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Report: Improvements needed in state’s suicide prevention efforts

By MARY SELL, Alabama Daily News

A recent review of the state’s suicide prevention efforts found a “fragmented” system in need of more focus and dedicated funding.

The suicide death rate of Alabamians increased an average of 34.6%, and as high as 85% for some groups, between 1999 and 2018, the state report said.

“No single organization is responsible for coordinating the state’s suicide prevention efforts, resulting in no fewer than four state agencies and multiple partners implementing a fragmented system,” said the September report from the Alabama Commission on Evaluation of Services.

The report is the first for the commission, referred to as ACES, created through legislation in 2019 “for the purpose of advising the Legislature and the governor regarding the evaluation of services, which may include evidence-based policymaking, within the state.”

Rep. Rich Wingo, R-Tuscaloosa and Sen. Arthur Orr, R-Decatur, sponsored the legislation. Orr is now the commission chairman.

“I think the ACES report shows that we have a need for improvement in the area of suicide prevention, but I’m also very pleased with the Alabama Department of Public Health’s steps that they’ve been taking to update our state plan,” Orr told Alabama Daily News.

Other key findings in the report include:

• Alabama lacks a comprehensive plan that addresses the entire at-risk population;

• Lack of consistent, dedicated funding has resulted in lack of capacity and collaboration, missed opportunities, and other inefficiencies that have prevented effective suicide prevention efforts;

• With no approved list of training materials, the approaches taken by schools to train certificated personnel in suicide prevention are disjointed across the state;

The report recommends the Legislature and governor designate a lead organization or agency to develop and publish a comprehensive suicide prevention plan and require it be evaluated against defined performance metrics. It should be updated at least once every five years.

Other recommendations include:

• Establishing a full-time state suicide prevention coordinator to oversee all state efforts;

• Approving legislation to require hospitals to report discharge data regularly to the Alabama Department of Public Health;

• Require the suicide prevention coordinator to submit a report to the governor and the Legislature annually on progress made under the prevention plan.

“It shows us we have a ways to go, but I’m glad for the focus,” Orr said of the report.

To create the report, the commission worked with several state agencies, including ADPH and the departments of mental health, education and veteran’s affairs.

“We are excited about the initial steps being taken following our first evaluation,” ACES director Marcus Morgan told Alabama Daily News. “Implementing recommendations is more meaningful through the cross-branch collaboration established by our commission.”

The Alabama Department of Public Health’s most recent suicide prevention plan is from 2004. A new draft plan was developed at the end of 2018, but was very youth-focused because of grant funding that ADPH received, Betsy Cagle, community based programs branch director for ADPH, said.

The Suicide Prevention Network of Alabama, a collaboration of service providers and state agencies, was created in 2019 and Cagle said the plan was kept in draft form until the prevention network could participate in updates. In 2020, ADPH, the prevention network and ADMH began working on updates to the plan. Now, ACES’ recommendations are being incorporated into the plan, Cagle said.

“It will be good to have an updated plan for our state to prevent suicides, particularly in light of COVID,” Orr said. “But with plans we’ll also need to follow through with funding to ensure that the plans are able to be executed accordingly.”

Data on increased suicides related to the pandemic is not yet available, Cagle said.

A Centers for Disease Control and Prevention report in August showed that the percentage of people who had seriously considered suicide had increased greatly between 2018 and 2020. The biggest increase was in young people.

First report, more to come

The commission has a four-person staff and received $500,000 in this year’s state education budget.

“I’m very encouraged by the ACES report, and its breadth and depth,” Orr said. “It’s the staff’s initial effort  to evaluate a particular program in our state.”

Orr chairs the Senate education budget committee and is also on the General Fund budget committee. He said it is often frustrating as a budget appropriator to know what state services are working well and deserving of more funding.

“This will give us a real tool in the appropriation process and in the decision making for agencies and others when it comes to deciding if we need to either expand successful programs, do we need to recalibrate or make substantial changes in marginally effective programs or do we need to just wind them up?”

The commission expects upcoming reports to focus on community corrections and prison education programs.

“The nature and depth of each evaluation will depend on direction from the commission,” Morgan said. “In general, our reports will always seek to provide meaningful information in order to promote continuous improvement.”

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