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Advocacy Forum 2011

Advocacy Forum 2011. Dr. Paula J. Clayton, Medical Director American Foundation for Suicide Prevention 120 Wall Street, 22nd Floor New York, NY 10005 1-888-333-AFSP www.afsp.org. Facts about Suicide. Facts.

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Advocacy Forum 2011

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  1. Advocacy Forum 2011 Dr. Paula J. Clayton, Medical Director American Foundation for Suicide Prevention 120 Wall Street, 22nd Floor New York, NY 10005 1-888-333-AFSP www.afsp.org

  2. Facts about Suicide

  3. Facts More than 34,598 people in the United States died by suicide in 2007. About every 15 minutes someone in this country intentionally ends his/her life. Although the suicide rate fell from 1992-1999, it was steady for 5 consecutive years despite all of our new treatments. The number of deaths rose by 955 in 2004, by 118 in 2005, by 663 in 2006 and rose even more, by 1298, in 2007. Although the rate in adolescents and the elderly is falling, alarmingly, the rate in middle age men and women (46-64) is rising. 3 3

  4. U.S. Suicide Rates by Gender & Age (with special attention to those 65+) 4 4 Centers for Disease Control, WISQARS. http://www.cdc.gov/injury/wisqars/index.html

  5. Prevention

  6. Prevention AWARENESS SCREENING EDUCATION MEANS RESTRICTION MEDIA GUIDELINES SIMPLE INTERVENTIONS TREATMENT 6 6

  7. Awareness Primary risk factor for suicide is psychiatric illness: “depression can be lethal” Depression is treatable Destigmatize the illness Destigmatize the treatment Encourage help-seeking behaviors and continuation of treatment Proposed: Billboard campaign AFSP: Depression and Bipolar Awareness: From Diagnosis to Remission Civnar, JG, Perspectives in Psychiatric Care, 2005 7 7

  8. Professional Education One of 3 Studies In the Swedish county of Jämtland the use of antidepressants in 1994 was 25% below the Swedish average and the average suicide rate during 1970-1994 was 10% above the national average. From 1995 to 2005, GPs were offered a two day seminar on treating depression which consisted of lectures, case discussions, and videotape presentations. There was an option to continue one day seminars in future years. Suicide rates per 100,000 Jämtland Sweden 1974-1994 27.7 25.0 1995-2002 17.3 17.6 Decrease seen mostly in women Henriksson S, Isacsson G, Acta Psychiatr Scand, 2006 8 8

  9. Professional Education Sales of antidepressants in Jämtland, Sweden 9 9

  10. Suicide Prevention Strategies: A Systematic Review (2005) Intervention Suicides, % Decline in Annual Rates Education Public Not available Primary care physician 22-73 Gatekeeper US Airforce 40 Norwegian Army 33 Increasing antidepressant prescriptions* 3.2 Chain of care Not available Restricting lethal means Guns 1.5-9.5 Domestic gas 19-33 Barbiturates 23 Vehicle emissions Not available Analgesics Not available Media blackouts Not available *There was a 414% increase in antidepressant prescriptions 1987 – 1999 Mann J, et al, JAMA, 2005 10 10

  11. Treatment and Dissemination National Network of Depression Centers 2929 Plymouth Rd., Suite 300 Ann Arbor, MI 48105 www.nndc.org

  12. Purpose NNDC’s Mission To conquer depressions, bipolar illnesses and related diseases so millions can live better lives by developing, disseminating and translating standardized, sustainable, evidence-based, large-sample research advances into clinical care via a national network Four INTEGRATED domains • Research Translation • Clinical Care • Education of a New Generation • Public Policy 9/16/2014 12

  13. Timeline and Progress

  14. Center of Excellence Membership The nation’s leaders in depression & bipolar care, research and education University of Cincinnati & Lindner Center of HOPE University of Colorado Denver Depression Center University of Iowa University of Louisville Depression Center University of Michigan Depression Center University of Pennsylvania University of Texas Southwestern Medical Center Weill Cornell Medical College Columbia University Duke University Emory University Brigham & Women’s Hospital, Partners Healthcare & Harvard Johns Hopkins University Massachusetts General Hospital, Partners Healthcare & Harvard McLean Hospital, Partners Healthcare & Harvard Stanford University University of California Los Angeles University of California San Francisco Depression Center 9/16/2014 14

  15. Vision andRoadmap

  16. Our Clinical Reach Opportunities and plans to reach many more Patients Treated Annually • Outpatient ~ 526,000 • Inpatients ~ 29,000 Current Staffing • Clinical Psychiatrists ~ 1,000+ • Clinical Psychologists – 336 • Social Workers – 300 • Nurses – 600 Current Facilities • Inpatient Beds – 1023+ • Child/Adolescent Beds – 276+ • 1028+ treatment rooms available for adult outpatient • 298+ treatment rooms available for child/adolescent outpatient 9/16/2014 16

  17. Committees & Task Groups Over 400 individual members from multiple disciplines participating Domain Committees • Research • Public Policy Task Groups Underway • Women & Mood Disorders • Primary Care Outreach • Bipolar Disorder • rTMS (repetitive Transcranial Magnetic Stimulation) • Biosignatures & Pharmacogenetics • School-Community Depression & Suicide Prevention • Child & Adolescent Mood Disorders • Suicide Prevention • Health Services & Intervention Dissemination • Electroconvulsive Therapy • Geriatric Depression & Bipolar • College Mental Health • Clinical Care • Education 9/16/2014 17

  18. Board of Directors Officers Founding Chair: John F. Greden, M.D., University of Michigan Depression Center Vice Chair: J. Raymond DePaulo, Jr., M.D., Johns Hopkins University Treasurer: Frank deGruy, M.D., M.S.F.W., University of Colorado Denver Depression Center Secretary: Terence Ketter, M.D., Stanford University 9/16/2014 18 *The NNDC Executive Committee includes members who are starred (*), in addition to officers.

  19. Selected Projects

  20. Research & Clinical Care • Common Assessment Package: providing standardized assessments for depression (“vital signs” of Psychiatry) • Women & Mood Disorders Registry, Database, & Pending Clinical Trial (10 member sites) • Bipolar Genetic Repository (6 sites) • rTMS Dose Enhancement/Outcome Project & communication with FDA (14 sites) • Intervention Dissemination Task Group for Evidence-Based Chronic Care For Bipolar Disorders (8 sites) • NNDC Data Coordinating Center (DaCC) • NNDC Data Registry • Joint research recruitment program with DBSA 9/16/2014 20

  21. Collaborative Grant Projects or Submissions Involving NNDC Centers • EMBARC (Establishing Moderators/Mediators for a Biosignature of Antidepressant Respeonse in Clinical Care) – NIMH-funded U-01 (contract) involving Columbia, Michigan, UT Southwestern, and Mass General-Funded • RAPID (Rapidly Acting Treatments for Treatment Resistant Depression ); NIMH-funded U01 to develop truly innovative treatments capable of improving Treatment Resistant Depression within 72 hours-Submitted 9/16/2014 21

  22. Education and Public Policy Education • Moodbook – a clearinghouse providing up-to-date, evidence-based information on mood disorders • Adolescent Depression Awareness Program (ADAP) • College Mental Health Task Force Public Policy • White Paper produced for U.S. Senate • Consultation with U.S. Senator to write legislation • Support funding for the ENHANCED Act • Position Statements from the NNDC 9/16/2014 22

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