Although New Hampshire has made great strides in suicide prevention efforts, suicide remains the second leading cause of death (after accidental injury) among New Hampshire youth and young adults up to age 34 and the fourth leading cause of death for adults up to age 55.
As shown by the chart below, the rate of suicide or self-harm related emergency department visits was significantly higher in the Winnipesaukee Region (20.5 per 10,000 population; equivalent to about 150 emergency department visits per year related to suicide or self-harm) than in the state overall during the period 2005 to 2009 (15.9 per 10,000 population; most recent data available).
It is also important to note that there are strong relationships between substance misuse, mental health and suicidal behavior. Drugs and alcohol can be a form of self-medication for underlying mental illness symptoms, can worsen underlying mental illnesses, or can cause a person without mental illness to experience the onset of symptoms for the first time. Youth in the Winnipesaukee Region who report on the Youth Risk Behavior Survey that they have attempted suicide in the past year are also twice as likely to have reported recent use of alcohol or marijuana and more than 4 times as likely to report having misused prescription medications.
| Geographic Area | Percent of High School Age Youth Who Report Having Attempted Suicide in the past year; 2017 |
| Winnipesaukee Region | 7.8% |
| New Hampshire | 5.9% |
Data Sources: NH Youth Risk Behavior Survey, 2017 and NH Health WISDOM, accessed 2017
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Regional Initiatives and Opportunities
Partners in Community Wellness (PiCWell) is working to develop improved capacity and strategies to prevent suicide through this Community Health Improvement Plan. Regional assets and opportunities for supporting this work include:
- A volunteer-based regional leadership team focused on behavioral health initiatives, which is comprised of local experts across a continuum of care, including health promotion & prevention, early identification & intervention, treatment, and recovery supports.
- Intentional alignment of regional efforts with the New Hampshire 10-Year Mental Health.
- Efforts are guided by a community engagement model that benefits from the participation of six core community sectors who are both impacted by suicide and who play a valuable role in community-based and sector-specific best practice efforts. The six sectors are identified as: business, education, health, safety, government and community based supports.
- Professionals in our region are trained to deliver the Connect Suicide Prevention and Postvention program, a best-practice curriculum developed by NAMI-NH, and the More Than Sad evidence-based curriculum developed by the American Foundation for Suicide Prevention.
Goals, Objectives and Strategic Approach
| Goal 1 | Reduce suicide incidence in the Winnipesaukee Public Health Region. |
| Objective 1 | Reduce the percentage of high school age youth who report having attempted suicide in the past year to 4% (baseline=7.6%, 2009-2013 YRBS) |
| Objective 2 | Reduce the rate of suicide or self-harm related emergency department visits to 16.0 per 10,000 population (baseline=20.5 per 10,000 population) |
| Objective 3(developmental) | Increase the number of people trained in Suicide Prevention, Postvention and/or Counseling on Access to Lethal Means (CALM) within key community sectors. |
| Objective 4(developmental) | Increase the proportion of media professionals who have received training in appropriate reporting of suicidal events following the national Reporting on Suicide: Recommendations for the Media. |
Objective 5(developmental) | Increase utilization of postvention training and protocols (i.e. After a Suicide Toolkit, Media Recommendations) for first responders, law enforcement, emergency departments, schools and others who may be involved or affected by a suicide to reduce risk of contagion and promote healing. |
| Objective 6(developmental) | Identify key data sources and tools that may better identify high-risk populations and/or other trends which would inform suicide prevention efforts. |
Strategic Approach
STRATEGY 1: Formalize a regional postvention response team comprised of members from various key sectors and representing regional geography.
STRATEGY 2: Target prevention efforts on populations with characteristics placing them at higher risk for suicide, such as: substance misuse, military experience, minority and refugee populations, sexual and gender minority populations, young adults not enrolled in college, justice-involved young people, and youth and young adults who have had an inpatient psychiatric admission.
STRATEGY 3: Coordinate prevention and postvention training across multiple community sectors and settings.
STRATEGY 4: Promote education tailored to specific high risk populations that includes hopeful messaging, suicide warning signs, help seeking behaviors, and resources.
STRATEGY 5: Promote the integration and coordination of suicide prevention and postvention best practices, policies and protocols across multiple community sectors and settings.