We want the trend of suicide deaths in Vermont to go down.

This is a Vermont Department of Health Healthy Vermonters 2020 objective and county level data is available.

Author: Vermont Department of Mental Health

Suicide is a major public health challenge, but it is often preventable. In 2016, Suicide was the 8^th leading cause of death for all Vermonters. ¹

Over the past two decades, trends in death by suicide have increased in Vermont and the United States. Since 2000, this rate in death by suicide has increased by 49%, which is the second largest percent increase in the United State (13.2 per 100,000 persons 1999-2001 to 19.7 per 100,000 persons 2014-2016). ²

In recent years, more than 100 Vermonters have died by suicide each year. Vermont's rates of suicide, calculated as the number of deaths by suicide per 100,000 people, are higher than the national averages.1 . Deaths by suicide in Vermont appear to follow national patterns in terms of age and gender breakdowns. More men die by suicide than women. Firearms are the method used for nearly two-thirds of the deaths by suicide. ¹

Only about a third of people who took their own life had a reported history of mental health treatment.³ Suicide is not just a mental health problem, it is community problem. Suicide touches every socioeconomic status, race, identity, and community… and everyone can help.

The Vermont Departments of Health and Mental Health are collaborating with community partners to reduce these rates.  One Agency cannot turn the curve alone; there are many partners who have a role to play making a difference.

Sources

1 Vermont Vital Statistics. For more data on suicide mortality and self-harm morbidity, please visit our website.  

2 Vital Signs: Trends in Suicide Rates and Circumstances Contributing to Suicide — United States, 1999–2016 and 27 States, 2015. MMWR Morb Mortal Wkly Rep 2018;67(22):617-624.

http://www.healthvermont.gov/health-statistics-vital-records/surveillance-reporting-topic/injuries

Suicide is a major public health challenge, but it is often preventable. If you or someone you know needs help call the National Suicide Prevention Lifeline is 1-800-273 TALK -- A crisis intervention and suicide prevention phone service available 24/7 at 1-866-488-7386

The Agency of Human Services is currently using the scorecard to assess our agency contribution to reducing the rate of suicide in Vermont, and to keep track of key data elements to guide our efforts. One Agency cannot turn the curve alone; there are many partners who have a role to play making a difference.

Updated in July 2019

Suicide in Vermont is a population health problem. More importantly, with a comprehensive approach, it’s a preventable problem.

The Agency of Human Services (AHS) and its Departments are working to reduce the rate of suicide in Vermont. AHS recognizes that preventing suicide is a community wide effort along with strong collaboration with healthcare providers. As such, Agency Of Human Services has created a AHS Suicide Prevention Leadership Group with representation from AHS central office as well as the Departments of Mental Health (DMH), Health (VDH), Disabilities Aging and Independent Living (DAIL), Children and Families (DCF), Corrections (DOC) and Vermont Health Access (DVHA). In addition there is a public-private-academic partnership at the Suicide Prevention Surveillance Workgroup headed by the Vermont Department of Health with participation from DMH, University of Vermont (UVM) and Vermont Suicide Prevention Center.

Vermont’s suicide prevention plan aligns closely with the World Health Organization’s (WHO) suggested strategy. The plan categorizes actions into three broad categories; Universal Prevention, Selective Prevention and Indicated Strategies essentially signifying primary, secondary and tertiary prevention strategies. These are broad and take a population health approach to this problem.

The Leadership Group in alliance with the Vermont Suicide Prevention Center (VtSPC) has created a broader group entitled the Vermont Suicide Prevention Coalition where there is representation from provider groups (inpatient and outpatient) suicide attempt survivors, family members, Agency of Human Services, Agency of Education, schools and higher educational institutions, Veterans Affairs, legislators as well as the Centers for Health and Learning. The coalition guides and informs the statewide prevention efforts.

The Vermont Department of Mental Health (DMH) will work in partnership with the Agency of Human Services Leadership Group as well as the Center for Health and Learning (CHL) will promote interventions in all three categories i.e. Universal, Selective and Indicated.

Universal Strategies

1. Increase access to healthcare
2. Promote positive mental health
3. UMatter campaign plans to accomplish the following:
   • Promote the message that suicide is preventable
   • Equip gatekeepers with the knowledge and skills to respond effectively to those in distress
   • Increase public awareness of the importance of addressing mental health issues
   • Establish a broad-based suicide prevention and intervention strategy throughout Vermont
   • Sponsor a media campaign to reduce the stigma associated with being a consumer of mental health, substance abuse and suicide prevention services
   • Promote positive youth development
   • Put into place long-term, sustainable approaches to prevention and early intervention
4. Vermont Gun Shop Project:

Since nearly two-thirds of all deaths by suicide in Vermont use firearms as the means, Department of Mental Health has partnered with the Center for Health & Learning, Vermont Sportsmen’s club, GunSense Vermont along with Suicide prevention coalition to increase the knowledge and awareness of gun shop owners in Vermont about the use of guns for suicide. In addition resources and helpline information will be made available to gun shops to post in their shops to give those who may go to a gun shop the information they need to get timely help

Selective Prevention

1. Targeted services for people at higher risk: This will include gatekeeper training as well as Mental Health First Aid training for those in key positions to identify people at higher risk. These gate keepers will be trained in screening for depression as well as trained in screening for suicidality.
2. Helplines:
   • DA crisis services
   • 211 - National Suicide Prevention hotline
   • Peer run warm line
   • Domestic violence hotline
   • Sexual violence hotline

Indicated Strategies:

Vermont has adopted the Nation Action Alliance for Suicide Prevention’s platform called Zero Suicide. Zero Suicide project is a collection of intervention designed to improve care for those identified with needing help with suicidal thoughts and other related problems. The alliance defines Zero Suicide as "a commitment to suicide prevention in health and behavioral health care systems, and also a specific set of tools and strategies. It is both a concept and a practice."

The four areas of intervention under this project are as follows:

1. Screening: Embed widespread screening of depression and suicidality in healthcare settings including primary care practices. The Blueprint for Health Medical Home practices to enhance their screening regarding suicidality by using Patient Health Questionnaire (PHQ) questions about depression and suicidal thoughts in Primary care settings.
2. Assessment: For those patients who screen positive to then do an enhanced screening/severity assessments regarding severity of suicidality e.g. Columbia Suicide Severity Rating Scale (CSSRS). Support Blueprint’s community health teams to help patients access appropriate treatment with the local DAs for individuals who screen as needing an intervention
3. Suicide focused/ competent treatment: Support Designated Agency (DA) pilot sites to access training in modalities specifically about care for the suicidal person:
   • Counselling about Access to Lethal Means (CALM)
   • Assist DA pilot sites to train clinicians in using Collaborative Assessment and Management of Suicide (CAMS) which includes an online initial training followed by a learning collaborative style continuous education on CAMS. Build capacity for ongoing training in Vermont by developing a Train the Trainer model
   • Reinforce use of Cognitive Behavioral Therapy and Dialectical Behavioral Therapy as the best treatment practices for problems commonly associated with suicidality such as depressive disorders, anxiety disorders and personality disorders. The CAMS methodology is complimentary to these treatments methods.
   • Roll training out to providers outside of the DAs: Community Health Teams, therapists embedded in Medical Homes, etc.
4. Follow-up: Partner with the inpatient psychiatric units as well as emergency rooms at hospitals to develop and send caring letters after a person who had suicidal thoughts is discharged from their facility. Designated Agency Crisis Centers to develop and send caring letters after a person who had suicidal thoughts is discharged from the hospital.

Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on mental health indicators, check out our Public Health Data Explorer.

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. Click here for more information.

This indicator is also part of the State Health Improvement Plan (SHIP), a five-year plan that prioritizes broad Healthy Vermonters 2020 goals: reducing prevalence of chronic disease, reducing prevalence of substance abuse and mental illness, and improving childhood immunizations. The SHIP is a subset of HV2020 and details strategies and planned interventions. Click here for more information.

Act 186 was passed by the Vermont Legislature in 2014 to quantify how well State government is working to achieve the population-level outcomes the Legislature sets for Vermont’s quality of life. It will assist the Legislature in determining how best to invest taxpayer dollars. The Vermont Department of Health and the Agency of Human Services report this information annually. Click here for more information.

The Agency of Human Services (AHS) operates in support of the Governor’s overall agenda for the state and his seven statewide priorities. Additionally, AHS’ mission and the work of its six Departments are targeted to achieve results in four strategic areas: the reduction of the lasting impacts of poverty; promotion of the health, well being and safety of communities; enhancement of program effectiveness and accountability; reform of the health system. Click here for more information.

Suicide is determined using the International Classification of Disease version 10 (ICD-10) codes for underlying cause of death (X60-X84,Y87.0, U03). Suicide rates are age-adjusted to the 2000 U.S. standard population. Age adjustment helps take into account the different age structures of populations that die by suicide, so Vermont’s rates can be compared to the U.S. and other jurisdictions. For more detailed information on age adjustment visit http://www.cdc.gov/nchs/data/statnt/statnt20.pdf.

This indicator is updated with final data from Vermont Vital Statistics.