Suicide prevention programs barely survive budget cuts

(Opinion) — After cutting $2.1 million for suicide prevention from the state budget, Wyoming is fortunate to still have a program.

It definitely needs one. The Centers for Disease Control and Prevention reports Wyoming had the highest suicide rate in the nation in 2012, the most recent data available. At 29.6 suicides per 100,000 population, the state’s rate is more than double the national average.

It’s unconscionable for Wyoming officials to make huge across-the-board cuts to programs that literally can be the difference between life and death. It makes the Legislature’s decision last year to spend $8 million to improve “athletic competitiveness” at the University of Wyoming even more asinine.

Administrators of several suicide prevention programs say they haven’t had to cut services — yet. But they also warn that additional state budget reductions would severely impact their efforts.

“We’ve had to find ways to be more efficient,” says Tabitha Madrigal, psychiatric rehabilitation services director at Central Wyoming Counseling Center in Casper. “But if more budget cuts came and we actually had to start cutting core programming, then we’d be in trouble.” Her program will look for other revenue streams, including grants, but such funds aren’t easy to obtain, she says

Erica Matthews, suicide prevention program director at the Wyoming Department of Health, says her agency still has $4.5 million for the 2017-18 biennium from tobacco settlement money and federal funds. But the latter are discretionary and can disappear at the whim of the feds, she explains.

The health department administers the state program and contracts for services through a competitive bidding process. The Permanent Management Organization currently has the contract and maintains at least one suicide prevention manager in each county, but some staff members lost their jobs due to the budget reduction that went into effect July 1.

Firearms used in two-thirds of suicides

Fortunately, Matthews says the cuts haven’t prevented the Teton County PMO office from “taking a look at lethal means of committing suicide and how to have a conversation about the issue in a state where people are very protective of their firearms.” In about two-thirds of all suicide deaths in Wyoming, firearms are used. It’s high time for the issue to be discussed throughout the state, including the halls of the Legislature.

Matthews attributes Wyoming’s “cowboy-up culture” as one reason the state has such a high suicide rate. “People here are very independent,” she says. “It can be somewhat stigmatizing for those suffering [from mental illness] to retain that attitude but also have an understanding that it’s OK to have a mental health issue.”

Tracy Blevins, chairwoman of the Natrona County Suicide Prevention Task Force, says 31 county residents took their own lives in 2015. She adds that nationally, suicide is the second leading cause of death for adolescents.

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Blevins agrees with Matthews that Wyoming residents’ traditional independent streaks are a problem for staff members trying to keep clients safe and lower the suicide rate. “We know that 90 percent of people who commit suicide have a mental health issue at the time,” she says. “We also know that 70 percent of those who commit suicide have a substance abuse-related issue. But we’re Wyoming, and there’s very clear ‘rules’ about how we need to be tough and not reach out and ask for help.”

Madrigal says her program is trying to break down some of the barriers that mental health professionals encounter when dealing with clients who display a high risk of suicide.

“When someone gets into a crisis we want to make sure we really use our community partners like the [Natrona County] task force to wrap around services as intensively as we can to keep that person safe,” she says. “If we can do that and keep them out of the hospital, then that’s what we do. It’s basically an ‘all hands on deck’ situation.”

Madrigal says staff members will check on a client several times a day if needed, and 24-hour assistance is also available at the counseling center. Sometimes, though, it’s necessary to start the process of placing a detention hold on the person. “That’s never our first choice,” she stresses, “because it deprives them of their freedom for at least 72 hours. But we have to make sure they’re safe.”

Blevins worries that families with suicidal relatives or ones who are abusing drugs will be in a higher state of crisis because of the funding cuts. She wants to see a youth peer-to-peer training program at Natrona County secondary schools continue because it has achieved excellent results.

“It’s been absolutely remarkable,” she says. “We provided training for about 1,800 kids in the district last year, and 96 percent say they now know where to go for help [if they have suicidal thoughts] or problems with bullies.”

Programs train police about mental problems

Madrigal says CWCC’s Psychological Rehabilitation Services also provides special training to law enforcement that is having a positive impact on how police officers and sheriff’s deputies deal with people they encounter who have mental problems.

The 40-hour Crisis Intervention Team course trains law enforcement about what to do when they encounter someone in crisis or distress “who may need a little different handling,” Madrigal says. The training includes learning verbal de-escalation skills and — with the help of a special helmet used to bombard the cops’ brains with non-stop voices and sounds — help them experience what it’s like to have schizophrenia.

“It gives them a different perspective,” Madrigal relates. “If someone in the field is ignoring them, it may be because they can’t comprehend what the police officer is saying. They have a more empathetic response to what people are experiencing, and that leads to better outcomes.”

About half of the Casper Police and Natrona County Sheriff’s Office have received CIT training, and Madrigal says 100 percent is the program’s goal. The Mills Police Department recently decided to also take the course.

The Wyoming Office of the National Alliance on Mental Illness doesn’t have specific suicide prevention programs, but it has teamed up with the county’s suicide prevention task force to host an annual statewide conference on suicide and other events. Since 2006 it has offered support programs for family members and people living with mental illness, and at times that work certainly includes suicide prevention.

“We had our state funding cut 100 percent, about $150,000,” says Tammy Noel, NAMI/Wyoming director. “We’re living off savings now. We have 10 months left in operating funds.”

She says her statewide agency will have to find different funding to provide its family training, peer recovery programs and its advocacy work.

“We weren’t really told we were getting cut completely,” Noel says. “We were just told in kind of a roundabout way, like other people telling us, but we never got a call from the state or anything.” She calls the news “devastating,” but adds it pales in comparison to the PMO budget reductions that were made by the state.

Wyoming lawmakers should consider restoring all or at least a significant portion of the suicide prevention funds they’ve cut when they meet in January. While not all of the efforts are coordinated now, each agency plays an important role in offering something unique in the overall attempt to reduce the state’s high suicide rate.

“It’s a collaborative relationship,” Madrigal says. “We’re not doing just one thing, we’re saying how can we come together as a community to take care of people. In a way there’s been one positive that’s coming from these budget cuts — it’s really forcing everyone to come to the table and say, ‘We’ve got a limited pool here. How can we be efficient together and make these partnerships work?'”