Two years later, a look at suicide prevention in three rural Washington counties

After making inroads in areas with the state’s highest suicide rates, Forefront’s rural initiative has closed one chapter – while continuing another.

Coalitions have been forged and thousands have received suicide prevention training and resources since the 2015 launch of a rural initiative funded by a pooled grant with Washington Women’s Foundation and the state Office of the Superintendent of Public Instruction (OSPI). In the first year, the grant focused on three counties with the state’s highest suicide rates: Island, Okanogan, and Stevens County.

The Washington Women Foundation (WWF) grant, which provided $50,000 in each of two consecutive years, ended June 31. But this month, a renewed grant from the OSPI begins its third fiscal year.

“The WWF grant is very community-focused. It made it possible to have collaborations with cross-sections of communities, to ask: “what can we do?” said Jennifer Barron, Forefront’s director of training and rural initiatives. “The important thing about this grant is that it gave us some time in these underserved areas to send the message that it’s OK to talk about suicide and know how to effectively help a friend or anyone who may be thinking about suicide.”

Forefront’s contracted field coordinators spent the past two years coordinating community and school members to form a coalition to provide local community awareness and training.

Each worked in counties with suicide rates higher than the state average of 15.9 (per 100,000 individuals). Here are their stories:

Growing awareness in Okanogan County

Systems change is slowly unfolding in Okanogan, which is Washington’s largest county by area. Not long before Forefront’s rural initiative began its work here, the county had elected its first coroner, David Rodriquez.

“Centralizing that job has brought the problem of suicide front and center to that office,” said Michael Blake, Forefront’s field coordinator for Okanogan County. “We have been working with the coroner to come up with ideas to build a better coalition and work with mental health services to educate and combat the staggering number of suicides and the toll that it takes.”

That includes educating teachers on how to talk to students and respond to warning signs: “I have received comments from educators that they were unaware of the levels of depression and suicide amongst the youth,” said Blake.

Stevens County students, communities play a role in prevention

Schools are also a critical part of the rural initiative in Stevens County, which straddles the U.S.-Canada border.

Colville School District has “taken a progressive and serious look at how to involve students in the districts suicide awareness and prevention efforts,” said Patty Erdman, Forefront’s field coordinator for Stevens County.

For the past two years, Erdman has been working closely with a group of dedicated high school students. This year, seven high school students in Colville presented Forefront’s LEARN™ curriculum to junior high schools – facilitating sensitive conversations and answering questions on a peer to peer level. They also presented to their high school’s Diversity Club in May.

“They genuinely care about their friends and fellow students and really took this opportunity to heart,” said Erdman. “I feel they are better equipped to assist their peers or anyone for that matter – if needed.”

Educating and empowering Island county

Island County’s breathtaking water-locked vistas belie a troubling fact, says Catherine Van Wetter, field coordinator for this county: “Many (in Whidbey Island) were shocked that such a beautiful place could have such a high rate of suicide.”

“Suicide is preventable,” she tells residents, schools, and community members. “It takes a community to help with this epidemic.”

For the past two years, Van Wetter has been building a coalition developed by Island County Public Health Department, to assist in training and educating people about depression and suicide. That includes busting myths about why a person may contemplate suicide: not because they are weak or want to die, but to end their pain.

“How can we as a global community learn to be present with the suffering of another? That, to me, is our work.”

Grant’s impact felt across communities

Forefront’s rural initiative provided a variety of trainings: Six-hour Assessing and Managing Suicide Risk (AMSR) training sessions for mental health and health care professionals, three-hour suicide alertness trainings (SafeTALK) for school employees, and one-and-half hour LEARN™ trainings for interested community members. Forefront was instrumental in passing ESHB 1366 and ESHB 2366, which mandated specific trainings for certain licensed professionals.

This two-year journey has taken Barron all over the state map to deliver trainings – including a recent six-hour AMSR training of 207 nurses in Wenatchee.

Last July, the Washington Women’s Foundation also funded the expansion of suicide prevention efforts in three additional high-risk rural counties: Clallam, Pierce, and Chelan.

But long after the Washington Women’s Foundation grant sunsets, its impact will linger.  These communities will now be connected to Forefront Cares – a peer bereavement support program for suicide loss survivors.

Looking forward: OSPI grant’s next fiscal cycle focuses on schools

Last year, 370 school personnel and seven school districts in the rural initiative participated in trainings specific to their professional roles.

One of Forefront’s 2017-2018 goals under the continued OSPI grant is to instill a “train the trainer” model within some rural schools, so that educators develop the capability to do their own training.

“This will expand the contact and resource base exponentially as they are able to build understanding and knowledge about steps to suicide prevention,” said Blake.

Additionally, Forefront will lay the groundwork for stronger partnerships with educational service districts and ongoing work to develop comprehensive school crisis response plans.

There’s still work to be done: Stigma in rural areas can be so strong, Barron said, that individuals are known to drive two to three hours away to see a counselor, instead of seeking help at a local community health center.

The mindsets about suicide and mental illness pose an around-the-map challenge: “I have learned that there are three distinctive cultures on Whidbey: Oak Harbor, Coupeville, and south Whidbey,” said Van Wetter. “Each one deals with suicide in different ways. Some are open to learning and discussing it, and others remain private.”

There was so much positive buzz about a parent night in a rural high school under the grant, that the school changed the venue to a larger room.

Only five parents attended.

“The desire is there. However, it is still a difficult subject for many people to think about,” said Barron. “Nevertheless, the conversations have begun throughout these communities and together we will continue the work.”

One by one, these conversations are saving lives: One woman who attended Barron’s training reported that the very next day, she found herself using the skills and tools to help someone in a crisis.