By Mary Alice Murphy
Most of the Grant County Community Health Council meeting featured New Mexico Department of Health employees talking about Grant and Hidalgo counties suicide statistics.
The first part of the meeting featured updates from Health Council Director Cari Lemon. She had earlier sent out to members her report, which had some of the same items. Member Kathleen Hunt, representing the mental health sector, said she appreciated the written report and "learned a lot."
During the update, Lemon said the Red Hot Children's Fiesta held Sept. 9 had 42 booths and additional live demonstrations from Oni Ken Karate, Cloud Edge, Monsoon Puppets and an opening featuring Mariachi Plata.
Booths reported being very busy. "It was deemed a success."
Lemon asked for some brainstorming from members for what the Health Council should focus on in its application to the Freeport-McMoRan Community Investment Fund. She said she had a couple of ideas, including how as a community, the various calendars could be streamlined into one big calendar having everything on it. Member Joe Kellerman, representing Gila Regional Medical Center, said a web-based calendar would allow anyone who wanted to post an event to log in and put the event in themselves.
Member Father Jaroslaw "Jarek" Nowacki, representing the ministerial sector, suggested something similar to Google calendars.
Member Connie Glenn, representing work force, asked if it would be possible to do a poll of who keeps numbers on how many hits their calendar gets and determine which has the most hits.
Kellerman also suggested Facebook as a possibility.
"I want more ideas," Lemon said.
She reported that using a small Con Alma grant to help build learning programs for the Inmate Support Group to use in the jail, she and another member had attended a conference, National Wraparound Implementation Academy, in Baltimore, MD. "It was an incredible conference and I think I made solid connections with people in New Mexico, and I learned a great deal."
During sector reports, Glenn said, for the past month and a half, her office at Workforce Connections has been busy. "We have succeeded in getting an enormous amount of people employed with the new restaurant in town."
Terry Anderson, representing the childcare sector, said the Community Partnership for Children has joined with the Grant County Community Foundation and United Way to share office space in the old Office of Sustainability. "So we have a home. We continue with our Grant County Early Childcare LINKS to work together on shared services. We continue to write grants. Things are moving quickly."
She said the partnership is working with one of the professors at the Western New Mexico University School of Business. "He wants the students to have hands on. This semester the students will help us with our business plan, and they are very excited to work with the Health Council on an assessment. Hopefully, we will have it ready for next semester to put the assessment out to the public."
Kellerman gave an update on the GRMC Cancer Center. "A person has accepted the offer to be a physician assistant at the center. As soon as he has completed his contractual obligations, he will go to the University of New Mexico for two weeks of training. Then the Cancer Center will be up and running."
Hunt said New Mexico Health Options is getting busier now and so is Border Area Mental Health Services. "We are waiting to hear from the New Mexico Department of Health for us to receive a letter that we are cleared from the previous allegations. We also are awaiting to be paid for the services that were unpaid at the time of the allegations."
Marilyn Alcorn, representing the senior sector, said she would defer on senior issues to Edith Lee, alternate representing Hidalgo Medical Services.
Lee said the transition from the county for HMS to provide senior services to the senior centers in Grant County "has been a bumpy transition. We have our focus on streamlining processes and getting aligned with DOH and the Area Agency on Aging. We had announced we would provide catered meals, but for now, we are keeping the functioning kitchens in Gila and Mimbres. They are serving between 12 and 20 seniors each weekday. The transportation budget significantly decreased, so we partner with Corre Caminos. But on October 1, Corre Caminos will no longer provide on demand transportation services, only fixed routes. We do not have the ability at HMS for assisted transportation for wheelchairs and such. We have never been funded for that service. We are getting calls from seniors, who don't want to lose the on demand services. Maybe we can get Community Investment Fund money to provide the services."
Co-chairwoman, with this author, of the health council and representative for the Extension Office, Judy O'Loughlin said 16 people completed the My Diabetes Self-Management class. "It took place for 2 ½ hours each time for six weeks, so it was a commitment. We plan to offer it again in the spring. It's a very powerful program."
On a discussion about September being named the month for the annual meeting each year and with a need to change the by-laws to reflect that, Alcorn wondered about whether it would need to be publicized. No one had an answer, other than that the council, because it is not a governmental entity, probably does not need to comply with the Open Meetings Act.
Carol Moss, mental health epidemiologist; Heather Frankland, sexual violence prevention coordinator; and Tierney Murphy, injury epidemiologist, all from the New Mexico Department of Health, presented data on suicidal behaviors.
Moss said the department publishes each year a publication titled New Mexico Substance Abuse and Epidemiology. "It has suicide as an indicator." She showed a map from it that had the communities above the state rate in suicide marked in red.
She noted that in Grant County during the latest five-year period for which there is data, the county saw 46 deaths by suicide. Divide the number by the population and the crude rate is 31.4. It is an age-adjusted rate, she said.
Sixth Judicial District Judge Tim Aldrich asked how suicides were identified. "By the Office of the Medical Investigator? Are these clearly separated from substance abuse?"
Murphy said it is often self-done, when it refers to attempts or notes. "It does not include accidental drug overdoses. Grant, Sierra, Catron and Hidalgo counties have the highest rates in the state, with all above the state rate. Doña Ana County is less than the state rate."
Frankland said a strong correlation between suicide and domestic violence exists. She had the council members and audience members work briefly on a mini-SWOT (strengths, weaknesses, opportunities and threats). They were directed to work with a partner that they did not regularly work with.
"This gives us a chance to find potential solutions," Frankland said. "Our group has passion for the topic as our strength. A person that has too many jobs is a weakness, which provides an opportunity for partners. Threats may be in the distance from resources."
After the mini-SWOT, Moss brought up mental health and resources. "Youth suicide, ages 12-17, hasn't changed in Grant County (with data up to 2015), with one in the area."
Murphy said she oversees violent death statistics. "We combine the statistics from law enforcement, the medical investigator, the scene and the investigation. During a 13-year period, Grant County had a rate of 32.1 per 100,000 and Hidalgo County 30.6 per 100,000. That compares to the state rate of 20.6."
Males typically have higher rates of suicide than females. In Grant and Hidalgo counties, although the rates are higher than the state rates, the ages from 10-24 had the lowest rates, with those aged from 25-44 having the highest rates.
The highest rate of method for suicide is firearms. Fifty-six percent of suicides were by firearms in Grant and Hidalgo counties.
Although rates are lower in the two counties, drugs and co-poisoning are more common in Grant and Hidalgo counties than in the rest of the state.
For indicators, 45 percent of those who committed suicide in New Mexico were in a depressed mood beforehand. It's lower in Grant and Hidalgo. In the state, 43.2 percent had mental health problems and 41 percent have a history of treatment for mental illness. These rates are higher in Grant and Hidalgo counties. The second one includes PTSD and other mental illnesses.
In other indicators, 34 percent were receiving mental health treatments and 19.7 had alcohol abuse problems.
A woman in the audience asked if these statistics includes those self-medicating with street drugs.
Murphy said for these statistics, the person had to have a prescription.
Females were more likely to have had a diagnosis of a mental health issue.
Frankland said relationships could be stressors. Males have a more than twice higher proportion of intimate partner problems. Women have more health problems, with chronic pain included. Females are at much higher risk of multiple suicide attempts.
She said she sees this is an opportunity to prevent suicide in those who disclose suicidal thoughts.
In age groups, the youngest and the oldest are depressed. Mental health is a problem for young adults. Those with a history of treatment commit suicide more often in younger adults. Alcohol is a problem for those 45 to 64.
She said the intimate partner problems decrease with age, but those who commit suicide because of physical health are generally those in the oldest ages. Those 25-44 years of age have a higher rate of disclosing their suicidal thoughts.
As for toxicology, 80 percent of suicide victims test for alcohol, methamphetamines, anti-depressants, cocaine, marijuana and opiates. About a third are positive for alcohol.
Moss said the state follows indicators from such assessments as the Youth Risk and Resiliency Survey. Non-suicidal self-injury is seen in those purposefully hurting themselves, but not wanting to die. Those who have seriously considered suicide have sometimes made a suicide plan. Grant County is higher than Hidalgo County in this statistic, with females being higher than the males.
New Mexico has a higher rate of suicide than many other states and has many of the indicators.
Grant County youths have higher emergency room admissions. More adults with mental distress can be found in Hidalgo County. Grant County is often higher than the state and Hidalgo County for emergency department admissions and hospitalizations for mental disorders.
Moss said next steps are creating a technical package for preventing suicide and transforming communities.
"Thank you for sharing your resources," Lemon said. She reported that a local person in his 40s has been posting on Facebook asking whether he should commit suicide. "What should be our response?"
Alcorn said looking at data, "it's all revolving around mental illness, with some depression and alcohol usage. Mental health is where the biggest problem is in Grant County. We need changes in attitudes, resources, law enforcement, the judicial system. To me mental health is the crux of the issue."
Lee said she is also a mental health clinician and trainer. "I teach mental health First Aid and reducing the stigma of mental health issues."
Frankland said Lee is seeing the opportunities. "The threat is older people who have the stigma about mental health. If a person is thinking about suicide, it's an opportunity. It's their last cry for help. You're in the right mindset."
Kellerman commented on the age groups. "Of those in the 25-44 age group, the females seek help. But the cultural machismo causes a problem for men, because they have a problem in admitting they have issues."
Moss said a program called Man Therapy that she believes is out of Colorado, has been well received. These resources are preventing suicides.
"We can offer more assistance from the Department of Health," she continued. "Our numbers are per 100,000 people. It relies on the percentage of people reporting. It's not just Grant County. Mental health issues are ignored countrywide and worldwide."
Sylvia Madrid of New Mexico Health Options said the group has been in existence more than a year now. "One of our problems is that Blue Cross Blue Shield has not credentialed us because it says we have too many providers in the area. But we have higher issues with mental illness."
Alcorn said one of the reasons for the discrepancy between males and females is that males in jail are not getting the resources to help them.
The next health council meeting will take place in November.