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Policy Recommendations

Delivered August 2, 2019. Contributor: Shannon L.

Goals

To verify and quantify statistics and policies related to suicide and violent deaths, including specific focus on African-American communities, for the purposes of making policy recommendations.

Early Findings

Preliminary research indicates there is evidence that the CDC can study firearm-related violence, but there is no funding for it to do so. There is also a National Violent Death Reporting System that is operated by the CDC, but its total funding requires additional research. The percentage of mental health providers that are trained in suicide prevention is known, but the number of them who are in predominently African-American communities requires more research. Finally, "safe storage" programs seem to refer to states that require firearms to be stored properly around individuals who cannot legally possess them, but there seem to be few programs (if any) that are designed for the purpose of when someone is experiencing a crisis. However, "red flag laws" seem to be more in line with suicide prevention strategies.

RESTRICTIONS ON THE CDC

  • Agency instructions that accompanied a spending bill signed by President Donald Trump in March 2018 included sentence that notes the Centers for Disease Control and Prevention (CDC) "has the authority to conduct research on the causes of gun violence."
  • The actual language in the bill states, "While appropriations language prohibits the CDC and other agencies from using appropriated funding to advocate or promote gun control, the Secretary of Health and Human Services has stated the CDC has the authority to conduct research on the causes of gun violence."
  • However, the authority came with no funding and researchers like Daniel Webster, of Johns Hopkins Bloomberg School of Public Health, say they're "not particularly optimistic that anything will change."
  • Therefore, the issue is not that the CDC cannot research the causes of gun violence. Instead, the issue is that the 1996 Dickey Amendment prohibits any funds provided to the CDC for injury prevention from being "used to advocate for or promote gun control."
  • Even the Republican lawmaker for whom the bill is named, Jay Dickey, regrets the amendment. He said, "It wasn't necessary that all research stop... It just couldn't be the collection of data so that they can advocate gun control. That's all we were talking about. But for some reason, it just stopped altogether."

NATIONAL VIOLENT DEATH REPORTING SYSTEM

  • There is a National Violent Death Reporting System (NVDRS) that is actually under that name and is maintained by the CDC.
  • The NVDRS "covers all types of violent deaths—including homicides and suicides—in all settings and for all age groups."
  • The database includes over 600 "unique data elements" that offer insight into and context about violent deaths and their causes (relationship problems, mental health issues, toxicology results, life stressors, job problems, financial problems, physical health problems, etc.).
  • The system also contains information on "weapons used, characteristics of subjects, and locations where" the violence occurred.
  • The NVDRS links this information together on violent deaths and provides insights about "why they occurred."
  • Violent death data collection began in 2002 with six states participating (MA, MD, NJ, OR, SC, VA).
  • In 2018, the final 10 states were added to the database (AR, FL, ID, MS, MT, ND, SD, TN, TX, WY).
  •  Puerto Rico and the District of Columbia are also included in the database.
  • In 2001, Congress allocated $1.5 million in funding to develop the NVDRS and begin collecting data on six states.
  • In 2011, the NVDRS was allocated $3.5 million in funding from Congress.
  • In 2014, the NVDRS was allocated 11.2 million in funding from Congress.
  • In 2015, the NVDRS was allocated $15.9 million in funding from Congress.
  • In 2016, the NVDRS was allocated $23.6 million in funding from Congress.
  • In 2019, the NVDRS was allocated $23.5 million in funding from Congress.

MENTAL HEALTH PROVIDERS AND SUICIDE PREVENTION TRAINING

  • As of 2017, only nine states "mandate training in suicide assessment, treatment, and management for health professionals." These are California, Indiana, Kentucky, Nevada, New Hampshire, Pennsylvania, Tennessee, Utah, and Washington.
  • Four additional states "encourage training in suicide assessment, treatment, and management for health professionals." These are Illinois, Louisiana, Montana, and Oregon.
  • As of 2018, "less than half of U.S. mental health professionals are trained in suicide prevention."
  • Only 50% of psychology training programs teach students how to identify individuals who are at risk of suicide and how to prevent them from completing it.

SAFE STORAGE PROGRAMS

  • Colorado has a Suicide Prevention Toolkit for Colorado Primary Care Practices that includes a Safety Plan that is a "prioritized written list of coping strategies and sources of support patients can use who have been deemed to be at high risk for suicide."
  • Included in this plan is to "remove all firearms and ammunition."
  • At the end of 2018, thirteen states had passed laws authorizing "preemptive, risk-based, time-limited gun removal orders." These are California, Connecticut, Delaware, Florida, Illinois, Indiana, Maryland, Massachusetts, New Jersey, Oregon, Rhode Island, Vermont, and Washington.
  •  Two additional states enacted "red flag laws" in 2019, including Colorado.

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