1. Briefly describe the problem indicating the “burden of disease” including morbidity and mortality and changes that have occurred in recent years.
Suicide is one of the major public health concerns within the United States. Among the leading causes of death in the United States, suicide rates continue to skyrocket each year. According to the Centers for Disease Control and Prevention (CDC) leading causes of death 2016 reports, suicide ranked at the tenth leading cause of death in the United States—being the cause of death of nearly 45,000 individuals. “During 1999–2016, suicide rates increased significantly in 44 states, with 25 states experiencing increases >30%. Rates increased significantly among males and females in 34 and 43 states, respectively. Fifty-four percent of decedents in 27 states in 2015 did not have a known mental health condition. Among decedents with available information, several circumstances were significantly more likely among those without known mental health conditions than among those with mental health conditions, including relationship problems/loss (45.1% versus 39.6%), life stressors (50.5% versus 47.2%), and recent/impending crises (32.9% versus 26.0%), but these circumstances were common across groups.” (CDC, Morbidity and Mortality Weekly Report, 2018). It is vital that health professionals understand and consider social statistic trends and common mechanisms of death among all levels when developing effective prevention techniques.
2. Briefly describe the course of the disease or condition using the concepts of incidence, prevalence and case-fatality. If these concepts are not relevant to your subject explain what they mean and why they are not relevant
Suicide is the tenth leading cause of death in the United States. Individuals may begin to experience suicidal thoughts and emotions when they feel hopeless and incapable of searching any other solution to their problems. Often, suicidal thoughts are related to mental health conditions, emotional distress, and lost of a loved one. According to Harvard School of Public Health, the percent of people who die in a suicide attempt by several methods of suicide varies. Firearms have the highest case fatality (82.5%), and drug/overdose ingestion (1.5%) and cutting (1.2%) have the lowest. Effective intervention and prevention can help in combating suicide attempts.
3. Identify at least two at-risk groups (those with an increased probability of developing and/or experiencing bad outcomes). Use the concept of relative risk and calculate or obtain relative risks to describe their probability of developing the condition or specific disease(s) relative to a specific low risk group.
Some demographic groups are at considerably higher risk of committing suicide compared to other groups. Selected risk factors may be significant to one group in comparison to another. The types of suicidal signals that are most common also vary across various groups. According to the CDC, in 2016 suicide was the second leading cause of death among adolescents, men, and women between the ages of 10 and 34, and the fourth leading cause of death among men and women between the ages of 35 and 54. Relative risk in relation to individuals who are likely to commit suicide varies between age, race, sex, and cognitive competency.
Individuals of all ages with mental illnesses have an increased probability of committing suicide. The distress and suffering caused by the illness is often overpowering—individuals may experience feelings of an irresistible desire to end their life. “The suicide rate among people with a mental illness is at least seven times higher than the general population. It is one of the main causes of premature death in this group.” (SANE.org, Suicidal behavior) Depression is the number one mental health condition associated with suicide in the United States. Individuals suffering from depression frequently find speaking about their traumatic experiences difficult causing the condition to advance undiagnosed and/or untreated.
4. Identify 5-8 options for potential interventions to address the problem. For each of the options identify the primary focus in terms of When (Primary, secondary or tertiary prevention), Who (individual, at-risk group, population) and How (education, motivation, obligation, invention). Number each of the potential interventions. Identify each option then bullet or create a table giving your answers to When, Who and How for each option.
Intervention When Who How
Public Health Marketing Primary Prevention: Measures aimed at preventing individuals from committing suicide before the process begins.
Addresses an entire population (the nation, state, local county or community, school or neighborhood).
Education: Educating individuals and families on coping methods and enhancing knowledge on ways to speak and seek help for suicidal loved ones.
Reducing Access Primary Prevention: Processes used to reduce the availability of common tools and methods used to commit suicide.
At-risk groups Obligation and intervention: Removing direct access to common triggers—keeping the individual safe.
Screening Programs Secondary Prevention: Programs aimed at identifying and assesses at-risk groups. Individuals
At-risk groups—youth Intervention: Measures such as active observation, evaluation through play, and one-to-one discussions that lead to early diagnosis and prompt treatment.
Skills Training Secondary Prevention: Programs that expose individuals to their talents—showing them that they are special. Trainers must practice active listening—allowing a clear understand the individual's feelings from his/her point of view. Individuals Motivation: Programs that provide at-risk individuals with opportunities for responsibility and leadership in positive aspects, while supporting the development of self-esteem.
Suicide Support Groups Tertiary Prevention: Group interventions to improve views of life and reduce suicidal triggers and temptations. At-risk groups
Population Education, Motivation, Intervention
5. From these potential interventions select 3 to 4 that you identify as most effective. Specifically indicate the advantages and disadvantages of each intervention that you selected and why you think they would be effective. Identify each option then bullet the advantages and disadvantages
Effective Intervention Advantages Disadvantages
Reducing Access Reducing access allows families and caregivers to monitor the lives of their loved ones. Placing restrictions on direct access to commonly used methods and tools for suicide can be effective in reducing suicide or suicide attempts. Individuals may explore alternate options—increasing their risks.
Skills Training Exposing and training individuals who are at-risk for suicide in skills that they posses help build self-esteem. They may begin to acknowledge their self worth and personal competency—lowering their risk for a suicidal attempt. At-risk individuals may experience difficulty finding/ accepting their skills and talents.. This can cause their triggers to heighten—believing that they are incapable and/or incompetent.
Suicide Support Groups Feeling isolated or lonely is common among suicidal individuals; support groups can assist in coping with those emotions that trigger suicidal thoughts. At-risk individuals may feel pressured or provoked by the stories of others within the group.
6. Indicate methods that you would use to implement the options that you have selected in #5
Many dynamics can increase the risk of suicide, however other factors can provide the support necessary to protect at-risk individuals from suicide. There are countless strategies that are aimed at preventing suicide attempts; they are most effective when they are used together as part of a carefully designed program. To implement successful interventions, methods that incorporate a systematic, data-driven process to understand the suicidal triggers are required. Health professionals should set clear coping mechanisms for at-risk individuals. In addition, creating activities that increase their views on self-love, acceptance, and value can decrease their risk of attempting suicide. Overall, suicide prevention and intervention methods are most effective when they are made up of multiple strategies that work together to provide assistance to individuals and families.
7. For at least three of your most commonly used citations evaluate each one separately indicating each component of quality using the criteria presented in the text, Public Health 101: Healthy People. (Table 3-4) on page 60.
Centers for Disease Control and Prevention (CDC): The purpose of the CDC is clear, this site provides concrete information on numerous diseases and health conditions, causes, interventions, prevention approaches, and statistics. The CDC site is easy to navigate and the information provided is reliable; there are answers to specific questions and studies with evidence. The links within the site are functional and resourceful.
American Foundation for Suicide Prevention (AFSP): The overall quality of the AFSP site is both informative and resourceful. The AFSP is a non-profit organization dedicated to suicide prevention. This site provides various support methods to assist at-risk individuals and their families. The AFSP provides reliable information and research studies specifically about suicide. Overall, the AFSP site was extremely educational and user friendly.
Harvard.edu. School of Public Health: Harvard is an Ivy League university; the school of public health's mission is to advance the public's health through scholarship, research, and interaction. The information provided is relevant to studies and supported by creditable resources. The site was easy to navigate and understand, while providing reliable material on suicide and case fatality rates.
*In order of use/mention
Morbidity and Mortality Weekly Report (MMWR). (2018, June 07). Retrieved December 2, 2018, from https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm
Riegelman, R. K., & Kirkwood, B. (2015). Public health 101 healthy people-healthy populations. Burlington, MA: Jones & Bartlett Learning.
Lethality of Suicide Methods. (2017, January 06). Retrieved December 7, 2018, from https://www.hsph.harvard.edu/means-matter/means-matter/case-fatality/
National Center for Health Statistics. (2018, January 11). Retrieved December 2, 2018, from https://www.cdc.gov/nchs/pressroom/sosmap/suicide-mortality/suicide.htm
Risk Factors and Warning Signs. (n.d.). Retrieved December 2, 2018, from https://afsp.org/about-suicide/risk-factors-and-warning-signs/
Suicidal behaviour. (n.d.). Retrieved December 7, 2018, from https://www.sane.org/mental-health-and-illness/facts-and-guides/suicidal-behaviour
Read "Reducing Suicide: A National Imperative" at NAP.edu. (2002). Retrieved December 7, 2018, from https://www.nap.edu/read/10398/chapter/10#274
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