UND partners with more than 20 North Dakota orgs on suicide prevention effort

Oct. 15—Editor's note: If you or someone you know is experiencing suicidal thoughts or is in crisis, help can be found by calling or texting 988 for the Suicide and Crisis Lifeline or by texting "HOME" to 741-741. Veterans may choose to reach out to the Veteran's Crisis Line, which can be accessed by calling 988 and then pressing 1. LGBTQ+ community youth can reach The Trevor Project, by calling 1-866-488-7386, or by texting "START" to 678-678.

GRAND FORKS — Academic leaders at the University of NOrth DAkota, alongside more than a dozen partners across the state, hope to increase suicide prevention efforts for veterans, rural individuals and LGBTQ+ youth in the state's western half with the help of a new grant.

"We believe suicides are preventable. That is absolutely the aspiration," said Thomasine Heitkamp, longtime faculty member and research developer in the Office of the UND Vice President of Research and Economic Development.

UND secured the grant, called North Dakota Healthcare, Opportunity, Prevention, and Education in Suicide prevention (ND HOPES), from the U.S. Centers for Disease Control and Prevent. It will provide the university with nearly $1 million per year for five years to implement multiple prevention and outreach programs across a 21-county area — mostly west of Bismarck.

The grant is a cooperative agreement that will implement suicide prevention programs in the state's western half and will also involve direct community outreach. As a part of the grant, UND will work with NORC at the University of Chicago, along with more than 20 state government agencies and nonprofit organizations. NORC is one of the largest independent social research organizations in the U.S. It was established in 1941 as the National Opinion Research Center.

Ethan Dahl, UND assistant professor in education, health & behavior studies and principal investigator of the grant, said work will focus on suicide prevention for LGBTQ+ youth, veterans and rural residents in the 21-county area because suicide rates among those populations are especially high.

"The rates are shockingly high," he said. "It's really sad."

North Dakota's death by suicide rate is greater than the national average. In 2020, the suicide rate in North Dakota was 18.1 per 100,000 residents, compared to 13.5 people per 100,000 across the U.S., UND Today noted in a story about the grant.

According to the CDC, there were 135 deaths by suicide in 2020 in North Dakota.

In rural areas that rate is higher — around 20.6 people per 100,000. And the death by suicide rate in the 21-county area covered by the grant is at 26.2 people per 100,000.

According to the CDC, suicide is the second-leading cause of death among people aged 10 to 14 and the third-leading cause of death for people 15 to 24.

The Trevor Project, an organization that focuses on suicide prevention efforts among lesbian, gay, bisexual, transgender, queer and questioning youth, says LGBTQ youth are more than four times as likely to attempt suicide than their peers. The Trevor Project estimates "more than 1.8 million LGBTQ youth (13-24) seriously consider suicide each year in the U.S. — and at least one attempts suicide every 45 seconds."

Overall across the country, the rate of suicides increased by 4% from 2020 to 2021 after two consecutive years of decline in 2019 and 2020, according to provisional data from CDC's National Center for Health Statistics released on Sept. 30.

The new provisional data show the number of suicides increased from 45,979 in 2020 to 47,646 in 2021, the CDC said. The number of suicides in 2021 was still lower than the all-time high of 48,344 in 2018.

Heitkamp noted that many veterans deal with post-traumatic stress disorder, putting them at a higher risk for suicide. Additionally, she said, rural areas are often isolated from access to mental health service providers.

The ND HOPES program is broken down into three tiers.

The first includes community-based interventions, including creating protective environments. Dahl said that will involve working to reduce access to lethal means of individuals at risk of suicide — safe storage of guns is one of the main focuses, for example.

Time is an important factor for someone who is contemplating suicide. The longer it takes for someone to act on those thoughts, the rate of completing suicide decreases significantly, Dahl said.

"Something as simple as having a lock on a gun can be enough to stop an individual from actually going through and completing a suicide," he said.

UND Today reported that training will be offered to select groups that come into regular contact with the three underserved groups, such as gun shop and range owners, organizations that serve veterans, staff working with struggling youth and affiliates of Dakota OutRight, a program that works with LGBTQ+ individuals.

That will also involve working with Sources of Strength, a now international youth suicide prevention project based in Bismarck, to implement their programming in schools.

The second tier will cover health care-based interventions with the implementation of Zero Suicide, an aspirational goal and a set of tools and strategies to effectively implement suicide care in health and behavioral health care settings. That work will focus on ensuring there is stronger access and delivery of suicide care within those communities.

Tier 3 focuses on reducing the provider shortages through tele-mental health. The program will deliver "evidence-based interventions including suicide risk assessment, safety planning intervention, Dialectical Behavior Therapy and follow up," according to UND Today.

Dahl said it's important for UND to show the efforts aren't just working for these communities, but working with them to bring in resources and other programming that's already going on in the state.

"We need to get buy-in from these communities to help them work through these problems themselves," he said. We recognize that this is an issue, and we want to do what we can to help the individuals in these communities work through ... this with them."

Each state received one grant for suicide prevention work, but UND was the only university to receive the dollars to help carry out the programming.

Heitkamp said the work connects UND with the western part of the state. It also shines a light on something that affects families statewide, she said.

"It's positive and everyone worries about suicide," she said. "It's rare that people (don't) have someone from their family who's struggling with some type of mental health or addictive disorder, so how can we be at that table with the key stakeholders doing this work?"

Dahl emphasized the importance of partnerships at the heart of this work.

"I think we are way ahead of the ball in terms of some of where these other states are because we already have commitment from so many of these different organizations," he said. "We're just trying to bring this funding in to boost them up, increase their outreach (and) bring them into this catchment area where we're going to be implementing some of these programs."