Tuesday, February 18, 2014

Hope Center plans community forums on suicide

From:  Aspen Daily News

In the wake of three suicides in the upper Roaring Fork Valley over a 10-day span, the Aspen Hope Center is planning a series of community forums on the issue.

The Hope Center has received dozens of calls, executive director Michelle Muething said, over the last week, from locals asking for a way to gather and discuss the valley’s persistently high rate of suicide. Muething said the nonprofit is planning multiple events throughout the valley, and will announce details soon. The center is also planning free suicide prevention trainings in Aspen, Basalt, Carbondale and Glenwood Springs over the next month.

“This is a big deal for our community,” said Muething.

Pitkin County’s suicide rate has regularly tripled the national average, and the valley has averaged a death by suicide every 11 weeks, according to a 2009 University of Colorado study. Muething said the rates in the study are consistent with what she’s seen since its publication. 

The Hope Center itself resulted from that 2009 study of suicide in Pitkin County, conducted by the University of Colorado Depression Center, and has focused on the top needs identified in the study.

The study made a total of 50 recommendations to better prevent suicide and treat mental illness here. Its primary conclusion was that locals had poor access to mental health help and its top recommendation was to “create a new locally driven entity to develop, implement, integrate, coordinate, and fund the needed behavioral health and wellness services for Pitkin County.”

The Aspen Valley Foundation — formerly the Aspen Valley Medical Foundation — took that recommendation and created the Hope Center to carry out other top needs listed in the Depression Center assessment. Opened in June 2010, the Hope Center has since focused on meeting two of the other crucial needs identified by the Depression Center: a 24-hour crisis line, to be answered by a clinician; and a continuum of care to shepherd people out of mental health crises.

The Hope Center’s Virtual Intensive Outpatient Program (VIOP) offers a middle ground between occasional therapy and full-time hospitalization for high risk individuals. It allows a patient to stay at home, but includes multiple daily therapy and treatment sessions. The stabilization program usually takes three to five days, though some have stayed in longer, as needed. Seventy-seven people have successfully completed the VIOP program, Muething said

“We utilize the resources in the community and the person’s friends and family, and that helps people get through what may seem insurmountable,” said Muething.

The program fills part of the need left by the valley’s lack of a psychiatric hospital or ward — a resource that’s standard in more populated areas.

“We have not considered opening a psych facility,” said Aspen Valley Hospital spokesperson Ginny Dyche. “Psychiatric patient care really requires a great amount of specialty expertise, both in the form of psychiatrists, staff and the facility itself. ... You can’t just set aside a room. There are many regulatory requirements.”

While devoted hospital beds for psychiatric needs might be desirable, the costs are too high for the benefits it would offer for a small community like the Roaring Fork Valley, health officials said. The Hope Center, Muething said, is focused on dealing with crises and will not likely expand that primary purpose.

The Depression Center’s doctors closely linked the valley’s permissive attitude toward drug and alcohol abuse to its suicide rate, and recommended establishing a detoxification facility in the Aspen area. Mind Springs Health, formerly the Aspen Counseling Center, opened one at Pitkin County’s health and human services building in January 2013.

Among other recommendations in the Depression Center assessment were strengthening survivor support services for family and friends touched by suicide, and community education.

To that end, the Hope Center founded a support group for people who have had a loved one die of suicide. It began with four members in 2010, according to Muething, and has grown to regular attendance of 19 people. Regarding community education, the Hope Center has trained all local first responders and more than 1,000 others in awareness and prevention tactics.

The Depression Center had recommended hosting training in Mental Health First Aid, a national certification program that teaches skills to recognize mental illness and substance abuse. The Hope Center decided not to take those on, opting instead for less-intensive training in the QPR (Question, Persuade, Refer) method. While the First Aid certification requires a lengthy course, QPR training takes just a day, and offers one-hour courses aimed at community members not in the medical field.

“It’s aimed at lay people and that’s why we chose that program,” said Muething.

Official trainings aside, Muething said the most effective form of prevention is awareness.

“I think the community in general needs to have a heightened state of awareness of the people they work with and love,” she said. “We need to keep that heightened sense of awareness when we know someone is going through a tough time, to keep them closer and ask them if things are OK. We know our friends well, so when they say, ‘I’m fine,’ we know they mean it.”

For people in crisis coming in for counseling, the Hope Center protocol has them bring friends or family willing to be part of their support system, and keeps clinicians in touch with those people during continued treatment.

“We like to keep that safety net as tight as possible, because it’s made up of people in your life,” said Muething.

The Hope Center’s financing likewise depends largely on community support. It split off from the Aspen Valley Foundation in October, after operating on about $1.4 million in foundation funds over its first three years of operation. The center’s financial independence has not adversely affected its fundraising power, or ability to fund its 24-hour services at a rate of roughly $20,000 per month, according to Muething.

She opened the Hope Center’s bank account in late October with just $1,700. By the end of December, the organization had raised $130,000 in donations and grants.

“We went into the new year stronger than we’ve been before,” she said.

The Hope Center is now expanding its seven-member staff, beginning with additional nurse practitioners.

The center’s medical director, Robert Davies of the University of Colorado School of Medicine, is in Aspen only part time, leaving the Hope Center without a full-time psychiatric doctor.

Muething said that having a full-time doctor, like a devoted psychiatric hospital, is cost prohibitive. They fill the need with a full-time psychiatric nurse, who doubles as a crisis clinician, and is available to meet with patients face-to-face seven days a week.

Those seeking help from the Hope Center also cut across age and gender demographics. Of their roughly 600 new clients last year, 59 percent were female and 41 percent male. Fourteen percent were under 14 years old, 20 percent were age 15-25, 24 percent were age 26-35, 14 percent were age 36-50 and 27 percent were age 51 and up.

The three recent suicides — in Aspen, Basalt, and Old Snowmass — likewise spanned the community.

“There have been three in 10 days and none of the three knew one another, or had a similar theme in their lives,” Muething said. “They’re of different ages, genders, walks of life — yet we had three in 10 days.” 

The Aspen Hope Center’s 24-hour Hopeline is 970-925-5858. Mind Springs Health, formerly the Aspen Counseling Center, is also offering free relationship wellness check-ups this week. Appointments can be made at 970-920-5555.