Suicide- Turning grief to action.

suicide 2 On February 18, 2011, Matt Adler, a successful lawyer and father of 2 young children, killed himself.

His wife, Jennifer Stuber, was stunned. Although Matt was suffering with a dark bout of depression, he was being treated, and Jennifer assumed he was being treated thoughtfully. But when she sought Matt’s medical records to try to understand what had happened, she ran into difficulty. No one wanted to give her the records.

As Jennifer herself points out, she was in a position to find out more. An academic and sociologist at the University of Washington in Seattle, she had plenty of experts to consult when she finally did obtain some records. She found that the medical personnel knew Matt was a suicide risk, and actually labeled him as a “risky patient’ as a lawyer with a potential lawsuit, but did not act to prevent suicide.  7 suicide prevention experts Jennifer consulted sadly said they were sorry, but were not surprised: few mental health professionals had training in suicide prevention.

This was not acceptable. Not only had Matt’s death been avoidable, but other people would be left at risk. How could what seemed to be a systematic hole in the medical system be fixed?

As a sociologist, Jennifer had a background in policy, and knew how the legislative process worked. (Lobbyist? for what?)  In July, a time when the state legislature was in recess and representatives had time to speak locally with constituents, she made an appointment with State Representative Tina Orwell, who represented the 33rd district. Jenniifer chose Orwell because she was a social worker, and so would know of the devastating effects of suicide on families: she was also a University of Washington alumnus.

Along with Sue Eastguard, a suicide prevention advocate, and with a lawyer from her husbands firm, Jennifer met with Orwell- and after they explained to Orwell what they had learned about the treatment of people who were suicide risks, Orwell said, “Let’s work on a piece of legislation.”

The legislation was written by Orwell and her colleagues with the help of Jennifer and her collaborators and was submitted for its first reading in the House in January as HB 2366- Requiring certain health professionals to complete education in suicide assessment, treatment, and management. The bill went through the House Health Care & Wellness, was passed by the House in on Feb 10, an amended version passed by the Senate on February 28, and was the Matt Adler Suicide, Assessment, Treatment and Management Act of 2012 (ESHB) was signed into law by the Governor on March 29, 2012, not even a year after its conception and initiation.

This bill required mental health professionals to receive training every 6 years in identifying and treating those at risk for suicide, which might have saved Matt, and would undoubtedly save other people. But the more one looked at the hugeness of the impact of suicide- over 36,000 people in the USA kill themselves every year- it was clear that there were many other pipelines to stop. Washington is one of only two states (Kentucky is the other)  that require that mental  health professionals be trained in suicide prevention.

Jennifer and her collaborators, with allies Tina Orwell and other state representatives, passed 2 more bills in the next 2 years: HB 1336, Increasing the capacity of school districts to recognize and respond to troubled youth, and HB 2325, concerning suicide prevention, which requires primary care medical professionals, among others, to be trained in recognizing and treating those at risk for suicide.

It was HB 2315 that was the most difficult to pass.

Approximately 50% of people who commit suicide have been to their primary care doctor in the month before they died. Surely, training would improve knowledge of suicide and would reduced the suicide rate. There was opposition from professional organizations and lobbyists serving doctors and nurses, who protested that they did not want anyone telling them how to use their CME (Continuing Medical Education) hours. There was opposition in the Washington State Senate, as the chair of the Healthcare Committee was aligned with the medical professional associations.

Because the bill would have have more trouble in the Senate,where there was organized opposition, Forefront focused on the Senate on the February 25th 2014 Lobby Day at the state capital. In that one day, 40 people whose lives had been affected by suicide spoke with 36 state senators. This testimony, which showed the life-or-death essence of the issue, was xxxx, and an amended form of the bill was unanimously passed on March 6. The bill signing by the governor took place on March 27th, 2014, making the bill law.

3 bills through the state legislature in 3 years is astounding activist success.  What enabled this success (and what other activists can learn from this) is, according to Jennifer:

Go local!  While suicide is not just a local issue, addressing the problem in the legislature is much more efficient at the city or state level. You can more easily find collaborators with whom you can work. You know the other issues the legislators face. The local victories have great potential to become other local, or national, causes.

Follow the “textbook” of activism in policy change: Know how the system works. Take advantage of a focusing event (in this case, the suicide of Matt Aler) and run with it. Find an effective champion in the legislature, someone who is sympathetic to the issue and is effective at making and keeping coalitions. Be adept yourself at making and keeping coalitions and collaborators (Over 300 people collaborated on getting the bills through the legislature.)

Know the rules, not just in the legislature, but in the other venues of your activism. For example, Jennifer is faculty at  the University of Washington, a state school. State schools follow state rules, and the University of Washington made it clear that there could be no grass roots lobbying in class or during a “regular” 9-5 day on the issue of lobbying for suicide prevention.

Jennifer continues to work with Forefront (http://www.intheforefront.org), the non-profit organization she and Sue Eastguard began in 2013 at the University of Washington, in developing evidence-based approaches to suicide prevention. Forefront not only works on legislation for suicide prevention, but on developing and setting up suicide prevention curricula, and helping families and organizations find help in prevention of and healing from suicide.

For a more personal look at the frustration Jennifer felt at the stigma of suicide even with the health care system, and her inability to find help for her husband, see http://www.washington.edu/alumni/columns-magazine/march-2014/features/stuber/  .

Know where to get help for family, yourself, co-workers.

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2015 update

Campus suicide prevention law passes

Last month, on April 23, Governor Jay Inslee signed into law SHB 1138 to create a suicide prevention task force across Washington’s 54 college campuses. The leadership of Rep. Tina Orwall and the persistence of many Forefront volunteers, some of whom lost a college-age child or a sibling to suicide, were essential to the bill’s success. Read more about the new law and the Husky Help and Hope (H3) initiative for promoting mental health and suicide prevention at the University of Washington in Faculty Director Jenn Stuber’s recent post on Forefront’s Insight Blog.

 

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