The Hippo


Apr 26, 2019








 Suicide Prevention Crisis Lines

All crisis lines provide free, confidential support available 24/7.
New Hampshire Headrest: Call 1-800-639-6095. 
New Hampshire Headrest Teenline: Call 1-800-639-6095. 
National Suicide Prevention Lifeline: Call 1-800-273-8255.
Crisis Text Line: Text 741741.
Red Nacional de Prevención del Suicidio: Llame al número 1-888-628-9454. 
Veterans Crisis Line: Call 1-800-273-8255 and Press 1, chat online or send a text message to 838255.
Military Hotline: Call 1-800-959-8277. 
Transgender Lifeline: Call 1-877-565-8860 for a hotline staffed by transgender people. 
Disaster Distress Helpline: Call 1-800-985-5990 for crisis counseling related to any natural or human-caused disaster.
The Trevor Project: A suicide hotline for LGBTQ youth. Call 1-866-488-7386.
How to help
Warning signs
The more signs a person shows, the greater the risk. Warning signs are associated with suicide but may not be what causes a suicide. Visit
Talking about wanting to die
Looking for a way to kill oneself
Talking about feeling hopeless or having no purpose
Talking about feeling trapped or in unbearable pain
Talking about being a burden to others
Increasing the use of alcohol or drugs
Acting anxious, agitated or recklessly
Sleeping too little or too much
Withdrawing or feeling isolated
Showing rage or talking about seeking revenge
Displaying extreme mood swings
If someone you know exhibits warning signs of suicide:
Do not leave the person alone
Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt
Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255)
Take the person to an emergency room or seek help from a medical or mental health professional

Mental health challenges
New Hampshire addresses increases in suicides


 By Scott Murphy 
Suicide rates have risen in all but one state over the last 15 years, with New Hampshire’s rate showing one of the highest increases in the country. In response, New Hampshire nonprofits and government agencies have been exploring ways of increasing access to resources and removing stigma around mental illness in the Granite State.
The data
According to a report from the Centers for Disease Control and Prevention, suicide rates rose by between 5.9 and 57.6 percent in every state but Nevada from 1999 to 2016, including a 48.3-percent increase in New Hampshire. This ranked the Granite State third on the list in terms of rate increases in this time frame, behind North Dakota at 57.6 percent and Vermont at 48.6 percent. Nationally, suicide is now the 10th leading cause of death in the U.S. according to the CDC, with 44,193 deaths annually.
The CDC report is in line with annual suicide deaths recorded by the New Hampshire Office of the Chief Medical Examiner. Between 2008 and 2017, the office reported a 45-percent increase in deaths by suicide in New Hampshire, increasing from 182 to 264 deaths annually in this time frame. 
“We were certainly aware that rates are going up in New Hampshire and nationally, but I think it’s fair to say for us in the suicide prevention community, the report was very difficult,” said Ken Norton, executive director of NAMI New Hampshire in Concord, a chapter of the National Alliance On Mental Illness. “Every suicide is a tragedy, and 45,000 a year in the U.S. is horrible.”
Reducing stigma
Preventing suicide involves everyone in the community, says Tricia Tilley, deputy director of the New Hampshire Division of Public Health Services.
“There are roles for the government and community organizations, as well as roles for individuals to help support friends, families and neighbors,” Tilley said. “All of us in the community can create better protective environments where there’s less stigma and help create connections in the community.”
Addressing the stigma around mental health is key, according to Norton. 
“Suicide is preventable, but part of that is doing a better job of recognizing it, and as a country, we’re not responding the way we should,” said Norton. “If you ask the average person on the street, they can tell you the warning signs of a heart attack. But they might not be able to do that for suicide, and more importantly, when they see those warning signs, they don’t feel comfortable intervening.”
While Norton noted that suicide is a complex problem with no simple solution, he highlighted a lack of funding as a key area of improvement. According to the most recent data available from the Kaiser Family Foundation, New Hampshire spent $9,589 per capita on health care overall in 2014 but only $138.40 per capita on mental health in 2013. 
“As a country, we put very little funding into research on suicide prevention and mental illness compared to other leading causes of death,” said Norton. 
He added that mortality rates for almost all other leading causes of death are declining while suicide rates have been increasing. 
“We need to be looking at suicide as the public health issue that it is and fund services and research accordingly,” he said.
Integrated care
While changing cultures can be challenging, Tilley said, New Hampshire health care providers have started chipping away at the stigma around mental health by increasing access to resources and pursuing protective policies. This includes a trend among New Hampshire health providers to offer integrated health care, a system that treats mental and physical problems simultaneously. Tilley said individuals are more likely to seek mental health care if there’s a connection between their primary care provider and onsite behavioral health professionals.
“People might not be seeking mental health care, but they might be seeking care at an acute facility, which is why it’s really incumbent on [primary care providers] to screen patients and make sure there’s a warm handoff to mental health providers,” said Tilley. “We’re seeing behavioral health services embedded right in community health centers, which allows providers to help patients build trust and ensure that connection is made. If you’re struggling with mental health and someone just hands you a phone number, it can be challenging to seek treatment on your own.”
10-year plan
On the state level, Tilley said the Department of Health and Human Services has been tracking data on suicides in New Hampshire to understand the trends and see what the agency can do to address the problem. The department is working with health care providers to draft a 10-year mental health plan, which will include input from health care providers, survivors of suicide and families of suicide victims to identify shortfalls and gaps in the state’s mental health system. The report is supported by the state legislature and the governor’s office and will be completed by the end of the year, according to Tilley.
In 2008, the New Hampshire legislature passed a law establishing the New Hampshire Suicide Prevention Council to study ways the state could reduce suicide and provide resources to at-risk individuals. Members include legislators, law enforcement, government officials and health care providers. Norton and Tilley have both served on the council since it was founded. 
The council published the New Hampshire Suicide Prevention Plan (2017-2020) in February 2016, which encouraged public-private partnerships and education on identifying risk factors for suicide and ways for individuals to assist those in need. 
This includes programs like Connect, developed by NAMI NH, which was recognized by the National Alliance for Suicide Prevention as a best practice model for suicide prevention training. The program offers customized classes focused on teaching prevention, intervention and postvention tactics for assisting people at risk of suicide.
For more information, visit and, or refer to the resources provided below. 

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