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Abstract
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In early 2017, within Brevard County, Florida, a community-based Task Force was assembled to intervene when the pediatric suicide rate reached one of the highest rates in the state of Florida. Pediatric mental health was previously identified as a top priority on multiple community health needs assessments performed by organizations throughout the region. Within the ensuing 24 months, the pediatric suicide rate was reduced to near zero, the lowest rate the region had seen in more than 20 years.
Over the past decade, the rate of suicide has continued to climb in the United States.1,2 Pediatric mental illness continues to take center stage as school shootings and other unfortunate outcomes related to mental illness are becoming commonplace in society.
The state of Florida is consistently ranked among the lowest for mental health care expenditure per capita.3 Within Brevard County, FL, the pediatric suicide rate for 2017 was one of the highest in the state and represented ongoing significant increases from prior years. Postmortem review of the suicide deaths from the Brevard County Medical Examiner's investigative reports indicated that most of these deaths did not have a health system contact in the months preceding the suicide. The opioid epidemic had also taken its toll on Brevard County, leading to the third highest rate of overdose mortality within the state of Florida.4 In this context, multiple members of the community called upon regional health network leadership (L.T.J., the Chairman of Psychiatry and Behavioral Health Services) to guide them in the pursuit of reducing pediatric suicide. Said leadership assessed the situation and advised that elimination of pediatric suicide was within the realm of possibility. L.T.J introduced the concept of a community Task Force and provided vision and advisement on every level and at every stage of its activity.
Eliminating pediatric suicide was the goal of the community Task Force. Given the fact that most of the suicide victims did not have contact with any health system in the months prior to their deaths, the intervention needed to be focused heavily within the community. Many previously published suicide prevention initiatives, including the Zero Suicide movement, primarily functioned within the confines of the health system.5-7
The Task Force was initially comprised of numerous community activists, school teachers, concerned parents, students, and a few mental health system leaders who gathered together to discuss the problem. In the past, when such tragedies struck the community, there was a tendency to have a discussion that did not lead to the longitudinal, cross-sectional interventions that could systematically address the problem at hand. Upon advisement from L.T.J., it was decided that a town hall discussion was not the answer, and the notion of an ongoing workgroup was introduced and agreed upon. The Task Force was initially led by L.T.J., a school teacher, and a community activist. The initial undertaking was to determine what the optimal composition of the Task Force should be given the overarching goal, and how to create momentum to charge the community with the unique challenge of preventing pediatric suicide. Because the Task Force was completely voluntary and community-based, the decision was made to welcome anyone who wanted to join but to also extend strategic invitations to leaders in various sectors across the region with some ability to influence a child. Capitalizing on momentum generated by community activists, these invitations were sent to leaders within law enforcement, the school system, state legislature, the community 211 Agency (a referral agency for community health and social service supports),8 faith communities, municipal leadership, multiple health care organizations, health insurance organizations, the YMCA, and the Boys & Girls Clubs of America.…
Language: en |