Legislature(2009 - 2010)CAPITOL 106
02/03/2009 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation: Suicide Prevention Efforts | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 3, 2009
3:09 p.m.
MEMBERS PRESENT
Representative Bob Herron, Co-Chair
Representative Wes Keller, Co-Chair
Representative John Coghill
Representative Bob Lynn
Representative Sharon Cissna
Representative Lindsey Holmes
MEMBERS ABSENT
Representative Paul Seaton
COMMITTEE CALENDAR
PRESENTATION: SUICIDE PREVENTION EFFORTS
- HEARD
PREVIOUS COMMITTEE ACTION
No Previous Action to Record
WITNESS REGISTER
MELISSA WITZLER-STONE, Director
Central Office
Division of Behavioral Health (DBH)
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Presented a Power Point and answered
questions during the presentation.
DIANE CASTO, Prevention and Early Intervention Manager
Prevention and Early Intervention Section
Division of Behavioral Health (DBH)
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions during the
presentation.
JAMES GALLANOS, Suicide Prevention Project Coordinator
Suicide Prevention
Division of Behavioral Health (DBH)
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions during the
presentation.
STEVE MCCOMB, Director
Division of Juvenile Justice (DJJ)
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during the
presentation.
ACTION NARRATIVE
3:09:23 PM
CO-CHAIR BOB HERRON called the House Health and Social Services
Standing Committee meeting to order at 3:09 p.m.
Representatives Herron, Keller, and Coghill were present at the
call to order. Representatives Cissna, Holmes, and Lynn arrived
as the meeting was in progress. Representative Seaton was
excused.
^Presentation: Suicide Prevention Efforts
3:09:58 PM
CO-CHAIR HERRON announced that the only order of business would
be a Power Point presentation titled "Strategies to Reduce and
Prevent Suicide in Alaska." [Included in the members' packets.]
3:11:37 PM
MELISSA WITZLER-STONE, Director, Central Office, Division of
Behavioral Health (DBH), Department of Health and Social
Services (DHSS), presented a Power Point titled "Strategies to
Reduce and Prevent Suicide in Alaska." She said that suicide
was a somber subject, and although she was using facts and
figures, it was talking about people. She reported that suicide
was a universal experience. She related her personal experience
with the suicide of friends, colleagues, and family, and said
that her experience was not unusual. She observed that there
were common questions of why, or what could I have done, as well
as feelings of shame, anger and depression.
3:15:05 PM
MS. STONE, referred to slide 2, titled "Background of Suicide
Prevention in Alaska," and established that DHSS focused on
suicide through cross disciplinary, community, and research
approaches. She stressed the need for prevention and
intervention, as the suicide rate in Alaska was twice the
national average. She reported that this rate was even higher
among teens and young people, the elderly, and Native Alaskans.
3:17:01 PM
MS. STONE directed attention to slide 3, "Background of Suicide
Prevention in Alaska," and explained the change in FY 2006 for a
more comprehensive approach of prevention and early
intervention. She described this as an approach to reduce risk
factors and improve protective factors.
3:19:44 PM
MS. STONE mentioned that slide 4, "Current Suicide Prevention
Funding," identified 16 community based programs.
3:20:50 PM
MS. STONE briefed that slide 5, also titled "Current Suicide
Prevention Funding," presented a FY 2009 targeted allocation
fund for a statewide strategy to reduce suicide across all age
groups.
3:22:08 PM
MS. STONE pointed out on slide 6, "DBH Long-Term Outcomes," the
long-term goals of substance abuse, mental health, and community
connectedness.
3:23:34 PM
MS. STONE discussed slide 7, "What the Data Tell Us... Alaska
Suicide Rates." She explained the comparative line graph of the
Alaska suicide rate per capita, the actual number of Alaska
suicides, and the national average per capita.
3:27:07 PM
CO-CHAIR KELLER pointed to the suicide rate increase from 2006
to 2007, and asked if the grant fund integration would have a
dramatic effect on the rate.
MS. STONE offered her belief that working with multiple partners
would have an impact.
CO-CHAIR KELLER asked if there were negative aspects to this
integration of grant funds.
3:28:47 PM
DIANE CASTO, Prevention and Early Intervention Manager,
Prevention and Early Intervention Section, Division of
Behavioral Health (DBH), Department of Health and Social
Services (DHSS), said that she had not seen any negatives, but
that she had felt some resistance, as groups were used to a
certain way of doing business. She described the grant
integration as "braided" so that DBH was still able to track by
grantee, but that the grantees were allowed to blend the money
together to provide services, for example suicide prevention and
substance use.
3:32:08 PM
MS. STONE relayed that slide 8, "What the Data Tell Us...Alaska
Age-Specific Suicide Rates and Numbers," plotted the graph by
the actual number of suicides within each age.
3:32:42 PM
MS. STONE affirmed that slide 9, "What the Data Tell Us...Alaska
Suicides by Sex," revealed that more females attempt suicide,
although more males actually commit suicide.
3:33:17 PM
MS. STONE examined slide 10, "What the Data Tell Us...Alaska
Suicide Rates and Numbers by Region." She explained that the
numbers on the black line were actual suicides while the bar
graphs reflected the suicide rate per 100K in each region.
3:35:03 PM
CO-CHAIR HERRON asked if this was consistent with historical
data.
MS. STONE replied that the ten year period was consistent with
annual periods.
3:36:01 PM
MS. STONE explained that the spike in Region 8 was due to a
larger population, although the rate of suicide was lower. She
pointed out that a higher suicide rate in a less populated area
often meant a lower actual number of suicides. She announced
that this was a challenge for the distribution of funding.
3:37:07 PM
MS. STONE remarked that slide 11, "What the Data Tell
Us...Alaska Native, Alaska Non-Native and U.S. Suicide Rates,"
revealed the disproportionate number of Native suicides.
3:37:53 PM
REPRESENTATIVE CISSNA declared that many grants have components
that affect mental health and environment. She asked if the
rate of risk was reviewed and then reflected in the grants for
an area.
MS. STONE agreed that these factors were taken into account.
3:39:54 PM
JAMES GALLANOS, Suicide Prevention Project Coordinator, Suicide
Prevention, Division of Behavioral Health (DBH), Department of
Health and Social Services (DHSS), explained that current grant
funding programs targeted rural areas with high suicide rates.
REPRESENTATIVE CISSNA asked about all the different monies spent
throughout Alaska that related to a bigger health picture.
MS. STONE said that the framework for the prevention grants was
a strategic prevention framework. She explained that this
required a community assessment, which looked at various data as
well as the resources of the community. She reported that the
developed plan was specific to the community.
3:44:13 PM
MS. STONE reported that slide 12, "What the Data Tell
Us...Suicide Methods in Alaska," revealed that firearms were the
most common method of suicide. She directed attention to
"MeansMatter, Suicide, Guns & Public Health." [Included in the
members' packets] She pointed out that as guns allowed little
time for response, this made it difficult to intervene.
3:46:12 PM
MS. STONE reported that slide 13, "What the Data Tell Us..."
summarized that the Alaska suicide rate continued to be among
the five highest states. She recounted that suicide accounted
for 68.6 percent of all violent deaths in Alaska.
3:47:09 PM
REPRESENTATIVE LYNN asked about any commonalities to the five
highest suicide states.
3:47:35 PM
MR. GALLANOS responded that Wyoming and Nevada shared low
density populations, lack of availability for mental health
services, and high native populations with common risk factors.
3:48:43 PM
CO-CHAIR HERRON referred to a map of state suicides on page 5 of
"MeansMatter."
3:49:00 PM
MS. STONE discussed slide 14, "What the Data Tell Us..." and
pointed out the Alaska Youth Risk Behavior Survey (YRBS). She
mentioned that the rate of suicide attempts had increased, and
that the highest rate of suicide was among Alaska
Native/American Indians.
3:50:06 PM
MS. STONE referred to slide 15, "What the Data tell Us..." and
mentioned that Anchorage/Mat-Su and the rural areas had a very
high suicide rate.
3:50:57 PM
MS. STONE told the committee that slide 16, "Current and Recent
Activities, Planning & Partnerships" referred to the "Alaska
Suicide Follow-back Study." [Included in the members' packets.]
She shared that the suicide characteristics were included on
pages 36 and 37 of the study.
3:54:07 PM
MS. STONE mentioned that slide 17, "Current and Recent
Activities, Prevention & Early Intervention," listed the 16
communities which received funding to address suicide prevention
and early intervention.
3:54:48 PM
CO-CHAIR HERRON asked how many communities had applied for
funding.
MR. GALLANOS responded that because the proposal process
included comprehensive prevention grant funding, there was only
one community which met the minimum requirements, but was
rejected.
3:56:10 PM
MR. GALLANOS, in response to Co-Chair Herron, said that some of
the grantees had multiple grants with the DBH.
3:57:24 PM
MS. STONE examined slide 18, "Current and Recent Activities,
Federal Garrett Lee Smith Youth Suicide Grant," and shared that
DHSS was notified that federal funds would be awarded for focus
on youth, ages 10 to 24.
3:58:52 PM
REPRESENTATIVE COGHILL asked to clarify that these grants were
usually in three to five year cycles.
3:59:35 PM
MS. STONE agreed and talked about slide 19, "Current and Recent
Activities, Outreach & Community Engagement," which listed a one
time increment of $200,000 to assist five regions with
development of suicide prevention strategy and implementation
plans.
4:01:05 PM
MS. STONE stated that, slide 20, "Current and Recent Activities,
Planning & Partnerships," reflected the DHSS partnership with
other agencies.
CO-CHAIR HERRON asked how these partnerships were measured.
4:02:32 PM
MS. STONE responded that most grant rewards had expectations of
outcomes with measureable indicators, although the impact might
be relative to a focus group, and thereby harder to measure.
4:04:18 PM
MR. GALLANOS agreed that it was a challenge to measure whether
the universal campaigns were making an impact. He acknowledged
that DBH looked for indicators of impact, such as an increase in
health seeking behavior.
4:05:39 PM
REPRESENTATIVE COGHILL asked if a man or a woman was most likely
to call.
MR. GALLANOS replied that the CareLine [crisis line phone
service] did not have the staff to make these assessments.
4:06:53 PM
REPRESENTATIVE COGHILL offered his belief that this targeting
information would be important.
MS. STONE agreed and endorsed multiple programs for greater
response.
REPRESENTATIVE COGHILL observed that the culture did not
encourage a cry for help.
4:08:38 PM
MS. STONE described Gatekeeper Training, which taught people to
recognize signs and symptoms. She also mentioned a newer
methodology for mental health first aid, which was widely used
in Australia.
4:10:14 PM
MS. STONE stated that slide 21, "Current and Recent Activities,
Outreach & Training" referred to the aforementioned Gatekeeper
Training.
4:11:06 PM
CO-CHAIR HERRON asked what the goal was for number of people
trained in Gatekeeper Training.
4:11:36 PM
MR. GALLANOS said that although he had no figures, he offered
his belief that there were 200 to 300 already trained. He
affirmed that DHSS relied on instructors to be advocates and
resources for the community.
4:13:20 PM
CO-CHAIR HERRON asked that Mr. Gallanos report back as to an
optimum number of Gatekeepers given per capita population.
4:16:19 PM
MS. STONE, in response to Representative Cissna, said that
Careline intervention was one of the multiple parts of a
comprehensive strategy, which included substance abuse and
mental health treatment systems. She added that funding was a
challenge.
4:17:04 PM
MS. STONE reviewed slide 22, "Current and Recent Activities,
Outreach & Community Engagement," and recounted that prevention
was part of the continuum of behavioral health services and that
there should be simultaneous efforts that address other family
and community support organizations.
4:18:25 PM
MS. STONE summarized slide 23, "Next Steps," and remarked that
the DBH methodology was to work toward local solutions.
4:20:03 PM
CO-CHAIR KELLER asked about measurement and timelines for
assessment of these programs.
4:20:32 PM
MS. STONE said that one grant requirement was for grantees to
report their outcomes. She expressed the challenge to
consolidate all the outcomes for a measure of the more general
outcomes. She responded that DBH would report the outcome.
4:21:14 PM
CO-CHAIR KELLER asked how to measure that the stigma of suicide
was removed.
MR. GALLANOS, in response to Co-Chair Keller, said that these
were intermediate outcomes and that DBH encouraged the grantees
to focus on short term outcomes. He explained that it was
difficult to measure outcome of preventions, as this was an
attempt to measure something that did not happen. He pointed
out the difficulty of reporting on outcome when often the
primary challenge was to keep the program running.
4:24:13 PM
[The audience was asked to introduce themselves and their
affiliations.]
4:32:17 PM
STEVE MCCOMB, Director, Division of Juvenile Justice (DJJ),
Department of Health and Social Services (DHSS), confirmed that
his goal was for zero suicides. He related instances of youth
suicides while detained. He explained that for the past three
years DJJ had performed a mental health screening in the first
hour of juvenile detention, adopted a universal precaution
routine, and treated all the kids as, at the least, a low risk
suicide potential. He recounted that DJJ had hired an expert
instructor for suicide prevention training, who had also
reviewed DJJ policies, procedures, and facilities. Mr. McComb
addressed the legal liability for DJJ.
4:40:11 PM
REPRESENTATIVE COGHILL asked about the problems of transferring
youth.
MR. MCCOMB responded that youth detainees were only supposed to
be held for a maximum of six hours. He reported that DJJ staff
training detailed the need for checks on the youth in no greater
than 15 minute intervals. He agreed on the need for more
training.
MR. MCCOMB, in response to a question from Co-Chair Herron,
specified that there were 286 beds and noted that the facilities
were at about 80 percent capacity.
CO-CHAIR HERRON asked what the risk factor for suicide was.
MR. MCCOMB said that 6 to 10 kids were on daily suicide watch.
CO-CHAIR HERRON asked how that suicide watch affected the staff
and if there were a training to deal with this.
MR. MCCOMB replied that the staff training included response
drills for mock suicide attempts.
4:45:59 PM
CO-CHAIR HERRON pointed out that the FY 2009 departmental budget
request for Johnston Youth Center (JYC) and he asked for a
comparison to the other state youth centers.
MR. MCCOMB mentioned that there were 12 separate units.
CO-CHAIR HERRON asked how the needs of Johnston Youth Center
compared with those of the other facilities.
MR. MCCOMB reflected that JYC was the facility with the second
most critical needs, and explained that each of the main
facilities were in phased projects to allow the same contractor
to return for back to back projects.
4:48:27 PM
CO-CHAIR HERRON commented that it was difficult to be a critic
of suicide prevention, but he noted that there was not a strong
consistent presence for prevention in the state.
MS. STONE responded that there were many behavioral factors
involved in suicide and that dealing with those factors was the
mission of the division.
REPRESENTATIVE CISSNA echoed that there had not been the
consistent state voice as a priority. She asked Ms. Stone for
suggestions of ways for the legislature to help.
4:54:28 PM
MS. STONE noted that there was now a better understanding of
suicide, and that the entire DBH budget was incremental to a
solution.
MR. MCCOMB said that he agreed that there was improvement and
that DJJ now looked at contributing factors and prevention.
4:58:39 PM
MS. CASTO, in response to a question from Representative Cissna,
said that in order to make change it was necessary to "maintain
laser beam focus." She allowed that suicide was hard for people
and communities to talk about, as it was incident driven, and
that the focus went away with the incident. She emphasized the
need for community readiness.
5:03:37 PM
REPRESENTATIVE COGHILL noted the tendency to celebrate a life
after it was lost.
MS. CASTO agreed with Representative Coghill's comments for
partnerships with workforce development, schools, and faith
based organizations to move forward positively.
5:06:25 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:06 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Feb. 3rd Strategies to Reduce and Prevent Suicide in Alaska-.ppt |
HHSS 2/3/2009 3:00:00 PM |