BY DEBBIE PAGE
About 100 community members and leaders gathered on Friday morning to launch the “Be Well Iredell” initiative, part of a statewide movement to improve the well-being and mental health of all residents so that everyone can cope with life’s struggles and thrive.
Miles Atkins, Iredell Health System’s director of Corporate Affairs & Government Relations, welcomed the crowd and thanked Susan Tolle, whom he credited as the reason “Be Well Iredell” is embarking on a comprehensive suicide prevention effort.
Tolle’s years of suicide prevention efforts “positioned us to move forward together as an entire county,” added Atkins.
BE WELL IREDELL COMMUNITY VISION AND GOALS
United Way Senior Director of Community Investment Sara Helmick said that the “Be Well Iredell” initiative recognizes that every resident does not thrive “with hope and resilience. Our emotional, mental, and physical well-being is not being prioritized enough. Protective tools to help individuals avoid and cope with a moment of challenge are not readily accessible. To ensure that ‘Be Well Iredell’ is effective, we will need to gather data into a common location to ensure we are targeting the correct audience members with outreach efforts.”
The group’s vision is “to foster a community where every resident thrives with hope and resilience and where we stand united in our commitment to ensuring the emotional, mental, and physical well-being of residents through collaboration and unwavering support. We aspire to empower our residents with the protective tools they need to overcome challenges and to foster a safe, nurturing environment where no person feels alone or forgotten.”
United Way Director of Major Giving Genevieve Glaser shared the group’s goals, including education and training, community engagement and awareness, and access to support and care.
The rationale for educating and training the community is to build and share the life skills that prepare individuals to tackle every day challenges and successfully adapt to stress and adversity. These skills include coping and problem-solving skills, emotional regulation, conflict resolution, and critical thinking.
The strategies for this goal include teaching coping and problem-solving skills to train a network of individuals who can share evidence-based mental health and suicide response skills with community members in need of help.
Community members will have opportunities such as attending evidence-based trainings or workshops, hosting a training or workshop at their place of business, or sponsoring a lunch and learn event to build this network of trained individuals.
The need for such training is clear when looking at the supporting data for this goal in the Iredell County Community Health Assessment, completed in fall of 2023.
Over 50 percent of those responding to the survey experienced bullying or anxiety. About 20 percent reported feeling excessive rage, and about 30 percent reported experiencing depression. Approximately 6 percent reported having suicide ideation.
State data also shows that self-harm is the third leading cause of death among children ages 0 to 17 in Iredell County.
“Be Well Iredell” also seeks to increase community engagement and awareness about mental health issues because identifying and supporting people at risk for suicide is critical to suicide prevention.
Creating community connectedness may protect against suicidal behaviors by decreasing isolation, encouraging adaptive coping skills, and increasing belongingness to help build citizens’ resilience in the face of adversity.
If community awareness and knowledge of mental health and well-being is improved, the stigma associated with mental health concerns and seeking care will decrease. This awareness will also help identify and support people who are at risk and promote healthy relationship connections, creating protective environments that lessen self-harm and prevent risk.
To achieve its second goal to create engagement and awareness by sharing information that increases knowledge of mental health topics, “”Be Well Iredell” will help host events for people to share their experiences and hear from peer support specialists.
The group also will promote safe storage of medication, firearms, and other household products that can cause harm and sponsor public service announcements to share basic facts about mental health topics to encourage conversations and promote getting treatment and help.
The community engagement goal is important because state data reveals that many groups are disproportionately impacted by suicidal thoughts, attempts, and/or suicide, including males (suicide), females (attempts), middle-aged, and older adults (suicide), people living with a mental health disorder, people who have previously attempted suicide, people with a history of non-suicidal self injury, veterans, and active-duty military personnel.
Males age 45 to 64 are at the greatest risk for suicide.
Increasing access to support and care in Iredell County, the initiative’s third goal, is essential to suicide prevention and treatment of mental health issues.
Data shows that over 121 million Americans live in areas without enough mental health providers to meet needs. Less than half of adults in the United States with mental health disorders have ever received treatment for their conditions.
The group seeks to identify ways to improve access to timely, affordable, and quality healthcare for people at risk for suicide or who are seeking mental health support and care. The group will support processes that help improve access to mental health treatment.
“Be Well Iredell” also intends to create guides on how to navigate pathways to access mental health, counseling, and related services and will convene groups of mental health professionals to provide opportunities for professional support, connection, and collaboration.
Residents recognize the need for expanded mental health services.
The 2023 Iredell County Community Health Assessment reported that 61 percent of respondents reported their belief that the county needs improved access to mental health care. Mental health is considered a pressing issue, evidenced by the 77 reported mental health-related deaths in Iredell in 2019.
EVERYONE IS SUSCEPTIBLE TO MENTAL HEALTH CRISES
Partners Health Management Community Engagement Specialist Jerry Campbell reminded the attendees that though they may be fine at the moment, at any time life stressors can plunge a person into an emotional or mental health crisis.
“Anyone here can be at risk when one of these stressors come your way.”
Life stressors reported by those with suicide ideation included recent or eminent crisis, problems with a partner, physical health issues, job issues, the death of a family member or friend, or financial problems.
From 2017 through 2021, Campbell said of the 178 violent deaths in Iredell County, 141 were deaths by suicide. Iredell is the 14th largest county in North Carolina but ranks ninth in death by suicide, with a five-year suicide rate of 17.3 per 100,000 (current population 199,710).
In 2023, 298 people reported a suicide attempt or self-harm when visiting an Iredell County emergency department, with 1,096 reporting suicide ideation. Self-harm was the third leading cause of death in children in Iredell County.
Because 74 percent of the Iredell deaths by suicide were gun-related, keeping firearms locked and secure is an important suicide prevention measure.
Females have higher rates of suicide attempts and self-harm (68.8 to 31.2 percent) and suicide ideation (55.4 to 44.6), but males have higher rates of actual death by suicide.
Sixty percent of the indiviudals who died by suicide in Iredell had current mental health problems and had received some mental health treatment. Thirty percent were depressed and currently in treatment.
Nationally, for every person who takes his or her life, 25 attempt to die by suicide, so with 49,000 suicide victims last year, an estimated 1.2 million attempts occurred. For every suicide, an estimated 135 people are affected by that person’s loss, according to Campbell.
NEXT STEPS
Iredell-Statesville Schools Director of Community Engagement Marlene Scott discussed the “Be Well Iredell” logo, which includes a half heart and half head held up by two hands.
“We want you to be thinking about the heart, passion, love, giving and resources; the head, the wisdom, knowledge, where I pull those resources. What is it I can do with my hands for my employees, my staff, my students? How can I be a help? We want you to join us.”
“We want to continue this – not just in this moment, but every single day.”
Scott urged each attendee to learn coping tools and suicide prevention measures through “Be Well Iredell” resources and then think of ways they could share these resources throughout the community, using their organizations, places of employment, churches, schools, or community groups.
“Join us, learn more, connect with other folks so we can continue to grow and learn from each other.”
Scott urged folks to employ their heart, head, and hands in this effort to ensure that all community members have the protective tools they need to overcome life challenges and to feel valued and safe.
NC PRIORITIES IN BEHAVIORAL HEALTH
Keynote speaker Kelly Crosbie, NCDHHS Director of the Division of Mental Health, Developmental Disabilities, and Substance Use Services, shared the state’s priorities in investing in citizens’ behavioral health.
Crosbie said everyone has lived experience with mental health concerns, whether personally or with family, or friends. She grew up in a small town in the Pennsylvania mountains and shared some of her own families’ struggles with mental health and substance use disorders, including a first cousin dying by suicide, that were prevalent in that area.
The stigma surrounding mental health and substance use disorder was strong and, though better now, still exists and prevents some from talking about their struggles with anxiety and depression or seeking assistance and treatment.
“We need to acknowledge it. It’s normal to be okay with it and talk about it,” she said. “We all deal with it, and we all should understand, address it, and talk to one another about it.”
Crosbie said the state’s mission is “to build systems, services, and supports that improve the well-being of all North Carolinians, with a focus on mental health, intellectual and developmental disabilities, substance use, and traumatic brain injury.”
The agency envisions “communities where all are supported to live healthier and happier lives,” and “Be Well Iredell” is a a part of that effort.
The state’s five-year plan will focus on promoting wellness and recovery, strengthening the crisis response system, expanding services for people in the justice system who often have substance use or mental health issues, preventing substance misuse and overdose, supporting choice and inclusion, and strengthening the workforce through enhanced employee well-being supports.
To support wellness and recovery, North Carolina is committed to increase timely access to evidence-based treatment for children, teens, and adults. Suicide prevention efforts will be targeted to specific age groups, and efforts to raise mental health awareness and reduce the stigma associate with seeking health will increase.
The state’s goals also include streamlining 988 suicide hotline operations to more effectively provide help, dispatch services to those in severe crisis, and collect data about the results. They also want to reduce wait time for mobile crisis services to under two hours.
Establishing a statewide network of behavioral health crisis facilities for all ages will also help reduce the number of mental health crises that involve law enforcement contact. The state also wants to decrease the amount of time emergency departments hold patients awaiting mental health services.
Crosbie said the state wants to create a continuum of care, ranging from having someone to call (988, 1-88-PEERS-NC, Partners 1-833-353-2093 24/7), to having someone to respond (mobile crisis team; Mobile Outreach, Response, Engagement and Stabilization (MORES) teams for children, adolescents and families; EMS; or Law Enforcement Crisis Intervention Teams), to having somewhere to go (a behavioral health urgent care, facility based crisis care, peer and community respite services, or North Carolina Systemic, Therapeutic, Assessment, Resources and Treatment- NC START).
Crosbie stressed the importance of having empathetic, accessible, and immediately available care to those in crisis. She urged “Be Well Iredell” to create a culture of helping and making mental health resources available throughout the community through training community members to recognize those struggling and knowing the coping tools to share with them.”
Eighty-five percent of the calls to the 988 hotline are not crisis situations, said Crosbie, but are people who need support, a listening ear, or access to resources and did not know where else to turn. About 45 percent of NC 988 callers are repeat callers.
To offer another source of help to these callers, North Carolina launched a new Peer “Warmline” (1-855-PEERS NC or 1-855-733-7762) on February 20 to work in conjunction with the North Carolina 988 Suicide and Crisis Lifeline by giving callers the option to speak with Peer Support Specialists, people living in recovery with mental illness and/or substance use disorder that can provide support and benefit using their lived experiences.
The peer support specialists offer non-clinical support and resources to those in crisis and strengthens overall engagement to gently guide them toward getting care.
Research shows that these “warmlines” improve outcomes for those in crisis by reducing hospitalizations and ED visits, reducing recurrent behavioral health symptoms, and increasing communication and collaboration between care teams, those in crisis, and their families, according NCDHHS.
JOIN “BE WELL IREDELL” EFFORTS
To become part of the solution to mental health and suicide ideation crises, visit the “Be Well Iredell” page at https://uwiredell.org/be-well-iredell/ or on Instagram at https://www.instagram.com/be.well.iredell/.
SUICIDE RISK FACTORS
Suicide is the second leading cause of death for youth ages 10 to 18 in North Carolina and the third leading cause of death for those ages 19 to 34, according to the N,C, Department of Health and Human Services.
People who survive attempted suicides are sometimes seriously injured and in need of sustained physical and psychological care.
Death by suicide was rising since before the 2020 pandemic but is now rising even more rapidly. The problem cuts across race and age groups. Though suicide rates involving the elderly are among the highest, youth are also exhibiting increasing mental health and suicide ideation issues. Rural communities and veterans are also dying by suicide at higher rates.
Experts believe suicide data is under-reported since deaths and attempts are sometimes classified under a different cause, like overdose.
Forty-one percent of adults and 54 percent of youth (10-18) who died by suicide experienced a recent crisis before they acted on their suicide ideation.
Other risk factors for suicide, according to the N,C, Department of Health and Human Services, include:
♦ Hopelessness;
♦ Behavioral health disorders, including self-harm and depression;
♦ Substance use and addiction;
♦ Loneliness;
♦ Risky behaviors;
♦ Poor coping skills;
♦ Interpersonal problems;
♦ Chronic physical illness;
♦ Physical, sexual, or psychological abuse;
♦ School or work problems;
♦ Insomnia;
♦ Chronic stress;
♦ Mental health problems at home;
♦ Family violence;
♦ Lack of support;
♦ Limited access to health and behavioral healthcare (22 NC counties do not have psychiatrists);
♦ Access to lethal means (firearms, medications, etc.);
♦ Bullying and discrimination;
♦ Racism; and
♦ Stigma associated with getting and receiving mental healthcare
Experts say that restricting access to the more lethal means of self-harm saves lives. Firearms were used in 61 percent of deaths by suicide in 2020, followed by hanging (22 percent), poisoning/intentional overdose (12 percent), with 6 percent using other means (falls, car accident, sharp weapons, etc.).