Most people who die by suicide in the year before their deaths 鈥� but only about one-third have received mental health services. This means that primary care and emergency room doctors, nurses and other specialists may be more often positioned to evaluate a person in crisis.

After Washington in 2012 became the first state to require suicide prevention training for health care professionals, the 天美影视传媒 developed a program, , to help providers identify people at risk of suicide.

A , published online June 23 in the journal Psychiatric Services, finds large-scale training in this critical work is possible. The first wave of health care professionals to try All Patients Safe also report improved understanding of suicide and how to respond to people at risk.

鈥淭he results suggest that it is possible to provide high-quality training to health care professionals about suicide, which is an important but not sufficient step in the prevention of suicide,鈥� said , associate professor of social work at the UW and the study鈥檚 lead author. 鈥淚t鈥檚 also essential to look at systems and policies to ensure there is maximum support for health care professionals to implement the clinical skills they were taught in the training.鈥�

, according to the Centers for Disease Control and Prevention. It is among the leading causes of death for teens.

Stuber, who co-founded at the UW, helped push for the Washington state legislation to train health care providers, following the death of her husband by suicide. The law is named for him. A few years after passage, the law was amended to include all licensed health care providers 鈥� not just behavioral health specialists 鈥� in the requirement for training. Behavioral health specialists must participate in training every six years, whereas other health professionals must take a course only once.

In addition to Washington, 17 other states encourage or require such training for health care providers.

All Patients Safe was developed in collaboration with a variety of experts and heath care organizations, including the UW AIMS Center, and is one of a few dozen suicide prevention trainings that have been approved by the Washington State Department of Health.

Administered online in three- and six-hour versions, All Patients Safe is structured in modules and uses case-based materials and videos that model provider-patient interactions. The aim is to educate and empower providers to identify at-risk behaviors and to discuss with their patients, among other things, limiting access to lethal means.

Between November 2018 and December 2020, more than 1,500 providers completed the six-hour course and a pre-training survey. Just over half filled out a post-training survey and were included in the new study. Participants were asked about their understanding of and confidence in addressing a number of topics with a patient, including storage of medication and firearms, and thoughts of suicide.

Results from that survey showed improved levels of confidence and understanding in all areas. For example, the number of respondents who believed they could identify warning signs of suicide increased by 60%, while confidence in asking about medication and firearms also rose.

Researchers say the results indicate at least a short-term knowledge gain, as well as the potential for delivering the training to large numbers of providers. They say more study is warranted on the longer-term efficacy of the training in specific health care settings.

Co-authors were Sarah Porter of the UW School of Social Work; Anne Massey of the UW School of Public Health; and and of the UW Department of Psychiatry and Behavioral Sciences.

For more information, contact Stuber at jstuber@uw.edu.

Talking to people at gun shows about suicide prevention and the risks of unsecured firearms can lead to safe weapons storage, according to a new study.

The research by at the 天美影视传媒, from visits to 18 gun shows and other community events around Washington state last year, found that engaging people in a community-based setting, in an empathetic conversation focused on safety, resulted in more people locking up their firearms.

The results are promising, lead author and Forefront co-founder said, because they show that meeting people where they鈥檙e at, physically and psychologically, can lead to behavior change that can prevent tragedy.

鈥淲e need to be educating people who own firearms or are considering purchasing them that suicide is a possible risk to take into consideration and to make plans in advance to mitigate these risks. So many people are in crisis today 鈥� from youth, to veterans, to our men in economic distress and in relationship turmoil 鈥� we are all vulnerable. We need to educate firearms owners, both experienced and new, at the point of purchase and other places we can find them to raise awareness,鈥� said Stuber, an associate professor of social work at the UW.

The published Oct. 20 in BMJ Injury Prevention.

According to and data, about half of all suicides involve firearms. In Washington state, three-quarters of all firearm fatalities are suicides, which most people aren鈥檛 aware of when they purchase a firearm, Stuber said. , and . A 2019 Forefront study focused on the potential role of firearms retailers in preventing suicides, by evaluating store owners鈥� willingness to learn about the issue and train their employees in how to spot and act on suicide warning signs. That study found that many retailers were interested in learning more and adopting prevention strategies among their staff.

The new study tested an outreach strategy created by Forefront known as SAFER, an extension of its multi-faceted program, which offers training, education and locking devices for firearms and medications in communities across Washington.

Forefront鈥檚 trained staff and volunteers regularly provide suicide-prevention trainings tailored to students, teachers, parents, veterans, health care workers and pharmacists. In reaching out to visitors to gun shows 鈥� who are mostly men, often veterans 鈥� Forefront designed the brief, motivational interviewing approach it calls SAFER (Signpost, Assess, Facts, Emotion and Recommend) to both educate and listen with empathy. By talking with a person about their familiarity with issues surrounding suicide and their understanding of the risks of unsecured firearms, the volunteer can deliver a suicide-prevention recommendation that encourages safe firearms storage. The volunteer also provides the person with a free locking device for hand-guns, rifles or AR-15s to take home.

In this study, 1,175 people received the SAFER intervention. They took a short, written survey to assess knowledge of firearms safety and suicide prevention prior to the SAFER conversation. Most SAFER encounters took about 10 to 20 minutes each.

Four weeks later, Forefront emailed a survey to people who received the intervention. Of the 372 who completed the survey, 66% said they now kept their firearms secure at home, a 15 percentage-point increase from the 51% who reported doing so during the pre-intervention survey.

鈥淭o my knowledge, this is the first study to assess receptiveness to suicide prevention messages and self-reported change in firearm storage behavior at gun shows,鈥� said , an associate professor of epidemiology and co-director of the at the UW. Prior had focused on clinical or other community settings, including in Washington state. 鈥淭his study is novel not only due to its outreach to participants in gun shows, but also because of its empathetic approach to engage them in conversations about suicide prevention. It can serve as a model for other regions of the country to use similar approaches and broaden the inclusion of individuals who might be at high risk of suicide in their outreach and prevention programs.鈥�

Initially, people may not think suicide-prevention awareness applies to them, Stuber said. But that鈥檚 a key message of the intervention: Life circumstances can and do change. Even if you never have thoughts of suicide, it鈥檚 critical to have a plan to protect yourself, your family, even friends or strangers who visit your home by locking up firearms and medications and understanding what to do if you are someone you care about is at risk.

鈥淲e鈥檙e building on the idea that people want to do the right thing here, but they don鈥檛 necessarily know what the right thing is,鈥� Stuber said.

As part of the SAFER intervention, volunteers also offered a locking device for medications. In the pre-intervention survey, 15% of participants said they safely stored medications 鈥� a proportion that grew to about 22% afterward, according to the study. Even a modest increase shows a positive impact, Stuber noted, and provides important information for enhancing the strategy going forward. Currently, the emphasis is on locking up firearms, which is the main goal for the audience and the setting.

Forefront continues to improve SAFER to hone in on the demographics of the person receiving the intervention and to tailor the message accordingly, Stuber said. For example, if the individual has children, the volunteer can focus on the risks of a child gaining access to a firearm and emphasizing the need for a fast-access firearm locking device, which participants also receive education about through a raffle at gun shows.

Another key is to expect emotion, Stuber added. People routinely shared personal experiences with suicide or concerns about friends or relatives, which could end up being an opportunity to counsel or provide resources beyond the individual receiving the SAFER intervention.

鈥淲e don鈥檛 want to firehose people with facts and statistics. We should be listening more than talking,鈥� Stuber said.

During the COVID-19 pandemic, Forefront has begun offering a 鈥渢ele-SAFER鈥� intervention, as well, through individualized Zoom sessions facilitated by veterans organizations and nonprofit groups, Stuber said.

The study was funded by a Boeing Global Engagement Grant and the Washington state Legislature. Co-authors were Brett Bass and Morgan Meadows of Forefront; and Anne Massey, a graduate student in the UW Department of Epidemiology.

For more information contact Stuber at jstuber@uw.edu

Firearm retailers around Washington state are willing to learn about suicide prevention and to train their employees in how to spot and act on suicide warning signs, a new 天美影视传媒 study finds.

With firearms the commonly used and most lethal means of suicide nationwide, the findings from the survey of nearly 200 independent firearm retailers across the state demonstrate the potential for key community members to be proactive in helping to prevent people from taking their own lives, said , a UW doctoral candidate of social work at and lead author of the paper.

The study, believed to be first to look at what influences firearm retailers in suicide prevention efforts, also finds that a lack of awareness of the role of firearms in suicide, as well as a reluctance to talk to customers about personal issues, likely inhibit greater progress in suicide prevention.

鈥淪uicide prevention hasn鈥檛 been an area of focus in the firearm community, and it shows,鈥� Walton said. 鈥淏ut there鈥檚 a definite willingness to pass on firearm safety information, and they want to be able to see how to integrate suicide prevention into talking about firearm safety.鈥�

The was published online July 29 in the journal Suicide and Life-Threatening Behavior.

According to the Centers for Disease Control and Prevention, of all suicides in the United States from 1999 to (the most recent statistics available) involved a firearm. The percentage is even higher in veteran suicides.

In Washington, the data is similar: From 2013 to 2017, , and 67% of veteran suicides, involved a firearm, according to the state Department of Health. Beginning in 2017, the state Legislature helped fund Forefront鈥檚 campaign, which offers training, outreach and locking devices for firearms and medications in communities with high rates of firearms ownership.

As part of its mission, the Safer Homes program has identified gun retailers as a key potential stakeholder in distributing information about suicide prevention. Other states, such as New Hampshire and Colorado have been working to engage firearm retailers in the issue; the UW study is the first aimed at understanding what influences such engagement.

The first step for UW researchers was surveying firearm retailers about their knowledge of suicide prevention and willingness to participate. Using records from the state Department of Licensing and the federal Bureau of Alcohol, Tobacco, Firearms and Explosives, Walton and Forefront director were able to find email or mailing addresses for nearly 800 independent retailers around the state. The team created a 42-question survey that was available in print or online.

Big-box stores that sell guns were not included because of corporate policies governing store-level training and outreach.

The researchers also partnered with the and the owner of a Spokane gun shop, who together sent an introductory letter to the retailers explaining the survey.

In the end, 178 surveys were completed. Sixteen retailers contacted the researchers to refuse the survey, while 62 were minimally completed, and 33 were returned as undeliverable. The remaining 500 weren鈥檛 returned.

鈥淭here are barriers to working with this population because of distrust and incomplete contact information,鈥� said Stuber, an associate professor in the UW School of Social Work. 鈥淏ut if you get the right messengers to get people to the table, there is clearly a willingness among retailers to be involved in the solutions.鈥�

The results can be grouped generally into three distinct types of questions: knowledge of suicide and how to prevent it; support for learning more; and a willingness to intervene directly with customers.

About half of the retailers who responded said they were familiar with warning signs of suicide, while nearly two-thirds of respondents said they wanted to know more about how firearm retailers can help prevent suicide. About 72% said they would provide free training to employees.

At the other end of the spectrum were beliefs about suicide and the retailer鈥檚 role in talking with customers in crisis. Nearly three-quarters said asking customers about their mental health might offend them. About 45% said asking about personal issues is not their responsibility, and 66% agreed with the statement: 鈥淚f a person wants to die by suicide, there is nothing I can do to stop them.鈥�

鈥淚t is critical to work on changing this common misperception that suicide is inevitable,鈥� Walton said. 鈥淔or the vast majority of individuals, the desire to die by suicide is fleeting, so anything any of us can do to prevent or postpone a suicidal act is helping to save a life.鈥�

Survey results also indicated that the more a retailer knows about suicide, and the longer they have been in business, the more comfortable they are with ideas about training employees and talking with customers. For instance, retailers for whom a majority of sales come from firearms and ammunition were more likely to support education and outreach around suicide prevention. Those with longer tenure in the industry, the authors wrote, were also more supportive of suicide prevention efforts and thus could be tapped as leaders in any future effort among retailers.

鈥淣otably, most firearm retailers lack awareness that suicide is the most common type of firearm fatality. Education about this fact is an important first step to increasing engagement in prevention efforts,鈥� Stuber said. 鈥淲e are going to need out-of-the-box solutions to reach communities with high rates of firearm ownership to create compelling public health messages about suicide prevention.鈥�

This research was funded by the Washington state Legislature.

For more information, contact Kristen Morgan, Forefront communications manager, at morgank5@uw.edu or 206-616-9940.

For every person who dies by suicide, at least another six are directly impacted 鈥� survivors who must cope with a type of loss that can be particularly disabling.

The nearly 1,300 suicides in Washington in 2017 鈥� including 255 veterans and 87 people under age 19 鈥� in one year. The numbers underscore a public health emergency, but one that suicide-prevention advocates and experts, including those at the 天美影视传媒鈥檚 , say is in many cases is preventable. And it takes a community to do it.

Community impact and public health solutions are the focus of the Forefront Suicide Prevention , to be held March 6 at the Washington Capitol in Olympia. Along with more than two dozen partner organizations, Forefront the lead organization, based at the UW School of Social Work, will present a series of speakers and events aimed at raising awareness, providing training and pushing for change.

鈥淭he Governor鈥檚 budget and the suicide prevention bills proposed this session represent a historic first as Washington鈥檚 first major public investment into suicide prevention,鈥� said Forefront co-founder , a UW associate professor of social work. 鈥淎nd it couldn鈥檛 come soon enough as we deal with the fall-out of a culture that is generally speaking, not good for our mental health. We鈥檙e here representing a large group of organizations, no longer a silent majority, raising awareness of this problem in society and focusing on solutions.鈥�

On that day, as they鈥檝e done in past years, Forefront volunteers will place mock headstones on the capitol lawn, one for each person who took their own life in 2017. This year, volunteers will mark the stones of veterans with yellow ribbons, and of young people with backpacks. 鈥淭he display is meant to be compelling and educational,鈥� Stuber said. 鈥淭hese are some of the populations that need focused help.

The Education Day program includes a ceremony dedicated to lost loved ones as well as to individuals with lived experience and allies; a training for those who work with veterans, and another in recognizing the signs of suicide and appropriate ways to respond; and, as part of Forefront鈥檚 campaign, locking devices for safe storage of medication and firearms. The UW Police Department will be on hand to provide safe medication disposal, alongside representatives from the Washington State Department of Veterans Affairs and from , a foundation established by the family of former Washington State University quarterback Tyler Hilinski.

All activities are free and open to the public. Registration is requested, which will be held at the Woman鈥檚 Club of Olympia.

Since its inception in 2013, Forefront has successfully informed suicide-prevention legislation each year in Olympia 鈥� including the first state law in the nation requiring suicide prevention training for all health and behavioral health providers.

With the 2019 legislative session newly underway, Forefront is focused on the items in the Governor鈥檚 budget and two other anticipated bills related to suicide prevention and workforce preparedness.

The first proposed bill, aimed at K-12 schools, would build on a law passed in 2013 that required school nurses, counselors and social workers to receive training in suicidal behaviors and for school districts to adopt a response plan for students exhibiting emotional distress. This year鈥檚 bill, sponsored by State Representative Tina Orwall, D 鈥� Des Moines, would fund a broader reach for suicide prevention training and interventions and establishes reporting requirements for school staff pertaining to students at risk of suicide.

A second bill would extend the geographic reach of Forefront鈥檚 Safer Homes initiative, launched in 2017. While a mix of public and private funds have supported Forefront鈥檚 visits to gun shows, community organizations and other sites in Western Washington, this year鈥檚 proposal, also sponsored by Orwall, requests a public allocation to fund a greater focus on veterans, workplace and Eastern Washington residents.

鈥淲e have been working on the issue of suicide prevention for the past six years,鈥� Orwall said. 鈥淚t鈥檚 gratifying to see such a strong effort to fund this work this session.鈥�

Gov. Jay Inslee has included support for suicide prevention in his budget proposal, including funding to expand crisis line services, hiring an additional staff member at the Washington State Health Care Authority to help improve health care quality and outcomes (an initiative established by the Legislature known as the Bree Collaborative), and funding for mental health navigators for each of the state鈥檚 nine educational service districts.

Forefront鈥檚 Education Day sponsors include Boeing, RI International, Hilinski鈥檚 Hope and participating organizations such as NAMI Washington, the state Office of the Superintendent of Public Instruction and Washington Arms Collectors.

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A full schedule of events for Education Day is available . For more information, contact Kristen Morgan, Forefront鈥檚 communications and development manager, at 206-616-9940 or morgank5@uw.edu.

With veterans鈥� mental health issues gaining increasing attention nationwide, Boeing has awarded a $205,000 grant to at the 天美影视传媒.

The award will help support Forefront鈥檚 campaign, expand veteran-specific outreach that addresses the needs of Washington veterans, their family members, and the providers and institutions that serve them.

Safer Homes, Suicide Aware, launched in September 2017, seeks to raise public awareness of suicide and offers people immediate steps they can take to make their homes safer. Research has shown that a temporary barrier between a person in crisis and a chosen means of suicide can be lifesaving.

Trained volunteers from Forefront, based at the UW School of Social Work, engage attendees at gun shows and community events to ask about their firearm and medication storage practices, assess their level of awareness about suicide prevention, and offer free firearm and medication locking devices. The Safer Homes campaign also offers online suicide prevention training for firearm retailers, gun safety instructors, pharmacists and medical professionals, and distributes informational materials at gun dealers and health care providers across the state.

鈥淭his grant from Boeing allows us to be in communities all across Washington, and meet veterans where they鈥檙e at,鈥� said Forefront director and co-founder , an associate professor of social work.

Across the United States, veterans experience higher rates of post-traumatic stress disorder and are at higher risk of suicide than civilian adults. A 2014听听found that nearly one in four active-duty service members suffers from a mental health condition.

With the support from Boeing, Forefront plans to:

• visit more gun shows and community events around Washington to expand the Safer Homes, Suicide Aware campaign;
• distribute its online training, which contains a module on veteran-specific risk and protective factors and an understanding of veteran culture, to providers working in community-based settings to serve veterans for free;
• Increase suicide prevention training and resources to community and technical colleges that serve large numbers of veterans.

Data from the show that firearms are involved in half the suicides in the U.S. Poisoning is the third most common form of suicide.

鈥淎s suicide rates creep up, the need for collaboration with as broad a scope of partners as possible becomes ever more apparent,鈥� said Brett Bass, program coordinator for Safer Homes.

In addition, Boeing awarded $95,000 to UW Tacoma to fund a career counselor for military-connected students and alumni and support development of a regional career network for military-connected individuals. These veteran-specific career services are a unique offering for the Tacoma campus, as most job counseling and placement services at public and private universities target either all students generally, or by academic program. UW Tacoma is just a few miles north of Joint Base Lewis-McChord.

Veterans and their families are among Chicago-based Boeing鈥檚 priority focus areas for philanthropy. The company鈥檚 describes how the company can support service members鈥� transition back to civilian life through workforce training, and recovery and rehabilitation programs aimed at physical and mental health, and suicide prevention. Veterans represent about of the company鈥檚 workforce.

The grant announcement was part of a $55 million package to more than 400 community organizations.

鈥淥ur people have unique skills and an unwavering passion for making a difference in the world, both through our products and services and the ways we give back to our communities,鈥� Boeing Chief Executive Officer Dennis Muilenburg said in a press release. 鈥淲hen that鈥檚 combined with our professional networks, partnerships and financial resources, we have the potential to drive positive, lasting change across the globe in important areas such as STEM learning and veterans鈥� support.鈥�

Founded in 2013, Forefront aims to reduce suicide by advocating for legislative change and helping individuals and communities take action. Its other major programs include (curriculum, training and outreach for K-12 teachers, staff and families) and its initiative, which works for mental health resources and awareness at the university and community college level.

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For more information contact Kristen Morgan, Forefront鈥檚 communications and development manager, at 206-616-9940, or morgank5@uw.edu.

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Nearly one-third of Washington college students have experienced depression in the last year, and more than 10 percent have had thoughts of suicide, according to a new survey of young adults attending schools around the state.

The survey of more than 10,000 students at 13 of Washington’s two- and four-year institutions shows the need for mental health services on campus, advocates say, especially as the state Legislature considers two bills that would fund suicide-prevention resources in higher education and additional mental health counselors for college students who are veterans. It was the first time the Healthy Minds Study was administered to students in Washington.

“Nearly 4 out of 5 college students report that emotional distress impacts their academic performance,” said , a 天美影视传媒 associate professor of social work and co-founder of . “During this major transition time in the lives of students, it is important to provide them with counseling and other types of support for emotional distress to ensure they can set a healthy course, flourishing academically, athletically and socially.”

Forefront and the are leaders of the statewide consortium of schools that is using the JED Campus Program to enhance听 suicide prevention programs. Schools in the cohort are able to access the Healthy Minds Study, an annual web-based survey of college students’ mental health that provided the newly released data about mental health in several states. The New York-based JED Foundation has developed similar, though smaller, groups of schools in other states 鈥� to build on student mental health, substance abuse and suicide prevention services.

Here in Washington, the consortium consists of 13 public and private colleges, including Seattle University, Whitworth University, Central Washington University, Lake Washington Institute of Technology, and the UW Seattle, UW Bothell, UW Tacoma and Washington State University. Students are randomly chosen to participate in the study; data for the new survey were obtained during the 2016-17 academic year.

The was created at the University of Michigan in 2007 to collect mental health data in higher education. It asks participants, for example, whether they’ve experienced “severe/major,” “moderate/other” or “any” depression or anxiety, whether they’ve had suicidal thoughts or attempted suicide, and whether they’ve consulted a counselor.

Among the survey’s findings in Washington for the 2016/17 school year:

• 31 percent of students reported any depression in the past two weeks; 14 percent reported major depression;
• 26 percent reported any anxiety;
• 12 percent reported having suicidal thoughts, while 5 percent reported having a plan to end their life;
• Of those who said they’d experienced major depression, severe anxiety or suicidal thoughts, 60 percent had sought treatment in the past year;
• 76 percent reported some academic difficulties due to emotional or mental health issues in the past four weeks.

Nationally, the for that year are similar. For example, 11 percent of college students reported having suicidal thoughts; 24 percent reported any anxiety; and 31 percent reported any depression.

Such data provide a foundation for campuses to develop plans based on student needs and experiences, said Ellen Taylor, UW associate vice president for Student Life. Not all students need counseling, for example, but the information helps guide prevention and education efforts, too.

“We want to help students develop healthy coping skills, resilience in the face of disappointment and life challenges, and enough awareness to know when they need help,” Taylor said. “The JED program provides a solid framework for analyzing the data, determining next steps for each campus based on local and national trends, and the ability to measure impact down the road.”

Stuber points to the two bills making their way through the Washington State Legislature: One, , would fund mental health counselors with experience treating veterans at all seven of the state’s public, four-year institutions; the other, , would establish a structure and source of funding for counseling and other suicide prevention resources for colleges. The UW Office of State Relations has expressed the university鈥檚 support at committee hearings during the past two legislative sessions.

A Forefront representative served on the state task force looking at behavioral health and suicide prevention that informed HB 2513, and the organization has been working on suicide-prevention efforts in higher education since its inception in 2013, Stuber said.

The JED Campus Program is a four-year initiative of the JED Foundation. As part of their participation in the program, campuses are able to provide the Healthy Minds Study with student-level data two times: at the outset 鈥� which is the new data set 鈥� and the conclusion. Forefront partnered with JED two years ago to encourage Washington schools to participate in the study and in an annual conference on suicide prevention. The Washington state effort is funded by the Jolene McCaw Family Foundation and the state Department of Health through a grant from the federal Substance Abuse and Mental Health Services Administration.

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For more information, contact Forefront communications manager Kristen Morgan at morgank5@uw.edu.

For information specific to mental health issues among and resources for student veterans, contact Peter Schmidt at the Washington State Department of Veterans Affairs, peters@dva.wa.gov; or Christian Crowell, a student veteran at The Evergreen State College, 1christianc@gmail.com.

With in Washington related to suicide, the scenario isn’t hard to imagine: A person thinking of ending their life enters a gun store to buy the means to do it.

Unfortunately, other scenarios play out, as well: A person filling a lethal dose of a prescription medication at a pharmacy. Or showing signs of depression at a doctor鈥檚 visit, without a screening for suicide risk.

In each case, there is an opportunity to prevent a death. Under the Safer Homes Suicide Aware campaign, led by at the 天美影视传媒 School of Social Work, and the Second Amendment Foundation, health care providers, gun dealers, firearm safety instructors and pharmacists can receive training in how to recognize and respond to suicide warning signs.

The campaign, to be launched in the Grays Harbor community of Aberdeen on World Suicide Prevention Day, Sept. 10, is the product of a years-long effort by multiple 鈥� and disparate 鈥� interest groups to legislate and fund outreach and training programs to prevent suicide. From gun stores to hospitals, pharmacies to schools, the Safer Homes project aims to protect and educate people in a variety of settings.

And in offering training for gun dealers and piloting the distribution of firearm locking devices and safety cases, the campaign is believed to be the first to have been produced with the help of firearm-rights advocacy groups.

Forefront co-founder , a UW associate professor of social work, said Safer Homes aims to change the discussion and behavior around suicide, to treat it as a public health issue.

Nationwide, the rate of suicide has over the past 15 years, especially among and middle-aged men. In 2015, there were 13.3 deaths per 100,000 people (of all ages) across the country; in , the rate was 15.6 per 100,000. Firearms were the leading cause of suicide, representing more than half of all deaths nationally, and a little more than half in Washington.

If the community approached suicide prevention like the proactive, “buckle up” seat belt campaigns of yesteryear, Stuber said, more people might be saved.

“We’re pushing for a big behavior change. Let’s lock up our guns pre-emptively to protect our families and ourselves, through the lens of suicide prevention,” said Stuber, whose husband took his own life in 2011.

Forefront worked with the Second Amendment Foundation and firearm advocacy groups on ways to promote a prevention message without encroaching on some gun owners’ desire to have ready access to a firearm for self-defense, Stuber said. Free giveaways of locking safety cases, in which the firearm can be worn on one鈥檚 person, is one such example. The collateral materials and the availability of the locking devices represent a joint effort to respect everyone’s goals while uniting around a common cause.

Home safety also extends to access to medications 鈥� how they’re stored and how to dispose of them, Stuber said. As of July, all pharmacists, upon renewal of their licenses, are required to take a suicide-prevention training developed by Forefront, the Washington State Pharmacy Association, and the UW and Washington State University pharmacy programs. The training for health care providers, known as All Patients Safe, will soon be underway.

By discussing suicide openly as a mental health issue, people can make more conscious decisions about making their homes safer to prevent suicide and helping someone they know who is struggling, Stuber said. Just as with other health conditions that can be mitigated or prevented, education could make a huge difference in suicide. Everyone, she said, has a role to play in suicide prevention.

To the staff of UW-based and the student volunteers with (HSPA), the Netflix series “13 Reasons Why” portrays suicide in exactly the wrong light 鈥� making it all the more important, they say, to broadcast the right message far and wide.

That message: That suicide is a public health issue, one that people need to talk and educate themselves about in order to provide help to those who need it, and to remove a variety of myths and misconceptions.

“If there’s one good thing to come from the show, it’s that discussions are happening,” said Shira Rosen, Forefront’s director of school & higher education programs. “The challenge for us is, are full, positive discussions happening, and who’s having them? That’s where we’re involving ourselves.”

To that end, Forefront published a on its website, which includes strategies for helping someone who is contemplating suicide and an analysis of how the Netflix series addressed various issues. For example, the show featured several ways in which the main character left clues that she would take her own life 鈥� but the other characters ignored or didn’t recognize the signs.

The show, an adaptation of a young adult novel, has sparked a flurry of criticism from schools and mental health professionals nationwide. Earlier this month, Netflix issued a acknowledging the concern, noting it would post an additional warning at the beginning of the series’ first episode, and directing viewers to a with crisis line numbers. The company subsequently announced that the show will return for a second season.

The greater attention to the issue comes as , the organization’s high school outreach program, prepares to wrap up its second year. In light of “13 Reasons Why,” many of the partner schools have asked for additional communication strategies and have distributed messages to parents, Rosen said.

“The Forefront in Schools program is helping schools to move from a crisis response to prevent student suicides further upstream to a听greater awareness of mental health and social and emotional learning,” said Forefront co-founder and faculty director , a UW associate professor in the School of Social Work.

The 13 schools currently involved in the Forefront program have spent the past two years assembling and training teams of administrators, teachers, parents and students in the organization’s suicide prevention curriculum, LEARN. In that program, each letter represents a strategy: Look for warning signs; empathize and listen; ask about suicide; remove the danger; and next level of care, a reference to helping provide access to counseling and other resources.

Forefront hopes to recruit an additional 15 schools next year.

Meanwhile, organizers of the 2-mile H3 Suicide Prevention Awareness Walk aim to draw 1,000 participants and to raise $10,000 at the May 20 event. Last year’s walk raised $8,000, which HSPA said helps fund campus suicide awareness programs and Forefront Cares packages to people grieving the loss of a loved one to suicide. This year, HSPA’s , a mental health campaign and storytelling platform, added portraits of advocates as another medium through which to raise awareness.

“When you see someone else’s story you can connect to it,” said Kayla Magers, the social media chair for HSPA and a photographer who shot the portraits for UW Speak Up. “By using portraits, viewers can see the person and read their story and understand mental health on a different level. Whether you live with a mental illness or not you can connect to these people and their stories.”

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For more information on the H3 Suicide Prevention and Awareness Walk, contact HSPA . For information on suicide prevention outreach and other Forefront efforts, contact Aimee Chou at akc2@uw.edu.

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Next month, volunteers from will erect headstones on the lawn in front of the Washington State Capitol, one for each of those lost lives. Colors in the visually striking memorial will reflect different manners of death: red for firearm, white for suffocation, yellow for poisoning or prescription overdose, green for jumping or cutting and blue for other means of ending one鈥檚 life.

On Feb. 16, the suicide prevention organization, which is housed at the 天美影视传媒 School of Social Work, will host a day of events in Olympia and join with partners 鈥� including firearms dealers, veterans鈥� organizations, pharmacists, health care providers and suicide attempt and loss survivors 鈥� to advocate for two legislative bills as part of .

Activities include a ceremony of remembrance and hope at the memorial from 11 to 11:30 a.m. on the Capitol lawn with speeches by legislators, suicide loss and suicide attempt survivors; lunch and a program on legislative priorities at the Governor鈥檚 Mansion from 12:15 to 1 p.m.; and a suicide prevention awareness training at the Woman鈥檚 Club of Olympia from 2 to 3:30 p.m. (Note: media or others wishing to attend the Governor鈥檚 Mansion program must and bring identification on Feb. 16.)

鈥淲e will have volunteers and staff at the memorial all week to provide support and suicide prevention education. Seeing it can be quite emotional for people, so many of whom have been touched by suicide,鈥� said Forefront co-founder and faculty director , a UW associate professor of social work whose in 2011.

鈥淲e鈥檙e going to drive this social movement forward, and we won鈥檛 stop until the memorial is down to many fewer headstones,鈥� she said.

Forefront is working with state Rep. on , including to create a fund for a Suicide-Safer Homes public education platform and to support comprehensive suicide prevention initiatives on college and university campuses statewide.

鈥淚 am very proud of Forefront and the higher education community for partnering together and coming up with critical next steps on how to support students and prevent suicide on our campuses throughout the state,鈥� said Orwall, prime sponsor of both bills. 鈥淭his approach puts student safety first and begins to identify the resources and best practices needed to prevent suicide at all our higher education institutions.鈥�

In the 2015-2016 academic year, nearly 10 percent of college students nationwide reported seriously considering suicide and 25 percent of students reported academic difficulty due to anxiety or depression. To address this often-overlooked and underfunded public health issue, the proposed , HB1379, would:

• Create free, publicly available statewide online training for faculty, staff and students that includes culturally relevant materials for underrepresented populations
• Establish baseline data collection on behavioral health concerns and responses at postsecondary institutions in Washington state
• Form a grant program for suicide prevention funding to help resource-challenged institutions develop basic plans and innovative partnerships with community crisis lines

would establish a public-private partnership fund to implement the work of the Suicide-Safer Homes Task Force to develop effective public health messages and help firearms dealers and pharmacists educate customers about suicide prevention and safe storage practices. Nearly 70 percent of suicides in Washington state involve guns or medications, and many of those deaths happen when guns, ammunition and medications are not stored safely.

The new fund would include money to train firearms dealers, launch pilot studies in two Washington counties with high suicide rates and create materials to support firearms retailers, pharmacists and health care providers in suicide prevention. The bill also adds dental professionals to the list of groups participating in training to help educate the public about the need for safe storage and disposal of medication.

In addition to the Education Day activities on Feb. 16, Forefront will also sponsor a separate suicide prevention awareness training and reception for state legislators and staff, executive and judicial employees, and others in the Capitol community on Feb. 13 from 5 p.m. to 6:30 p.m. in the Columbia Room of the Washington State Capitol.

For more information, contact Aimee Chou at akc2@uw.edu or Jennifer Stuber at 206-604-7740.

As a reminder of that truth, Forefront is participating in Saturday, Sept. 10, by offering suicide prevention workshops in two locations and the premiere of a powerful short documentary film about a Vashon Island teen lost to suicide.

Stuber, Forefront’s co-founder and faculty director, said the film and workshops both underscore a public health warning as simple and lifesaving as “buckle your seat belts” 鈥� that firearms and other potentially dangerous items in the home, such as prescription medications, should be stored safely and away from children.

The 10-minute film, called “Thunderstorm in My Brain,” was produced by Stuber with David Friedle, a film instructor and recent graduate of the UW College of Education’s Danforth Program. It tells the story of the life and death of Vashon Islander Palmer Burk, who died at the age of 14 from a self-inflicted gunshot four years ago 鈥� and discusses how to prevent similar tragedies from happening to other families.

The film will premiere in a free screening at 1 p.m. at the , 17723 Vashon Highway SW, in Palmer’s hometown. Space is limited, so is requested.

The screening will be followed by a question and answer session with Stuber and Friedle, and will conclude with a suicide prevention training session on how to tell if someone is at risk for suicide and what to say and do if that is the case.

Also, from 10 a.m. to noon the same day in Room 305 of the School of Social Work, , Forefront co-founder and training director, will give a two-hour workshop focusing on five skills that can help prevent suicide, from a Forefront curriculum called . Briefly put, these are how to look for warning signs, empathize and listen, ask directly about suicide, remove possible dangers and know what to do next. Space is limited for this, too, and is requested.

Eastgard said, “It is Forefront’s belief that most suicides are preventable and that anyone can learn to recognize the warning signs for suicide, as well as the resources for helping a person in emotional distress.”

The film is a personal project for Stuber, who lost her husband to firearm suicide in 2011. She said she worked on it during a sabbatical, glad for the opportunity to do something “outside the box.” Friedle was a filmmaking teacher for Seattle Public Schools looking to make a film focusing on social issues who met Stuber and decided to use his filmmaking skills for her suicide prevention efforts.

“As we dug into the issue, it became very clear that in order to help prevent suicide we needed to reframe the gun safety debate as a public health issue,” he said. “The statistics around the use of guns for suicide are staggering.”

Friedle said he and Stuber want to use the film to spark conversations about suicide prevention in the hardest-hit areas of the state, particularly rural communities. They also feel it important that gun owners see the film.

“Thunderstorm in My Brain” has been accepted to the Ellensburg Film Festival and is under consideration by others. Its Vashon showing is co-sponsored by the Vashon Alliance to Reduce Substance Abuse and the Vashon Theatre.

“This is not an easy topic, but there is hope in the progress that we are making,” said Stuber.

“And for me the film hits home 鈥� if you do nothing else the safe storage is so, so critical, particularly if you have children in the house. Also, attending suicide prevention training is another thing you can do to play a role in suicide prevention.”

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For more information, contact Friedle at 206-650-4310 or david.friedle@gmail.com; Stuber at jstuber@uw.edu; or Eastgard at 206-543-1016, eastgard@uw.edu or ffront@uw.edu.