Personal connection can help prevent suicide. Electronic safety net may help.

We were heartened to write last week about a program Albany County and nine other counties in New York State started using this summer called e-Connect, which assesses kids in the juvenile justice system for their risk of suicide and then outlines immediate steps to help those who need it.

The program, which Albany County helped to pilot two decades ago, is the result of a quarter-century of research by Dr. Gail Wasserman and the Center for the Promotion of Mental Health in Juvenile Justice at Columbia University.

Youth answer questions on a tablet for real-time assessment of their risk. A report, downloaded by their probation officers, outline steps that must be followed. “You make a path and grease the pathway,” Wasserman told us.

She also said, “It’s a no-brainer to me. You want to identify risk systematically … That’s not the end game. The point is to get the needed services.”

By Wasserman’s calculations, of the 500 youth expected to answer the questionnaire in Albany County in a year, five or 10 of them would be at imminent risk of killing themselves, 20 would be in crisis where they would need help in 72 hours, and 250 would need treatment where standard protocol would be used for mental-health or substance-abuse problems.

Colleen Breslin, with the Albany County Probation Department, was part of the initial pilot project 20 years ago and saw the value of seamlessly linking juveniles to the services they need. Now the department’s deputy director, Breslin said the current need is greater since there has been an influx of youth with mental-health issues and since the wait-lists are long for mental-health services.

The same day we were writing our story on e-Connect, our congressman, Paul Tonko, the lead sponsor of the Scientific Integrity Act, was addressing the House Science Committee Hearing.

“Every time government scientific reports are delayed, distorted, or hidden,” Tonko said, “the American people pay the price in the form of lost rights and freedoms, lost wages to medical bills, burned or flooded homes, lost years from our lives and the irreplaceable loss of loved ones …

“Allowing political power or special interests to manipulate or suppress federal science hurts all of us. It leads to dirtier air, unsafe water, toxic products on our shelves and chemicals in our homes and environment. And it has driven federal inaction in response to the growing climate crisis.”

That, of course, is the largest concern, since by denying the reality of the climate crisis and supporting dirty energy instead of clean energy, the current administration is leading not just the United States but the world to a path of ultimate suffering.

But scientific research affects citizens’ lives in many, many ways beyond the all-important environmental issues.

The e-Connect program, for example, is backed by the National Institute of Mental Health. The current program, with electronic tablets to link juveniles in need with life-saving services, is based on decades of scientific research. 

According to the National Institute of Mental Health, in 2017, there were more than twice as many suicides (47,173) in the United States as there were homicides (19,510), and suicide was the second leading cause of death for peope between the ages of 10 and 34. Suicide rates increased by 24 percent among youth in the general population between 1999 and 2014 while rates have have risen 31 percent for boys since 2015, and doubled between 2007 to 2015 for girls. 

The National Institute bases these statistics on death reports compiled by the Centers for Disease Control and Prevention. One of the ways science is under threat by the current administration in setting federal public policy is the CDC staff were banned from using the words “evidence-based” and “science-based” in budget documents.

“Science doesn’t serve political power; it just tries to tell us the truth,” Tonko said in his opening remarks at last Wednesday’s hearing. “And that is always worth protecting.”

It is only through the research that lays bare troubling truths that solutions can be found. In the case of Wasserman and her group at Columbia University, because  pathways were mapped out for probation officers to follow, kids increased service access three-fold.

The worth is immeasurable to the friends and family of a juvenile saved from suicide but it also has a benefit for society as a whole; effective intervention prevents recidivism as well as saving lives. These youths can then become productive members of society.

Orator Frederick Douglass, the great abolitionist, said it well: “It’s easier to build strong children than to repair broken men.”

Albany County Executive Daniel McCoy, in announcing the e-Connect program said, “We’re hoping this is successful and we can roll it out past probation.”

We share that hope. We believe the county legislature, which has been a leader in public-safety issues, should take this on as a project.

We spoke on Friday with Brian Barr who, as a social worker, devoted his career to helping troubled youth. He said, in an Enterprise podcast, it was a “bitter, bitter pill” to swallow when his own son, Kevin, killed himself at age 18. He has used that horrible experience to educate others.

Barr, who serves on the Suicide Prevention Education Task Force, went over what he sees as the three essential steps to reducing suicide. The first is raising awareness about suicide and suicide risk.

We’ve written on this page many times about the need to lift the stigma around suicide and about various programs to help those contemplating suicide or those left behind in its aftermath.

A 2018 Vital Signs report from the Centers for Disease Control and Prevention suggests offering activities to bring people together so they feel connected and not alone; offering help for those struggling to make ends meet; and teaching coping and problem-solving skills so people can manage challenges with their relationships, jobs, health, and other concerns.

The CDC report also has this advice that each one of us can follow: “Everyone can learn the signs of suicide, how to respond, and where to access help.” The 12 warning signs are: feeling like a burden, being isolated, feeling increased anxiety, feeling trapped or in unbearable pain, increased substance use, looking for a way to access lethal means, increased anger or rage, extreme mood swings, expressing hopelessness, sleeping too little or too much, talking or posting about wanting to die, or making plans for suicide.

The CDC then lists these five steps to help someone at risk: Ask, keep them safe, be there, help them connect, follow up.

If all else fails and someone you love has killed themselves, help is offered through the American Foundation for Suicide Prevention, which provides toolkits for schools and workplaces after a suicide, bereavement clinicians, and support groups.

Barr says of that first step, raising awareness, “Implied in that, at the other end, is bona fide help.”

For the juveniles in the e-Connect program, immediate help is to be made available. But Barr is looking at the bigger picture.

“Treatment is often disappointing, frustrating because it may not be there; it may be very costly … Families will be quick to tell you how difficult it is,” said Barr.

A study published five years ago in the Journal of the American Medical Association Psychiatry found that therapists are the least likely of all medical providers to accept insurance; only 55 percent of psychiatrists accepted insurance plans compared with 89 percent of other health-care providers.

Suicides have increased with the nationwide opioid crisis. In 2008, the Mental Health Parity and Addiction Equity Act was passed, but by 2016, suicide nationwide had increased 16 percent and fatal overdoses had increased by 66 percent.

The President’s Commission on Combating Drug Addiction and the Opioid Crisis, in its recent report, states, “The health insurers are not following the federal law requiring parity in the reimbursement for mental health and addiction. They must be held responsible” and further notes “health insurance companies are failing their subscribers on this issue today leading to deaths.”

“The third part,” says Barr, “is the most powerful and significant of all — that is research.”

He went on, “Suicide has been with us since the beginning of mankind. It’s depicted on the walls of caves. Yet, to this day, we do not have proven protocols for how to treat suicide … We have to dedicate a whole armament of research to get at this. The stigma surrounding suicide has held back research efforts.”

Barr notes how other leading causes of deaths in the country have far more funds for research. He notes the particularly high rates of suicide among veterans; among adolescents; and among lesbian, bisexual, transgender, and gay people. “And yet the amount of money for research is paltry compared to other major diseases,” he concludes.

We back our congressman in his call for scientific integrity. The need is real and strong for more research, accurately reported, to help combat the increase in suicide. And we urge that insurers be held responsible, as the commission called for, in following the federal law requiring parity in the reimbursement for mental health and addiction.

But, if our national government fails us, we commend those closer to home — Albany County and the researchers at Columbia University for the progress they have made in getting help quickly when it’s most needed for those in the juvenile justice system. We call on our local legislators to expand the e-Connect program as the county executive has suggested.

And finally, we make a personal plea to those reading or listening to our editorial — follow the advice in the Vital Signs report: “Everyone can learn the signs of suicide, how to respond, and where to access help.” 

We wrote on this page last week about the pain a family still feels from a young man’s suicide in 1984. The ripples spread wide and are long-lasting. Let’s do what we can, each of us, to ease that pain.

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