 So we are going to begin our next panel, which is Exploring Community Solutions in a few minutes. But quickly, we'd like to share a few videos with you from our Find Your Words campaign. And it was referenced earlier in Dr. Mordecai's comments this morning. So could we please play the videos? Thank you. So it's my pleasure now to introduce Colleen Carr. She is the Director for the Secretariat for the National Action Alliance for Suicide Prevention or the Action Alliance, Nation's Public-Private Partnership for Suicide Prevention. It coordinates a comprehensive national suicide prevention response in the U.S. and works with more than 250 partner organizations to coordinate the implementation of the National Strategy for Suicide Prevention. She's responsible for providing strategic direction to the Action Alliance's distinguished leadership and working with leaders from federal agencies in the private sector to help coordinate and align efforts around advancing the National Strategy for Suicide Prevention. She cultivates partnerships and commitments to support our national efforts as well. Welcome Colleen. Colleen will then be introducing the other panelists. Thank you. Good morning. How is everyone? So I just want to thank Kaiser for having this event today and Dr. Mordecai who's been on the Action Alliance Executive Committee for a number of years now for their national leadership around suicide prevention. It's really great to see where this work continues to go. We have a panel today that's going to be all about exploring community solutions. So a nice follow on to our morning topic around clinical and we'll talk a little bit about how these efforts really need to come together into a comprehensive approach. So a little about the Action Alliance. Dr. Franklin referenced earlier today and is another one of our Executive Committee members in the room today. The Action Alliance started in 2010 and we are the nation's public-private partnership for suicide prevention. And we're really tasked with coordinating the national response to suicide, advancing the National Strategy, and bringing new non-traditional partners to the table because we know if we could solve the suicide problem with mental health and healthcare alone we'd be making a lot more progress than we've made to date. And so we're really charged with reaching out to new partners and new sectors and getting them involved in our effort. Around the table we have all of the federal agencies involved in suicide prevention so senior leaders from Defense and VA and Education, Justice, Homeland Security, and the many components of Health and Human Services from CDC to SAMHSA to HRSA and NIMH. So really broad diversity around our public sector stakeholders. And then on the private side we have leaders from the auto industry, construction, railroad, news media, entertainment, law enforcement, technology, social media, etc. So feel free to go to our website to see the breadth of some of our partners involved but really we're all aligned around advancing the National Strategy and that's our roadmap. And I'm going to talk a little bit about our priorities and lead us into the community conversation. So we have the National Strategy. One of the first things we did at the Action Alliance after being launched in 2010 was revised this. And in 2010 with the Surgeon General's Office released the updated strategy. There's 13 goals and 60 objectives. So one of the first things we realized was that we were not going to do all of that at once. So we've selected some high priority objectives from the National Strategy which I'll talk about today. Our first priority is transforming health systems and this is where the early efforts to catalyze zero suicide came from around 2012. And so this work includes both scaling up zero suicide as well as transforming crisis care through the Crisis Now initiative, improving financing and care transitions which Dr. Cornette talked about as well. But we know that health care is just one piece of the puzzle because we need to have strong communities around health systems to make sure we're getting people into care. But then when they're leaving care they're going back into the community. They're also, the community is going to be where they're living, where they're working, where they're going to worship services and we really need a comprehensive approach. And so we have transforming communities as our second priority. And this is where our work with faith communities comes into play and I'll talk a little bit about that but Dr. Mullick will certainly go into more detail about the role of faith communities and the role of the workplace. We know people especially adults at highest risk for suicide spend the majority of their day at the workplace. So we need workplaces to be prepared and supportive of those who are struggling with mental illness, thoughts of suicide. And it's also where people go back after treatment to find meaningful work as Dr. Franklin talked about this morning. So we need to improve our health systems. We need stronger, more supportive communities. But we also have a national narrative about suicide prevention and we're committed to really changing that conversation about suicide nationally so it's supporting our prevention efforts. For far too long we didn't talk about suicide at all. Then we started talking about it but our narratives really focused on the death and the despair and the tragedy of suicide. But we know there's so much more there. We know that millions of people think about suicide every year and the vast majority of them do not go on to die by suicide as we've heard. So what is their story? What is their story of hope and recovery and survival in these circumstances and how can we tell those narratives? And so that's our effort nationally to change the conversation. Our partners at CDC released this data over the summer and it was so important because we know that it's more than just mental health but we needed stronger data to point us to the direction of where do our public health efforts for suicide prevention focus. So we know now that while 54 percent of suicides had a known mental health condition, all of these other factors were playing a significant role in suicide. So relationship problems, substance use, job financial problems, legal problems, physical health or a crisis that has just occurred or is about to occur. And so this again directs us to that public health approach where we can address these factors as well as the mental health condition. So our community effort as I mentioned is really focused on both faith and workplace as where we've started. We have a faith task force that has launched the faith hope life campaign and this is really focused on getting every faith tradition involved in suicide prevention nationally. We have a website where there's resources for various faith traditions outlined by the traditions both Abrahamic faiths and non-Abrahamic faiths and we really wanted to make this a place where people could go to get started. We know faith leaders are already involved in suicide prevention because people are going to them in crisis. They're conducting services when someone has been who has lost their life to suicide and supporting families. But we wanted to be more intentional about that. So one of the first things that we did was create kind of an easy entry point. So we want faith leaders to help us get people into treatment. We want them to help support families but we really want them to start the conversation. And so we launched about two years ago the National Weekend of Prayer for Faith, Hope and Life and the idea was really to just start with can we say a simple prayer in whatever faith tradition it is just as we pray for those who have physical illnesses. Can we start to include those who are struggling with mental illness and thoughts of suicide? And this has really I think taken off like wildfire. We were not expecting the readiness and the hunger among faith communities to have a space where they can have this conversation. And I'm just going to play a short video. Let us pledge to be aware of those around us who are struggling with any of life challenges, especially those affected in any way by suicide and to be there for them in their times of need. Be there in person, be there with care and be there with prayer on this faith hope life day. We pray for emotional mental and spiritual healing just as we regularly pray for persons with physical concerns such as cancer or heart disease. We especially pray this day for those dealing with mental health concerns and feelings of hopelessness and for the people who love and care for them. It's time to break the silence around suicide and help all who struggle. Please join us. Join us. Please join us. Because where there is faith, there is hope. And where there is hope, there is life. So faith hope life day. Let's be there in person with care with prayer. And we'll hear more in a minute about the role of faith communities. But from a suicide prevention perspective, it's really been amazing to see what kind of traction this has received in such a short period of time. And I think what we find is when we go out into the community, there's a need and there's a hunger for this information. And how can we forge those partnerships? We did a public opinion poll last summer. And what we found was that the vast majority of Americans know suicides an issue. You know, it's on the nightly news. We're hearing about it more and more. But we haven't done as good of a job of doing is saying, and here's what you can do about it. We say it's complex. We say, you know, all these factors, but we haven't empowered everyone to kind of play their role. And we found four out of five people in the public opinion poll said, I want to know what I can do in simple steps. And this is part of that conversation, the be there campaign from the VA and DoD is part of that conversation. So how do we layer all of these, the health system, zero suicide, the faith communities, the workplace, and this national narrative. On the national narrative side, we have three key audiences. We work the news media, the entertainment media and everyone who's messaging about suicide, which is everyone in this room today and more. And I just want to point to three key resources. We have the media guidelines that we've heard about already. This is when we're talking to the media, our messaging matters, but we can also help them follow their journalistic ethos in a way that is reporting on suicide in a way that's safe and accurate and actually helps tell better news stories. We have a public messenger resource at suicide prevention messaging dot org to make sure when we're putting messages out there, they're strategic and action oriented and moving beyond awareness and moving to action. And then just this month, we released entertainment depiction guidelines, which was an effort over the last 12 months with the entertainment industry and suicide prevention field in collaboration with SAMHSA and the entertainment industries council to really develop a tool for content creators because they're creating this content. We're finding out from the research that it's impacting suicidal behavior. And so we've gone and developed suicide in scripts.org as well. So I'm going to stop there and we're going to hear from our panel today. And first up, we have Holly Wilcox. Please come on up. Dr. Wilcox is an associate professor in the Johns Hopkins Bloomberg School of Public Health and School of Medicine. She's involved in several suicide prevention initiatives in Maryland and nationally and co leads a federally funded project focused on conducting data linkage and informatic approaches to utilizing data resources to improve risk identification and prevention. Thanks for being here. Good morning, everyone. Thank you so much for inviting me to be part of this day. It's been really great for me so far to hear about a really strong synopsis of the work that's going on and thinking about ways to go forward from here. So my role today is to talk about schools. I'm going to go upstream, pretty far upstream also. I'm going to talk about two evidence based approaches and one promising approach that's being rigorously evaluated right now. And what I'm going to ask you to think about is maybe taking these approaches, one in primary school, one in middle school and one in high school and thinking about layering them and making them part of every school's programming. We have a real opportunity with health education class to be able to implement and embed suicide prevention related programs or programs that can impact suicide have been shown to impact suicidal ideation. We have an opportunity to embed them in a naturalistic setting such as schools. I've been in the field of suicide prevention for about 30 years and the challenges that we face, you know, of course we talked about stigma earlier. We've talked about access to high quality mental health care in the community, which is another issue. But I do think that schools are a natural place to reach students and most kids attend school so it makes a lot of practical sense to think about how we can move upstream and embed high quality programming into schools. The other thing, the other problem that we have in this field of suicide prevention is that most of what's available in terms of prevention programming is for people who are already in crisis. Some of what I'm going to talk about today focuses on preventing that crisis from ever happening and the disruption in terms of social, academic fields, friends and family that those problems can cause if issues aren't addressed early. So in terms of school-based programs, right now there's a current evidence base showing that programs that are implemented in primary school that target aggressive disruptive behavior can a decade or more down the line reduce risk for suicidal ideation or attempts. There are three examples of this. I put two in the slide. The Seattle Social Development Program, which I'm not going to talk about today. The Family Checkup is another program that's been implemented that has shown to have an impact downstream on suicidal thoughts and behaviors but today I'll focus on the Good Behavior Game which is the program of the three that I've worked most closely with. So what is the Good Behavior Game? It is a universal intervention program much like Dr. Franklin was talking about the different levels of intervention. Good Behavior Game is universal so it's implemented to everyone and in this case it was carried out and studied by our group at Johns Hopkins as implemented in first and second grade students but we have a project now going on in Blackfeet Nation in Montana that's looking at studying the Good Behavior Game's impact in nursery school. In this case the Good Behavior Game is directed and targeted directly at disruptive aggressive behaviors manifested in a classroom setting and back in 1985 and 86 when this trial, the trials on Good Behavior Game first started it had been replicated around 20 times and it was of interest to the school system. We have had three generations of Good Behavior Game trials in Baltimore, Maryland and I'm going to talk a little bit about those trials and the results. So in terms of what is the Good Behavior Game it's pretty straightforward it's a program that teaches teachers on how to manage their classroom typically in schools kids in first and second grade they don't change classrooms they're with the same teacher all day and the teachers can be given tools to impact behavior. In this case students sit in groups and the teacher defines the rules for the students and they understand them even if they can't read the rules are posted and the kids work in teams when they're playing the game at different periods during the day they are told that they're playing the game and they there will be tick marks put on the board if the student violates any of the rules of the class in any of the groups. So there's a chance for all the teams to win the game and there's the chance that once they do win the game they're distributed rewards and so rewards can be whatever is rewarding to the students and it's really important to think about selecting rewards that are affordable and maximally rewarding. So in Baltimore there are dance parties there's pencil tapping there's you know teachers can get really creative with with delivering rewards and what the rewards are and the results of this first generation trial were published in drug and alcohol dependence in 2008 with all the impact on a variety of outcomes that I'll go over here this is just looking at the outcomes across different domains so you'll see there was an impact of this GBG as played in first and second grade with high fidelity in this instance so the teachers did this and were monitored and mentored on how to implement this program. You can see kind of across the board around a 50% reduction or a 50% lower incidence in in the GBG group as compared to the standard setting which was the control condition that didn't receive the intervention. My results are on the bottom from my paper which focused on suicidal ideation and attempt and you'll notice here that for the other outcomes there was more impact in males and highly aggressive males and in my paper there was slightly more impact in females actually. So after this special issue came out in a couple of other papers were published on high school benefits in terms of high school graduation and sexual risk behaviors an analysis was done by the Washington State Institute for Public Policy and they found that for every dollar invested in the good behavior game there was about a 64 dollar return in investment in terms of the benefits across the board on the outcomes. Now this first generation was done with fairly high fidelity and it hasn't been replicated to the same extent by our group or others in terms of the suicide outcomes but we're actively trying to replicate those initial findings. In terms of another approach that's gotten a lot of attention is the youth aware of mental health program that comes from Europe. This is a program that was evaluated in a very large randomized trial that involved 10 countries in Europe mostly high income countries over 10,000 students were part of this and what they did is they compared a lot of the interventions that we use in the U.S. in schools like a keeper training question persuade and refer this new intervention called youth aware of mental health which is pretty much a role playing type of intervention approach and screening and referrals kind of like signs of suicide teen screen program which you may be familiar with and compared to control as well and what they found is no real difference at three months for suicidal ideation or attempt but they found a pretty dramatic reduction of around the magnitude that we found in the good behavior game so about a 50 percent reduction in suicidal or reduced incidence of suicide ideation attempt among the youth aware of mental health program group and this program is about five hours and it's heavily based on role play where the kids select problems that they often encounter and they problem solve together in groups and it's an interesting approach because it's very practical and it's kid driven because they pick the problems and it's discussion based as well and they get education the other program that we have going right now is funded by the born this way foundation which is lady Gaga's foundation we've taken teen mental health first aid from Australia and abroad to the United States they have a randomized trial of teen mental health first aid ongoing right now in Australia with some promising results they're doing the 18 month follow-up actually really promising results but I can't tell you about it because it's not my own work but anyway um teen mental health first aid is directed at the youth so the youth get trained kind of like gatekeepers they're trained and it's about a four hours easily embedded into health education class and into the curriculum of the school and it's a peer-to-peer program so the idea is how to recognize your friend when they're in crisis and what to do with your friend when they're in crisis it's very practical high quality materials interactive and 10 percent of the adults in the schools are intended to be trained as well these are the states that are participating in our born this way foundation piloting and adaptation to the U.S. cultural context this is being done in high schools and hopefully in the future we'll develop the program for middle schools as well so this is our trajectory right now we're piloting there's going to be a launch that will take place in the fall and the program should be readily available sometime in 2020 hopefully so what is needed to address in the school domain well one one big concern is that these programs even though they're evidence-based are not are not making it out into most schools so most schools are not implementing them and and if they are implemented oftentimes they're not sustained so we have to think about potentially some public policy solutions to get these programs embedded into schools and how they can be implemented in sustained long term and most of these programs show that unless they're implemented with high quality or high fidelity you're not going to get the payoffs or the returns that we would expect like from the first generation good behavior game trial so that's another thing we have to think really carefully about and i'll stop there thank you next up we have dr sherry mollick she's an associate professor in the department of psychology at george washington university and she teaches undergrad and graduate courses on developing suicide and hiv programs for teens and african-american churches she serves on the steering committee for the suicide prevention resource center and the national action alliance for suicide prevention's faith task force and as a grant reviewer for nih and is a founding pastor of the beloved community church in maryland thank you also for inviting me and excuse my voice i'm a little bit hoarse because there's a lot of pollen out today so i wanted to acknowledge to lead the arnold who i'm actually substituting for her she's the co-chair of the action the faith task force of the national action alliance i'm also a member of that task force and so i just wanted to make sure that we acknowledged her contribution i do wear two hats i'm going to be bringing both of those hats today as a professor in psychology at george washington university and also my role as a co-pastor of the beloved community church i've been in um i've been a gw for 20 years i've been a pastor for 11 years i've been in ministry for 20 years okay so why should we include faith communities um as part of our first responders are part of the people who should be associated with helping people get good mental health care the bottom line is that in faith communities a lot of times for people who are participants or members of a faith community it's like one-stop shopping and i'm going to talk more about my experience my contact which is the african-american christian church but mental health tradition issues affect all kinds of people and all from all faith traditions faith leaders are definitely often first responders um even if they don't feel qualified or trained to um to address some of the mental health issues oftentimes their community members will feel more comfortable talking with them as opposed to a mental health professional in fact but the reason i got involved with this research was because i realized that most of the would not see me as a mental health professional but would talk to me because i was a member of a faith community um faith communities are very holistic in their approach to the family and to the person's issues and concerns um we interact with people in diverse settings congregations include people from diverse workplaces including mental health professionals and so i was privileged to be part of a um the starting or the founding of a pastoral counseling center in prince george's county called the baraka counseling center pastoral counseling center which still exists and we started this about 25 years ago and they grew out of the african-american episcopal church just having a huge need for people um who wanted to get some mental health or emotional issues addressed and the first month that we opened which was in i believe 1996 we saw 600 people all of the providers there were members of that church community this is a mega church all of us had mental health backgrounds we had a psychiatrist social workers myself as a clinician i actually had students of mine training as externships in that setting so there's a lot that you can do there and then also we know that oftentimes the mental health crisis also becomes a crisis of faith so there are barriers to seeking um care and faith communities one is that for many um communities suicide violates faith communities cultural gender and role and gender role norms so for example i know in my own community oftentimes there's a perception that men don't um think about suicide and if they do they're weak sometimes suicide can be seen as a moral failing or as a crisis of faith that if your faith was strong enough you wouldn't be thinking about suicide and it also i know in my own faith tradition um a lot of times black people think that suicide is a quote unquote white thing you know that's not something that it occurs in the black community on tuesday i was at a congressional hearing from the congressional black caucus about this very issue so some of this has a lot to do if we need to educate people that that is in fact not true and we know that there are slave narratives of people jumping off of ships and so that people have always completed suicide in all communities and also there's a sometimes a big stick associated with mental illness in particular there's also distrust of mental health professionals when i was in seminary people would lately say things like you know don't talk about your jesus or your faith in a mental health context because people will try to take jesus from you um there's a whole concern about that mental health professionals will minimize your faith beliefs or traditions and they're also and this is true that many mental health professionals are not trained to deal with faith concerns in the context of the of a session um and we'll talk a little bit later on about how you can do that clergy know very little about suicide lethality so i have had situations where um people have been acutely and actively suicidal and people have prayed and not referred and so prayer is really important but this prayer plus referral is important as well on clergy are less likely to make mental health referrals particularly if the clergy i'm engaged in what's called other world theology other world theologies are ministries that focus more on the afterlife and may be promoting um the things in this life or this context are difficult and and you should expect trials and tribulations but the focus is going to be on living a pious life so that you can have an afterlife other churches focus more on what's called this worldly theology and those churches tend to be um workers around social issues and social justice issues and they're more likely to make referrals but the good news i'm eternally optimistic is that this is changing um so i think that there's less a stigma associated with suicide in religious communities people are looking more at um not um demonizing mental illness but really thinking more about it in terms of challenge um in terms of mental health or health status and looking more at less at the issue whether or not suicide is an unpardonable sin in some communities but looking more as added is a mental health challenge as much more focus on being compassionate towards people who have mental health challenges as well mental illness is also now beginning to be seen like other diseases and not a reason for shame in my own church we talk a lot about because i have asthma it's pretty well known in my congregation so i often make analogies to my asthma and to for example the need for taking medication if i don't take my medication i'm a risk for i'm having an asthma attack and if you don't take your medication then you're more at risk for having an episode we also see um really importantly that more and more clarity persons are seeing themselves as a member of a team and that they have an important role to play they're not to be the substitute for a mental health professional but they're an important resource for mental health professionals um there's a really good book out called cultivating wholeness and it talks about the fact that faith leaders are designed to cultivate gardens and that the gardener the soil is basically the holistic approach to to persons physical and mental and spiritual well-being and that there's a concept called mattering i don't know if you've heard about this but mattering is basically not just feeling accepted but feeling really important what you think how you live um how you behave what you're going through is really important in that community and there's lots of research that suggests that when people feel that they matter even in the middle of a mental health crisis that they have better outcomes one of the ways that we can do that is connecting people i think there's often a lot of concerns about doing interventions in faith communities because of the stigma associated with suicide but the other really strength that um faith communities have is that they're really good at connecting people and we know that connected this on multiple levels is really important i work more with youth and one of the things i love about working in faith communities is that even if the youth is not a member of that community that people most faith traditions or faith communities really love working with youth and will work with youth and incorporate them into programs that they have even if the family or the child his or herself are not members of that congregation it's a wonderful opportunity to have education netters of hope worship experiences and advocates and i'll go into these in a few details so as i said earlier um you can foster a sense of connective and and mattering both in and outside the the four walls of the edifice of the institution these are just some examples easter egg hunts for those of you or christians we recently had easter um that bottom picture on is actually my church where we have a family day every year and we we just spend with our normal service and we actually have games being played and that's my daughter playing some kind of card game in the bottom so shout out to my daughter we have lots and lots of educational opportunities so my church we do series in bible studies and we just finished a series on scandals we've also done series on um prayer theology we've done series on mental health issues we do lots of sermons one of the biggest ways that you can make changes is to normalize the conversation so we have inserts in our bulletin about suicide hotline we have a community table and we have mental health information about that we really focus a lot not just on suicide but on help seeking because i think that for all of the good ideas we're going to talk about today if we don't encourage people to normalize help seeking it's not going to matter we could have we could have a clinic in every place we could put you know all these great things in schools if we don't change people's norms about that it's okay to seek help so part of what we do in our faith communities we normalize the conversation about help seeking in july there's a minority mental health month and every year we have telling our stories i remember our people earlier talked about telling your stories and one of the most powerful things that we do all year is those storytelling where people get up and talk about family members or themselves their challenges with mental health it's very hopeful um one of the most powerful ones was my youngest daughter did hers about six or seven years ago and talked about her struggling with bullying in her school and how mental health resources particularly she's said cpt really helped her and she's doing really well now so those stories have a really big impact and we also know that in faith traditions there's often narratives of hope historically this is example of the civil rights movement again there's a lot of faith communities will have grandparenting programs where they'll have older people adopt children who are younger and they may or may not have grandparenting in their lives and they just engage in activities worship again i love doing things in faith communities because you have a captive audience and sermons are designed to be persuasive one time so um this is a challenge for researchers though research oftentimes we've written to several grants that have not been funded and one of the comments has been we're not heavily dosing our messages enough and then it's a it's a realization that science and the faith community has different ways of messaging and coping and presenting and communicating information so a sermon is designed to be impactful once and so these these are things that can happen really helpful um i already talked about telling our stories and we don't just do it around suicide we do it around people we have members of our church we have children on the autism spectrum bipolar disorder or PTSD we have members who talk about taking their medication they name the medication i love lexapro why they do it don't like it so that's really important um i've already talked about the the community tables our website has information our facebook page one of the most powerful things you can do is use social media so this conference today is on my work my personal facebook page but it's also on my church's west facebook page it's also on my denominations website so every time i can do that i'll be i'll be tweeting throughout the conference and so you can reach a lot of people my church is a small church we have about four or five hundred hits a month so even with 60 people it's amazing and those people go on to share more information so that's really important um treating prevention as a social justice issue is actually a different lens to use but it's also one that that people in our community at least can um easily resonate with and so we it also helps to reduce the stigma to talk about as a social justice issue that just like everyone should have um access to health care everyone should have access to mental health care um let's see there's also people in the um we also call it policy in the pulpit it's kind of a really good and important platform that you can have to help to change policy and to encourage members of your community to talk to their congress persons for example when legislation is coming out so all of those things both locally and nationally so the take home messages that faith communities are an untapped resource it really does take a village um caring for persons with mental illnesses and their challenges really takes it really involves partnerships I think uh faith communities and their leaders are a really important part of that village and I think that they inherently have many protective factors that we can access and rely on the other thing is that um as a clinician I'm only going to see someone once or twice a week a faith person a faith leader is going to see that person many more hours a week has access to them and the bottom line is we make house calls so I think it's an important resource that we need to take advantage of and to realize that with the for the team approach that we can all work together to make people whole these are just resources people have already talked about these and action action alliance has a great resources and tools so does the suicide prevention resource center if you need to get statistics um that can be localized to your community the CDC is also a good resource and so thank you great and now we have Francis Gonzalez who's senior director of marketing and communications for the national suicide prevention lifeline and vibrant emotional health hi thank you for taking the time to listen to me talk about community solutions so how do I even do this okay perfect so the national suicide prevention lifeline you've heard it mentioned before I hope that you might be familiar with our number 1-800-273-8255 and the lifeline's mission is to reach and serve all persons who could be at risk of suicide in the U.S. through a national network of local crisis centers so we are SAMHSA funded we are administered by vibrant emotional health which is my parent nonprofit and we're made up of over 160 crisis centers local crisis centers in over in 49 states and we also support the national disaster distress helpline and provide support for the veterans crisis line as well and the reason why I'm mentioning the 20 the network of over 160 centers is because it puts us in a unique position so we are a national line that we encourage people to share that national number but when you call the lifeline you are routed to a local crisis center and when you do that that provides opportunities not only on the national level to share messages of hope and recovery but also on the local community level so working with organizations working with local crisis centers in order to integrate suicide prevention and the lifeline into their local communities so how does the public feel about suicide prevention so we have found that 94 percent of people believe suicide is preventable 94 percent of people would do something if someone close to them had suicidal ideas I don't really have a lot of questions for like the other six percent so 64 percent of people would encourage friends and loved ones to seek mental health help I do want to note that only 38 percent of people would share hotline information or another resource in those moments of crisis which is extremely notable for us and 78 percent are interested in learning more how people how they could help people so 94 percent of people believe that they would do something but almost 50 percent of Americans identified bears that stopped them from trying to help someone who was at risk in those moments and those fears were based on why they didn't do it was based on fear that they would say or do something that was wrong and that would make it worse instead of better and also a very fundamental to lack of education not knowing how to find help for that person in crisis so for lifeline communications in particular not only do we work to promote the lifeline phone number but we also work to come up with resources and messaging to address the needs of the general public like this and so one of our key messages is focusing on stories of hope and recovery so healing hope and help are happening this used to be the suicide is preventable message but we felt that instead of just saying or you know saying suicide is preventable what we needed to do was illustrate those stories of hope and recovery that are actually happening every single day in different communities around the nation so we want to share those stories of hope and recovery and focus on the people in crisis now as well as those who've survived crisis illustrating those things that help them get through those difficult moments and the people who help them get through those difficult moments and so that is supported by our second message everyone can take action to prevent suicide how we frame this message is one of personal empowerment and community connection so we want to remove suicide prevention from the professional mental health room only and make it a universal message something that can be applied across communities and not only across communities but through interpersonal interactions and connections and so be the one to was born so we be the one to was started in about 2015 and these are five action steps that any person can take to help somebody in their life that might be in crisis they are evidence informed and they are intentionally written to be very accessible to everybody so with the notion that you may be in a situation where you don't know what to do so you're talking you're having a conversation with your friend you realize this person might be going through something but now you think to yourself I don't know what to do now and so these five steps serve as a blueprint or as we like to say suicidal crisis CPR they can sort of walk you through that interaction from beginning to end so asking someone if they're suicidal keeping them safe refers to asking them how they would hurt themselves and removing that means from them being be there talks about how to listen without judgment and effectively help them connect talks about how to connect that person to other supports and resources whether that is faith a church counseling system the lifeline and also following up so checking up on that person in the days and weeks after a suicidal crisis we launched this in 2015 and we have over 50 partners who participated in this at some point or another and this started as a digital campaign but as we built it out we realized that what we wanted to do was to offer a national framework but also opportunities for adaptation and customization on the community and local level so we designed it to have a lot of different ways of participation whether that's just sharing the steps on social media creating your own graphic kit if you have the resources to do that sending a postcard or sharing a postcard with us talking about the time somebody has helped you through a crisis participating in a twitter chat hanging up posters and donating to your local crisis center now these are only a couple of the ways that people have a help to promote the be the one two steps are also integrated them into systems that they already have for instance the us navy has integrated the be the one two steps into existing tool kits that they were already creating and these are now integrated as a section of those kits metro north railroad created posters that illustrated the different steps and encouraged people to check out the website that they hung on their trains and also in their stations and also the office of mental health in new york city utilize be the one to as a potential grant program for their local community organizations asking them to take be the one to and find ways to customize that for the communities that they were serving so this is just an example of a customization that we have on our website people creating their own kits and organizations creating their own kits that more accurately reflect the communities that they're trying to serve how does this work in media we also encourage our local crisis centers and our partners to integrate the message of be the one to which is that everyone can do something to prevent suicide as well as those individual steps in their talking points when they're working with media with local community partners when they're addressing local incidents in their own towns so these are just two examples on more of a national scale of how we integrated that so the first one on the left is in a recent reprinting of 13 reasons why we worked with them to include the lifeline number but also be the one to we also worked with CNN in June 2018 I'm sure all of you familiar with Anthony Bourdain dying by suicide and Kate Spade dying by suicide and CNN actually approached us and said hey we see that you have these steps that are available can we put them on our site during our coverage and the answer of course was yes please do okay in addition to that talking more about digital communities more specifically the same idea of a framework which is to provide standards across the country but then allow for customization and implementation on a community level so the lifeline has worked with suicide social media platforms for over 10 years to develop safety processes for suicidal individuals and you can see some of those logos there we also have a facebook page there's over 300 000 followers and extremely active moderation and we also realize we're receiving a lot of the same questions over and over from the public about social media posts that they were encountering on their own forums and so we came up with our social media toolkit we released this in September 2018 and what this was is a is a turnkey set of guidelines for moderators community moderators social media platforms and also users on the individual level so the kit works to identify and help promote engagement with people in crisis online and addresses common recurring questions and it once again is also designed for people who are unfamiliar with the mental health space it also is designed to be educational the idea is that we want you to take this kit educate yourself about how to recognize people who are in crisis online but also to customize your engagement with that individual in order to match the tone or the needs of your specific group because we believe that you above all else know what your community particularly needs or the users of your community needs and we provide the insight and the guidance as to what those resources should look like and how they should be implemented for instance we do provide canned messaging but we also provide guidance on why the can messaging is how it is so considering a post about suicide to be serious and genuine developing a system of monitoring and responding when someone's in crisis crafting responses that are sensitive to the situation but realistic as to your ability to handle those situations and educating people about imminent risk in those times when you may need to actually reach out to emergency services we found that this actually has a much broader use than it was originally intended for for moderators blog posts things like that we found that it is actually useful for all communities with some form of digital presence so we've provided it to influencers content creators and storytellers who are actively sharing stories about mental health or who are interested in sharing stories about mental health we've provided it to the SAMHSA office of communications we've also shared it with journalists and media organizations who are thinking about writing stories of suicide prevention but are worried about doing so because they're worried about the kinds of comments they're going to get when they post that story online and we can say to them hey yeah you can write these stories you can prepare for what might come in advance we also provide it to public figures with large social media followings as I mentioned earlier so there are postcards in the back about be the one to please take them because I don't want to bring them home you can find more information about the lifeline at suicideprevention lifeline.org and our parent org at vibrant.org and of course there's my information there if you'd like to talk more about these solutions hi everybody this was a fantastic panel thank you so much for your comments I'd like to encourage the group now to take some of the information that you learned from this this panel on the community context and apply it to an exercise that we'll be doing at your seats at your table so first can I ask our facilitators that are sitting at each table to raise their hand okay so this is your facilitator and we'd like to pick up on some of the themes that were addressed in the conversations at the table so your facilitators will give you guidance about the exercise that's coming up and we also encourage you to ask our panelists questions over lunch which will happen after this exercise okay great thank you thank you all