 California EpiCenter database 19 Behavioral Risk Factor Survey, Santa Clara County 2004 Chartbook, Santa Clara County Public Health Department, 2004
20 Santa Clara County Youth Suicide Rate 2005‐2007. California Department of Public Health, Center for Health Statistics, Vital Statistics Query System. http://www.applications.dhs.ca.gov/vsq/default.asp. Retrieved 3/3/10 through kidsdata.org 21 Youth Suicide Fact Sheet. www.suicidology.org. Retrieved 4/22/10. 22 California EpiCenter database 23 American Foundation for Suicide Prevention,
http://www.afsp.org/index.cfm?fuseaction=home.viewPage&page_id=E2464DF6‐0397‐BD56‐ A8E232923B04ED5C Retrieved 3/4/10
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 132 of 136
24 Potter, L., Silverman, M., Connorton, E., & Posner, M. (2001). Promoting mental health and preventing suicide in college and university settings. Suicide Prevention Resource Center.
Retrieved October 15, 2007, from www.sprc.org/library/college_sp_whitepaper.pdf. 25 Benton, S. A., Robertson, J. M., Wen‐Chih Tseng, Newton, F. B., & Benton, S.L. (2003).
Changes in counseling center client problems across 13 years. Professional Psychology:
Research and Practice, 34(1), 66–72.
26 Picture This: Depression and Suicide Prevention. Prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the Entertainment Industries Council, Inc. http://www.eiconline.org/resources/publications/z_picturethis/Disorder.pdf. Retrieved 4/14/10
27 Santa Clara County Suicide Prevention Advisory Committee Basic National Data, presented by Victor Ojakian on January 13, 2010. http://www.sccmhd.org/SCC/docs/Mental Health Services (DEP)/attachments/National_State_Data_on_Suicide_slides_Mtg_1_13_2010.pdf. Retrieved 4/23/10.
28 American Association of Suicidology: Suicide and the Economy. Available at http://www.suicidology.org/web/guest/current‐research. Accessed May 19, 2010. 29 California EpiCenter database 30 Ibid
31 The National Alliance on Mental Illness. Communities: Major Depression. Available at:
http://www.nami.org//Template.cfm?Section=major_depression& template=/Forums/TopicDisplay.cfm&ForumID=1&ForumActiveFlag=Y&TopicActiveFlag=Y.
Accessed August 13, 2007.
32 Picture This: Depression and Suicide Prevention. Prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the Entertainment Industries Council, Inc. http://www.eiconline.org/resources/publications/z_picturethis/Disorder.pdf. Retrieved 4/14/10
33 Kulkin, H., E. Chauvin, & et al. (2000). Suicide among gay and lesbian adolescents and young adults: a review of the literature. Journal of Homosexuality, 40(1), 1‐29. 34 Remafedi, G., J. A. Farrow, et al. (1991). Risk factors for attempted suicide in gay and bisexual youth. Pediatrics, 87(6), 869‐875.
35 Eisenberg, M. E., & Resnick, M.D. (2006). Suicidality among gay, lesbian and bisexual youth:
The role of protective factors. Journal of Adolescent Health, 39(5), 662‐668. 36 Kessler, R., Borges, G., & Walters, E. (1999) Prevalence of and risk factors for lifetime suicide attempts in the national comorbidity survey. Archives of General Psychiatry, 56, 617‐626 37 The Archives of Pediatric and Adolescent Medicine (May 1999) 38 Ibid
39 Data Summary Sheet on Suicide Deaths and Non‐Fatal Self‐Inflicted Injuries. California Department of Mental Health, Office of Suicide Prevention. (2007). 40 American Foundation for Suicide Prevention. http://www.afsp.org/index.cfm?fuseaction=home.viewpage&page_id=04ECB949‐C3D9‐5FFA‐ DA9C65C381BAAEC0, retrieved 6/26/10
41 Court addresses causes of juvenile delinquency, San Jose Mercury News, November 23, 2002
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 133 of 136
42 Huskey & Associates in association with National Council on Crime and Delinquency, Profile of In‐Custody Minors in Santa Clara County, CA, Santa Clara County Probation Department, Preliminary Findings, July 17, 2008
43 Huskey & Associates in association with National Council on Crime and Delinquency, Profile of Out of Custody Minors, Santa Clara County Probation Department, Preliminary Findings, September 2, 2008
44 Data provided by the Santa Clara County Department of Probation, 4/15/10 45 Office of Justice Programs, Bureau of Justice Statistics. Suicide and Homicide in State Prisons and Local Jails, Christopher J. Mumola, August 21, 2005, NCJ 210036. http://bjs.ojp.usdoj.gov/index.cfm?ty=pbdetail&iid=1126 46 Ibid
47 Data provided by the Santa Clara County Department of Correction, 4/5/10 48 Ibid
49 New Navy Program Encourages Sailors to "ACT" to Prevent Suicide. Navy.mil (Official Website of the U.S. Navy) Story Number: NNS061203‐09. Release Date: 12/4/2006 9:01:00 AM.
Retrieved 4/22/10 50 Charles W. Hoge, M.D., et. al, Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care, The New England Journal of Medicine, July 1, 2004, Vol. 351, No 1 51 Kaplan, M.S., Huguet, N., McFarland, B.H., & Newsom, J.T. (2007), Suicide among male veterans: a prospective population‐based study, Journal of Epidemiology and Community Health, 61(7), 619‐24.
52 Eli Clifton, U.S.: Suicide Rate Surged Among Veterans, Washington, Jan 13, 2010 53 Ibid 54 Mark S. Kaplan, DrPH, Bentson H. McFarland, MD, PhD, and Nathalie Huguet, PhD, Firearm Suicide Among Veterans in the General Population: Findings From the National Violent Death Reporting System, The Journal of TRAUMA® Injury, Infection, and Critical Car, Volume 67, Number 3, September 2009 55 American Fact Finder. TM‐P044. Percent of Civilian Persons 18 Years and Over Who Are Veterans: 2000, Universe: Civilian population 18 years and over, Data Set: Census 2000, SF 3 56 Parent, Richard 2004. "Aspects of Police Use of Deadly Force In North America ‐ The Phenomenon of Victim‐Precipitated Homicide," Ph.D. thesis, Simon Fraser University 57 USA Today. Suicide rate jolt police culture. 2/8/2007 58 Selzer, M. L., & Payne, C. E. (1992). Automobile accidents, suicide, and unconscious motivation. American Journal of Psychiatry, 119, p 239
59 Dennis L. Peck, Kenneth Warner (Summer, 1995). Accident or suicide? "Single‐vehicle car accidents and the intent hypothesis."
60 Murray, D.; de Leo, D. (Sep 2007). "Suicidal behavior by motor vehicle collision." Traffic Injury Prevention 8 (3): 244–7. doi: 10.1080/15389580701329351. PMID 17710713 61 http://www.menstuff.org/issues/byissue/unintentional‐suicide.html. Retrieved 4/21/10. 62 Scott Poland, District Administration, Solutions for School District Management, “Preventing Cluster Suicides,” October 2009
63 Brent DA, Moritz G, Bridge J, Perper J, Canobbio R (May 1996). "Long‐term impact of exposure to suicide: a three‐year controlled follow‐up". Journal of the American Academy of
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Child and Adolescent Psychiatry 35 (5): 646–53. doi: 10.1097/00004583‐199605000‐00020.
PMID 8935212
64 Phillips DP, Carstensen LL (September 1986). "Clustering of teenage suicides after television news stories about suicide." New England Journal of Medicine. 315 (11): 685–9. PMID 3748072. 65 Picture This: Depression and Suicide Prevention. Prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the Entertainment Industries Council, Inc. http://www.eiconline.org/resources/publications/z_picturethis/Disorder.pdf. Retrieved 4/14/10
66 American Association of Suicidology, Scott Poland, Prevention Director, “Preventing Cluster Suicides,” District Administration Solutions for School District Management, October 2009 67 American Roulette: Murder‐Suicide in the United States. Violence Policy Center. 68 Picture This: Depression and Suicide Prevention. Prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the Entertainment Industries Council, Inc. (EIC),under subcontract to ENCORE Management Corporation, contract number 280‐02‐0701, with SAMHSA, U.S. Department of Health and Human Services (HHS).Anne Mathews‐Younes, Ed.D., Government Project Officer.
http://www.eiconline.org/resources/publications/z_picturethis/Disorder.pdf. Retrieved 4/14/10
69 Robins, E. (1981).The final months: A study of the lives of 134 persons. NY: Oxford University Press.
70 Barraclough, B., & Hughes, J. (1987). Suicide: Clinical and epidemiological studies. London:
Croom Helm.
71 Conwell,Y., Duberstein, P.R., Cox, C., Herrmann, J.H., Forbes, N.T., and Caine, E.D. (1996).
Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. American Journal of Psychiatry, 153, 1001–1008. 72 Brent, D.A., Perper, J.A., Moritz, G., Allman, C., Friend, A., Roth, C., & et al. (1993). Psychiatric risk factors for adolescent suicide: a case‐control study. Journal of the American Academy of Child and Adolescent Psychiatry, 32 (3), 521–529.
73 Shaffer, D., Gould, M.S., Fisher, P.,Trautman, Ph., Moreau, D., KJeinman, M., & et al. (1996).
Psychiatric diagnosis in child and adolescent suicide. Archives of General Psychiatry, 53 (4), 339–348.
74 Potter, L., Silverman, M., Connorton, E., & Posner, M. (2001). Promoting mental health and preventing suicide in college and university settings. Suicide Prevention Resource Center.
Retrieved October 15, 2007, from www.sprc.org/library/college_sp_whitepaper.pdf. 75 Kidsdata.org, a program of the Lucile Packard Foundation for Children’s Health 76 Kids in Common 2007 Santa Clara County Children’s Report 77 Santa Clara County Department of Public Health and WestEd. California Healthy Kids Survey 2005‐2006. 78 Picture This: Depression and Suicide Prevention. Prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the Entertainment Industries Council, Inc. http://www.eiconline.org/resources/publications/z_picturethis/Disorder.pdf. Retrieved 4/14/10
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79 American Foundation for Suicide Prevention,
http://www.afsp.org/index.cfm?fuseaction=home.viewPage&page_id=E2464DF6‐0397‐BD56‐ A8E232923B04ED5C. Retrieved 3/4/10
80 Picture This: Depression and Suicide Prevention. Prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the Entertainment Industries Council, Inc. http://www.eiconline.org/resources/publications/z_picturethis/Disorder.pdf. Retrieved 4/14/10
81 Regier, D.A., Farmer, M.E., Rae, D.S., et al. (1993). One‐month prevalence of mental disorders in the United States and sociodemographic characteristics: The epidemiologic catchment area study. Acta Psychiatria Scandinavica, 88, 35‐47. 82 Conwell Y, Brent D. Suicide and aging. I: patterns of psychiatric diagnosis. International Psychogeriatrics, 1995; 7(2): 149‐64.
83 Conwell Y. Suicide in later life: a review and recommendations for prevention. Suicide and Life Threatening Behavior, 2001; 31(Suppl): 32‐47.
84 Health Trust, Health Aging Initiative. http://www.healthtrust.org/initiatives/aging/facts.php.
Retrieved 4/23/10.
85 Santa Clara County Public Health Department, Epidemiology and Data Management, 2005‐ 2006 Behavior Risk Factor Survey Santa Clara County Chartbook; 2004 Adult Health Status Report. http://sccphd.org/portal/
86 Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (October 11, 2007). The NSDUH Report: Depression among Adults Employed Full‐Time, by Occupational Category. Rockville, MD.
87 “Veterans Stress Cases Up Sharply,” USA Today, Oct. 18, 2007, http://www.usatoday.com/news/washington/2007‐10‐18‐veterans‐stress_N.htm 88 Ibid
89 Defense Medical Surveillance System, Post Deployment Health Self‐Assessment of Service Members Who Had Served in Iraq, Behavioral Health Services for Veterans and their Families, February, 2008, p.1. 90 Leonard, Power Point Presentation, “Welcome to the Veteran Services Town Hall Meeting.” 91 All about Depression, Suicide and Depression.
http://www.allaboutdepression.com/gen_04.html Retrieved 3/4/10 92 Picture This: Depression and Suicide Prevention. Prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the Entertainment Industries Council, Inc. (EIC),under subcontract to ENCORE Management Corporation, contract number 280‐02‐0701, with SAMHSA, U.S. Department of Health and Human Services (HHS).Anne Mathews‐Younes, Ed.D., Government Project Officer.
http://www.eiconline.org/resources/publications/z_picturethis/Disorder.pdf. Retrieved 4/14/10
93 The Trust about Suicide: Real Stories of Depression in College. http://www.afsp.org/files/College_Film//factsheets.pdf Retrieved 3/4/10 94 Santa Clara County Public Health Department, Behavioral Risk Factor Survey, 2005‐2006 95 Oxford Journal of Medicine: An International Journal of Medicine, Volume 99, Number 1, Pp. 57‐61
Santa Clara County Suicide Prevention Strategic Plan June 2010 Revised March 2011 Page 136 of 136
96 Hufford M. R., Alcohol and suicidal behavior. Clinical Psychology Review 2001; 21:797–811. 97 Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D. Factors Contributing To Suicide Risk, Updated: Oct 24th 2007
98 Protective Factor List Published by the U.S. Public Health Service 1999 99 Centers for Disease Control and Prevention, Suicide Prevention Scientific Information:
Prevention Strategies.” http://www.cdc.gov/ncipc/dvp/Suicide/Suicide‐prvt‐strat.htm.
Accessed 5/12/10.
100 Santa Clara County Mental Health Department 2009 data 101 http://www.sprc.org/grantees/statetribe/2010/7B%20Inspire%20USA%20handout.pdf 102 Clebsch, W. A., Jaeckle, C. R. 1983 103 Community for a Lifetime, 2005 104 Developed in a collaborative effort among American Foundation for Suicide Prevention (AFSP), the Annenberg Public Policy Center, the National Institute of Mental Health, the Office of the Surgeon General, the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the American Association of Suicidology, the World Health Organization and several other agencies.
105 Santa Clara County Mental Health Department 2009 data
RESOLUTION NO. _____
A RESOLUTION OF THE CITY OF SANTA CLARA, CALIFORNIA IN
SUPPORT OF THE SANTA CLARA COUNTY SUICIDE PREVENTION
STRATEGIC PLAN (THE PLAN) AND APPROVAL OF THE CITY OF
SANTA CLARA SUICIDE PREVENTION POLICY AND MENTAL
HEALTH PROMOTION
BE IT ORDAINED BY THE CITY OF SANTA CLARA AS FOLLOWS:
WHEREAS, the Surgeon General, Dr. David Satcher, issued a landmark report in 1999 titled, "The Surgeon General’s Call to Action to Prevent Suicide," which stated that suicide in the United States is a serious public health issue and the most preventable form of death; and,
WHEREAS, the National Strategy for Suicide Prevention: Goals and Objectives for Action promotes "increasing the proportion of family, youth and community service providers and organizations with evidence-based suicide prevention programs"; and, WHEREAS, from 2018 – 2021, Santa Clara County has lost an average of 158 individuals per year to suicide, and a far greater number of County residents attempt suicide or express suicidal thoughts, making this a significant public health issue locally; and,
WHEREAS, the City of Santa Clara supports the Santa Clara County Suicide Prevention Strategic Plan (The Plan), adopted by the Santa Clara County Board of Supervisors in August 2010, and revised in March 2011, with goals to (1) reduce the number of deaths by suicide, (2) increase awareness and understanding of suicidal deaths and what to do, (3) improve data collection, monitoring, and follow up, and (4) have residents respond to a person in need; and,
WHEREAS, the Santa Clara City Council and City Administration understand the concern that suicide poses to their residents and employees/employers. Within that framework, the City shall adopt suicide prevention strategies and intervention procedures. These policies and procedures will be compatible with The Plan. This policy promotes planning, implementing, and evaluating strategies to identify and prevent loss of life, encourages mental health care, takes steps to remove the stigma around seeking mental health treatment and provides support mechanisms to individuals impacted by suicide.
NOW THEREFORE, BE IT FURTHER ORDAINED BY THE CITY OF SANTA CLARA AS FOLLOWS:
SECTION 1: That a new Section ____ is added to the Council Policy Manual titled “Suicide Prevention Policy and Mental Health Promotion” and to read as follows:
The Santa Clara City Council and City Administration understand the concern that suicide poses to their residents and employees/employers. Within that framework, the City’s Office of Emergency Services (OES) shall adopt a suicide prevention policy . This policy and accompanying procedures will be compatible with the Santa Clara County Suicide Prevention Strategic Plan that was adopted by the Santa Clara County Board of Supervisors in August 2010, and revised in March 2011. To meet these goals, mental health care shall be promoted and supported for community members and employees/employers in need.
This policy shall be consistent with the current strategies and best practices as designated by the Suicide Prevention Resource Center, a national agency promoting the National Suicide Prevention Plan, and the California Suicide Prevention Plan.
This policy promotes planning, implementing, and evaluating strategies to identify and prevent loss of life, encourages mental health care, takes steps to remove the stigma around seeking mental health treatment and provides support mechanisms to individuals impacted by suicide.
Departments throughout the City have inventoried existing community and employee resources and contributed to a preliminary plan to increase training in identifying those at risk and how to report suicide threats to the appropriate professionals. A strong and effective educational program to promote the healthy mental, emotional, and social development of residents and employees/employers including, but not limited to, understanding of problem-solving skills, coping skills, and resilience.
Additionally, an easily accessible list of mental health and suicide prevention resources will be established and maintained.
This policy may also provide for active collaboration with the Santa Clara Unified School District and other local and regional authorities, including Santa Clara County government. This policy may include parent education, youth outreach, mental health support of students, and grief support amongst other actions.
The City’s OES manager or his/her designee shall explore how this policy relates to the City’s Emergency Operations Plan.
SECTION 2: Ordinances Repealed. With exception of the provisions protected by the savings clause, all ordinances (or parts of ordinances) in conflict with or inconsistent with this ordinance are hereby repealed.
SECTION 3: Savings clause. The changes provided for in this ordinance shall not affect any offense or act committed or done or any penalty or forfeiture incurred or any right established or accruing before the effective date of this ordinance; nor shall it affect any prosecution, suit or proceeding pending or any judgment rendered prior to the effective date of this ordinance. All fee schedules shall remain in force until superseded by the fee schedules adopted by the City Council.
SECTION 4: Effective date. This ordinance shall take effect thirty (30) days after its final adoption; however, prior to its final adoption it shall be published in accordance with the requirements of Section 808 and 812 of “The Charter of the City of Santa Clara, California.”
PASSED FOR THE PURPOSE OF PUBLICATION this XX day of XXXXXX, 2022, by the following vote:
AYES: COUNCILORS:
NOES: COUNCILORS:
ABSENT: COUNCILORS:
ABSTAINED: COUNCILORS:
ATTEST: ___________________________
NORA PIMENTEL, MMC
ASSISTANT CITY CLERK
CITY OF SANTA CLARA
Attachments incorporated by reference:
1. Santa Clara County Suicide Prevention Strategic Plan (The Plan)
RESOLUTION 2015 -050
RESOLUTION OF THE TOWN COUNCIL
OF THE TOWN OF LOS GATOS
ESTABLISHING A SUICIDE PREVENTION POLICY
WHEREAS, the County of Santa Clara Board of Supervisors adopted the Santa Clara County Suicide Prevention Strategic Plan on August 24, 2010.
WHEREAS, the Plan identified specific action items for populations of different ages, tailored to their needs, and the Plan also called for governance advocacy, such as local governments adopting suicide prevention policies.
WHEREAS, certain Town employees are trained in suicide prevention and intervention, and have successfully helped Town residents and visitors with suicidal tendencies and responded appropriately in other mental health situations.
WHEREAS, Los Gatos has experienced a high rate of suicide compared with other communities in Santa Clara County during the period of 2009 through 2013.
NOW, THEREFORE, BE IT RESOLVED:
1. The Town Council hereby establishes a Suicide Prevention Policy to advance best practices as identified in the National Suicide Prevention Plan, the California Suicide Prevention Plan, and the Santa Clara County Suicide Prevention Strategic Plan.
2. This Policy calls for employee education, and for all residents, public and private institutions, businesses, and other entities to work towards preventing suicides and creating a healthier and safer community.
PASSED AND ADOPTED at a regular meeting of the Town Council of the Town of Los Gatos, California, held on the 18'
h
day of August, 2015, by the following vote:
COUNCIL MEMBERS:
AYES: Steve Leonardis, Rob Rennie, Marico Sayoc, Barbara Spector, Mayor Marcia Jensen NAYS:
ABSENT:
ABSTAIN:
SIGNED:
MAYOR OF THE TOWN OF LOS GATOS
LOS GATOS, CALIFORNIA
ATTEST:
CLERK ADMINISTRATOR OF THE TOWN OF LOS GATOS
LOS GATOS, CALIFORNIA
Minutes of August 17, 2021 City Council Meeting Page 9
After discussion, M/S: Landry/Bybee – That the City Council adopt Resolution 12752 adopting the Mitigated Negative Declaration for the Measure O - Civic Center Improvements Project No. 21-MM. The motion was adopted by the following roll call vote:
RESULT: ADOPTED [UNANIMOUS]
MOVER: Landry
SECONDER: Bybee
AYES: Bybee, Gibbons, Landry, Lopez
RECUSED: Resnikoff
Vice Mayor Resnikoff rejoined the meeting.
NEW BUSINESS
9. Adoption of a Suicide Prevention Policy (Resolution/Roll Call Vote) Recommended Action: That the City Council adopt a Resolution approving the addition of a Suicide Prevention Policy to the Council Policy Manual.
City Manager Brian Loventhal presented a Staff Report dated August 17, 2021 stating support of the County’s Suicide Prevention Strategic Plan and that many cities have adopted Suicide Prevention Policies. The City of Campbell understands the significance of its role in implementing policy to raise public awareness, promote resources and encourage mental health care. Drawing upon the best practices and policy models in nearby cities, staff is recommending a policy where the City will promote strategies and resources provided by Santa Clara County and utilize its platform to directly outreach to city employees, retirees and residents; as well as update public safety protocols governing the City’s response to a suicide attempt in City facilities. The County Behavioral Health Services agency will be a key partner to assist the City with the identification of mental health resources and safe messaging practices. City staff will reach out to Behavioral Health Services staff to coordinate trainings/ education sessions that can be offered virtually to all city staff. Additionally, September is National Suicide Prevention Month and thus provides a relevant opportunity to launch the City’s suicide prevention and education efforts.
Vic Ojakian, National Alliance on Mental Illness (NAMI) Santa Clara County Board Co-President, Santa Clara County Behavioral Health Board and Suicide Prevention Oversight Committee and Former Palo Alto Mayor spoke in support of adoption of the proposed policy and shared the local National Suicide Prevention Crisis Hotline number, 1-855-278-4204, which is available 24/7, and includes a text line as well. Mr. Ojakian noted that stigma is one of the hardest barriers for people to overcome when talking or thinking about suicide and much of the County’s and advocate’s efforts are focusing on pushing past the stigma and encouraging all Cities to get involved and embrace suicide awareness, prevention training, and share their resources and knowledge with their communities.
Minutes of August 17, 2021 City Council Meeting Page 10 Mayor Gibbons opened the floor for public comment.
Dr. Shashank Joshi spoke in support of the City’s Suicide Prevention Policy and noted that much of the everyday doses of well being and connection with each other as peers, trusted adults, and parent and community members have been lost in our communities over the past 20 months, so now more than ever the Cities efforts to bring light to suicide is needed.
Councilmembers expressed support for the proposed policy and thanked Mr.
Ojakian and Supervisor Ellenberg’s Office for their tireless advocacy of suicide prevention and mental health services.
Councilmembers confirmed consensus for making suicide prevention hotlines and other resources readily available on the City website.
M/S: Landry/Lopez – That the City Council adopt Resolution 12753 approving the addition of a Suicide Prevention Policy to the Council Policy Manual, including Desk Item 9. The motion was adopted by the following roll call vote:
RESULT: ADOPTED [UNANIMOUS]
MOVER: Landry
SECONDER: Lopez
AYES: Bybee, Gibbons, Landry, Lopez, Resnikoff
10. Authorize Staff to Proceed with Standard Design-Bid-Build Delivery Method for Police Operations Building (Resolution/Roll Call Vote) Recommended Action: That the City Council adopt a Resolution authorizing the City Manager to proceed with the construction of the proposed Police Operations Building using the standard Design-Bid-Build project delivery method in order to retain a higher level of design control through the preparation of design documents.
Vice Mayor Resnikoff recused himself because his personal residence lies within 500 feet of the subject property. Vice Mayor Resnikoff turned off his microphone and turned off his video camera.
Special Advisor Timm Borden with Management Partners provided a presentation to Council on the project delivery method for the Police Operations Building. Mr. Borden explained that Council has two options for a project delivery method, a traditional Design-Bid-Build or a Design-Build method. Mr. Borden reviewed the advantages, disadvantages, and next steps with each project delivery method option. With a Design-Bid-Build project delivery method it is a linear scope of work and the risk and onus is on the project owner (City) to carry a contingency for unforeseen conditions. With a Design-Build project delivery method there is a need for a well-defined scope and basis of design (bridging documents), there is the potential to accelerate the delivery and the risk and onus is on the contractor to carry contingency for unforeseen conditions. Staff is recommending the use of the Design-Bid-Build project delivery method in order
RESOLUTION NO. 21-___
RESOLUTION OF THE CITY COUNCIL OF
THE CITY OF SARATOGA ESTABLISHING A
SUICIDE PREVENTION POLICY
WHEREAS, the City of Saratoga recognizes that suicide is a public health issue, evidenced by data from County of Santa Clara Behavioral Health Services that shows that after a three-year decline in the suicide rate in the County, suicide rates increased in 2018 and 2019; and WHEREAS, the City of Saratoga seeks to support the strategies recommended by the Santa Clara County Suicide Prevention Strategic Plan; and WHEREAS, educating the community on suicide risk factors, warning signs, how to report threats of suicide or those showing signs of becoming at risk, and removing the stigma about mental health treatment, recovery, and resiliency is an important step in addressing suicide as a public health issue; and
WHEREAS, the Suicide Prevention Policy formalizes a process by which general resources are shared and safe messaging best practices are followed when communicating with employees and the community.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Saratoga hereby adopts the attached Suicide Prevention Policy.
The above and foregoing resolution was passed and adopted at a regular meeting of the Saratoga City Council held on the 15th day of December 2021 by the following vote:
AYES:
NOES:
ABSENT:
ABSTAIN:
Tina Walia, Mayor
ATTEST:
DATE:
Britt Avrit, MMC, City Clerk
City of Saratoga Suicide Prevention Policy
Adopted December 15, 2021 via Resolution 21-__
CITY OF SARATOGA SUICIDE PREVENTION POLICY
Adopted December 15, 2021 via Resolution 21-__
I. Purpose
The policy reflects an ongoing commitment to increase awareness of suicide a public health problem. The framework in this policy promotes the planning, implementation, and evaluation of strategies for suicide prevention and intervention, as well as encouraging mental health care.
II. Policy
This policy shall advance current strategies and best practices of County of Santa Clara Behavior Health Services, National Council for Behavioral Health, National Alliance on Mental Illness, and the World Health Organization.
This policy shall call for the collaboration between the City of Saratoga and local and regional organizations to provide information to employees and residents to gain a better understanding of the causes of suicide, learn the appropriate methods for identifying those at risk, and learn how to report threats of suicide or those showing signs of becoming at risk for to the appropriate authorities.
The City will promote strategies of the Santa Clara County Suicide Prevention Strategic Plan and resources provided by the County as well as the Suicide Prevention Resource Center under the following guiding framework:
City Employees: Annually, the City Manager or the City Manager’s designee will share information with employees that helps staff gain a better understanding of the causes of suicide and learn the appropriate methods for identifying and preventing the loss of life. The Human Resources Division will work with the County of Santa Clara Behavior Health Services to ensure information shared reflects current research. Additionally, the City shall provide a copy of this policy to all employees.
City Facilities: The City Manager or City Manager’s designee will develop public safety protocols governing a response to a suicide attempt on City facilities and will ensure that those protocols are reviewed annually. This review of protocols will seek to update internal procedures and address any needed support for employees that may witness such events. The City Manager or the City Manager’s designee will further ensure an appropriate communications strategy is in place if a suicide attempt occurs in a City facility The communication strategy will reflect the best practices for reporting on suicide, as provided by the County.
Community: The City will link to the County of Santa Clara Behavior Health Services and actively collaborate with the County to disseminate information, including event information and resources as they become available. The City Council will also raise awareness by recognizing National Suicide Prevention Month annually in September.
STAFF REPORT
Meeting: City Council - Dec 20 2022
Agenda Heading: NEW BUSINESS
Staff Contact: Steve Leonardis,
Department: City Manager
Title: Consider and Approve City Council Committee/Commission for Calendar Year 2023
Recommendation(s):
Staff recommends the City Council considers and approves the City Council Committee/Commission Assignments for Calendar Year 2023.
Background Information:
City of Monte Sereno Resolution No. 1691.7 amended Resolution No. 1691 to add a process regarding City Council Committee and Commission assignments. The resolution amended the Regulations and Guidelines for the Conduct of Public Meetings and in Section C.4, Subsection 6, the guidelines state the Mayor recommends various standing committee (and commission) appointments to the City Council for approval. The guideline also states that the appointments will be done at a scheduled Council meeting in December of each year.
The current and proposed City Council Committee/ Commissions is included as part of this report.
Fiscal Impact:
There are no unbudgeted fiscal impacts with this agenda item.
Public Noticing:
The City Council’s agenda was posted at City Hall and the agenda and this report appear on the City’s website.
Attachments:
Current and Proposed Committee/ Commission Board Assignments
2022 and 2023 Proposed
COMMISSIONS/COMMITTEES 2022 Members Alternate Proposed 2023 Alternate J.P.A. Library Board Leuthold Lawler Craig Ellahie
Monte Sereno Youth Commission Lawler Turner Craig Mekechuk Joint Venture Silicon Valley Network Turner Leuthold Ellahie Craig Santa Clara County Cities Association -
Board of Directors
Ellahie Mekechuk Ellahie Mekechuk
Santa Clara County Cities Association
-Legislative Action Committee
Ellahie Mekechuk Ellahie Mekechuk
Santa Clara County Cities Association
– City Selection Committee
Ellahie Lawler Ellahie Mekechuk
Santa Clara VTA Policy Advisory
Committee
Mekechuk Leuthold Mekechuk Craig
Silicon Valley Clean Energy Authority Ellahie Mekechuk Mekechuk Craig Association of Bay Area Governments Turner Lawler Mekechuk Turner West Valley Sanitation District Turner Leuthold Turner Craig West Valley Solid Waste JPA Mekechuk Turner Mekechuk Turner West Valley Clean Water Board Mekechuk Turner Mekechuk Turner League of California Cities Peninsula
Division
Lawler Leuthold Mekechuk Wolsheimer
Santa Clara Valley Transportation
Authority’s State Route 85 Corridor
Policy Advisory Board
Turner Lawler Turner Craig
Santa Clara/Santa Cruz Counties
Airport/Community Roundtable
Turner Lawler Turner Craig
Comprehensive County Expressway
Planning Study Policy Advisory Board
Leuthold Ellahie Turner Wolsheimer
Santa Clara Valley Water District
Commission
Lawler Mekechuk Wolsheimer Mekechuk
Silicon Valley Animal Control Authority Lawler Turner Wolsheimer Turner Mayor/Mayor Pro Tempore
West Valley Mayors & Managers Ellahie Mekechuk Mekechuk Wolsheimer Proposed Board Assignments 2023 Page 1