State of Utah Suicide Prevention Legislative Report, November 2018

1. November 2018
Kimberly Myers, MSW Suicide Prevention & Crisis Services Administrator
Data Sourced from the Utah Department of Health & Suicide and Firearm Injury in Utah Report from
HSPH
Utah Suicide Prevention
Legislative Report

2. What do the latest data tell us about suicide in
Utah among youth, adults, and other demographic
groups, and changes over time?
• The overall suicide rate between 2015 and 2017 was relatively, but
high at 25.6 per 100,000 in 2017
• The rate of suicide in 2017 was comparable to the two previous years
(2015 and 2016).

3. Utah and U.S. Suicide Rate,
1999 to 2016, 2017
Data Source: Utah IBIS, Office of the Medical Examiner and CDC WISQARS
3
12.2 12.1 12.5 12.7 12.5 12.8 12.7 12.9 13.2 13.7 13.9 14.3 14.6 14.8 14.9 15.4 15.8 15.915.8 15.9
16.7
17.6 17.3
19.2
17.1 17.3 17.4 17.7
20.0 20.6 21.4
23.3 23.9
22.9
24.6 24.2 24.7
0.0
5.0
10.0
15.0
20.0
25.0
30.0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
CrudeRateofSuicidesper100,000
Year
U.S. Utah

4. Utah and U.S. Youth (age 10 to 17) Suicide
Rate, 1999 to 2016, 2017
3.1 3.3 3.1 2.9 2.7
3.0 3.0 2.7 2.4
2.9 3.1 3.0
3.4 3.5 3.7
4.0 4.2
4.6
3.8
5.0
5.3
6.9
5.4
5.7
3.4 3.4
3.0
4.7 4.6
5.9
4.6
5.9
8.4
9.0
11.1
7.9
10.2
0.0
2.0
4.0
6.0
8.0
10.0
12.0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Rateper100,000population
Year
U.S. Crude Rate Utah Crude Rate
Source: Utah Department of Health, Office of the Medical Examiner; CDC WISQARS

5. Utah’s suicide rate is higher than the nation’s,
but similar to its neighbors.

6. Utah suicide rates were highest among white
and American Indian males.

7. The higher suicide rate in the most rural counties
was driven by a higher firearm suicide rate among
all ages.

8. How much money has been appropriated for each
component of the state’s suicide prevention program?
Prevention Funding Programming Component/Statute Addressed
Prevention by Design Contract: NAMI
Utah
(Local Coalition Sub- Contracts)
$45,000 (a)Deliver resources, tools and training to community based coalitions;
(c) town hall meetings for building community-based suicide
prevention strategies;
(d) suicide prevention gatekeeper training;
Gatekeeper Instructor Training $47,200 (a) delivery of resources, tools, and training to community-based
coalitions;
(d) suicide prevention gatekeeper training;
Utah Suicide Prevention Coalition:
Website Redesign
$20,000 (a) delivery of resources, tools, and training to community-based
coalitions;
Conference Sponsorships $16,000 (b) evidence-based suicide risk assessment tools and training;
(d) suicide prevention gatekeeper training;
(f) evidence-based intervention training;
(g) intervention skills training; and
BRFSS $10,933 (a) delivery of resources, tools, and training to community-based
coalitions;
Means Safety Activities $8235 (a) delivery of resources, tools, and training to community-based
coalitions;

9. How much money has been appropriated for each
component of the state’s suicide prevention program?
Intervention Funding Programming Component/
Statute Addressed
NCVS: Crisis Response Planning and
Brief Cognitive Behavioral Therapy for
Suicide Risk
$29,925 (f) evidence-based intervention training;
(g) intervention skills training; and
CAMS Care: CAMS Training $13,300 (f) evidence-based intervention training;
(g) intervention skills training; and
Crisis Line Advertising $15,000 (a) delivery of resources, tools, and training to community-based
coalitions;
Postvention Funding Programming Component/
Statute Addressed
Survivor Boxes $1000 (a) delivery of resources, tools, and training to community-based
coalitions;
(h) postvention training and support
OME- Loss Books $14,000 (h) postvention training and support

10. How much money has been appropriated for each
component of the state’s suicide prevention program?
Justice Involved Youth Funding Programming Component/
Statute Addressed
NCVS: Crisis Response Planning
Training and Case Consultation for
adults serving justice involved
youth
$76,000 Suicide prevention programs that focus on the needs of
children who have been served by the Division of Juvenile
Justice Services.
Promising Youth Pre-Conference $6,000 Suicide prevention programs that focus on the needs of
children who have been served by the Division of Juvenile
Justice Services.

11. What has been the effectiveness of each
component of the state’s suicide prevention
program?

12. Prevention by Design/Gatekeeper Training
• Number of trainings
• 2017: 268
• Number of people trained
• 2017: 7660
• Training outcomes:
• The Evaluation Score for all skills
based interventions was 93.45%.

13. Faith Leader Summit: Effectiveness
Question Yes Neutral No
“I feel more confident in my ability to talk about
Suicide to members of my congregation.”
87% 12% 1%
“I learned something about suicide at today’s summit
that I will use in my congregation.”
97% 3% 0%
“I feel more confident in my ability to intervene with
someone who is having a suicidal crisis.”
84% 9% 2%
“I would recommend that others in my faith
community attend a future suicide prevention
summit.”
99% 0% 1%
“I would like to attend future trainings on suicide
prevention.”
98% 0% 2%

14. Treatments That Reduce Suicide Risk
Treatment Modality Duration ↓ Attempts ↓ Ideation
Multiple Clinical Trials
Dialectical Behavior Therapy (DBT) 12 mos √
Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) 2-3 mos √
Crisis Response Plan (CRP) / Safety Planning Intervention (SPI) 1 session √ √
Collaborative Assessment and Management of Suicidality (CAMS) Variable √
Caring Contacts N/A √
Single Clinical Trial
Mentalization Based Psychotherapy (MBP) 18 mos √
Attempted Suicide Short Intervention Protocol (ASSIP) 1 mo √
Post Admission Cognitive Therapy (PACT) 3 days √

15. Intervention/Clinical Training
Trained over 500 providers in evidence-based, suicide-specific
treatment modalities with the following outcomes:
Evaluation Question Percentage responding “Agree”
prior to training
Percentage responding “Agree”
after to training
I am confident in their skills in
assessing patients for risk of
suicide
45% 100%
I am/will be implementing crisis
response planning with
patients/clients at risk of suicide
45% 94%
I can effectively create a crisis
response plan with clients
45% 95%

16. What are the conclusions of the state suicide
prevention coordinator’s study on the use of guns
in the state?
Community Education on risks of firearms and suicides
• 85% of gun deaths in Utah are suicides.
• Utahns can use Utah data as they weigh the relative threat of stranger
violence, domestic violence, and suicide with respect to their own family’s
safety and their own household’s acquisition and storage of firearms.
• Educate that loved ones of people at risk for suicide lock any household guns
and hold onto the keys/combination or store the guns away from home until
the person recovers.
• Campaign with reducing access to lethal means
• DABC Partnership
• Continue cable style gun lock distribution (over 125K to date)

17. What are the conclusions of the state suicide
prevention coordinator’s study on the use of guns
in the state?
Training
• Concealed Carry Permit Training
• In 2016 we partnered with DPS to embed a suicide prevention module into
concealed carry course. We will work with stakeholders to ensure that permit
holders are trained when they first obtain their permit and when they renew it.
• Counseling On Access to Lethal Means (CALM) training
• Suicides that occur during an argument indicate not all suicides are planned; lethal
means counseling may be advisable with people at risk, in addition to people who
disclose plans to attempt suicide.
• Gatekeeper Training
• We have embedded a firearm safety module into our suicide prevention training and
will set a goal to increase use of that module.

18. What are the conclusions of the state suicide
prevention coordinator’s study on the use of guns
in the state?
Health Care Quality Improvement
• With half of suicide decedents seen in the hospital in the year before
death, DSAMH encourages all health and behavioral health care systems to
adopt and implement a goal of zero suicide for people in care by adopting
the Zero Suicide framework. DSAMH hosts a Zero Suicide Learning
Collaborative and invites all interested providers to join us in this aspiration
goal (email kmyers@utah.gov for more information).
• Health care settings are also poised to convey the message of the potential
safety advantage of storing guns away from home or otherwise inaccessibly
to the patient until he or she recovers. Many providers have not
historically been trained on how to navigate these conversations. We
encourage all providers to become trained in Counseling on Access to
Lethal Means (CALM).

19. What are the conclusions of the state suicide
prevention coordinator’s study on the use of guns
in the state?
Partnerships
• Firearm Safety for Suicide Prevention Work Group of the Utah Suicide
Prevention Coalition will be meeting in December to review the
report in depth and come up with additional prevention strategies.
We will continue to expand these critical partnerships.
• Firearm Safety Mini Grants: DSMAH will provide mini grants to six
communities to further outreach to partners from the firearm
community to further firearm suicide prevention efforts.

20. What are the conclusions of the state suicide
prevention coordinator’s study on the use of guns
in the state?
Policies
Utilize the best available data available to help guide policy decisions
regarding firearms and suicide from experts in suicidology. Some
resources/research include:
• Means Matters-Harvard School of Public Health
https://www.hsph.harvard.edu/means-matter/
• Michael D. Anestis, Joye C. Anestis, “Suicide Rates and State Laws
Regulating Access and Exposure to Handguns”, American Journal of Public
Health 105, no. 10 (October 1, 2015): pp. 2049-2058.
• Kivisto AJ, Phalen PL. Effects of risk-based firearm seizure laws in
Connecticut and Indiana on suicide rates, 1981-2015. Psychiatric
Services. 2018; 69(8): 855-862.

21. Suicide and Firearm Injury in
Utah: Linking Data to Save Lives
Harvard T.H. Chan School of Public Health
in partnership with the Utah Division of Substance Abuse and Mental
Health, Utah Department of Health, and the Utah Department of Public
Safety

22. How many deaths, by type of
death, involved the use of a
gun?

23. 85% of firearm deaths in Utah are suicides.

24. Where did the victim obtain the gun, and was it
obtained legally?
• ATF Trace Data will be supplied as an amendment to the report.
• This will give us an idea of if the decedent was original purchaser.

25. Most suicide decedents (about 87%) could have
passed a background check for firearm possession
on their day of death.

26. Did the victim have a history of
mental illness, or was the victim
undergoing treatment by a
mental health professional?

28. Most firearm decedents could have passed a
background check, regardless of whether they had
a drug or alcohol problem, a criminal problem, or
previous suicide attempts.

29. Were any medications, illegal
drugs, or alcohol involved?

30. Alcohol was the drug that most frequently
tested positive among suicides.

31. If the incident involved the
injury or death of another, did
the shooter have a history of
domestic violence?

32. On average, a homicide-suicide incident occurred
every other month in Utah; 91% were intimate
partner or domestic violence.

33. What were the demographics of the shooter and
the victim, including criminal history and gang
affiliation?

34. What were the demographics of the shooter and
the victim, including criminal history and gang
affiliation?

35. Are gun deaths seasonal?
• Considering all firearm deaths, there are no seasonal differences.
• Suicide: There are no major differences by season, but there is a small
increase in March.
• Homicide: Differences are relatively small from month to month, however
homicides are most likely in June, July, November and December; least likely
in March and April.
• Accident, Law Enforcement-Involved, and Undetermined Intent Deaths:
Incidents are too rare to determine seasonality.
Data Source: Utah Office of the Medical Examiner, 2014 to 2017

36. How many individuals in the
state own guns?

37. Nearly half of Utah households have firearms, with
ownership highest in rural counties and in Tooele.

38. 13% of households in the most rural counties have
an unlocked and loaded firearm at home compared
with 6% statewide.

39. Heavier drinkers were more likely, and people with
poorer mental health were as likely, as others in
Utah to report having guns at home.

40. Q&A
Kimberly Myers
kmyers@Utah.gov
Suicide Prevention and Crisis Services Administrator
Utah Division of Substance Abuse and Mental Health
Michael Staley
mstaley@Utah.gov
Suicide Prevention Research Coordinator
Utah Office of the Medical Examiner