Volume No. 18 Issue No. 9 September 2021  



  Suicide prevention resources and a BHCON of hope
  

     The National Institute of Mental Health states suicide was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 44.
   
   The 2020 El Paso County Coroner’s Report showed there were 178 total deaths (19%) in the county due to suicide.
   
   Question Persuade Refer is an emergency mental health intervention for suicidal persons created in 1995 by Paul Quinnett. The QPR Institute website conveys the intent is to identify, interrupt the crisis and direct that person to the proper care.
   
   The QPR Institute provides examples of direct and indirect verbal, behavioral and situational warning signs for suicide:
   
   Verbal: “I’ve decided to kill myself,” “I’m going to end it all,” “Soon I won’t be around,” “I just want out.”
   
   Behavioral: Putting personal and business affairs in order; taking out insurance or changing beneficiaries; sudden interest or disinterest in church; giving away money or prized possessions.
   
   Situational: Anticipated loss of financial security; death of a spouse, family member, or friend (especially if by suicide or accident); flare up with friends or relatives for no apparent reason; a recent move, especially if unwanted.
   
   One clue or warning sign may not mean a great deal, but any warning sign suggesting acute distress, despair or hopelessness about the future, or a desire to “end it all,” is worth asking about.
   
   The following is a brief summary of the QPR model:
   
   Question: Don’t wait. If in doubt, ask the individual if they are thinking about suicide. If they are reluctant, be persistent. Remove the audience, talk alone in a private place. Actively listen, and allow plenty of time for a full conversation.
   
   Persuade: Once the question has been asked, most people thinking of suicide want to talk. Your role is to listen first. Remember suicide is not the problem, only the solution to a perceived insolvable problem. Do not rush judgment. Offer hope in any form. The goal of persuasion is for the person to agree to get some help and help them follow through to said help.
   
   Refer: The best referral involves taking the person directly to a licensed professional. Second best is getting a commitment from them to accept help, then making the arrangements with a mental health organization. Lastly, give referral information and try to get a good faith commitment not to attempt suicide. Any willingness to accept help at some time, even in the future, is a good outcome. Ask the person who else might help — family, friends, physician or a religious leader. Follow up a few days later.
   
   Research shows the most effective intervention is to ensure the removal of the means of suicide, especially guns. UCHealth provides lethal means counseling upon discharge and also provides gun safes and medication lockboxes.
   
   If there is a mental health emergency, the El Paso County Sheriff’s Office has the Behavioral Health Connect Unit or BHCON (pronounced Beacon) — a co-responder model patrol unit that responds to mental health related 911 calls.
   
   The BHCON Unit pairs an El Paso County Sheriff’s Deputy with a UCHealth licensed behavioral health clinician for a coordinated response to emergency calls.
   
   The BHCON Unit is funded by a grant from the Colorado Department of Human Services and is a five-year pilot consisting of a partnership with the El Paso County Sheriff's Office, the El Paso County Department of Health and UCHealth.
   
   BHCON has two units covering seven days a week, from 10 a.m. to 8 p.m., and is primarily assigned to unincorporated regions of El Paso County. In the event that a BHCON Unit is unavailable, there are deputies who have crisis intervention training.
   
   The El Paso County Sheriff’s Office and Fountain Police Department added an additional BHCON unit, with a UCHealth clinician, to cover the Fountain jurisdiction and southern patrol districts of El Paso County.
   
   The daily duties and responsibilities of the BHCON team include responding to crisis 911 calls, taking referrals from other EPSO deputies to respond to identified individuals, and completing follow up visits and/or phone calls to individuals previously contacted by BHCON.
   
   El Paso County Sheriff’s Office Deputy Jennifer Knutson and Dru Wacker, a UCHealth behavioral health clinician are BHCON Unit 2.
   
   Knutson said, in general, they (deputies) introduce themselves and secure the scene from weapons or other dangers. If the person is aggravated or distressed, the deputy will attempt to de-escalate the individual before bringing in the clinician to talk and evaluate.
   
   The BHCON Unit does their best to immediately help the individual and keep them out of jail and emergency departments. When an individual is an immediate danger to self or others or is gravely disabled, a licensed clinician or a law enforcement officer can place the person on a 72-hour mental health hold. They also follow up with the individuals or the mental health providers as much as possible.
   
   Wacker said she works with the individual to create a safety plan — to identify people they can call for support, recognize triggers and employ techniques to calm down. The plan is written and a copy is placed where the individual can see it as a tangible reminder.
   
   Both deputies and clinicians must apply for selection to BHCON. Knutson said she had to pass a panel interview before she became a BHCON Unit. Dru Wacker stated she applied to her bosses at UCHealth.
   
   Both shared that patience and active listening are incredibly important aspects of their job.
   
   From the El Paso County Sheriff’s Office BHCON page, in 2020 the El Paso County Sheriff’s Office received 4,282 mental health calls:
  • BHCON units responded to over 900 calls
  • 55% were treated in place, eliminating the need to remove individuals from their home/school by providing immediate intervention and resources
  • 12% placed on a mental health hold
  • 1,178 follow-up calls were made to successfully reach clients 58% of the time after initial contact to provide continual support

   
   BHCON completed 507 subsequent administrative calls to mental health providers ensuring clients received the care they needed.
   
   When multiple deputies responded to the scene of a mental health related 911 call, BHCON was able to release 577 responding deputies back into law enforcement service while BHCON remained on the scene.
   
   There are many ways in which professional help can be provided for those in need: Safe2Tell Colorado: students, parents, school staff and community members can anonymously report concerns regarding their safety or the safety of others.
  • Suicide Prevention Line: 800-273-8255
  • Colorado Crisis : 844-493-8255
  • Lighthouse Walk-in Crisis Center: 719-635-7000, 24/7 walk-in crisis support
  • Cedar Springs: 719-633-4114 — provides adult and youth programs, acute inpatient, half-day programs for students, rehab (military only) and psychiatric residential services
  • Diversus Health: 719-635-7000 — programs for addiction, counseling, crisis and psychiatric services.
  • Peak View: 888-235-9475 — mental health, addiction, youth service and outpatient programs.
 
El Paso County Sheriff’s Office Deputy Jennifer Knutson and Dru Wacker, a UCHealth Behavioral Health Clinician, comprise BHCON Unit 2. Photo by Ava Stoller
 
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