After Lost&Found took on the mission of the former Sioux Falls nonprofit Survivors Joining for Hope on August 1, 2022, Lost&Found’s staff didn’t have to wait long to start this new postvention services work.
Dakotah Jordan was hired as coordinator of Lost&Found’s new Survivors Joining for Hope program in September and, as of late January, has already assisted 13 families who have lost a loved one to suicide.
Dakotah Jordan is Lost&Found’s Survivors Joining for Hope Coordinator.
“Once we were able to get the word out about the program, the applications started coming in quicker than we initially expected,” Jordan said. “For the next two months, I was actively working on an application or talking to someone who just needed resource support nearly every week.”
This fast pace of requests for help from grieving families shows the need for postvention services in South Dakota, which had a record 202 suicides in 2021. “We cannot ignore the fact that we are losing people, and the ripple effect that has on the people and communities left behind,” Jordan said.
A renewed focus on postvention
When Lost&Found was founded in 2010, it first focused on postvention. “The group of young college students who launched the organization committed to raising funds, support, and awareness for those who experienced suicide loss,” said Erik Muckey, who was one of those young college students and now serves as Lost&Found’s CEO/Executive Director.
Its young leaders soon realized they needed to change their approach, in part because postvention work requires time and capacity that the startup organization could not sustainably provide. And so Lost&Found switched its focus to the suicide prevention work that has become the core of its mission.
The opportunity last year to take on the work of the nonprofit Survivors Joining for Hope, which had been serving suicide loss survivors for six years, was a way for Lost&Found to return to its initial desire to help those suffering from suicide loss.
This change was also a recognition that postvention isn’t a separate kind of work from suicide prevention; it is in fact one method of prevention. One reason for this is that people who lose a loved one to suicide are sometimes the people most motivated to try to prevent suicide in others, and they can become strong advocates for and practitioners of suicide prevention efforts to try to keep others from experiencing the pain they are experiencing. But another reason for seeing postvention work as suicide prevention is that the people left behind after a suicide are at increased risk of suicide themselves. In the midst of shock and grief, they may need resources that they don’t have the first idea how to find.
“Lost&Found cannot seek to prevent suicide without recognizing that postvention is prevention,” Muckey said. “We must support suicide loss survivors to prevent further loss of life and the immense grief and trauma that follows.”
The work of Survivors Joining for Hope
Lost&Found’s Survivors Joining for Hope (SJ4H) program prioritizes providing financial assistance to those who fit in Lost&Found’s target age demographics (10-34) in South Dakota, Minnesota, and Iowa, but all applications are considered. The people who have sought assistance from the program in recent months have had some things in common, Jordan said: “They are predominantly low-income families who have lost a male family member to suicide that need help paying off funeral expenses for their loved ones.”
Families can request up to $2,500 in assistance. While funeral expenses are the most common need for funding, families can also apply to the SJ4H program for help with other burial expenses, the cost of therapeutic and supportive services, biohazard cleanup, and other expenses related to a suicide loss.
“In addition to financial assistance, we seek to provide emotional support to anyone who has experienced a suicide loss,” Jordan said. “We talk with individuals and families about support groups, therapy options, peer support, and more that are available in their area. Our program isn’t just about financial support—it’s also about connection and making sure that these individuals don’t feel as isolated after a devastating loss.”
Eight families so far have asked for financial assistance. This pace of helping families will require more resources.
“As we continue to build this program, we are looking to host fundraisers in 2023 that will specifically provide funding for our financial assistance account,” Jordan said. “We will need to build relationships with donors that are passionate about supporting these families in need to continue to cash flow these needs moving forward. As we continue to get the word out about this program, we anticipate that the requests for assistance will only increase.”
Postvention policy services
The SJ4H program is one part of Lost&Found’s new Postvention services department. Lost&Found’s staff also assist college campuses with developing postvention policies and suicide response plans.
“When I was hired, we already knew that the region needed more support for policy development and suicide response plans on college campuses,” Jordan said. “Since August, our team has been researching and actively supporting one campus in South Dakota in developing a comprehensive suicide response plan and complimentary prevention and postvention policy. This work includes gathering resources and supportive services for faculty, staff, and students, as well as supporting them in all logistical planning such as protocols on how to communicate suicide loss to the campus community.
“Unfortunately, this type of policy development becomes a priority after a tragedy has occurred,” Jordan said. “As we build out this supportive service in our organization, we hope to proactively support our college campuses in their prevention and postvention policy development in order to save more lives across our region. Campus postvention work will be a priority for our department in 2023.”
Jordan said Lost&Found can also provide postvention policy assistance to other entities, such as communities or workplaces.
Support during a tragedy
For a variety of reasons, losing someone to suicide can make survivors feel very isolated. This feeling can make a terrible situation even worse, Jordan said.
“Often suicide brings up emotions like complicated grief, shame, anger, sadness, and more,” she said. “Postvention provides support so that people don’t have to go through those complicated emotions alone. People who are exposed to suicide are at a higher risk for suicide, so it is important that we provide support to them.”
It’s in this support that postvention becomes suicide prevention.
“The more that we can be open to conversations about suicide and the emotions that surround it, clear up misunderstandings, and prevent isolation, we can prevent future suicides from happening,” Jordan said. “While we at Lost&Found are trying to create more of that open conversation all of the time, the reality is that some of those conversations happen after a tragedy has occurred, and it is an opportunity to reach a new level of resilience and create a positive impact even when someone was lost.”
To learn more about Lost&Found’s Postvention department or to fill out a request for assistance, go here.
House Bill 1079, which would provide $4 million to the South Dakota Department of Health to fund mental health and suicide prevention programs and services, passed unanimously out of the House Health and Human Services Committee on Jan. 24.
Lost&Found CEO/Executive Director Erik Muckey was among the six people speaking in support of the bill.
“The bill addresses three core areas—mental health and suicide prevention peer support training; community mental health and suicide prevention data services; and suicide loss response services—totaling $4 million on one-time funding,” Muckey said in his testimony. “Each of those three areas in the bill would address at least three core strategies of the South Dakota Suicide Prevention Workgroup.”
Muckey said the bill would allow current suicide prevention work to continue—work that is slated to lose funding in six months to a year.
“We really need to make sure that we have support and funds in place to continue this work, and not lose steam on an effort that’s being made by the Department of Health and state agencies to solve this problem,” he said.
The organizations doing the work and receiving the funding designated in the bill would be selected through an RFP process. Muckey said that Lost&Found is well-positioned to do the work described in the bill, since it would allow the expansion of work Lost&Found is doing already.
“The focus of this bill is really about adoption and implementation,” he said. “How do we make sure that programs and services that schools and colleges want to implement have the support and technical assistance necessary to make sure that they’re successfully adopted over the next few years?”
Muckey concluded by emphasizing why the bill is important.
“If we don’t take action, we’re going to continue to have a problem in which 10- to 29-year-old South Dakotans are experiencing suicide death at the highest level … it’s their greatest risk for death at this point,” he said. “There is no single grand solution to suicide. There are a lot of solutions that are needed. This is one part of that, but an important one that has some importance in terms of meeting gap funding, but also doing the work that’s really working right now for South Dakota youth and young adults.”
The bill was sponsored by Rep. Taylor Rehfeldt (R-Sioux Falls), who provided statistics illustrating how suicide has reached a crisis level in South Dakota, such as the record number—202—of suicide deaths in 2021. She said she was motivated to put the bill forward in part because of her own experience as a suicide loss survivor. One of those suicide deaths was of her uncle, and his death affected her family greatly. “That really has influenced me and who I am, and has influenced how I approach this subject. And really has encouraged me to speak about it more,” she said.
She concluded with this call to action: “Our interventions and our decisions can change the trajectory of suicide in South Dakota. Let’s be the ones who say ‘Yes, we can do more,’ and let’s be the ones who say ‘Yes, we will do more.'”
Four others spoke in favor of the bill:
Deb Fischer-Clemens of Avera: “This is a very, very important piece of legislation. And it’s important because of so much work that needs to go into helping young people and other people to help deal with depression.”
Mitchell Ray of Sanford: “I’ve talked to with our mental and behavioral health folks at Sanford, and the numbers are troubling. It’s almost a crisis level, and it’s something we need to address. I think that this funding will help address that need. I think anything we can do to support these folks is is a step in the right direction.”
Caleb Weiland, President of the South Dakota Student Federation: “The Student Federation is an organization that represents over 30,000 students that attend our state’s regional institutions. And in a unanimous voice, we made mental health not only our number one priority, but our only priority. We see it every day from my freshman year. We all have the stories that mental health is a real issue. … Let’s address it with a more proactive system, a more proactive skill set for our students and the next generation of South Dakotans and say, if you’re experiencing depression and anxiety, we have coping skills training, we have peer mentoring, so you can have a community so you can be a community-oriented citizen, and future focused with this policy. (This bill) does all those things.”
Blake Pulse, lobbyist with the SDSU Students Association: “South Dakota today really has the opportunity to show their support of mental health efforts to better the lives of students across the state and the mental health, better mental health resources for the students at South Dakota State University and across the board of regents system.”
The actual motion was sending the bill to Joint Appropriations with a do-pass recommendation. The 13 representatives present all voted “aye.”
You can listen to the section of the committee hearing here:
The full transcript of the discussion of HB1079 is below.
Transcript of discussion of HB1079, S.D. House Health and Human Services Committee, Jan. 24, 2023
Rep. Kevin Jensen, chair
So we will move on to House Bill 1079. Make an appropriation to the Department of Health to provide grants to support mental health and suicide prevention programs and to declare an emergency. We have any proponent testimony?
Rep. Taylor Rehfeldt
Good morning, Mr. Chair and members of the committee. My name is Taylor Rehfeldt, and I am a state representative in District 14 in Sioux Falls. Today, I’m proud to bring you HB 1079 for your consideration. So today, I’m going to kind of split up my testimony into two components. I’m gonna go with first a logistical and practical component, and then along with a more of a heart component to explain more of why I’m so interested in this topic.
Rep. Taylor Rehfeldt
So first, let’s talk about the business and the practicality of this bill and why it makes sense. I’d like to remind the committee about some of our South Dakota statistics. Suicide is the leading cause of death for ages five to 34 is the 10th-leading cause of death overall, and suicide has been the ninth- or 10th-leading cause of death for the last five years. It’s the seventh-leading cause of death for the Native American population. And Native Americans have 2.6 higher incidence then the South Dakota white races. In 2021, we had the highest number ever for suicide attempts and deaths at 202 deaths. That’s the seventh highest suicide rate in the nation in 2021. Over the last 10 years, suicide deaths have increased by 50%. They’re 79% male and 21% are female. Even more alarming 21.5% of South Dakota high school students considered suicide and 11.9 (percent) of South Dakota high school students actually attempted. Unfortunately, four of our South Dakota counties rank is the top 1% of highest suicide rates in the entire nation. That’s Buffalo, Todd, Corson and Oglala Lakota. I also think it’s important to highlight our self-harm statistics. From 2016 to 2021, there were 4,186 hospitalizations, and 6,169 emergency department visits for non-fatal self-inflicted injuries. I believe these statistics probably tell you enough about the story, and why this grant is important.
Rep. Taylor Rehfeldt
Now on to the heart of why this isn’t so important. Now I’m emotional, I’m sure you can all tell. And suicide has really impacted my life, from a toddler to an adolescent to an adult. And so I want to explain a little bit of that excuse my emotion, but it’s very important to me. I have had two family members commit suicide and die by suicide. And one was when I was a toddler, her name was Judy Longville. And I was able to watch my family work through that process and watch the pain and suffering that happened as a result of that. Fast forward 20 years. So my uncle, his name was Don Longville died by suicide when I was in college. And he, I still remember his laughter that remember his his emotion. And I remember more than that my dad’s reaction to his death. And he was his best friend, his partner in crime is what I would like to call him. They did everything together. So that really has influenced me and who I am, and has influenced how I approach this subject. And really has encouraged me to speak about it more. It’s not an easy topic to talk about. And I’m sure many of you in this room have been impacted by suicide. And understand what I’m talking about when I talk about this topic and how gut-wrenching it really is for family and gut-wrenching it is to watch someone that you love to make that decision.
Rep. Taylor Rehfeldt
In addition, I think I’ll just share a little bit about my path as an adolescent. You know, I grew up in a very nice home. My parents love me deeply. But I too, like many kids suffered from depression, hopelessness, and I don’t want kids in our state to have no one that makes an intervention. Thankfully, my mom is a therapist. So what I like to describe as I was in therapy for brushing my teeth wrong. So, you know, that happened to me frequently. We, you know, therapy is a normal part of our family. We go in and out of it. There’s always interventions when there’s something wrong, and I’m thankful for that. I’m thankful that I had a mom that cared about me, but not all kids have that. Most kids don’t. And you know, the hopelessness in our world has probably increased, at least in my opinion over the last 10 to 20 years. And I think it’s time for us to say that we need more, we need more interventions to take care of our kids that are suffering, because not everyone has somebody to be that person to say, “Are you okay?”
Rep. Taylor Rehfeldt
So, I’m gonna get to logistics of the bill now. The Department of Health has been doing really great work in suicide prevention. So I don’t want to downplay any of the work that they’ve been doing, because they’re trying diligently. I sincerely do appreciate their work, and this bill is really intended to strengthen that relationship with the Department of Health, not to point fingers or say that they’re doing something wrong. But here’s the reality, we absolutely can and we absolutely should be doing more. We should not be hearing about eight-year-olds dying by suicide. My son is seven years old and I cannot imagine. What this bill does, is provides funding for suicide prevention services that target youth and young adults, primarily targeting those under 30 years old. The grant program would support both existing and new programs. And the intention of it is written this way so we continue to utilize the already existing programs that are working well. And then some of these programs are at risk of losing funding over the next year, six months to a year. In addition, we also want to provide additional opportunities for target our youth, what I mean by that is under 18 years old. We want to support data collection within these populations so we can find gaps, learn, and make progress. You will hear from mental health experts today and about organizations that are currently working in this space with suicide prevention, and that are willing to step up to the plate and do more. Federal funding tends to be where most of our money comes from for suicide prevention. We cannot continue to rely only on, you know, inconsistent federal funding for this space. Suicide prevention should be our number one priority. Our interventions and our decisions can change the trajectory of suicide in South Dakota. Let’s be the ones who say “Yes, we can do more,” and let’s be the ones who say “Yes, we will do more.” Thank you.
Rep. Kevin Jensen, chair
Thank you. Do we have any other proponent testimony? Good morning.
Deb Fischer-Clemens
Good morning, Mr. Chair, members of the Health and Human Services Committee. I am Deb Fischer-Clemens, I represent Avera as we speak today. And as you are all well aware of Avera has been very involved in behavioral health with our facilities, particularly one in Sioux Falls, but also in Aberdeen. We do work in Yankton. So the number one thing I want to talk about is that this is a very, very important piece of legislation. And it’s important because of so much work that needs to go in to helping young people and other people to help deal with depression. I’ll say number one, according to research, suicide is the leading cause of death among those who suffer from depression. Now think about any of your friends or family that you have that they have experienced depression. So many people. So Avera started a campaign, I think it’s about a year ago this time to, to input some resources into it, to raise the awareness for the importance of asking the question, and it’s not how are you? It’s not how are you feeling? It’s not how do you how are you doing today? It’s “Are you considering suicide? I’m very concerned about you. Is there any chance that you’re thinking about suicide today?” And they’ll answer the question. Think about that. Don’t ask how people are doing if you’re concerned, ask if they are considering suicide. It’s a huge campaign across America right now, because we have seen the statistics. That is why I’m also supportive of Lost&Found which you’ll hear about here shortly. We need all the help we can get in this state to help our young people who have been suffering and some of that suffering has come from COVID. We’ve all lived through that. But young people who were kept in their homes and didn’t have social interaction are suffering. They are depressed. It is the number one reason for young people to commit suicide. Ask the question. Support the bill. Thank you.
Rep. Kevin Jensen, chair
Thank you. Do we have any other proponent testimony? Good morning.
Erik Muckey
Good morning, Mr. Chairman. Good morning, members of the committee. My name is Eric Muckey. I am a registered lobbyist. I’m also representing our organization Lost&Found. Lost&Found is a comprehensive suicide prevention and postvention services nonprofit based out of Sioux Falls, South Dakota, that deliver services for youth and young adults ages 10 to 34, and their immediate support networks, our programs and reach cover the entire state. We are primarily serving higher education institutions statewide, currently in partnership or working with in some programmatic fashion with eleven institutions of higher ed throughout the state of South Dakota, extending from Spearfish to Sioux Falls. Our work focuses on training mental health peer mentors. We also help organizations measure outcomes for mental health and suicide prevention. We train community members on how to, as Deb Fischer-Clemens just shared, ask the question and talk about suicide with family and friends, but then also be able to address the support needed for suicide loss survivors with partners like the Helpline Center. Our organization was primarily an association of campus-based student organizations founded by a group of South Dakotans in 2010, myself included. Our organization adapted dramatically during the COVID-19 pandemic. And since 2020, our organization has trained over 400 young adults for mental health peer mentorship throughout the state of South Dakota. Our evaluation research services and policy services directly or indirectly impact more than 200,000 South Dakotans. We’ve served, since the fall of 2022, 13 families who’ve been impacted by suicide loss with financial resources, particularly those who are low to moderate income. And lastly, we’ve engaged over 5.1 million people online through digital mental health content. Obviously, that’s not just South Dakota at that point.
Erik Muckey
What I’m here to share in terms of our support, our organization supports House Bill 1079 for three key reasons. One is that it gives the Department of Health one-time funds and flexibility in continuing their important suicide prevention and postvention services statewide while also meeting state suicide prevention goals. Secondly, it continues to address the data that you’ve been hearing about. We have a tremendous need for youth and young adults in our state right now. Thirdly, we support this bill knowing that there are providers in the state who can meet the need of this bill, ourselves included. And so when I think about this bill, and starting first with the bill itself, the bill addresses three core areas—mental health and suicide prevention, peer support training, community mental health and suicide prevention data services, and suicide loss response services—totaling $4 million on one-time funding, based on the terminology for one-time funding, it would last us through June of 2027. Each of those three areas in the bill would address at least three core strategies of the South Dakota Suicide Prevention Workgroup. So Lost&Found is a nonprofit member of the sub work group, lots of words to say, there’s state agencies that are collaborating on the state suicide prevention plan, and certain nonprofits involved in that process as well, which includes Lost&Found. This gives the Department of Health flexibility at a time when these funds and the services are needed most to additionally augment the work that they’re already doing. It also gives them agency through the emergency clause to address these needs at a timely fashion and in the fashion that the Department of Health has processes to address.
Erik Muckey
The second reason we’re supporting the bill is something that you’ve already heard about. You’ve heard a lot of the statistics. What I think I can add to that as far as what’s going on in South Dakota: If you look at current 2022 data for suicide, 42% of the data captured today it says that suicide is under the age of 35. So 42% of the suicide deaths in 2022 are under the age of 35. We know that suicide impacts everybody, especially suicide risk. In particular, we know that this data is showing us that youth and young adults are particularly impacted in South Dakota, especially in our rural communities in our tribal nations. We also know based on recent data that’s been shared about the 988, the new three-digit number for the national suicide prevention hotline that’s manned by the Helpline Center here in South Dakota, that around 59% of callers to 988 in the past year have come from folks under the age of 30 years old. There’s a pretty significant need at this point. And when I think about this problem of suicide, we also have to consider that it’s not just a problem of suicide. We also have a problem with mental health care workforce shortages and trying to sustain these programs with limited or in some cases no funding. At this point in time, based on the data provided by the Department of Health all 66 South Dakota counties are in a mental health care workforce shortage. Wait times can be as long as one to six weeks depending on the institution you’re engaging with. And depending on the ratios you’re looking at, certain national organizations have said that only 10.7% of schools in South Dakota K-12 have enough counselors to meet the need. Given that, and given that there’s a current partnership that Lost&Found has with the Department of Health for certain services that will likely expire in terms of continuation funding after June 2024, as well as the fact that certain programs for high school peer support are set to expire as early as June 2023, we really need to make sure that we have support and funds in place to continue this work, and not lose steam on an effort that’s being made by the Department of Health and state agencies to solve this problem.
Erik Muckey
The third reason why we’re supporting the bill is that there’s reason or there’s organizations who can support this work. Specifically, if Lost&Found, for example, were selected to do this work under RFP process of the Department of Health, we’d be able to meet each of the three goals in four years, with four different programs. In terms of the first goal of the bill, mental health and suicide prevention peer support training, Lost&Found has an existing peer support program delivered to postsecondary institutions in South Dakota that would continue under this. The second peer support effort would be called the Hope Squad. It’s a program based out of Provo, Utah, that it’s a federally evidence-based program that Lost&Found would partner with and ensure that it’s delivered to every region of South Dakota specifically partnering with the 11 regional community mental health centers. To address goal number 2, community mental health and suicide prevention data services, Lost&Found has created what’s called the Resilience Index that helps create dashboards to aggregate suicide prevention capacity data, again delivered to schools and colleges. The third area of work suicide loss response planning, Lost&Found currently engages with institutions of higher ed and would engage with schools to develop suicide loss plans and postvention policies. Overall, these outcomes directly and indirectly, would support as many of the 66 counties as possible, and ensure that these program funds are delivered to as many schools and postsecondary institutions as can implement them. The focus of this bill is really about adoption and implementation. How do we make sure that programs and services that schools and colleges want to implement have the support and technical assistance necessary to make sure that they’re successfully adopted over the next few years?
Erik Muckey
As an organization, we work every day to raise private funds to support these types of programs. And so when I say this, I say with certainty, no matter the outcome of the bill, our organization is committed to doing this work in South Dakota will continue to do so to the best of our ability. We’re also proud member of the South Dakota suicide prevention workgroup will continue to support the state prevention plan. And we’re continuing our partnership with Department of Health and excited to do so. I’ll leave you with this. When it comes to suicide, just echoing something, just think about the fact that more than 200 people died by suicide in 2021. In South Dakota, it’s an all-time record. Right now, we’re on pace to exceed previous records. If we don’t take action, we’re going to continue to have a problem in which 10- to 29-year-old South Dakotans are experiencing suicide death at the highest level, that’s their, it’s the greatest risk for death at this point. There is no single grand solution to suicide. There’s a lot of solutions that are needed. This is one part of that, but an important one that has some importance in terms of meeting gap funding, but also doing the work that’s really working right now for South Dakota youth and young adults. So I thank you for the time. Thanks, Mr. Chairman.
Rep. Kevin Jensen, chair
Thank you. Do we have any other proponents testimony? Good morning.
Mitchell Ray
Morning, Mr. Chair, members of the committee. Mitchell Ray with Sanford Health. I just want to align myself with comments of the other proponents. I think they laid out well, how how much of an issue this is in our state. And I’ve talked to with our mental and behavioral health folks at Sanford, and the numbers are troubling. And it’s almost a crisis level. And it’s something we need to address. And I think that this funding will help address that need. And I think anything we can do to support these folks is is a step in the right direction. So with that, I urge your support. Thank you.
Rep. Kevin Jensen, chair
Any other proponent testimony? Good morning.
Caleb Weiland
Good morning, Mr. Chair, members of the committee. My name is Caleb Weiland. I am the president of the South Dakota Student Federation and the University of South Dakota Student Government Association. I’m representing both organizations here today. The Student Federation is an organization that represents over 30,000 students that attend our state’s regional institutions. And in a unanimous voice, we made mental health not only our number one priority, but our only priority. We see it every day from my freshman year. We all have the stories that mental health is a real issue. You heard today many powerful testimonies, powerful statistics that shows that suicide isn’t discriminatory. Mental health issues aren’t discriminatory. And when we did analysis of regental mental health services, it was even worse than what I expected. And to be honest with you, it’s not just from a suicide prevention standpoint, but the fact that we have counseling shortage. And those counselors who are working now are working their tails off. I’ve talked to many of them from over four institutions that are experiencing burnout. And it’s at what point are we going to say that we have a problem here? Let’s address it with a more proactive system, a more proactive skill set for our students and the next generation of South Dakotans and say, if you’re experiencing depression and anxiety, we have coping skills training, we have peer mentoring, so you can have a community so you can be a community-oriented citizen, and future focused with this policy. It does all those things. And I urge your support on behalf of the South Dakota Student Federation. Thank you.
Rep. Kevin Jensen, chair
Thank you remember, well, and I can say thank you, Caleb, because he was an intern here for us for a couple of years. And I’m so proud of you and moving forward and all this. Thank you. Any other proponent testimony?
Blake Pulse
Good morning, Mr. Chair, members of the committee. My name is Blake Pulse, a registered lobbyist with the SDSU Students Association and currently the Students Association President. I’m here today to speak and on behalf of the 11,331 students who call South Dakota State University home, and here today to speak in favor of House Bill 1079. It’s no secret that mental health is a growing epidemic across the United States in South Dakota and of course on our college campuses. A recent study conducted by international accreditation of counseling services developed a theorem for calculating institutional need for mental health resources, showing that campuses should be able to serve about 15% of their student population. Here at SDSU, we will need to hire three additional counselors or have more resources to be able to reach that 15%. As of yesterday, SDSU had 110 students waiting on the waitlist to get into mental health counseling. In order to serve that current need, we would need to hire two additional counselors. Without those counselors or resources, these students often give up and seek other resources off campus, which are equally as full, and they’re often met with “no.” We understand that this bill does not guarantee any counselors, but any resource is a win for mental health for our students, especially within our online students and satellite campuses. There’s a nationwide mental health professional shortage and limited funding to go along with it. So South Dakota today really has the opportunity to show their support of mental health efforts to better the lives of students across the state and the mental health, better mental health resources for the students at South Dakota State University and across the board of regents system. So in conclusion, I would really appreciate your support of House Bill 1079. Thank you.
Rep. Kevin Jensen, chair
Thank you. Do we have any other proponent testimony? We have no one online? I don’t believe so. Any other proponent testimony? Do we have any opponent testimony?
Rep. Kevin Jensen, chair
Good morning.
Mark Fuller
Morning, Mr. Chair, and committee members. My name is Mark Fuller with the Bureau of Financial Management. In front of us is House Bill 1079. As previously mentioned, this bill appropriates $4 million in one-time funding to the Department of Health to supply grants to suicide prevention programs. At this time, the ongoing budget includes dedicated budgetary resources for suicide prevention programs within the Department of Health, Public Safety and Department Social Services. In addition to the current budget, the governor’s recommended budget for the fiscal year includes an additional $1.6 million in ongoing general funds within the Department of Social Services and support to support the 988 suicide crisis lifeline. For this reason, we respectfully refer this bill to a Joint Committee on Appropriations so it can be a part of ongoing budget discussions. That being said, the governor does support suicide prevention members and does recognize the statistics within the state. So thank you. Thank you and standby for questions.
Rep. Kevin Jensen, chair
Thank you. Do we have any other opponent testimony? Okay, seeing none, we have any questions from the committee.
Rep. Fred Deutsch
Mr. Chair.
Rep. Kevin Jensen, chair
Representative Deutsch.
Rep. Fred Deutsch
Thank you. Question for the prime sponsor, please. Kind of a multi-part question, if I might. First can you share with us how you arrived at the figure of $4 million? And is it enough?
Rep. Taylor Rehfeldt
That’s a great question. And I appreciate it. You know, the $4 million dollars was kind of not really a exact number. I was trying to find a reasonable number that wasn’t too large and asked to raise a lot of red flags, but also that I felt would give an impact. I think going lower than the $4 million, then would split out some of these categories and make them less effective. So that was why trying to get to that larger number.
Rep. Fred Deutsch
Should the committee decide to move this on, have you had discussion about if it should go to Appropriations?
Rep. Taylor Rehfeldt
Mr. Chair? Yes, the recommendation would be to go to Joint Appropriations so that we can further analyze the budget along with the rest of what’s going on in our state. I have also had conversations with many of the joint appropriators, and there’s a very much of a desire, I think, to fund this, the actual mechanism of funding, whether or not it’s one-time or ongoing funds, is still to be determined. So I want to be very forthright with the committee on that, that I am open and flexible. And I think that the work that should be done and could be done is also able to be flexible with what that funding would look like.
Rep. Fred Deutsch
Thank you.
Rep. Taylor Rehfeldt
You’re welcome.
Rep. Kevin Jensen, chair
Yes, I just would mention, the motion if we decide for do pass would be to refer to Joint Appropriations with a do pass recommendation. That would be the motion. So are there any other questions? Seeing none, I’ll end the question period and open it up to committee discussion and or action. Representative Nelson.
Rep. Kameron Nelson
Thank you, I move do-pass when referring to Committee on Appropriations.
Rep. Kevin Jensen, chair
Representative Cammack,
Rep. Gary Cammack
I believe that the proper motion would be to refer it to Joint, not necessarily do pass, but. Is it? Okay.
Rep. Kameron Nelson
My motion stands.
Rep. Kevin Jensen, chair
Okay. So just to paraphrase, Representative Nelson’s motion is to refer to Joint Appropriations with a do-pass recommendation, seconded by Representative Mulder. Any discussion on that motion? Okay. Thank you. Any other discussion on the motion? Thank you. So, yes, Representative Deutsch.
Rep. Fred Deutsch
Just to thank the good representative for bringing the bill. I thought was a really good conversation and good bill and appreciate it and look forward to supporting it all the way to the governor’s desk.
Rep. Kevin Jensen, chair
Okay, so everyone understands the motion, correct? Okay, so I ask secretary to call the roll.
Secretary
Representatives Cammack.
Rep. Gary Cammack
Aye.
Secretary
Kull.
Rep. David Kull
Aye.
Secretary
Moore.
Secretary
Deutsch.
Rep. Fred Deutsch
Aye.
Secretary
Donnell.
Rep. Joe Donnell
Aye.
Secretary
Healy.
Rep. Erin Healy
Aye.
Secretary
Heermann.
Rep. Mellissa Heermann
Aye.
Rep. Scott Moore
Aye.
Secretary
Mulder.
Rep. Brian Mulder
Aye.
Secretary
Nelson.
Rep. Kameron Nelson
Aye.
Secretary
Schaefbauer.
Rep. Brandei Schaefbauer
Aye.
Secretary
Weisgram.
Rep. Mike Weisgram
Aye.
Secretary
Rehfeldt.
Rep. Taylor Rehfeldt
Aye.
Secretary
Jensen.
Rep. Kevin Jensen, chair
Aye.
Secretary
13 ayes.
Rep. Kevin Jensen, chair
Thank you. House Bill 1079 will be referred to Joint Appropriations with a do-pass recommendation. Thank you.
The Centers for Disease Control and Prevention updated its guidance for those working in suicide prevention late last year.
This document serves as a foundational piece of Lost&Found’s approach to suicide prevention work. For example, Lost&Found’s Campus Resilience Index measures how well a campus is achieving the CDC’s recommended strategies and approaches. The CDC guidance is intended to present the best available evidence for strategies that prevent suicide and has been reviewed by many experts in the field.
Much of the document stayed the same as the initial release of the document from 2017. It still starts from a public health approach, as described in the document: “The public health approach uses data to define the problem, science to determine what works for prevention, and widespread adoption of effective programs, practices, and policies with a particular focus on upstream prevention that seeks to prevent suicide risk in the first place.”
The seven strategies did not change; each of the strategies has 2-4 approaches to achieve that strategy.
There are some key differences, however, between the old document and the new one.
The message “Suicide is preventable” was moved to the top of the document: “Suicide Can Be Prevented: Like most public health problems, suicide is preventable. The National Center for Injury Prevention and Control’s vision of ‘No lives lost to suicide’ relies on implementing a comprehensive public health approach to prevention.” (page 11)
A number of statistics in the document were updated. Most of them had gotten worse since 2017. One improvement from 2017 was that suicide had moved down as a leading cause of death for those ages 45-54 and 55-64, in part because COVID-19 moved up the list as a cause of death for those age groups. Some of the updated statistics are summarized in the chart below.
Updated statistics in CDC’s
“Suicide Prevention Resource for Action”
Text in 2022 document
Change from 2017 document
Suicide was responsible for nearly 46,000 deaths in the U.S. in 2020. This is about 1 suicide every 11 minutes.
Up 44,193 deaths in 2015, and up from 1 every 12 minutes
Suicide is a leading cause of death for people ages 10–64 years. Suicide rates rose 30% from 2000 to 2020, including small declines in 2019 and 2020.
Up from 28% increase from 2000-2015
Suicide rates vary by age, race/ethnicity, and other socio-demographic characteristics. In 2020, suicide was the second leading cause of death for people ages 10–14 years and 25–34 years, the third leading cause for people ages 15–24 years, the fourth leading cause for people ages 34–44 years, the seventh leading cause for people ages 45–54 years, and the ninth leading cause for people ages 55–64 years.
Suicide had been third leading cause of death for 10-14, and second leading cause of death for 25-34 (moved down the list for 45-54 and 55-64)
Non-Hispanic American Indian or Alaska Native (AI/AN) people have the highest suicide rates, followed by non-Hispanic White people. Racism, historical trauma, and long-lasting inequities such as disproportionate exposure to poverty have contributed to higher suicide rates among non-Hispanic AI/AN youth and other groups who have been marginalized.
No change, but description of contributing factors was added
Another recent study found that trends in suicide attempts among adolescents from 2009-2019 increased overall, and Black students, both male and female, had the highest prevalence estimates for suicide attempts.
New study
In 2019, suicide attempts were more prevalent among students who reported having sex with persons of the same sex or with both sexes (30%) and students who identified as lesbian, gay, or bisexual (23%)
New data
Transgender adolescents are at high risk of suicidal ideation and behavior compared to cisgender adolescents.
New data
Over 121 million Americans live in areas without enough mental health providers to meet their needs
Up from 85 million
Suicide’s cost in the US was $460 billion in 2019
Up from $93 billion in 2013
The 2022 document places a new emphasis on the cumulative effect of both risk factors as well as protective factors on a person’s suicide risk:
“Research indicates that suicide risk varies as a result of the number and intensity of key risk and protective factors experienced.” (page 13)
“The effects of ACEs (Adverse Childhood Experiences) are often cumulative. Experiencing more ACEs is associated with greater risk for future poor outcomes when compared to people with fewer ACEs.” (page 15)
The new document also now includes a mention of the increased risk during transition periods: “Transition periods are also associated with higher risk of suicide. This includes transitions from … high school to college …” (page 12)
There were two subtle changes to the seven strategies listed in the document. While the strategies stayed the same, the order of those strategies changed, as two strategies switched places in the list: “Create Protective Environments” moved up to the No. 2 spot, and “Improve Access and Delivery of Suicide Care” moved down to No. 3. The strategies are listed in order of broadest reach (more people) to more targeted reach (fewer people), which would suggest that experts in the field believe that more people can be affected by creating protective environments than improving suicide care. Also, the word “Healthy” was added to the fourth strategy on the list to make it “Promote Healthy Connections.”
Three approaches were added to the list of how the strategies could be achieved.
Under the strategy “Create Protective Environments,” the approach “Reduce substance use through community-based policies and practices” was added.
Under the strategy “Improve Access and Delivery of Suicide Care,” the approach “Provide rapid and remote access to help” was added. This approach included the mention of apps that can be used as part of treatment.
Under the strategy “Teach Coping and Problem-Solving Skills,” the approach “Support resilience education through education programs” was added. This is relevant to Lost&Found’s resilience education work, including the Advocates program.
Here are a few other changes, in brief:
The document puts a new emphasis on the idea that “approaches to put time and space between lethal means and suicidal individuals may help save lives.”
There is a new mention of substance use disorders and suicide risk being associated.
COVID-19’s effect on mental health is mentioned.
Reducing stigma is newly mentioned as a potential outcome of several of the recommended approaches.
There is a new emphasis on multi-sector partnerships and strategic planning among multiple sectors.
The document also includes new evidence for most of the strategies and approaches listed in the document.
Lost&Found staff members reviewed the changes in the document during their all-staff retreat on Jan. 26 and discussed how they can continue to build upon these guidelines in their work.
