Event ID: 2206971
Event Started: 9/4/2013 8:50:30 AM ET
Please stand by for realtime captions.

Good morning everyone. Mining is Dennis Romero in the regional administrator for the public mental health services and ministration. Here in region two

I would like to welcome the participants in New York City, the individuals who are joining the webcast across the region, in our distinguished -- and our distinguished presenters.

We are here to learn today of the great efforts taking place across our region. We will hear about state and community best practices and suicide vegan for at risk populations. Will also take part in a special herbs training in TCR. In evidence-based tool for gatekeepers on the Morningside of tools I.

As many of you know, September is suicide prevention month, and on September 10 we will celebrate world suicide prevention Day.

It is important to recognize the collaborative efforts that are taking place in suicide prevention in collaboration with federal, state and municipal government agencies. The community partners call, schools, community basement of health and social services organizations.

And the faith-based community as well.

Today is another -- today's event is another example of collaborative effort across HHS region to.

The office of women's health of the office of the assistant secretary of -- for health and SAMHSA our print -- proud to sponsor today's events.

To help us get started I would like to invite Dr. [ Indiscernible ] HHS regional director to say a few words.

In morning everyone. On behalf of the secretary civilians I want to send a warm welcome to all of you here and to those of the you joining us by webcast across the region. As we all know the Secretary. Sibelius and this administration have made behavioral health a national priority. And I am pleased with the leadership of the president of SAMHSA at region to we're doing all of our parts to contribute to this [ Indiscernible ] that so many in our community struggle with.

As you all know, behavioral health is essential to health and across the nation we need to embrace this attitude and approach. And now with the affordable care act, every client will have essential health benefits that include behavioral health and mental health that will be offered to every person in our community.

I want to acknowledge and thank Sandra [ Indiscernible ] the author of women's health and [ Indiscernible ] from Samsung -- SAMHSA and I am pleased that won't and OASH and the office of women's health have partnered to bring this training seminar to our region.

Affording this -- affording be provided community and opportunity from New York and New Jersey and community providers on the best and -- promising actors in suicide prevention for at risk population that is a priority for us.

So I wish everyone here and across the region much success and I hope you have a wonderful time, because I will learning about this new efforts.

Thank you Dr. Torres. Now for some housekeeping rules, those of you here present at 26 Federal Plaza we have a resource -- resource tables with information regarding suicide from both the office of the assistant Secretary. for health , office of women's health and from SAMHSA. I would like to invite now Ms. -- to 12 -- Ms. Sandra Bennett Pagan who will serve as moderator for today. She is a clinical social worker talk and serves as the regional women's health coordinator with the office of assistant secretary for health. Sandra.

Thank you Dennis. And good morning everyone. I am really happy to have you here in person and those here for the seminar and we also welcome those who are viewing this via webcast.

We are here to -- and the -- do you want to start from the beginning of this PowerPoint?

And so as Dennis Romero mentioned, on September 10 will be the 11th annual suicide prevention Day. And easier there is a theme, and this year's theme is [ Indiscernible ] a major barrier for suicide prevention. Stigma.

The cosponsors of this event to the suit international prevention of suicide prevention in the world health Association. This is a global public health wellness campaign.

And it is and it is a company to action to refocus the collective energy and develop creative new methods for erratic stigma.

-- Eradicating stigma.

And we can only do that together with Cumbria to the color -- international plans with Princeton of suicide to -- cannot reach the problem of suicide prevention in less stigma is also addressed.

The world suicide for prevention Day is I AFP -- [ Indiscernible ]/info/S [ Indiscernible ]

Nationally our work -- our works nationally are, do the work that is being done globally. And just in terms of and the issue -- of suicide is one that has always been present as a public health issue. For -- or a behavioral health issue. But it has always been kept in the dark. And it is among whispers when there have been cases of suicide in the family's or in our communities.

In the mid-1990s there was a national conference -- consensus conference on suicide prevention with community advocates and government partners and to place in Reno and Nevada -- Reno Nevada.

And as a result of that conference in 1999, the US Surgeon General put out or worked of actions to prevent suicide. A lot of activities to place regionally and along the state -- the state was one of the regions that was really one of the areas of the country that was a leadership role in creating a very comprehensive statewide plan on suicide prevention. And they currently provide training and technical assistance.

There were a lot of universities that took action like universities of Columbia University for public health. Community advocates -- community-based organization coalitions, were involved like the Samaritans and others.

And in 2001 the US Surgeon General came up with an update of the original strategy, and release the updated report. Him up with a national report and was then updated in 2010. In 2012 am a national strategy provided more of a focus of a call to action. And the key points that started all of this was from the Reno Nevada report. And they are the suicide prevention must recognize and confirm that value and validity of each person. Suicide is not totally the results of inner conditions, but also from Seidl conditions and attitudes. -- Stewart -- society envisions and attitudes.

Some are at greater risk of suicide.

Individuals and communities and organizations and leaders at all levels should vote suicide or vegan. And the success of the strategy alternately rests with individuals and communities across the US top and they first put up the call to action.

So over time, with studies, research studies and with feedback about this and promising practices statewide -- and locally, we have learned a lot. There are still a long way to go but those -- what we do know is those at greatest risk of suicide include those who are bereaved by suicide am a that is the head of family members, loved ones -- of loved ones who have passed because of suicide. Those who are in justice and child welfare settings, those who engage in non-suicidal injuries such as cutting, those with medical conditions, those with mental health or substance abuse disorders, such as depression or use of alcohol and drugs. Those from the LG BD community -- members of the Armed Forces and veterans, first responders which are police officers and firefighters. Older men, native Indians and Alaska natives.

When comes to these things you can see that -- well anyone can be at risk for suicide -- the data has shown that these are the populations at risk. Noticed that it may see more men related then -- in very broad terms where men may commit suicide at greater risk, there are populations of women that attempt suicide and maybe not completed. And eight include young Latina adolescent girls and older Asian women.

So some of the resources that are important to note for suicide prevention of the national suicide invention lifeline, the number there is one 800 673 talk or one 800 one 800-8255 -- is also the website suicide prevention lifeline.org. And in order -- if you would like a copy of the latest national suicide strategy -- suicide prevention strategy -- the website is under www. www.SurgeonGeneral.gov www.SurgeonGeneral.gov.

So today what we will be focusing on is the 2012 national strategy for suicide prevention. Report of the Surgeon General, and the national action alliance for suicide prevention which is a national coalition of community-based organizations and subject matter experts around the country.

Here about community best practices and suicide prevention for at risk population and I'm pleased to also announce that that will include training in to PR -- questions persuading refer -- this is the mental health version of suicide prevention that corresponds to CPR. And TPR isn't editing state tool for gatekeepers on the one side of suicide.

What we will be doing is we will have a series of presentations this morning.and that will be followed by the specialized training in CPR and we will be receiving questions and answers from both the question -- the audience of those colors and viewers throughout the web.

So with that, I like to introduce the next speaker -- Dennis Romero who you met very briefly. Dennis Romero is the regional administrator of SAMHSA which is substance abuse mental health administration at the national health Institute. Region two covers New York, New Jersey, US Virgin Islands -- I lived in Puerto Rico. And Mr. Romero has been appointed the service -- the first regional administrator of SAMHSA for region two.

In this capacity, he assists with outreach to the right information regarding behavioral health issues, state territory tribal nations, providers, community -- communities and other stakeholders. Funding opportunities and federal policies -- disaster preparedness. And provides opportunity to collaborate with colleagues in the regional office to be better informed of behavioral health needs this country.

Mr. Romero recently served as the acting director of the office of Indian alcohol abuse substance abuse. At one. And responsible for establishing the new office and providing executive leadership in establishing the framework necessary to ensure necessary coordinated approach from involvement with partners -- department of justice.

The department of the interior and HHS tribal government for training technical assistance to enhance the alcohol and substance prevention -- per mention initiative.

Prior to this initiative Mr. Romero served as the deputy executive officer and deputy director for the office of program services at SAMHSA which oversees the conduct of management and ministry to actions across the agency.

And he is also served another leadership -- senior leadership positions at SAMHSA in the Center for substance abuse prevention.

So I will invite Mr. Romero up to talk a little bit more about the national strategy on suicide prevention.

Rate, thank you Sandra. Alright if you're getting they had already, we are starting with the big picture and working the way down to a more local work that is help -- happening across the region. I want to start by talking briefly about world suicide -- specifically the national strategy for suicide prevention.

When we look at the staggering realities, we note that approximately 36,000 Americans die each year of suicide. We know that suicide is a serious public health issue. That causes immeasurable pain, suffering and loss of individuals, families and communities nationwide.

For every person who dies by suicide, more than 30 others attempt suicide. Every suicide attempt affects callous numbers of individuals. Family members, friends, the workers and others in the community also for long-lasting ones as of suicide.

Not to mention that suicide also places a huge burden on our nation in terms of emotional suffering of families and communities experience as well as the economic cost associated with medical care and loss of productivity.

I would like to say that this life pretty much speaks for itself -- we look at the leading causes of death for selective towards, we see that suicide is consistent across much of the continuum.

And friendly to me it is quite startling to see that we need to need to continue to pay attention to this devastating issue. If not for anything else, we know that suicide behavior behaviors -- continues to this day to be met with silence and shame in many of our communities.

So a little background about the national strategies -- just to put things in perspective. Assets are mentioned, recognizing the importance of suicide prevention to the nation -- in 2001 -- Surgeon General David statue relates the first national strategies of suicide prevention talk this landmark argument launched an organized effort to prevent suicide across the United States. In 2012, the national strategy was revised to reflect major developments both in suicide prevention and research and ultimately the practice that will take hold.

Activities in the field of suicide prevention have grown genetically since his national strategy that started back in 2001.

Government agencies at all levels, schools, nonprofit organizations and businesses have started programs to that -- address suicide prevention. And some of the important achievements of the state include the enactment of the Jerry D Smith Memorial act, the creation of the national suicide prevention line.

800 -- which is one 800 273 talk.

And it is partnership with the veterans crisis marked and the establishment of the suicide prevention resource Center also known as SP RC.

Other areas of progress include the increased training installations and community numbers in the productivity prevention of suicide risk. Is appropriate response and enhance communication and collaboration between the public and the public health sectors.

Today we will have the opportunity to be exposed to a particular type of training that Sandra has mentioned. But it speaks to improving the awareness in which we deal with suicide in our own community.

The national strategy is a call to action is intended to guide suicide prevention action in the United States. It outlines for strategic erections with 13 goals and 60 objectives that are meant to work together in a synergistic way to prevent suicide in the nation.

So first, research confirms any health condition such as mental illness and substance abuse as well as tremendous environment can influence a person's soup -- risk for suicide. Research also connects -- suggests that connectedness to committee organizations, teachers, family and social institutions can help protect individuals from the wide range of health problems including suicide.

Secondly we know that research continues to suggest that research has different regional groups regarding thoughts of the community. This research emphasizes that communities and organizations must specifically address the needs of these communities when preventing suicide strategies.

Next new evidence suggests that a number of interventions such as behavioral health -- therapy and crisis lines are particularly useful in helping individuals at risk for suicide.

Social media and apps provide new opportunities for intervention. Finally we know that new methods of treating suicide attempt is with hospital after attempting is a prevention that helps to can -- that helps.

This was developed to be closely allied with the national prevention strategy. Which was released back in June of 2011. Which outlines the nations labor promoting better health and wellness among the population.

Like the national prevention strategy, the 2000 while national strategy recognizes that prevention should be woven into all aspects of our lives out because businesses, educators, health care institutions, governments might communities and every single American has eight role in preventing suicide in creating a healthier community.

The national strategies and goals within or strategic directions as I mentioned earlier. This organization represents a slight change from the aim which is awareness, intervention and methodology framework in that -- outlined in the 2001 strategy.

Although some ethnic groups have higher rates for suicidal behavior than others, the goals and objectives do not focus on specific population

Rather they are meant to be addressed to meet distinctive needs of each group organizing -- including the groups that may be organized in the future for at risk suicide behavior.

So to learn more about the work that has been done in 2001 and specifically looking at the suicide prevention research Center, I encourage you to please go to eat the.org for more information about suicide prevention. I also encourage it to look at look@tran1.gov and type an F ST -- NSST in the search box for more information about SAMHSA Here are some additional resources that I think will be helpful to all in suicide. And I should say and I think I failed to mention this at the beginning of my presentation -- that this webinar will be archived for later to access and use should you want the information that was offered in today's presentation.

But my day without the -- or my presentation would not be complete if I did not mention something that -- in opening remarks at it is important that open enrollment under the affordable care act is just a month away or less than a month away. And so to learn more about the lock him in the emphasis on preventive care, and about the new essential health benefits which include mental health and substance use services including behavioral health, please go to www.healthcare.gov. And there you will find plenty of information and resources that you can help share with your friends and family.

I also encourage you to visit tran1.gov and certainly our suicide prevention lifeline.

Without I thank you for your willingness to purchase today.


This is what we are focusing on another issues of suicide prevention. So across the nation, we -- remain vigilant and focus on this. And now I will turn back to Sandra.

Okay we're moving right along. Thank you Dennis for the excellent overview.

So we are ready now to start with the final presentation. And we really have put together a thoughtful program for you. We mentioned that region to robbers for jurisdictions and what we are highly instate are some of the state and local efforts that are going on in New York and New Jersey. With distinct population is at risk for suicide prevention.

I failed to mention when we look to the state -- this has significant for us in this region -- significance for us in this region because world suicide day is actually September 10, but the following day is September 11. And for those of us in the New York and New Jersey metropolitan area, events of 9/11 world trade center attacks are always present in the mind and it is another population that is also at risk for suicide. So we want to hear more today about what efforts are underway. So the first speaker -- I will introduce other speakers. So the first speaker is going to be Miriam Steinberg. She is a coordinator of the Latina youth prevention suicide center at [ Indiscernible ]. Ms. Steinberg has been working in the field of suicide prevention for seven years. She has trained teenagers and gatekeepers and numerous mental health and non-mental health professionals. In addition she is co-author of the article psychoeducation -- model for young suicide prevention. And the book suicide prevention for young people. Saving lives.

The next speaker is going to be -- is going to be -- [ Pause ] Tina Averell. Tenet serves as the Executive Vice President of health for the Warriors -- Tina plays a role in identification and limitation of strategic directions for the organization. Developing policies for the current generation of comeback -- combat -- people. Her work promotes education and support for the military to medication -- the native population.

Tina graduated from -- prior to joining over the Warriors she worked excessively for the medical field in both hospitals and ministration and social work.

For the past 20 years, Tina has also helped healers in leadership roles in the military family support system. And traditional roles in the social work prevention including being part of the national Association of social workers in the state, serving as the division director for

County and advisory member of interstate veterans health training initiative and shared for the advocacy and government relations community.

Expanding field of social workers for military families is her passion and Tina is super visor in fields -- and is a supervisor infield instructor for Masters social work export them, Columbia and University of Southern California social work.

And so she will be the next speaker.

The following beaker will be [ Indiscernible ] [ Indiscernible - heavy accent ] is a regional training coordinator for the youth suicide prevention training center at the New York [ Indiscernible ] -- she is one of the Kerby Smith suicide prevention Grant in New York State. Ms. [ Indiscernible ] hasn't a a degree in human services from the prongs community college and ADA in MWS social work in Q&A [ Indiscernible ] college. She has been working in child welfare for several years as a social therapist and the therapeutic unit at Graham Windham. She later moved to providing independent -- the training skills to adolescence and [ Indiscernible ] in foster care. And she has provided advocacy and training to therapeutic use in foster care. She prided counseling for adolescent girls and facilitated a group for adolescent regnant teens [ Indiscernible ].

In addition to coordinating suicide prevention training, she has also provided training as an assist -- eight SAST they talk suicide talk and [ Indiscernible ] trainer.

And last but not least we are pleased to have a state representative from New Jersey -- Alexander [ Indiscernible ] -- who is the regional manager of unity health services for the New Jersey division of mental health and addiction services [ Indiscernible ] is a public healthcare administrator with more than 20 years of leadership and supervisory experience in the development and implementation of successful immunity mental health care system serving just -- children throughout


Demonstrating success in service systems, government entities how much consumers and families to improve the delivery of mental health services to adults and children including those people with diagnoses with substance abuse and develop mental for disability.

She is experienced in Lanning and intimidation.

Of behavioral health and subs abuse row Graham -- and those in suicide prevention focused on [ Indiscernible ] throughout the lifestages.

Mr. LeBlanc E has a bachelors degree BA and [ Indiscernible ] in Temple diversity in Philadelphia and an MA in public affairs community service and ministration from Rider University in [ Indiscernible ] New Jersey.

And so I will invite the first of our speakers to come up and present and that will be Miriam Steinberg.

Welcome Miriam

Thank you everyone for coming today. And to see you here today means that you are interested in learning more about different types of prevention and your heart is really out there to try to do something to help the people at risk.

So my name is Ms. Steinberg -- might might offices at [ Indiscernible ] Avenue in New York. [ Indiscernible - heavy accent ] my office is in the Bronx when I provide training all over the place as well as [ Indiscernible ] Island. Long Island.

The center that I worked Latino youth prevention Center has the grant to the New York State office of mental health. And to this grant we are able to fight training and to provide different services to teenagers at risk to suicide.

And you can see her my nation.

You configure my information. And [ Indiscernible ] [ Indiscernible - heavy accent ] .org. Is the best way for you to contact me talk and the state training from all over the place and to [ Indiscernible ] and [ Indiscernible ] of Trinity life -- [ Indiscernible - heavy accent ]

About Trinity life -- community life mission is to improve the quality of life and for tomorrow for New Yorkers with special needs in the community's. By providing the competent health and human services in a continuum of affordable [ Indiscernible ] [ Indiscernible - heavy accent ] . With by different types of programs at community life. Provide housing services for people living with mental illness. And -- we also provide therapeutic services -- [ Indiscernible ] [ Indiscernible - heavy accent ]

So what do we do -- part of this plan we do training. And we provide training in the Bronx in Long Island. Some of the trains that would provide our slides -- we sought intervention skills training.

Restraining is an intervening with [ Indiscernible ] [ Indiscernible - heavy accent ] is a one-on-one intervention and small-group intervention pocket was a provide key PR in a distant Spanish. And I think we have one coming up in Spanish as well. And we provide other training on lifeline. I find has three different types of parts -- one is a prevention part. Restraining is basically for students -- and for parents -- and we have lifeline intervention part -- and restraining is for the staff who are working in the field -- for when they have certain issues or at risk for suicide.

We also provide the lifeline for pension which is for schools and sometimes we think about prevention I think the training we should have training like this when suicide happens. But this training is to prepare yourself in the case of suicide. To think about who is going to talk to the media. How we're going to put their the classes and teams provided by the school's. How we're doing to prepare -- prepare a memorial. And we take this -- is important to take the training very serious.

Training is for the clinical staff and the community have also attended training. Clinical clinicians -- they are very good at providing health, providing clinical services. However we have found that many clinicians have not been trained on suicide prevention while they're taking classes. The only training that they receive is when they working on the field they know that they have to call 911 and they have to write it up in the report. So that's why it is important to train clinicians. You might know -- if you are a clinician you might know exactly -- might have some tools to access suicide -- you might have resources, but it is also good to take trainings to develop [ Indiscernible ] the skills to do the jobs of the teams that have risk

Also teenagers who are at risk of suicide there is [ Indiscernible ] that they will contact their parents -- there is no more -- no more likely to contact their teachers but they will contact their fears -- appears. -- There appears. -- There here -- peers.

So it is important to have suicide prevention as a focus. So as you see the right trainings to all the areas. It's not just one area -- suicide -- and too many things to do about it. To be providing different types of training.

What else to do but regarding [ Indiscernible ] and final services -- we link suicide to mental health services. One of the programs that I said before -- we have a mental health clinic in the Bronx. And I do visit -- [ Indiscernible ] [ Indiscernible - heavy accent ] with teenagers who are there because they -- I connected to the services that we provide at our clinic. And also I connect them with -- [ Indiscernible ] it is called life expressions. This program is for Latino girls is that -- are at risk of suicide bridge 17 -- in for this program [ Indiscernible ] [ Indiscernible - heavy accent ] imparted this case management is to help them with services. Many of the clients pursue -- they don't speak Spanish and they're going to speak English -- they need help with Spanish speakers and translations is something we provide aquifer by housing application -- and and also we have -- the support and the teachers and the school officials to find out we can do to better help the seniors.

We also have [ Indiscernible ] [ Indiscernible ] attending the program. They show that would provide -- [ Indiscernible - heavy accent ] and mental health management and the ways parents can improve the mitigations with her teams.

What is unique in our administration -- ride specific services -- the majority of clients are Spanish speakers and Latinos. So we provide services. Most of the staff is has multiple [ Indiscernible ] and training focusing on the importance of taking [ Indiscernible ] [ Indiscernible - heavy accent ] and incorporating the [ Indiscernible ] information that they, with -- with the country and incorporate that into the services that we provide.

Evidence-based services and standards are services that we provide focused on [ Indiscernible ] therapy -- that was sign approach that works. And we also provide safety planning with is the different companies that clients can use with their having a suicidal crisis. And to assist clients we use tools that are evidence [ Indiscernible ] which [ Indiscernible ] [ Indiscernible - heavy accent ] -- [ Indiscernible - heavy accent ] the

Has a very good rating and identifying suicide relations and suicide attempts.

And we have in the best practice registry are the trainings [ Indiscernible ] with the lifeline -- of healing, family connections that will chocolate more -- R Bennett -- part of the best practice issues.

So so far were we doing -- we are providing family clinicians and Long Island. And providing lifeline intervention this -- studies targeting counselors to address suicides with -- teenagers was suicide. And I think the five different types of students on how they can approach a students and the students who are laughing all the time and date deal -- it is hard than to take serious assessments.

So we help the counselors in the approach of the students.

And suggest healing with the program that we view after suicide is happening she has happened in the community where the organization. Would provide CPR and updates. And outreach in -- and -- [ Indiscernible - heavy accent ] in the program and they have attempted suicide or they and [ Indiscernible ] in the organization.

And who the next speaker will be -- thank you so much.

Good morning. I am peanut after all. I am with hospital warriors -- which is a national nonprofit which is a post-combat 9/11 veteran military active-duty military for the families and the families of the fallen.

And it is really exciting to be here today. To present on behalf of our organization and the really cool things that we can do is a nonprofit. Not only on national scope but on a real community-based aspect. That is really where we are in the different areas we are really able to reel in such as New York and New Jersey which I is where I am based out of.

I can think Mr. Romero or for seeing the importance of discussing the military and veteran population. And the family. Because we are a little bit different.

Kind of come from a different line and experiences when you look at the risk -- and the risk population was first put up their. And I think we have several of those markers as well as the military veterans.

One of the important things that I noted that was mentioned was the pension strategy. As an organization that is really where I come from. Hope for the Warriors has taken a very active approach to come from the wellness model of prevention model. Which is waiting for that crisis moment.

And without you that I take a lot of importance in educating not only our staff with the volunteers that our community on suicide prevention, the crisis moment and where it to best reach out for the resources.

Salami just walk through what we have found important -- that the team has important -- reported back to me what they want you to know about what our work is within hope for the Warriors, as well as the communities and other agencies that we work with.

Because it really is a collaborative effort. We don't get alone or would we be excessive -- successful in what we do if we did not work with all of the community partners. Selects a training assessment and resources is where we start. Would we get our information -- at our at risk population we work collaboratively with the VA. Very important with us -- to work with the team that comes in. And work with the training model. We are not the experts but they are. They come in and train the staff as well as the volunteers as well as other organizations. There are so many nonprofit organizations working in the veterans community that needs to have some competency in terms of the overall mental health picture. With the office of mental health. All the things of the community-based organizations have used pretty well -- and -- do we have another community -- and another for training for the staff -- and the next Appleby will be to get the phone call

And will we get that call where do we refer them to -- must abort is a better Priceline.

That is their lifeline. From there we understand their community. So far I have learned one -- -- and also recognizing the military and their family have a family that is willing to support them and that is in their backyard. So we do that through extensive case management, knowing where the resources are and where other providers are out there that can help with that.

's youth team -- someone already up -- so who is the team X somebody already approach that -- and we work with the community so we know who our commanders, who our leadership is him and the -- there are some phenomenal leaders out there that want to talk about stigma. So our job as an organization to get in there and really let them know what we are seeing -- with the true stories are and what really seems to be helping.

The VA come a BA caseworkers in different businesses -- in vision three which is in the area here have phenomenal mental health writers. And again it is our response ability to work collaboratively with them.

To work with the family and the caregiver. Was going to basket with the story of what is going on at home. And that is -- where we are welcome to take the phone call from. Many organizations in agencies will see that the organization said he veteran or military health member -- worry if you look at what is going on at home you will get a lot of information that you will be to provide -- one thing I would like to go back to and if you really think about or us as a nonprofit -- we are lucky because we are able to work outside the scope of a lot of different standards. But we do in terms of the evidence-based part -- that's where we are worded with professionals -- everything from therapist to coastal workers -- we have a psychologist that does the clinical supervision that has intensive inpatient experience. And the case managers and other professionals with different lenses I can really provide supportive services.

And the question of how you measure the immeasurable. I think that has always challenges from the very beginning. Because that is most important me. I would rather not measure how many service writer members have come through the doors who have completed suicide, I would rather know about the program and really felt a resistance he -- Rijo and see -- resiliency and services that are immeasurable.

Peer support is very big within our organization and again part of the strap -- staff answer -- infra structure. We have learned a lot and has been brought up and it will be brought up again and again. Especially with the veteran population when they leave their active-duty base and the comfort of home -- and leave the uniforms -- who are they. It is really a different picture and the military family member -- that helps me going to civilian community -- you really lose that common language. Is quite after-the-fact pier support is very helpful. Sometimes we will be working with a veteran that says hate my buddy is doing with this. If we really listen to what they say and open up the door for the peer support, we have some incredible things that occur.

And really listening. But I think about reducing stigma -- that is our thing. We listen to the community around us.

And again a part of our prevention strategy is a strength-based support, person centered planning. One of the biggest issues is the veteran population. Thinking outside the box. If I just put up a sign and they help for the Warriors here to talk about whatever issue you may have come a we would not be seeing about 4500 service members and families across the country. It is a pretty high number for nonprofit but what we do is some of the community based things.

In New York here we found that the fired apartment in the police department our first responders on a very common liquid with military and veterans. So we have community lunches. We have visits to the World Trade Center site. For the individuals that may be visiting the area. Those are some of the most important elation ships that we can never make. Began, it is unmeasurable. -- And again it is immeasurable.

Is the testimonies in the work that we are able to do after that visit. For reducing the isolation. Developing that culture to reduce isolation and encourage connectedness and making that part of what the introduction is about.

Sometimes we forget that clinicians -- want to go right into the skills and go right into what we are supposed to do about what we are supposed to write in the records and sometimes people don't want to talk about the things that really count. And that is the relationship.

So we work a lot on restoring through -- previous activities. What did they do before -- but we have 2 min. I knew I was great to me that from you.

Let's talk about skills were quick. This is really important going forward. And that they wanted me to share -- we work a lot to me that were there at. If you are social workers, that is the baseline skill. So what does that really mean?

Again I know I'm coming from an organization has different boundaries. I worked off the tremendous support from the American population. People who want to donate to make sure that we can do what we do.

So I am not controlled by insurance about pipe billing, bistate funding, local funding. So as I say that, that has -- reduces some challenges for me. But I do feel less that that is good for the organization. And we are able to engage beyond that treatment parameter.

So what does that mean for me -- we may be working first with the servicemembers -- everything mighty because this is important for them.

They can be working with the servicemembers are common and don't necessarily get where we need to be in 12 weeks. Guess what -- we will be there in 18 months when they call again. We have the ability to do that that's what we're seeing. That is truly a cycle for the military and veteran community. And it looks like post-appointment -- looks completely different post home. And they come all the way home, get back in their community, the RAND study has shown that 18 months post -- home home is where they will see the significant fracture that that's what we see.

We need to change my focus where we may have met them at the military base. Very very important and that's where he seen the parameter.

And we see in the military family -- whether that is active-duty or veterans -- mom that her cousins -- to really normalize invalidate what's going on.

We have a hard conversation -- and when I say a hard conversation is -- -- that will get you through that and guess what -- will be back here again. That is a true conversation. Just like with working with someone who may be dealing with addictions and recovering from that. There is no relapse -- they know relapses normal. Relapse is normal. Within the population that we might see at risk.

So those are just some of the things that are really -- it is different, thinking outside the box -- in the nonprofit world we have a little bit more flexibility. But remember to normalize, validate and empower. And Vicki for your time.

-- And thank you for your time.

[ Please hang up the telephone so the next captioner can dial in. Thank you. ] Good morning.

-- My name is [ Indiscernible ] and I work the New York family New York trade center.

[ Please hang up the telephone so the next captioner can dial in. Thank you. ]

Very long title -- does not even did on my card. -- Does not even fit on there is a lot of -- hi lost -- and they will have high incidence of suicide [ Indiscernible ] and we are kind of at the forefront of training for suicide prevention -- as I said before.

No one has trained on this.

[ Please hang up the telephone so the next captioner can dial in. Thank you. ]

As a person myself I was not trained very well and my training consisted of students who were thinking about suicide -- call 911 -- to your supervisor.

[ Please hang up the telephone so the next captioner can dial in. Thank you. ]

We are also training the LGB -- and those of you people not familiar that very long acronym -- lesbian gay bisexual -- and [ Indiscernible ] which is to spirit -- which is something that Native Americans -- and upstate New York.

[ Please hang up the telephone so the next captioner can dial in. Thank you. ]

-- [ Captioners transitioning ]

[ Please hang up the telephone so the next captioner can dial in. Thank you. ]

This is our direct staff. Especially at the residential facility. We talk about suicide a lot. We talked about options. We are training foster parents. They are the front line staff. When a teenager expresses suicidal [Indiscernible] . We want to prepare the people who are close to them mama if they see something come up -- , and they can prevent it. I think, because it is a taboo subject, I do not want to tell anyone. I do not want people to think I am in trouble. We want to make sure that the people in the use life -- youths life is informed. There is sadness, loneliness and isolation. It does not look the same in every person, especially with a adolescent. It there is a boy who kicks the chair might be just as depressed as the sad you -- youth. We have extended our foster parent training. You are welcome to come to any of our training.

Another training we are doing, is training people that justice people. Nonsecure placement is a new addition for us. For people that have been incarcerated. It is not a lock down the tension center -- detention center, but it is still a facility that can help. We will do training for all of our staff. They have asked us to come in and train. It is the same population, who are at high risk or in trouble. These are kids that do not have resources to get them through high school or to a higher level. These are the kids that end up with -- high suicide [Indiscernible] . This is risky behavior.

I believe another program that is -- we had clergy. We had a church group ask us to come in and do training. And we were happy, getting into a church and talked about suicide which is a taboo subject among Christians. We have done training at New York City public schools. Also, that QBR training. We are training the cafeteria staff and the paraprofessional test that we -- and we train them. Community outreach, we have social media. This is where the youth lives -- live. And there is Facebook -- this is where they can express their real feelings. It is on Facebook or twitter -- any social media. We want to get out there and talk about the programs that are out there. We need to keep abreast on what they are putting out on Facebook or twitter. We have to make sure that we are aware of that. We are doing some other outreach through foster care. We want to make sure that all kids are safe. Not just kids in child welfare or just in school. We want to train all gatekeepers. My contact information is on this last slide. Please feel free to contact me. If you want to see training that has already happened in the community you can go to the website. The calendar will show any training happening across New York State. I hope people do reach out. Because these training -- program is free and available to anyone. Thank you and have a wonderful day.

Good morning everyone. I am from the state of New Jersey. I want to thank Dennis for inviting us. I want to share with you today on what we have been doing with suicide prevention. We are doing quite a few things. This first slide, one of the things we have had a challenge with, it is basically increasing the Life Line. As you can see we have a lot of hotlines in the state of New Jersey. Not all of these are funded by the state. They have grown and matured because there is a need. We do fund the local centers. We have 21 counties. We have five Live Line crisis centers. We have help a vets -- A Vet hotline, and also Mom to Mom hotline. The challenges, we can get into little silos. One of the things we like to do -- let me go to the next page. In order to increase the number of lines, we did a request for a proposal. We wanted to identify one provider. We wanted to have a 24/7 provider. We did not have this capability. We wanted to have text messaging and chat as well as social media. We wanted to have one clinician per shift. We wanted to provide follow-up calls and to do a warm transfer and emergency transfers. During the review process, this was awarded to [Indiscernible] for this new service. This is been in operation since May 1. It is now called a New Jersey Hope Line. These are really lifelong -- life line calls .

This is a statewide backup for this service. One of our rules -- we expect there would be a person that will answer the line -- and you can see they are answered within 10 seconds. You can see there are quite a few people on the line. Especially on the emergency priority section. Other proximately 151 calls were emergencies. 50 of them were a suicide in progress. They were all connected to emergency services. This is important to us. It was built into this process. It is important we link people up as soon as possible to the services they need. There is a demographic -- you can see over 50% of the people identified their age. So we're reaching youths and adults. Another thing we wanted to do, we had additional help from Life Line folks to realign the phone line. And to better match the resources. So people can access the phone line in New Jersey easier. The plan would be that the Hope Line would be the backup. This is the only crisis hotline operating late night and early morning hours. All of the crisis centers agreed to meet as a group several times a year to work together. These are volunteers that make up the people who answer the lines. We have to remember that our own staff needs support. This can be a traumatic experience especially when you are dealing with suicide on line. We have done some things for the department of health in New Jersey. They basically keep track of what is going on with suicide and violent death reporting system. We now have quarterly meetings. We have included the department of health and medical examiner. The medical examiner is the office -- they are actually in the legal department of law. They make a determination if they suicide was actually a suicide. You can see there are things that are going on -- such as drug overdose. This is another growing concern. Another thing that we have done with court nation -- collaboration -- between Department of Health and transportation. There have been a number of deaths -- is basically suicide by train. We are trying to work together to come -- together to figure out a solution. We have a robust youth production. -- Suicide prevention. We need to help youths them transition. Another thing we are trying to do some research through the injury control center. It is located in Rochester. We hope to identify issues that we could work together -- and come to a solution. Now we have safe messaging. We're doing a robust advertising -- we need to make sure we do not give off the wrong signal. And this is what we are trying to coordinate here. This last one, was an award that are program -- our program received. It is a toll-free line -- but it is not 24 seven -- 24/7 .

They basically answer the line and receive support. They are that innovative program of the year. Thank you.

Who is next?

I think that is you Sandra. Statement -- so I think we should get everyone a round of applause.

We are working with veterans, use -- youths in suicide prevention. We will open it up for questions and answers. I will ask is just enough -- Justina can help us with questions. I think we have a microphone in the room. Stephen I want to invite -- and I want to invite those other webcasts to ask questions. We will begin. Who has a question in the audience?

I have a question for those Ú -- working with the youths . I was wondering if you use peers? And any other techniques you use for the youth?

We have Life Expresstion. This is for age 12 to 17. In the program they work as a support group. They are the only ones dealing with depression at home or in the school. So we train teenagers. N/A provide -- and they provide support for other teenagers.

We have a school-based program. We take the leaders in the school -- or who have influenced in the school. Where they are able to help their peers. We are teaching teenagers how to teach at other teenagers -- how to provide support. Most of the programs we do our -- are evidence-based programs.

Any other questions?

We have a question from a web. Though rules of peer support, clarification is needed regarding peer support services is a pro.? -- If we were yet [Indiscernible-low volume]

Sometimes there is a relationship -- where someone can have the same challenges. It needs to be -- we need to have a perspective on what they are doing. We do have training available for the peers . So they understand the nature of what they say -- and how it would be received. Sometimes they can understand the influence they can have. I think it is helpful. We have Hope Centers throughout New Jersey. It is peers helping other peers.

Do we have -- any other suggestions?

Within the veteran community, we get a group of individuals together -- and it they had served there is a common language. I had the opportunity to sit in -- the national states [Indiscernible] where they were helping this type of program. When the individual is not well -- for instance they are not in treatment. They are in the same boat -- but it does not mean that we are restoring. We need to provide technical assistance for the peer to peer training program. I needed to go back to school so I could learn the language. So people could hear my story. I think training is very important when it comes to peer to peer training.

Thank you. We are going to move on. We want to thank each of the panelists. You have done a great job, thank you so much. We will continue with our specialized training. I would like to introduce Dr. Sylvia Giladocky. We will focus on New York City and Long Island. She is also a member of the [Indiscernible] . She holds a master in psychology. And a doctoral degree in psychology from [Indiscernible] University in Italy. These are evidence-based training on suicide prevention. So please join me in a warm welcome.

Thank you Sandra. Thank you for hosting this event and I am delighted to be here. We will start training in just a moment. I want to give you a little history on the YM. -- who I am. I covered the region -- so we do get around a lot. I do have a small team. We have Melonie, who is in Alberni. We work closely with the suicide prevention -- and the state. We are proud of this initiative. We have added so many resources, trading -- training. What I would like to do, I want you to go to our website. You should have a booklet. And on the back, you will see our website. You can also Google, mental health and your state. Then you will find a lot of information. You will find trading. -- training.

I recommend that you look at the website. With this initiative, there is one piece I want to mention. We do believe that we need to provide good assessment tools, and good training. And a lot of support for all of the hard work that centers do.

If we want to reduce the suicide rate, we need to adopt the public health of roach. -- approach.

Suicide remains a table -- to do. There is a lot of shame and stigma around talking about suicide. We want to change the cultural norms. And this is where we fit in. I will start the video. This one includes statistics. The video is old -- so the numbers have changed. I have the recent statistics right here. I would suggest that you look at this as well. Let me see if I can start the video. Some -- it may be hard to imagine, of proximately 1 million people die of suicide. More than 20 80,000 word in the -- then 28,000 in the United States. For every life lost to so aside -- suicide there is more attempted suicide. An average of six family members have committed suicide. Brands, -- friends, colleagues and family have been touched by suicide. Many of these deaths occur with children under 12. And many college students and military personnel. According to the survey, 25% of American youth have contemplated suicide. You may ask, what is happening? Suicide is not a new problem. But suicide is now preventable. 90% of Americans who died from suicide have a mental disorder such as depression or substance abuse. Remember that lives can be saved.

The statistics have changed. More than 30,000 Americans die each year by suicide. Some deaths may not be recorded as a suicide such as in an overdose. Was it accidental or suicide? Imagine a car accident in the middle of the day, and there is no sign of raking -- braking -- is this a suicide because there is not a note? Sometimes this is not accurate. Because unless someone goes into the emergency room, we really do not know if someone has attempted suicide. With statistics, we are always a few years behind -- it takes time to collect numbers and share them. I have another video for you.

-- [ Video playing ]

Cameron is 17 years old. His team is about to win the state championship. He is going to get a scholarship. But Cameron recently told, a counselor he wished that all of the pressure in his life would go away.

Walter, is celebrating his 77 birthday. He is surrounded by his children and his grandchildren. But last week, he mentioned when his wife died his whole world is empty. He feels like he is a burden to his family.

Julie, lives a good life. She is the perfect wife and mother. Tonight she plays the product -- perfect wife, standing next to her husband. Later tonight, she will be arrested for drunk driving. Cameron, Walter and Julie will attempt suicide. If you know someone thinking about suicide -- do you know what to do? A suicide crisis can survive -- during this time the person needs help. Talking about suicide is uncomfortable for many of us. Or we are afraid of pushing them over the edge. Most people who consider ending their life have warning signs. In one hour you can learn to recognize the warning signs. In the same way thousands of Americans are -- survive because of CPR, we can prevent suicide.

This is designed how to make the -- a impact on a person. Substance abuse, greatly increase the risk of suicide. We talked about cancer, and sex, and domestic violence -- it is my hope that we can comfortably talk about suicide.

He suffered from depression on and off for all of his life. He even asked -- would you do anything crazy? He probably wanted to talk about it and I did not give him an open door. To tell me, mom -- I am in trouble.

I was in shock. I could not believe it at first. Then I was angry. I could not believe he did this to us. We will never have another holiday in this family that will be the same.

Every day, something reminds me of him.

He had a nervous breakdown. He was very depressed. No matter what came up, it was completely negative. And decision-making was a tough thing.

Maybe I should jump off the bridge or get a gun -- or something.

There is somebody who knows this person -- who should've said, would you like some help? And the person would have said, yes I would like help.

Suicide has no color. It does not care what your race is. It doesn't matter who you are. As an aunt, I did not know how to help. If I was trained -- may be I could have helped. Because people who are contemplating suicide legal helpless -- feel helpless. How can we respond to them? I think this is important.

The concept of read competitive training, can allow you to react instinctively. We need this reinforcement -- just like medical personnel. We have been -- an organized process.

I feel I am part of a system. Parents call me -- John is not transitioning very well this year. The football coach says, I feel something about John not performing. A couple of friends stop by and say -- I am concerned about my friend. I say to John, are you thinking about killing yourself? And you will be surprised when they say, yes I am. Once you ask the question, they are able to deal with it. Maybe you can refer them on -- and that alone is a blessing.

To save a life from suicide we need knowledge. We need to talk about suicide openly. We need to give a message of hope. Ask a question and save a life. It is something that we all can do.

[ Video ending ]

Before we continue, there might be people in the room who have struggled with suicide -- I would like to ask [ Indiscernible -- Heavy Accent ] . There are people that can speak to you. In the meantime I have Sandra and Danny, who can speak to you. There might be people in the room who have experienced a loss of a family member. And these can bring up emotions or memories. This was developed by [Indiscernible] Institute.

I am having a problem advancing my slides.

I think I need help.

Let me mention, on the table there is a form. This is part of the grant we received. We are really trying to get feedback -- not only for people receiving training, but those who have had training. If you indicated that we can contact you, this does not mean that you will be automatically receiving a phone call. On the back, please provide your contact information. I do not have the certificates with me, but I will be happy to mail them to you.

So what is QPR? It is to provide training -- public training. No one can stop a suicide. What do we think about that? In general, what we came to understanding -- if they are given the help they need, many of them will not go on and contemplate suicide again. Another best -- myth , if we talked about suicide it will make the person angry. It might be a teacher or a friend. If we ask, are you thinking about killing yourself -- that the person will be offended. We know that people who have gone through a suicide crisis, for the most part they do not get angry. They welcome the opportunity to speak about something that is serious. So it opens up communication. We encourage people to become comfortable using the word, suicide. Every time we use the word suicide, we are shipping a way at the -- chipping away at the stigma. Another myth, that only professionals can prevent suicide. Every community should be able to recognize warning signs. I do a lot of training. And many times, I will be in a room with a lot of clinicians. I asked, it gives us suicide tendencies -- in QC suicide -- [Indiscernible]

Another myth, -- I think I have the same problem again.

In the meantime, does anyone have any questions?

Suicidal people keep their plans to themselves. We have learned, that most people who think about suicide might communicate their intentions to others. They might do this in a indirect way. Most people communicate in one way or another.

Another myth, people who talk about suicide are not serious. People who talk about suicide, might attempt suicide and die of suicide. And we should take this seriously. Another myth, once a person decides to complete suicide there is nothing we can do to stop that. We are finding, people who have gone through a suicide crisis, that this is not the case. This is the most preventable kind of death. People do not stay suicidal for a long period time.

We are going to talk about suicide clues and warning signs. The more you observe, the more you need to take this seriously. Some of the signs, might be very direct. It could be something like, I wish I were dead, I am going to end it all. These are very direct and clear statements. And sometimes people actually do you say or express in a direct way. Often times people do not. We might see things like, I am tired of life, my family would be better off without me. These are people who are thinking of suicide -- they think they are a burden to their family. They have a terminal illness. The devout people who have struggled with mental health issues such as depression. They feel they are a burden on the family. I feel dead anyway, I will not be around much longer, Purdy soon you will not have to worry about me -- pretty soon you will not have to worry about me. Why is it that people would not use direct signs? Why do they not just go to somebody, and say I need help. There are a lot of reasons. The number one, is that -- shame. So it is difficult to overcome. A lot of people are afraid if they say, I think -- I will commit suicide they will be admitted to the hospital. They may have gone through a suicide crisis, and have asked for help and not received the help they were hoping for. They might have heard, why are you thinking of suicide? Some people are afraid of losing their job. I worked with a woman who had a husband who committed suicide. This woman was struggling with the reason why he committed suicide. Eventually, she realized there was a barrier for her husband -- he was afraid he would lose his job. There can be behavior clues. There are things that people can do. In a previous suicide attempt, should be taken seriously. Humans are wired to be afraid of dying. We are required to be -- wired to be afraid of pain.

So some people will step over that line. So we want to take this seriously. We do have people who attempt suicide, and they get help and they never attempt suicide again. Many died during the first attempt. If someone has attempted suicide before, they might feel -- find themselves contemplating suicide again.

Look for a mentor. In the United states, suicide is connected to the fire alarms. States that have -- [ Indiscernible -- Heavy Accent ]

We have moodiness and hopelessness. Lack of hope, is important when we are thinking about suicide. Putting aside fears. If you are seeing someone who is suddenly putting together wheels -- wills and making arrangements for the family. We really need to think of that as a clue. As they are giving away prize possessions. I am not organized, and I decide to give away all my books -- I beat my family and children would be wondering what is happening. Are they are interested or disinterested in religion. This is also a very important one. People who attempt suicide, are [ Indiscernible -- Heavy Accent ] at the time. When people are feeling depressed, they may self medicate. We know that alcohol and drug might become a factor. Irritability -- I think I mentioned inker. -- anger .

A very angry kid might be a very sad kid. This is one where we cannot wait. Remember, under anger there could be a desperate kid. That we have situations or circumstances. These are things that happening to people -- such as being fired or expel from school. There is a loss. It is a powerful loss. Maybe a child who is being moved. Maybe all of his friends are not there . It could also be diverse -- divorce. And also it could be a breakout. A breakup at 15, can seem to be the end of the world. Another loss, is the loss of a spouse, child or friend. This is a group they can struggle with suicidal thoughts. Especially if they lost one Especially if they lost 12 suicide -- especially if they lost a loved one to suicide. We need to understand what one would do -- in the community to provide support. Many times I contacted by a community after a suicide happens. Some people are called -- will call for suicide prevention after a suicide. We provide suicide prevention, -- we always wait several months before we do any kind of training after suicide. Because this is a time for healing. We want to focus on self-care. Another loss is loss of health. Some people have terminal illness. They may think of suicide as an option. Suicide is a way to cope with extreme emotional or physical pain. If a person cannot figure out any other way -- is another warning sign. Loss of freedom. We have a height suicide -- high rate of suicide in prisons. We try to ensure safety -- when people are in the hospital or prison. Anticipating loss of financial security. For a number of years we have been dealing with loss of income. Loss of favorite counselor or teacher. This is something that we hear a lot. Do we have any questions? Before we move on to the second step? We need to recognize clues or warning signs. Then we will move into, what do we do? Do we -- I want to ask if anyone has any questions?

If you have the impression that someone is thinking about suicide, -- you need to ask directly and as soon as possible. Here are some keys for asking. If the person is real luck and come -- reluctant, keep asking. Allow the person to talk freely. If you are worried about someone who is thinking about suicide, we have a tendency to want to do something. If the person is not in immediate danger -- they do not have a gun. If they are safe at the moment, let the person speak freely. Listen to the person. Sometimes, when people have an opportunity to talk about why they want to die -- they can talk themselves out of their suicidal crisis. They have an opportunity to talk to someone who is listening. How do we know if someone is listening to us? You will have eye contact. You are not checking your phone or checking the time. Sometimes when we listen, it is hard not to interject what we want to say. This is about being able to hold back what we hear without adding anything extra. Give yourself plenty of time. It is good to have your resources handy. If a person is going to need to be referred to someone -- give them a sense of how to go about this. On the back of this booklet, we have good resources. Remember, how you ask the question is less important than asking. Just ask the question. Have you been unhappy lately? Are you thinking about ending your life was marked -- are you thinking about ending your life ? I want you to think about -- how to ask about suicide. If you ask them, have you been silent lately and they say yes -- but they cannot tell you why this is a warning sign. I asked a client, are you thinking about hurting yourself with smart -- are you thinking about hurting yourself ?

This can be misunderstood. They might be thinking we are asking if they are self inflicting pain -- such as cutting ourselves. Suicide is not about hurting ourselves, it is about taking away the pain. Linguistically, I beat that when we are afraid or uncomfortable using the word, suicide -- and we say, are you going to hurt yourself? We are letting that person know we are afraid. Anytime you can use the word, suicide -- we are creating a cultural space dust -- we are letting them know that we are someone that can actually have a conversation like that. We are not afraid to have a conversation about suicide.

Here are some examples. This is a direct way of asking. I am wondering if you were feeling this way -- sometimes when people miss school or work and they cried a lot. Or they are experiencing a loss. Sometimes people think about suicide. You should ask, are you thinking of suicide? I think you are miserable, are you thinking of suicide? Dr. Shae who is a wonderful speaker and expert in suicide. He said if we refuse to use the expression, are you thinking of killing yourself? When people are thinking of suicide, what goes on inside your head -- I am thinking about killing myself. They do not go around thinking, I am thinking about attempting suicide. These are direct ways to ask. If you cannot ask the question, that is okay. Then you should find someone who can ask the question.

So this is how not to ask the question. You are not suicidal, are you? How you use the language, carries a lot of meaning. Language reflects the shame and stigma that surrounds suicide. If someone committed suicide, the word -- committed has a negative connotation. So we encourage you to think about language. Another expression we hear, is a successful suicide. This is upsetting to family members. They do not think it is successful. There is nothing successful about their loss.

A failed suicide is an expression we hear. And this has a stigma. It implies, that someone is not only suicidal, but they are failing. Getting the help the person needs. Let me check my time to see if we are doing okay. The next step is, persuade. How do we persuade someone not to commit suicide? Remember, suicide is not the problem. Do not rush to judgment. This is a big one. We all carry judgments. We all have opinions. Sometimes a judgment is something is difficult to keep under control. We might even be afraid or anxious -- about suicide.

Then you want to ask, you have asked that are you thinking of killing yourself? You have done this in a private setting and you have time to spend with the person and listen to the person. Work you go to get help? This is not about solving all of the problems. There are many complicated reasons why a person wants to die. When we are doing an intervention, we are not trying to solve the problem. Our task, is to inquire and connect the person to a person who will take it from there. Who will do the long-term work if needed. Will you let me help you get help? I think there are people out there, they want to keep their promises. If they promise something, they do their best to keep their promise. There are people out there who might promise and actually just say that -- because that is what you want to hear. And it is the end of the conversation. You also want to make sure that the person is connected to the resources that can help. If you think about it, if there is one person who cares enough -- about you to spend time with you. Who will listen to you. And wants to help you. This implies there may be other people in the community that would help. The last step, is referral. Suicidal people often believe they cannot be held. -- helped. Some feel that their problems are very serious. Usually when I see the family -- what I hear is the family has serious problems. They want to make sure that I understand their problems are really serious. So we have to work harder. The best way to refer someone -- take the person directly to someone that can help. It doesn't necessarily mean the emergency room. That sometimes you do have to call 911. Sometimes it can be as simple as calling the Life Line. And getting a commitment. This is for people who need help. I think, my preference is to refer -- if you are a teacher or a counselor, a good way to make a referral, is to make a phone call with the person. Give them referral information. And the willingness to accept help. I know there are -- I think it is on one of the tables, the prevention hotline. It is always good to get this number to people who are thinking of suicide. Sometimes people think about suicide in the middle of the night or when they are a loan. -- alone.

It is good to have a resource -- night and day, seven days a week.

To per se -- to prevent suicide, do not hesitate to get involved. I think this really speaks to the relationship piece. When you are really taking time to sit with someone who is thinking about suicide, something happens. There is going to be more work. You do need to plant the seed of hope. We are close to the end of QPR. I want to talk about resources. We have the national suicide prevention Life Line as you can see here. We have the office of mental health website. You can even find providers -- I do not think we have mentioned Why.org

They have of coming training. I also want to mention Samaritans also have a suicide prevention hotline, and that is 212-673-3000. They also provide support groups for suicide survivors. And also to those who have lost loved ones to suicide. We are talking about people in that community who have survived the suicide of a loved one. They offer a lot of support. The American foundation for suicide prevention, which is not here. But it is easy to find on the Internet. They provide a lot of resources. This includes an outreach program. They have a group of trained volunteers, who have survived losing a loved one to suicide. At any point after a suicide -- it could be a year or months later -- they have resources for the community. On the booklet you have Support [Indiscernible] group. They have a wonderful website. They also provide training. They also have a chat room. Are there any other resources that you are aware of?

For effective program -- again you really want to inject as much hope as possible. Use yourselves. In a moment, you are the best -- let them know that you want them alive. I am a family therapist -- this kind of work can be difficult. It is not something we can do alone. You need to know the people in your community. Especially when you know someone thinking about suicide. Are there any family members or friends that can be involved push Mark -- ?

Is there a spiritual need? Can they be part of the support system? Veterans -- there are a lot of people in that community that can help their peers. In New York, being a culturally sensitive community is important. By cultural I do not mean terms of ethnicity or language -- cultural can be a -- have a broader meaning. Some of the most rewarding work I have done, I collaborated with New York City Police Department. I really did not speak their language -- and I do not mean English or Italian. It was New York City police department language. I needed to find someone who understood the culture. We have trained peers, who can provide the support and help during a suicide crisis. They had an understanding about the culture. Now the people -- know the people. Joining a team. Follow-up with a visit, phone call or a card. This is up to you on how much you want to be involved. It depends on the relationship you have with the person. It could be a stranger in the park or in the subway. If you can, it is nice to have a follow-up. You need to think about this carefully -- it has to be a clinical way of thinking. Because this is sometimes where we dropped the ball. If the follow-up piece is not followed thoroughly -- sometimes we miss an opportunity to keep the person safe. If we are doing it as a public health perspective -- just a call to see how the person is doing. And to see if they follow through what they said they would do -- is important. Remember, plant the seeds of hope. With this, I the we are ready for questions. Your questions can be about QPR or the suicide prevention initiative. I will be happy to talk about all of the above.

We have a question regarding suicide prevention initiative in Puerto Rico. What are the resources available to our region? I want to remind folks, we had this grant and funding available. We are training in Puerto Rico. We have identified gatekeepers, faculty, students and staff in the school. In Puerto Rico you have the ability to receive [Indiscernible] funding. We have wonderful resources. This morning we heard about additional resources available to those in the Virgin Islands and Puerto Rico. All of our resources have to be done in a gentle, respects full and -- respectful and cultural manner. I encouraged others on the web, to go to our website as a starting point for resources and prevention.

If you want to invite me to the islands -- I would be happy to go.

To we have any other questions?

I have a health provider. The depression in women is a big problem. And sometimes it is overwhelming. I was thinking back about screening for depression. As a provider, when we ask, are you going to hurt yourself -- we dread the answer, yes. We did add something to our screening, when someone is contemplating suicide we take certain steps to pass them on to someone who can take care of this right away. When you ask the question -- and they say yes, it is a big deal.

We asked this question because we want to know and then we find out -- the answer is yes. This gives me an opportunity to talk about prevention and safety planning. There is [Indiscernible] about thinking about depression. The idea has been, to treat suicidal [Indiscernible] we have to treat the Prussian, -- depression. The long-term work, -- if you have someone who is struggling with depression this is obviously long-term work. But we are bringing forward the idea, there are specific ideas to prevent suicide. If the person is not in imminent danger -- it is more of a feeling or thought. If the safety planning -- have you heard about the, no suicide contract? They have moved away from this because they do not have the validity. It is more about what we do not want the person to do. It is about, what the person can't do we going -- can do when thinking about suicide? We need to have a collaborative plan. And give the person a strategy. Before the person goes to the hospital. It can start with something like -- I go for a walk with my dog, or I played video games. They can think about something else for a couple of hours and not thinking about suicide. But if that is not enough -- what would you do next? We have to think about safety. You may have to go to the emergency room.

When you do send someone to the emergency room -- it is a tremendous ordeal for them.

Yes. Sometimes it will happen.

May we have the panelists back up here? So we can deal with these questions? We have a few questions for the panel. We have a question from someone asking, where can we go to become certified?

Which state?

Let's say it is New York.

If you are in New York you can contact me or the office of mental health. We provide a workshop. We have a network of resources.

To become a trainer, it is a full day of training. You can also become a trainer online. That involves I think you have to write something when you're doing it online.

We have a question for the panel.

We all know that the federal government is one of the larger employers across the country. Aside from [Indiscernible] what other support can we find for suicide prevention for smart -- ?

I think the Life Line. And personally, Smason has a locator of services. I know of a number of lines we have in New Jersey, people can call those. Basically it is, Hope Line.

As a reminder to those who are on the web, on our website come up we will include information about our treatment locator. And information about suicide helpline. We are running short on time, we are wrapping up. Give a round of applause to our panel.

As we and -- end today -- a few things come to mind. We have a request -- this is going to be archived on our website. As well as the national suicide prevention site. The request has come from Rochester, who would like to share this webcast to those in Australia. I hope you enjoyed the weather. I wanted try to come up with one word to summarize today. For community life -- the word I keep coming back to. Was, empowerment. You are engaging the youth and those who surround the youth to be empowered and held -- help.

We know that sharing knowledge is powerful -- but it helps bring down those walls of stigma. Alan, the best word I can come up with for you is, partnership. So that fewer people fall through the crack.

Tina, to me -- it was connecting the dots. You can connect the dots -- for the veterans. And for all of the help that we can all muster together.

Sylvia, connective is the word that comes to mind. The most difficult part about depression or suicide ideas -- it is feeling I'm connective -- unconnective . And through this training opportunity you are shutting lights -- shedding light .

It empowers all of us to do well. To be there for others. This is the best commodity we have with suicide prevention. I want to thank all of you for coming today. I want to thank all of you for being here. The state of New York, does tremendous work. New Jersey, they are doing tremendous work insuring that people have access to support and resources. I am excited to be part of these efforts going on in New Jersey.

Nothing or everything can be done by just one person. We need to help make this event possible. I want to think the office of women's health, who has been a wonderful partner in this effort. I will turn it over to Sandra.

Thank you Dennis. I think you did a great job summarizing and highlighting all of the key points. The national action strategy on suicide prevention is online. We are in this together. It does that mean if you are a professional, we all have a responsibility. The original program that was done in June in June 27 was meant to be a call to action. For those who are working in a community, working with clients, social service settings -- every day is suicide prevention with that we woke close our program -- with that we will close our program. Thank you once again.

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