Warm resources: Can Routt County work together better to prevent suicide? | SteamboatToday.com

Warm resources: Can Routt County work together better to prevent suicide?

Teresa Ristow

Suicides by year in Routt County

2015—6*

2014—6

2013—5

2012—6

2011—6

2010—11

2009—5

2008—9

*Through November 2015

National annual suicide rate: 13 people per 100,000 (CDC, 2013)

Routt County extrapolated suicide rate: 28.7 per 100,000 (average for 2008 to 2015)

Routt County suicides completed using a firearm: 71 percent (2008-2012)

24-hour crisis support lines

Reaching Everyone Preventing Suicide (REPS) 970-846-8182

Advocates Building Peaceful Communities 970-879-8888

Mind Springs Health 1-888-207-4004

Colorado’s Suicide Prevention Lifeline 1-844-273-TALK (8255)

Colorado Crisis and Support Line 1-844-493-TALK (8255)






John F. Russell

— With an average of six or more residents in our small community taking their own lives each year, Routt County’s suicide rate is more than double the national average and higher than typical averages of 49 states.

While multiple agencies, organizations and committed individuals in the community are working to try to decrease these numbers, many are in agreement that more collaboration is needed to strengthen prevention efforts and avoid leaving loved ones unconnected to the post-suicide support that could be at their door.

What can Routt County do better to bring warm, welcoming suicide-prevention and mental-health resources and crisis support to those in need?

Where Routt County stands

By the end of this November, six suicides had taken place inside Routt County’s borders — three were hangings and three were self-inflicted gunshot wounds, the last of which occurred only a few weeks ago.

Five or six residents have died by suicide each year since 2011, while 11 died in 2010.

Suicides by year in Routt County

2015—6*

2014—6

2013—5

2012—6

2011—6

2010—11

2009—5

2008—9

*Through November 2015

24-hour crisis support lines

Reaching Everyone Preventing Suicide (REPS) 970-846-8182

Advocates Building Peaceful Communities 970-879-8888

Mind Springs Health 1-888-207-4004

Colorado’s Suicide Prevention Lifeline 1-844-273-TALK (8255)

Colorado Crisis and Support Line 1-844-493-TALK (8255)

“It’s the saddest part of my job,” said Rob Ryg, Routt County’s coroner for the past 12 years, and one of the first people dispatched to the scene of any unexpected death in the area.

As coroner, it’s Ryg’s job to help determine what took place at the scene and to consider whether the person intentionally caused his or her own death.

Ryg writes out the basic details of each death he investigates on a large whiteboard inside his office in the annex of Routt County’s Historic Courthouse. Most scenes Ryg responds to aren’t suicides, but the deaths that are ruled suicides far outnumber the one, or rarely two, homicides that might happen each year.

The largest percentage of suicides in Routt County and the United States overall are carried out with a firearm, with 71 percent of suicides from 2008 to 2012 in Routt County completed using a gun.

The high rate of suicides here takes its toll, not only on families and friends of those who die, but also on Ryg, law enforcement, mental health professionals and others who play a role in the community’s response to suicide.

Prevention and intervention

A number of organizations and agencies exist to provide crisis support, mental health and psychiatric care, outreach and public awareness and support to families left behind after a suicide.

Education is one of the first lines of defense for preventing suicide, and suicide prevention programs reach students as young as middle school-aged each year through It Takes Courage, run by Heather Savalox, a Steamboat Springs resident whose niece died of suicide after ongoing bullying took its toll.

Savalox’s program reaches three classes of Steamboat Springs eighth graders each year and is presented to other youth groups and schools in the county.

“It’s an anti-bullying suicide prevention program,” Savalox said. “We have a need to be really proactive, and we need to share information in the community. People need to know that help is out there.”

Savalox hopes the conversations that begin during It Takes Courage events will help remove the stigma of discussing suicide and suicide prevention openly.

“People treat suicide like it’s this bad word that shouldn’t be said,” she said. “That’s really the wrong attitude to have.”

It Takes Courage operates as a program under Reaching Everyone Preventing Suicide, or REPS, a Steamboat nonprofit that studies suicide prevention and works to bring down the suicide rate in Routt and Moffat counties.

REPS organizes regional trainings to teach applied suicide intervention skills and oversees a network of volunteers who visit emergency rooms as part of the Suicide Prevention Advocates, or SPA, program. These individuals are there to sit with and offer resources to patients who are visiting the hospital because of suicidal thoughts or a suicide attempt.

Due to the potential for safety concerns, law enforcement typically responds first to possible or definite suicide attempts.

The Steamboat Springs Police Department has responded to 27 such calls so far this year.

The situation is evaluated, and police rely on Mind Springs Health, the region’s mental health provider, to respond and provide a mental health evaluation, when appropriate.

Mind Springs staff members said they receive about 600 calls on the organization’s crisis line each year, primarily from law enforcement and hospitals, and they respond about 400 to 500 times, with about half or more of the responses involving a situation in which a person is experiencing suicidal thoughts.

“The people that respond are trained in therapy and crisis management,” said Gina Toothaker, program director for Mind Springs’ Steamboat Springs office. “If we intervene, those people tend not to commit suicide.”

Twenty-four-hour crisis lines also are offered by REPS and Advocates, an intimate partner violence support organization based in Steamboat, and both are able to provide remote support for someone undergoing a crisis or connect the individual to in-person help.

Advocates staff and volunteers are quick to refer clients who are undergoing a crisis to Mind Springs, REPS or private providers.

Acknowledging challenges

Despite contact from law enforcement, interventions from Mind Springs, the availability of crisis lines and prevention efforts from REPS and others, numerous barriers exist in preventing suicide.

If police respond to a potential suicidal party and the person they visit claims he or she isn’t suicidal and is feeling fine, law enforcement must leave.

“If they say they’re not suicidal, there’s nothing we can do,” Steamboat Springs Police Chief Cory Christensen said.

When a person undergoes an intervention by Mind Springs, it could lead to a deeper mental health evaluation and the need for a person to undergo psychiatric care.

However, such care is limited in Steamboat, and even if it’s determined this type of treatment or a psychiatric consultation is needed, a Mind Springs client may have to wait a minimum of three weeks to meet with a psychiatrist via a video screen appointment, due to a shortage of psychiatric providers, a problem not unique to Northwest Colorado.

Apart from what Mind Springs can offer, psychiatric care is limited to one private psychiatrist and two prescribing nurses in town, according to Mind Springs staff.

REPS wishes its staff would be called more often to offer support during suicidal situations.

“We don’t want to replace law enforcement, but add on to what they do and be a warm resource,” REPS Executive Director Meghan Francone said.

According to Francone, the organization has no way of knowing when a suicidal crisis is taking place, so they must rely on law enforcement and other agencies to involve REPS, which rarely happens.

Christensen and longtime SSPD Captain Jerry Stabile said current policy dictates calling Mind Springs for an intervention when it is deemed appropriate, though offering the services of REPS also occasionally happens.

The aftermath

Responding to a completed suicide can be the most difficult part of Ryg’s job as a coroner and is often a distressing scene for local law enforcement to investigate.

“It’s one of the toughest things our people deal with,” said Stabile, who joined the Steamboat Springs Police Department in 1990.

Completed suicides initiate a different set of responses from law enforcement than suicidal thoughts or an attempt, according to Christensen.

The scene first becomes a law enforcement investigation and can potentially turn into a crime scene. Law enforcement works to balance beginning its investigation while addressing the needs of loved ones who may be at the location.

The coroner is called to determine the cause and manner of death, and, after serving as a pastor locally for 18 years before becoming coroner, Ryg often finds himself offering support to families on scene, particularly when the person who died is someone he knows.

Steamboat police officers are trained to offer resources such as Mind Springs, REPS or Advocates to the family members left behind, but they said those resources aren’t always welcomed and sometimes harshly denied by loved ones.

“The officers automatically offer resources, but we don’t force it upon the individuals,” Christensen said.

In some instances, law enforcement does call Mind Springs to offer crisis support to loved ones left behind, but the calls don’t come as frequently as they once did, according to Tom Gangel, regional director for Mind Springs.

“In the past, they would call us more often when they felt we could be of service to the families,” Gangel said.

The calls from law enforcement regarding suicides are “very infrequent,” and Mind Springs often finds out about a suicide from an existing client, according to Toothaker.

“That’s the part that frustrates me. A lot of times, we hear about suicide in the same way that the community does,” she said. “We’re not the first people that are called, and we should be more frequently.”

For several years, the Steamboat Springs Police Department relied on the services of a volunteer chaplain to respond to suicides when requested, offering non-denominational spiritual support to those left behind and often acting as a conduit between law enforcement, families and other organizations.

The volunteer position, usually filled by a pastor with knowledge of multiple religions, has been vacant for the past year, and the police department is hopeful someone else in the community might be able to step up to the role.

“(Our chaplain) was an unbelievable resource to us,” Stabile said.

“We would love to get that back in place,” added Christensen.

Though Mind Springs would like to offer more support following a suicide, Toothaker and Gangel made it clear that staff wouldn’t respond directly to a suicide.

“We do our best not to show up on the scene,” Gangel said. “We really don’t want our staff on the scene. We don’t want to be causing more trauma.”

Steamboat police said it isn’t expected for a crisis support or mental health professional to immediately respond to the scene of a suicide, but the staff at REPS said they think such a response should happen, and their organization is willing to be at the scene when needed.

“I know I don’t get called every time,” said Francone. She added statistics suggest that people close to someone who has committed suicide are at a higher risk of doing the same.

Francone is hopeful that calling REPS will be written into the protocol of all local law enforcement.

Collaborate and educate

While leaders with the Steamboat Springs Police Department, one of several law enforcement agencies in the region, think lines of communication between their agency and suicide prevention and post-suicide resources are strong, REPS and Mind Springs both expressed a desire to be more involved during crisis situations with all local agencies.

Last month, leaders from Mind Springs, REPS and Advocates met to discuss creating a flow chart that would outline which agencies ideally responded in which situations and consider who makes contact with whom.

Now may be the time, according to Gangel, to start discussions between law enforcement, the coroner, mental health professionals and other organizations — meetings he said took place more frequently in the past.

“We should reconvene those meetings,” he said.

He’s also hopeful stronger partnerships between agencies might lead to a change in the way the community discusses mental health.

“As agencies, it would be great if we could all help the world see that it’s OK to seek mental health care,” Gangel said. “It’s just like any other physical disease.”

Savalox said community education efforts have progressed from her perspective, but there’s still an opportunity for more education to make sure teens and young adults are aware of the help available to them.

“I think we’ve moved forward a great deal with the communication and education pieces, but I agree that there could be a need for more collaboration,” Savalox said.

Police in Steamboat agree.

“People need to understand there are resources,” Christensen said. “There’s a way out.”

Both Steamboat police leaders and Ryg said they’re willing to reopen a dialogue regarding how best to respond to attempted and completed suicides and are willing to entertain the ideas of agencies such as REPS to strengthen protocol.

“I’m very much open to talking with them,” Ryg said.

Advocates Executive Director Diane Moore also acknowledged more collaboration be-

tween all agencies appears to be needed.

“It sounds like there’s an opportunity here, for the appropriate agencies to look at the protocol for who needs to be called, so that everyone has that support,” Moore said.

More collaboration between agencies would increase the chances that all Routt County’s residents are getting access to the resources available to them and that families left behind after a suicide are getting the support they need, Francone said.

“We have the resources available, but we’re so siloed,” Francone said. “I think we have agencies here that want what’s best for the community, but we definitely need to work together and step outside our silos more, or we’re going to keep losing people.”

To reach Teresa Ristow, call 970-871-4206, email tristow@SteamboatToday.com or follow her on Twitter @TeresaRistow


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