The Oregon Plan for Youth Suicide Prevention
Section 1: INTRODUCTIONTHE NEED FOR A CALL TO ACTION
The United States Surgeon General, Dr.David Satcher, has declared suicide a serious public health concern and has issued a call to action for each state to implement suicide prevention strategies.1
Although Oregonians in every age group die by suicide, the upward trend in rates over the past few decades has been driven principally by suicide among adolescents and young adults (OHS, 1998). The grim facts speak for themselves:
- Suicide is the second leading cause of death among Oregonians aged 10 to 24
- Oregon's 1997 suicide rate among youth aged 10 to 24 was 17th highest in the nation
- Oregon's suicide rate among youth aged 15 to 19 increased from 2.8 per 100, 000 during 1959-1961 to 13.4 per 100, 000 during 1995-1997
- In 1998, the emergency room suicide attempt registry reported 761 attempts among youth under 18
- In 1998, 373 Oregonians aged 10 to 24 were hospitalized for suicide attempts
- In 1999, 16% of Oregon youth surveyed reported seriously considering suicide.2 (See Appendix A for an epidemiologic profile of suicide among Oregon youth.)
Suicide prevention is a statewide responsibility that affects the community as a whole. The purpose of The Oregon Plan for Youth Suicide Prevention: A Call To Action is to prevent suicide among Oregon youth by providing a multidisciplinary framework that calls for:
- communities to select, implement, and monitor youth suicide prevention strategies
- state agencies to integrate the coordination of technical assistance and resources
- collaboration between community-based organizations, state and local agencies, advocacy groups, professional associations, businesses, educational institutions, and foundations to implement prevention strategies
The strategies outlined in this call to action have built upon efforts that began in 1997 with recommendations from the Governor's Task Force on Youth Suicide. The 1997 Oregon Legislature established a Youth Suicide Prevention Coordinator position at the Health Services. The primary task of that coordinator is to facilitate the development of a statewide strategic plan addressing youth suicide. More than 500 Oregonians participated in the community assessment and planning process that resulted in this plan.
Efforts to reduce suicide rates show the most promise when multiple strategies are implemented simultaneously. There are many paths to suicidal behavior. Risk and protective factors and their interactions form the scientific base for suicide prevention. Risk factors are associated with a greater potential for suicide and suicidal behavior, while protective factors are associated with reduced potential.3,4,5 The presence of multiple risk factors in adolescents is linked to a dramatic increase in the probability of having made a suicide attempt.6 Significant reductions in Oregon's youth suicide rate will require integrated efforts to produce long-term, system-wide changes. This plan outlines how to achieve that effort at the state and local levels.
COMMUNITY ASSESSMENT, PLANNING, AND MOBILIZATION
This plan contains tools to help communities assess their needs, plan to meet them, and mobilize for action. Because every Oregon community is unique, the implementation of suicide prevention strategies is best determined by community members who know local needs, resources, and possibilities. Community mobilization for youth suicide prevention requires that each community:
- identify an existing group or form a community team of stakeholders in youth suicide prevention
- assess the community?s needs, resources, gaps in service, and readiness for addressing youth suicide
- determine strategies to be implemented and develop an implementation plan
- coordinate strategy implementation with local, state, and national partners and resources
- implement and monitor strategy implementation
- evaluate the effectiveness of strategy implementation
Because youths have a unique perspective and role to play in prevention, communities are encouraged to involve them when appropriate to advise adults on the planning, implementation, and evaluation of local youth suicide prevention strategies. Communities should also recruit and invite members of minority populations to join planning processes. This will help to assure that activities are culturally appropriate.
BUILDING STATE AND LOCAL CAPACITY THROUGH A MULTI-AGENCY TEAM
State agencies have expertise and resources that can support community activities by:
- providing technical assistance to communities in planning, implementing, and evaluating youth suicide prevention strategies.
- coordinating statewide efforts and resources in establishing youth suicide prevention and intervention strategies.
- monitoring the implementation of the statewide plan for youth suicide prevention.
This role can be accomplished through the formation of a multi-agency State Team for Youth Suicide Prevention. The core state agencies will include: Divisions and Offices of the Department of Human Services (the Health and Mental Health Servicess, Office of Drug and Alcohol Abuse Programs, State Office of Services to Children and Families, Adult and Family Services), the Commission on Children and Families, the Department of Education, and the Oregon Youth Authority.
Other organizations, and special interest groups should be identified as partners of the state team. These may include such entities as the Indian Health Board, Tribal Health Services, the American Foundation of Suicide Prevention Northwest Chapter, the Oregon Family Support Network, and the National Alliance for the Mentally Ill.
U.S.Public Health Service. The Surgeon General?s Call to Action to Prevent Suicide. 1999. Washington,DC. 2
Center for Health Statistics. Youth Suicide.Results from the 1999 YRBS. Oregon Health Trends, Number 57. Health Services, Oregon Department of Human Services. 2000. Portland, Oregon. 3
Blumenthal S. Suicide: a guide to risk factors, assessment, and treatment of suicidal patients. Med Clin North Am 1988;72:937-71. 4
Jenkins R. Principles of prevention. In:Paykel E, Jenkins R, eds. Prevention in Psychiatry. London: Gaskell,1994:11-24. 5
Silverman, M, Felner R. Suicide prevention programs: issues of design, implementation, feasibility, and developmental appropriateness. Suicide Life Threat Behav 1995;25:92-103. 6
Lewinsohn P, Rohde P, Seeley J. Psychosocial characteristics of adolescents with a history of suicide attempts. J Am Acad Child Adolesc Psychiatry. 1993;32(1):60-8. Back to Top