Background
The Mesa County suicide rate is 31.4/100,000 and for 15–19-year-olds: 28.0/100,000 which is much higher than the Colorado suicide rate (22.3/100,00;13.9/100,000) and US rate (21.0/100,000; 10.5/100,000) respectively. White males account for 89.4% of the suicide deaths which is 46.3% of the population (MCPHD (Mesa County Public Health Department), 2021). Twenty percent (20.7%) of Mesa County adults have been diagnosed with a depressive disorder. Compared to 7.6% of Colorado students, 8.6% of Mesa County high school students have attempted suicide and 37.4% (opposed to 34.7% for Colorado) have felt so sad or helpless that they stopped doing usual activities almost every day for two plus consecutive weeks during the past 12 months (MCPHD, 2021). Mesa County ranked 8 out of 64 Colorado counties in youth suicide rates (MCPHD, 2021).
For each death by suicide, 135 persons are exposed, that is 6.9 million annually (Cerel, 2019). As many as 40-50% of people have been exposed to suicide in their lifetime (Fiegelman et al., 2017). The number of suicide survivors in the U.S. is 5.4 million, 1 in 60 Americans in 2019. This number grew by 285, 066 in 2019 (Fiegelman et al., 2017).
Significance
Need for Suicide Loss Survivor Support
Mental illness and suicide are top issues in the Mesa County area. (Schwartz et al., 2015). Socio-economic stresses are known factors that contribute to stress on mental health (Phongsavan et al., 2006). The purpose of the project was to create a framework for the Mesa County Suicide Postvention Community Action Plan with an intended outcome of a clearly defined action plan for stakeholders and community that would support and provide for the needs, recovery, and restoration of suicide survivors. There is a need for improved data collection and record keeping of suicide survivors that may allow NAMI and the postvention stakeholders to reach more survivors with support and resources.
Purpose of Developing a Postvention Framework
The internship purpose was to provide a service opportunity to observe and practice foundational public health competencies and community-specific competencies. Goals and objectives were to develop and provide a framework for a community action plan, study and apply other national and international models of similar communities and create awareness and education amongst key stakeholders specifically first responders, health care providers, mental health care providers, and education professionals. The internship methods used were mixed methods in which quantitative and qualitative data was gathered to provide a clear picture of the need at all socioecological levels and to develop appropriate intervention. Activities included interviews, surveys, historical research, and development of a community action plan. The project began in July and completion of findings in December. There is a timeline that extends beyond the scope of this project as the stakeholders take ownership of the framework and continue to autonomously develop their individual and collaborative parts.
Benefits to NAMI and the Service Population
Benefits of the internship to the NAMI agency and its service population include a valuable framework and roadmap for support and restoration of the suicide survivors that fits within the mission of NAMI to educate and support those with mental illness and their caregivers. As NAMI effectively addresses suicide prevention, addressing postvention is a proven and vital step to reducing suicide. NAMI support group programming will benefit by adding survivor-specific grief groups indicated in the community action plan.
Exposure to Suicide Increases Survivor Suicide Attempts
The purpose of the project was to create a framework for the Mesa County Suicide Postvention Community Action Plan. The intended outcome was a clearly defined action plan for stakeholders and community that would support and provide for the needs, recovery, and restoration of suicide survivors. Mental illness and suicide are a top issue in Mesa County area. (Schwartz et al., 2015). The primary health-related need is availability and access to appropriate mental healthcare. Access to healthcare and health insurance for mental illness is limited due to resources, lack of coverage, time, or transportation. Evidence-based research has found that exposure to suicide increases the chance of the survivor attempting suicide. Knowing the issues with mental illness and suicide that have been present in high volume in Mesa County further brings attention to the need for suicide postvention. To effectively administer support for suicide survivors, an incident plan needs to be developed, a community action plan that is clearly defined for the key stakeholders involved.