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The 1996–1997 United States network television schedule is for the United States broadcast television on all six commercial television networks for the fall season beginning in September 1996. All times are Eastern and Pacific, with certain exceptions, such as Monday Night Football.

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Transcription

Good morning. My name is Jeff Coady. I'm the Regional Administrator for the Substance Abuse and Mental Health Services Administration. I also serve as the chair for the Region 5 Department of Health and Human Service Work Group that is responsible for today's event on suicide prevention. I would like to welcome the participants here in Chicago, the individuals who are joining us via webcast, and the echo sites around the nation. Echo sites are organizations that have volunteered to open their doors to community partners, to listen to the day's event, discuss and collaborate on the public health topic of suicide prevention. On September 10th, 2012, the Office of the Surgeon General, Vice Admiral Dr. Regina Benjamin, in partnership with the National Action Alliance, released the revised National Strategy for Suicide Prevention. We will hear today from some of the top experts in the field about suicide prevention, about programs that have been successful in reducing deaths from suicide. Our goal for the day will be to learn about the National Strategy. But our second goal for the day, most importantly, will be to take the strategy and turn it into action. It is our communities where the strategy will become action. And the result of the acts in our communities in the next 75 days, to September 10th, which is National Suicide Awareness Day, will be that we will strategically advance suicide prevention in our nation. Now, without further ado, I'd like to introduce the acting HHS Region 5 regional director and CMS Medicaid Consortium administrator Jackie Garner. Good morning, everyone, and good morning to people in the echo sites. So happy that we could do this virtually, and that everyone could join us. I am so pleased to be with you here today, and I want to thank Jeff and his team for all of the work that we have done, they have done. We are so fortunate to have SAMHSA here in Region 5, and even more fortunate to have Jeff at the helm. Some very exciting work is going on. So I'm here today for several reasons. But the first and foremost reason, and those of you who know me well this, is that I believe so deeply in your work and am truly dedicated to the field of behavioral health. And my dedication on this issue goes back far too long probably, as far back as my early years out of college and grad school, when one of my very early jobs was that as a substance abuse counselor at a community mental health center. And that early experience shaped my career like no other. I know first-hand the importance of the work that you do each and every single day. I'm honored to be with you here, as you kick off a long-term strategy for combating one of our nation's top public health issues: suicide. Today, the message I want to relay is that there is hope, not only for the people we serve, but for the country as a whole. At no other time in this field's history has there been a confluence of legislation and partnerships to make the lives of individuals with mental illness better. The Mental Health Parity and Addictions Equity Act and the Affordable Care Act bring about changes that we have never seen before. The two pieces of legislation, for all intents and purposes, eliminates the practiced of unequal health treatment of mental health and substance use disorders. Prior to the law, insurers could place strict and oftentimes random treatment schedules that were not founded in any research or personalized to the severity of an individual's illness. By providing parity insurance coverage for substance use and mental health disorders is now equal to other chronic health conditions such as diabetes, asthma and hypertension. The Affordable Care Act takes this one step further, in that it will provide insurance coverage for millions of people who otherwise could not access private insurance either because of the treatment they sought or they were denied because of a preexisting condition, or they simply were not able to afford coverage that included mental health services. Because of the ACA, insurers are no longer able to discriminate against individuals with preexisting conditions. Additionally, they will not be able to increase premiums because of a health issue, such as treatment for depression. With the passage of the ACA, coverage is extended through requirements that qualified health plans, Medicaid benchmark and benchmark equivalent plans, and new plans in the individual and small group markets -- and this is all very good news, and it provides a great deal of hope for people with chronic illness. But as you know, more than anyone, there is still much work to be done, and you are taking the very first step today. Well, not the very first step, let's face it. You've all been working on this for a while. But you're taking an important step today. By raising awareness about suicide, you are bringing mental illness out of the shadows and helping to shed an important light that hopefully will encourage people to access treatment and have the knowledge they need to make sure that their treatment is appropriate and covered by insurance. Starting on October 1st, 2013, this fall, people will have the option to purchase health insurance through the marketplace. The marketplace will not only provide an open market for health insurance choice, but will also provide consumers with apples to apples plan comparisons. Individuals shopping on the marketplace can also rest assured that the plan they select will provide coverage for mental health and substance use disorders, and it will also provide parity. So thank you for the work you do, and we look forward to our continued partnership with SAMHSA and the Office of Women's Health, and all of the health and human service partners, to bring the resources you need to do the work that you do so well. Now, at this time, I have the distinguished honor to introduce to you a very special guest: the 18th surgeon general of the United States, Regina Benjamin. Dr. Benjamin has been a strong prevention advocate, and, in 2012, as Jeff said, released the National Strategy for Suicide Prevention, which we will be referring to throughout today. So, please join me in welcoming, via video, the surgeon general of the United States, Dr. Regina Benjamin. [applause] Good morning to everyone in Chicago, and those of you who are participating in sites around the nation. I would like to welcome you to "Everyone Plays a Role in Suicide Prevention: Turning strategy into action." Preventing suicide is everyone's business. Nearly 100 Americans die by suicide every day, and in the past year more than 8 million Americans thought seriously about suicide. That does not include 16 percent of all high school students who report having seriously considered it. Suicide is a tragedy of untold proportions, and those of you who are part of that tragic story line know its anguish all too well. Last fall, we, in partnership with the National Action Alliance, released the National Strategy for Suicide Prevention. Over the next 10 years, this strategy will be our nation's guide to prevent the burden of suicide and suicidal behavior. It captures the progress we've made so far, the knowledge we've acquired, and the promise that's within our grasp, that suicide is preventable. The National Suicide Prevention Strategy is organized with four strategic directions, and there are 13 respective goals and 60 objectives. But, don't worry, I'm not going to list them all for you. But there are some major themes in the National Suicide Prevention Strategy. We hope to foster dialogue, to counter the shame, prejudice and silence, to integrate public health with behavioral health in order to ensure continuity of care. To reduce access to lethal means among individuals at risk. We want you to talk about it. Don't be afraid to ask, "Are you thinking about killing or hurting yourself?" And know the warning signs, which you're going to learn today. Remember, there is a free suicide prevention lifeline which connects people with the skilled, trained profession. Just call 1-800-273-TALK. During today's meeting, you're going to hear specific about suicide prevention, and how you can develop action plans specific for your community or your organization. Working together, we can dramatically reduce the risk of suicide. So, please, help us turn strategy into action. It's nice to get applause, even though it was for surgeon general. Just pretend it was for me. [applause] Thank you. And good morning. And, again, welcome to "Everyone Plays a Role: Turning strategy into action." My name is Michelle Hirsh, and I'm with the Office on Women's Health here in Region 5, in Chicago, and I extend greetings from Dr. Nancy Lee, the director of the Office on Women's Health, to both all of you who are here in Chicago at this live event, as well as to everyone who is participating. There are several thousand of you who are participating across the country, either individually at your computers or you've come together in groups in your communities to figure out how to address suicide and create action plans. In the Office on Women's Health, we address an array of issues for women and girls across the life span. Though one of the focal areas, which is particularly germane to this conversation about suicide, is unaddressed trauma. We know that exposure to traumatic events is so pervasive in our culture, and is a key predisposing factor to both substance abuse and mental illness, both of which are really key factors in creating greater risk for suicide. Recognizing this, we have a variety of efforts addressing violence and trauma, including increased awareness to both destigmatize as well as encourage individuals to seek help. And we are also working to help train health and social service providers to better understand trauma and provide trauma-informed care. The Office on Women's Health also has an outstanding website. It's womenshealth.gov, and I encourage all of you to take a look at that. There are phenomenal resources. It's a reliable site for accurate information, as well as lots of links to other resources, not the least of which suicide prevention efforts. We must act on the knowledge that one size does not fit all. And, in fact, that there are differences based on sex and gender. I ask you to keep this in mind as you go forth and create your action plans to help prevent suicide. Now it gives me truly great pleasure to introduce our master of ceremonies, Dan Ridenberg. Dan is the executive director of the organization, Suicide Awareness, Voices of Education, also known as SAVE. He's also the state suicide prevention co-lead for Minnesota. Dan served on the National Strategy for Suicide Prevention taskforce, and was the lead for strategic priority number one. He is the US representative to the International Association for Suicide Prevention, and leads the international taskforce that created the recommendations for media reporting on suicide. Please help me welcome Dan Ridenberg. Thank you very much. I appreciate that, and I'm glad to be here. I know that we're already a little bit behind, so we'll keep my comments very short. And although we're behind, definitely Region 5 is the stellar region in the nation, so we're proud of that, and that should encourage any of the other regions across the country, as they develop their actions plans, to reach our level. Let me begin by thanking Dr. Cody, who has led this effort to bring us here today. I also want to repeat what we heard about Dr. Benjamin, who has been a great champion for us in suicide prevention as the United States surgeon general. I want to welcome the panelists that are going to be speaking, the experts that you're going to hear from, and all of you across the country who are participating at your computers or at the various echo sites. We've got some great information to share with you today. We've got some great, remarkable stories that you're going to hear about today. This movement started with a passionate group of people, and it continues today with those same voices, and new voices that are being added every day, sometimes out of tragedy, but also out of hope. And we want you to know that you are part of that, and we are making progress and saving lives in this country. For some of you participating today, we know that you know the pain of brain illnesses, mental illnesses, and the emotions that go with that. We also know that some of you know the pain and the agony of loss of someone you love to suicide. I'm sure I can speak for all the panelists and the experts that are here today in saying that our thoughts are going to be with you, and our hope is that we can help keep others from knowing the pain that you've lived through and experienced in your life. The vice president of my board of directors once said that suicide was the greatest human tragedy, and not only do I agree with him, but I also know that the greatest human strength and hope in suicide prevention can be found right here today in all of you participating in this event. Regardless of your background, whether you're a clinician, a camp counselor, a state suicide prevention coordinator, a member of the faith community, we all have a role in preventing suicide. It doesn't happen alone, it doesn't happen in the nation's capital, or the state's capital. It happens in our community and in our families, in our businesses. When a suicide occurs, it tears apart not only the family, but it rips apart the soul of our community and our nation. And that is why we are here today, to prevent that from being torn any deeper than it already has been. While there is much to learn about the brain and many other things that are involved in suicide prevention, preventing suicide is not only possible, it is all of our responsibility. Finally, after we break into our work groups and you break out in your echo sites across the country, the goal of today, as you heard Dr. Cody say, is simple but large: We want to continue this conversation about suicide and suicide prevention. In doing so, we want to keep the momentum going of the recently released strategy, engage those across the country in our communities that want to do something, but that don't know how to do that. And of course reduce the incidence and burden of suicide while also recognizing the countless great efforts that take place every day across the country in saving lives in America. With that, I want to get our program underway, and tell you that echo sites from across the country that are participating can submit questions to EveryonePlaysaRole@SAMHSA.hhs.gov, and in person attendees, when we have time for questions, can come down to the front two microphones. We don't have a lot of time for questions, but we do really encourage you to submit them. And I know that the panelists and the experts here don't have anything to do after today, so please feel free to submit all of your questions, the thousands of you, and I'll be emailing them directly with those questions. We'll have questions for each speaker after they present. If you have a smart phone handy, please remember to help spread the message of today's event by tweeting out using the hashtag #EveryonePlaysARole, and don't forget to retweet our messages on Twitter accounts of all of our HHS partners who have collaborated for this event -- the Administration on Children and Families, the Administration on Community Living, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Office of Women's Health, and the Centers for Medicaid and Medicare Services. Also, don't forget to look on our Facebook pages for more content and information, and be sure to share the suicide prevention resources that are listed there for you. Now, it is my great pleasure to introduce our first speaker, a colleague and a good friend of mine, Dr. Jerry Reed. Dr. Reed is the executive director of the Suicide Prevention Resource Center. He was a featured panelist earlier this month at the White House Conference on Mental Health. Dr. Reed is the co-lead on the National Strategy for Suicide Prevention Resource Taskforce. With the surgeon general, he led that effort, and we have a fantastic new document that I hope you all have access to. And if you don't, download it online. It's crucial to the creation and the dissemination that the work that Dr. Reed and Dr. Benjamin led is carried out by all of you. So, let's bring up here Dr. Reed, and have him explain to us a little bit more about that, and the ending of the tragedy of suicide. Ladies and gentlemen, Dr. Reed. [applause] Good morning. It's wonderful to be in Chicago after several delays yesterday getting here. It was nice to make it, so that I could do honor to my good friend and colleague, Commander Cody, who sent an invitation a long time ago to join you. In many ways, it's a bit of a reunion for me, because we had many meetings here in Chicago as we went through 18 months of writing the National Strategy for Suicide Prevention, and putting it all together. And even more of a reunion than just geography, several of the wonderful people who helped do this task are in the room today. So, I'd certainly like to acknowledge my good friend, Admiral Jim Galloway, Richard McKeon, from SAMHSA, Dr. Mort Silverman from Chicago, and a member of the SPRC staff, my colleague, Dan Ridenberg, who sits behind me, and of course Dr. Benjamin, who we heard a moment ago, and many, many others who helped us do this formidable task. I also would like to thank my colleagues here at Region 5 for allowing us to come home in a way, and celebrate a bit of a reunion. It's been a long journey, and I'm glad we're able to talk about it a little bit today. So, having said that, I am personally delighted to be here to speak to "Everyone Plays a Role in Suicide Prevention: Turning strategy into action," and that was certainly a sub-theme that we held onto from Day 1, as we wrote the national strategy, was: How do we really make this a living document that people everywhere across the country can do something with. Not just researchers in academic environments or our clinical staff in agencies around the country, but how can everybody at every level do something in suicide prevention? So, my hope is that at the end of the 20 minutes that I've been given, we'll begin the journey of kicking off 75 days to World Suicide Prevention Day, September 10th, 2013, with demonstrable steps that can show we are, in fact, doing exactly what we had in mind. So, before I get into the few brief charts I'm going to share with you, I just want to reflect on the day that I think I got the call that said, "Jerry, we'd like for you to chair the taskforce with Dr. Benjamin on revising the National Strategy." Well, putting my name in the same sentence with Dr. Benjamin was a little awesome to start with, but it made me remember a few other points in my life that I stopped, took pause, and said, "How did this happen?" One of those was the day my wife told me we were expecting our first child. I said, "Now, that's a big task." Having watched my mother and father raise seven of us, I thought that was pretty awesome. I also remember going to graduate school and deciding I was going to get a doctorate. I don't know what I was thinking. I was so happy when they said, "You're accepted," but I had no idea what the next five years of my life would be about. But I did it, and I've raised two wonderful children who are 29 and 25 and I'm happy to say, with regards to the National Strategy, we did it, and it was a much more pleasant experience than I thought it would have been. But I will start by saying, and I think I hope it sets the tone for those of us here in Chicago as well as people all across the country in echo sites, I'm reminded at a meeting I was at many years ago in Ottawa, Canada, with our colleagues in Canada who were addressing first nation issues, and our colleagues here in the United States that were addressing Native American issues. And as is so often typical, an elder welcomed us to Canada. And as he entered the room and gave his blessing, he said to us, and it stuck with me all these years, "Just remember, it's not by accident that you're in this room." So whether you're here physically or whether you're here virtually, you're here for a reason. You're here because there is something you can do. And I would ask you to hold onto that as we go through the day, and as you return to your communities or to your workplaces and do the work that needs to be done. Our field has grown so incredibly much from the years when I started, which was back in 1996 and '97, when, frankly, you could have put the field in a very small room, and a lot of smart people would have talked about where we needed to go, to the point where we are at today, where we have so many nonprofit organizations, so many researchers, every state in the nation has a state suicide prevention plan, tribal communities all over the country are doing the best they can to make a difference in the lives of the folks who live in their communities. And I could just go on and on about how much our field has grown. And I think it's an amazing, amazing journey. And I want to start with a dedication that is in the front of the National Strategy, that I think we held very closely to as we wrote the strategy, and I would ask all of you to remember as you do this important work. And the dedication reads: "To those who have lost their lives by suicide, to those who struggle with thoughts of suicide, to those who have made an attempt on their lives, to those caring for someone who struggles, to those left behind after a death by suicide, to those in recovery, and to all those who worked tirelessly to prevent suicide and suicide attempts in our nation, we believe that we can and we will make a difference." And I really want to emphasize the fact that, in my humble opinion, much of where we are today is because of the courage of those who have lost a loved one to suicide, who chose to speak up, and encourage all of us to fly in formation and fly in the direction of preventing this very preventable form of death, and to all those who have struggled with having made an attempt, who have the courage to add their voice to this conversation, to help us realize what needs to be done in clinical settings, in communities, in workplaces, to make sure we don't marginalize them for that event, learn from them, and hopefully prevent the suicide and the deaths that we all want to prevent. So, turning strategy to action. This is the strategy. If you don't have one, I would strongly encourage you try to get one from the SAMHSA clearinghouse or, as Jeff said and certainly Dan, download one, because it's full of many, many remarkable directions. I want to just start with a couple of pictures here. I'm not going to put a lot of PowerPoint charts with text, at the advice of my staff, since this is such a large conversation. I thought a picture would tell a thousand words, and maybe keep it a little bit more interesting. So let me just begin with some of the major developments that have occurred since 2001, that really led us to the conclusion that it was time to revise the National Strategy. So, first, down in the right hand side, you see the Action Alliance for Suicide Prevention. On September 10th, 2010, Secretary Sebelius and Secretary Gates launched the public-private partnership to help us advance suicide prevention in this nation by not relying on any one agency, any one sector, but on multiple sectors, and multiple voices, to help us do all that was necessary for suicide prevention. When that action alliance was launched, we were given the mandate to revise the National Strategy for Suicide Prevention, and quite clearly were told, "Please do it in 18 months. Let's get it done so people can have the tools they need to help us move forward." You also see the logo for the national lifeline that was mentioned earlier. So we now have a response system in this country staffed by wonderful human beings in over 150 crisis centers, that all you have to do is dial 1-800-273-TALK, from any where in the country, and you will be seamlessly connected to a helping asset, with really great people. And that expanded just a little bit when the Veterans Administration, in partnership with SAMHSA, could provide an option one that now allowed veterans and active-duty military and those that love them, if they have someone in their life that struggles, all they have to do is push option one, and they will be seamlessly connected to Canandaigua, New York, and the whole reservoir of VA medical centers to get that kind of help, which is a fantastic contribution to our national infrastructure. Social media, as you can see in the middle there, is making huge contributions, and something we need to embrace, and our strategy did embrace. And also just the increased recognition that no one best practice, no one intervention, no one person, no one event is going to change the nature of suicide in this country. It's got to be comprehensive. If you're going to train gatekeepers, then you need to make sure the clinicians in your community are trained to receive them once they're identified, as individuals are identified. If you are going to engage primary care practices in helping to screen and look for those at risk, we have to make sure there are support services available outside the primary care offices, for those individuals who may have been identified. If we're going to work with emergency departments and ask them to really screen for suicidal risk when someone presents, so that once we treat the injury that brought them to the emergency department, as well they have continuity of care, access to community resources, follow-up, and a very clear message that, "You matter to us, and we want to make sure that you get well from this presentation." So all of this has really helped us understand, we made a very coordinated and comprehensive approach, and none of us should look at it as one best practice or one best approach is going to solve the challenge. So, this slide basically kind of is going to talk about the strategic directions, but I will say that, as those pictures showed earlier, over the last 10 years we've learned that there's a burden of suicide in the military and certainly in the Veterans Administration, and much is being done to address that burden. We understand that if we're going to truly be effective in suicide prevention, we're going to have to enhance our surveillance, and have data on suicide nationally that's much quicker at hand, so we can see the reality of what's happening in the environment and what's the impact of that happening in the rates of suicide. And CDC is working very hard to reduce the time from when deaths occur in states to when that death data is aggregated, so we have the kind of information we need to do very progressive things with it. And I just want to go back and just say that the recognition that the voice of those who have lost one by suicide, someone they love to suicide, and the voice of those who have made an attempt, are clearly, I think, the conversation that has to be at every table. So in your community coalitions around the country, I hope you make sure you have the voice of the consumer, and the voice of the bereaved, at the table, so we can learn what needs to be learned as we move forward. So: Let me just share with you how the strategy is organize. Dr. Benjamin stated that there's four strategic directions, and what you see here are those four strategic directions. What we tried to do as we thought about the National Strategy was building a healthy and wholesome community, building a prevention-prepared community, in strategic direction too, making sure that the availability of treatment and after-care services were available for those who needed those services, and, on the far left up here, making sure that surveillance and evaluation and research remained a part of our conversation, so we could learn from that we're doing, add to the best practices, and hopefully continue the momentum to get better and better and better at saving lives. Thirty-eight thousand lives were lost in 2010. We certainly know there are many people who consider suicide from some of the data that SAMHSA puts out. So we have a long way to, and this strategy and these directions were intended to help us get there. So, Strategic Direction 1: The goals in this area seek to create supportive environments that will promote the general health of the population, and reduce the risk for suicidal behavior and related problems. So, looking at problems that may have shared risks, and trying to make sure that all the providers know those risks, know those protections, and so if someone walks into your setting or if you don't know the warning signs for suicide, or someone you love is behaving very differently than they ever have before, making sure we prepare everyone in this nation to be on the lookout for that and take steps if they see that occurring. Strategic Direction 2 really seeks to ensure that clinical and community-based programs are in place, and prepared to help individuals who struggle navigate their care efficiently and effectively. In short, we want to make sure that every door in the community is the right door -- whether it's a social service agency, whether it's a substance abuse treatment agency, whether it's a crisis line, or whether it's a school setting. We want every setting to be aware of what needs to be done to make sure someone who passed through that door gets the help they need. Strategic Direction 3 just basically speaks to, let's make sure the best practices, the best interventions, the best after-care, and I can't emphasize enough how important post-vention is -- post-vention being making sure you address the needs of a family, a community, et cetera, a workplace, after the death of someone in that setting, so that we really can prevent what could be a subsequent death by making sure we compassionately and knowingly reach out to that setting, so that people can understand what occurred and how we move forward as a community. And lastly, as I said, Strategic Direction 4 supports additional efforts in surveillance, research and evaluation to consider and to continue to make the advances that we need to make. What we did quite strategically, and you'll see this when you look at the strategy, after every single strategic direction there is a page that talks about what the federal government can do, what states and tribes can do, what businesses can do, what healthcare systems can do, what universities, what schools, what nonprofits, and, lastly, what individuals and families can do. So there is a roadmap of sorts after every strategic direction that gives some very tangible and concrete steps that can be taken to advance the objectives and the goals in that particular strategic direction. And that was done because people -- We always say, "Everyone has a role," but we never took the time to explain what that role was to people who may not be as conversational about suicide prevention as we are. So we tried very hard to do that in this National Strategy. So, everyone plays a role, or everyone has a piece of the puzzle. I bring today a piece of the puzzle that I bring very often when I go to speak to communities around the country about the strategy. And it's significant, because this puzzle piece was given to me by a mom who lost a 15-year-old daughter to suicide many years ago. And when we were trying to talk about how do we mobilize the nation to respond -- before the Action Alliance for Suicide Prevention was launched, way before it was launched -- trying to build momentum for this concept. I invited her to come and share her story, so that federal and senior executives from the Washington area could benefit from her story, so that we could see how important doing something really was. And she said, "I really don't have anything to say. I'm not sure that my story would be helpful." We talked a bit, and I kept trying to assure her -- at the time I ran an advocacy organization that tried to build political will, called the Suicide Prevention Action Network -- and we talked a bit. And finally she agreed to come. And I said, "Your story will matter." And so, she was moving from one home to another, and as she was cleaning out the room that belonged to her daughter, she found a puzzle that her daughter had worked on prior to her death. And she said, "This may be my message." So, she took the puzzle pieces, put it in a felt bag, brought it to Washington, and in front of about 75 people passed around this felt bag and asked each of us to take a puzzle piece. This is mine. I still have it to this day. And it just said to me, "Never forget why we're doing this." We're doing this to try to each do the part that we have to do, to make sure that other moms don't lose their 15-year-old child. And eventually get to the place we are, a suicide-prevention prepared nation, and every door is the right door, and people who struggle do so without bias, discrimination and false judgment. So that's the goal that I have. So, I would ask all of you, as you think through the day, to think about your piece. It may be small, it may be big. But there is something each and every one of us in this room can do around suicide prevention. So, when you look at this, those were the very things Dr. Benjamin mentioned. These are the things that guided us as we went through: Promote connectedness. It's not just enough to talk about risk. We have to talk about protection. What protects people who do struggle from making tragic decisions. Strength and continuity of care, so it's not enough just to walk in and get treated at the emergency department, but you'll be followed until well. And that' got to be part of our paradigm. Training the professionals. Many of us who went through graduate school never had the kind of training in suicide risk assessment that we needed. The field has grown. The nation is engaged in a conversation. We have to make sure that our next generation of mental health professionals know how to assess and manage suicide risk. So when a gatekeeper identifies a patient, or when a school identifies someone at risk, there's a clinician who knows exactly what to do, so we can give that patient exactly what they need. We have to challenge ourselves to think about alternatives to approach and setting. You know, maybe it's not always the right thing to do to admit someone to an in-patient facility. Maybe it is, maybe it isn't. But we ought to be really thoughtful before we make that decision. Post-vention, as I mentioned, multi-sectoral engagement, doing everything we can to make sure that everybody in the community plays a part. And if you want to understand what comprehensive means, I would encourage you to look at page 12 of the National Strategy, where Dr. Silverman, who is with us today, wrote a very convincing one page that said a truly prepared community, who's doing all that it can to help a person identified with depression, these are all the things that would have to happen if we were to honestly say we've done all that we know to do, to make a difference. And I think it's an amazing contribution, Dr. Silverman. So, I'd like to kind of close my remarks by saying what was said earlier: Suicide has a ripple effect. And way back in the late '90s, when we first started talking about suicide, there wasn't a whole lot that we knew. But one thing that stuck with me is if you throw a pebble in a pond, it ripples. And that suicide doesn't just affect the individual who died by suicide, but it affects their family, it affects their neighborhood, it affects their school, it affects, affects, affects. And it's not just a short-term effect, it's a long-term effect. So, my goal in this cause, and I'm sure the goal of all of you, is that we understand that each and every suicide that occurs in this country, while we may not know the person who died by suicide, it, in my humble opinion, truly affects our fabric as a nation, and I couldn't be prouder to be an American involved in such a cause, where we're not afraid nationally to talk about preventing suicide and engaging all the federal partners, all the private sector partners, and everyone in between, to do their part for suicide prevention. So let me close by just saying there is something that each of us can do. As the day progresses, I hope you'll think about that from where you sit. As Gandhi said, "Be the change you want to see in the world." From wherever you sit, be the change that you want to see in the world, and that you are uniquely positioned to contribute. So, if it's sponsoring a training, if it's developing a protocol, if it's starting a ministry in your faith community, if it's joining a community coalition or developing a curriculum that might be used in your school based on some of those that are already on the best practices registry, I just ask you to never forget there is something truly that each and every one of us can do. So I thank you very much for the opportunity to join you today. [applause] Thank you very much. Thank you very much, Jerry, for that great overview of the National Strategy and how it came to be. We're way behind, but I do want to take a question for Jerry, a very quick question. What surprised you most during the development of the new National Strategy? After I got over the shock of being asked to write the National Strategy, I think for me it was how much collegiality there was. We had a public comment period for 90 days that people could offer their suggestions about what should be in the National Strategy. We had 14 taskforces of the Action Alliance for Suicide Prevention, all of whom were looking at a different topic and every one of them took the time and the energy to give concrete suggestions, and with what I thought would have been a much more difficult process, to pull it together and have it make sense. You could just tell the nation was on the same page, and the field had been flying in formation for a long time, so based on the 13 goals that were in there, it was very clear that the people who had responsibility for input to the goals really gave this serious thought, so there wasn't a lot of changing that needed to be done once it came to the National Strategy taskforce. It was just a matter of writing it in a way that looked like it was one team, one fight. So, nobody got hurt in the process? Nobody got hurt. The people didn't carry agendas that were uniquely theirs. Everyone rose above, I think, that unique agenda, for my opinion, and really helped us do what needed to be done to put a strategy together that, as Dr. Benjamin said, would take us through the next 10 years. Well, that's great, Jerry. I mean, I noticed a lot of us lost a lot of hair in the process, but -- I lost a lot of hair in the process. Thank you again for all of your leadership in the nation in suicide prevention. Now, moving on, it's my great pleasure to introduce Dr. Richard McKeon. Some of you know Dr. McKeon. He is the branch chief of the suicide prevention branch at SAMHSA, so he's the head guy. He's the one who makes it all happen. He has a great team that works with him. He's a well-known expert in the field, and today he's going to be sharing some information about the science of suicide prevention with us. He was a member of the National Strategy for Suicide Prevention Taskforce. He's authored many articles and books on the topic of suicide prevention. And over the last 20 years, as some of you know, SAMHSA has been integrally involved in trying to move mental health and substance abuse forward. They've taken on the initiative of suicide prevention, and for all of those of you in attendance today and participating, we hope that you learn more about the science of that, that's being led by Richard, his coworkers, and SAMHSA. So, Richard McKeon. [applause] Thank you, Dan, for that kind introduction. And I also want to acknowledge our administrator, Pamela Hyde, who has just been an incredible champion for suicide prevention, working to try to move the national agenda forward. My background is as a clinical psychologist, and I spent numerous years working in a hospital-based community mental health center, running a psychiatric emergency service, and being clinical director of the mental health center. But I just want to follow up on one thing that Jerry mentioned, which has to do with the ripple effects. And suicide has ripple effects, and suicide prevention has ripple effects. And let me just mention two stories -- one sad and one much more happy. The sad one has to do with a time when I was covering psychiatric emergencies for our hospital over the weekend. And I got a call from the emergency room physician, who said to me that there was a family in the emergency room, and they were very upset, and could I come and talk with them? Because the mother in the family had taken a serious intentional overdose. She had made a suicide attempt. And she was at the moment in intensive care. And they asked if I would come in and talk with the family and try to help them through these difficult moments. So I did that, and I came in, and talked to the family. There were a couple of daughters and a son, and a husband. And while I was talking with them, the emergency room physician came into the room and said, "I'm sorry, your mother is gone." And I will never forget the cries of anguish from that family. I will also not forget the way in which over the next several years the daughter in that family, we struggled to try to keep alive as she made a series of suicide attempts herself. It made very vivid and palpable the tragic legacy that suicide can bring in many circumstances -- the anguish is always there. The suicidal behavior doesn't necessarily happen every time as a consequence of a death by suicide, but there are heightened risks. But there are also ripple effects to suicide prevention. I also remember a time where I got a phone call from a woman whose daughter had said that she had a friend who was planning on killing himself that night. And we worked with the mother and then with the daughter, and we were able to locate the boy, and intervene with him and found out he had made extensive efforts to kill himself, that he had prepared, and he had extremely serious intent. We hospitalized him, and he was not particularly happy about being hospitalized -- he was a 17-year-old and his parents were actually in Europe, so we couldn't find someone to give parental consent. But we were so sure he was going to kill himself that we held him. His parents arrived the next day. They were very grateful. We worked with him. I saw him as an outpatient therapist for about a year afterwards, and kept in contact with him afterwards. He became an adult, he got married, he became a successful businessman, and he touched many, many lives in a very positive way. So, both suicide and suicide prevention have ripple effects. And sometimes we may not see them. I was fortunate enough to know what happened to him afterwards, and know that his story had a happy ending. So, the actions that all of you take can have effects both close and further down the line. So, regarding national strategies, which we're talking about today, one question would be very reasonable for each of you to ask yourselves, is, do we have evidence that national strategies can reduce suicide rates? And my answer to that would be yes, we do. We have seen evidence that implementation of national strategies and national efforts in at least two different countries have documented reductions, significant reductions, in suicide rates. And those were in England and in Taiwan. We've also seen that organizations in the United States, when they made suicide prevention a central priority, have been able to bring down suicide rates. Organizations as different as the United States Air Force and the Henry Ford Healthcare System have been able to show reductions. In England, they found reductions in communities that reduced, that implemented the national strategy there. And when they compared them to ones that did not implement it, they found differences in the suicide rates, as well as pre- and post- differences from before where they implemented the strategy. So, compelling evidence that the work that they were doing in England was helpful. And some of the things most strongly associated with reductions -- and this was information that we took and integrated into the US National Strategy -- were the availability of community crisis teams and proactive outreach. I want to emphasize that. If we wait for people at risk for suicide to show up in the offices of clinical psychologists, myself, or a psychiatrist, we may never reduce the suicide rate. Everyone has to play a role for it to be successful, and that means that people have to encourage loved ones and friends and coworkers and colleagues, and other students, et cetera, to get help, and to have hope. A follow-up within seven days of in-patient discharge was associated with reductions. Training of clinical staff at least every three years. Having dual diagnosis policies, being aware that substance abuse is a major risk factor for suicide. In Taiwan, the focused on following up after those who had made suicide attempts in a national effort, and found an extraordinary 63 percent reductions in suicide, by paying attention and providing proactive follow-up to people who had attempted suicide -- a major need within our country. Now, the Air Force is an example within the United States of where suicide was able to be reduced. They were able to reduce suicides by about a third using a comprehensive approach. And I want to emphasize that approaches need to be comprehensive, but they also need to be sustained. And there's very solid research regarding the Air Force model, and this is back in the 1990s that this was first done. And you can see in there part of what happened is that the suicide rate, after going down, started to climb back up. When they looked into it, they found that adherence to implementation of the strategies involved in the Air Force's model had slipped. And when they redoubled their efforts to make sure that they were, in fact, doing it, that the rates went down again. So very important information. Suicide prevention is not a one-time effort, and it must be sustained over time continually in order to be successful. And it could also be done in a healthcare system. The Henry Ford system had remarkable success reducing suicides, for four consecutive quarters not having any suicides, and they somewhat audaciously set as their goal having zero suicides. And in some ways, sometimes in mental health you can be taken aback a bit by that. But if the goal is not elimination of suicides entirely, what can the goal be? It means that we would have to accept some number of suicides as being acceptable. So let me just talk briefly about some key issues. One is that we need to integrate and coordinate suicide prevention activities across multiple sectors and settings. So, it can't just be a mental health issue. We need a comprehensive lifespan approach. We know that, at least from the teenage years through old age, that suicide is a major cause of death. We know our efforts have to be data-driven, and we need to strive to continually improve. We don't have a foolproof formula that we can apply. We need to be working on what we know has shown promise, and we need to be learning from our experience on an ongoing basis. It needs to involve both the public and the private sectors. So, that means that healthcare providers certainly need to be involved. But also educators, workplaces, faith-based entities, community-based organizations all have a role. This is why I just underline the point, again, that substance abuse is a major issue in suicide prevention. It was incorporated into the National Strategy. About 30 percent of all suicides involve alcohol, and about a similar number of suicide attempts. So it is imperative that that be taken into account, and that settings that are involved in the prevention and treatment for substance abuse are involved in this important effort. It's also vitally important that emergency rooms are part of this. And we are working actively with emergency rooms, because that is the place where people are most frequently seen after suicide attempts. And a lot of times they do not receive treatment afterwards. So, the improving continuity of care is a major theme in the National Strategy. What this says, and it may be hard to read all of it, this is using SAMHSA's NISTA (?) data, and it's just looking at different groups, and showing the numbers. We have past year suicidal ideation and attempts in different categories. So, just to give you a sense of the multiple settings that are required for suicide prevention. The NISTA (?) data would emphasize, for example, that there are approximately 74,000 suicide attempts per year by military veterans. So, that's one area. Adults on Medicaid or on CHIP, 270,000. Fulltime college students, and SAMHSA works actively with colleges on suicide prevention as well as through organizations such as the Judd (?) Foundation, 108,000. Adults on probation or parole, so correctional and legal settings we need to be aware of as places that offer opportunities and needs for suicide prevention -- 161,000. And adults in substance abuse treatment, 106,000 reported a past year suicide attempt. So just to give you an idea of some of the diversity of settings that require intervention. Jerry mentioned this, I'm not going to spend too much time on it, but the important need for training -- training of various sorts. Training of gatekeepers, of people working in schools, and people of faith-based communities, but also of providers, because I often tell folks that I only had one lecture on suicide prevention in my entire training as a clinical psychologist. The problem with that was -- at least I got one -- well, the problem with that was that I gave it. [laughter] Because our professor in our psychopathology class said, "Everybody pick a topic and present to the class," and I picked suicide prevention. So that was it. I talked to supervisors, because I had suicidal clients and suicidal patients. But it gives you a sense. Some things have gotten better, but more work needs to be done. The need to recognize the warning signs, and we now have evidence-based practices, things like dialectical behavior therapy, and cognitive behavior therapy, that have shown in randomized controlled trials the ability to reduce repeated suicide attempts. Now, regarding the issue of the behavioral health workforce specifically. This is kind of a busy slide. Let me just tell you what it means. What you see there are courageous folks in behavioral health systems around the country, who are really working to try to make suicide prevention a core priority in their systems. And what they did was they asked their workforce, did they feel like they had the skills to work with suicidal people? Did they have the training to work with suicidal people? Did they feel they had the support to work with suicidal people? And what they found was, very significant numbers said no. Now, the good thing was they also have data, which was when people got training, that the numbers improved significantly, that people at least felt better and felt more competent in being able to do that. So, this is important work. Now, one of the goals in the National Strategy is making suicide prevention as a core component of healthcare. Now, what would that look like, if our healthcare system, and particularly our behavioral healthcare systems, had suicide prevention as a core component? And this really mirrors what the objectives in the National Strategy are. Well, if we were to make it a core component, and the clinical workforce would be routinely trained in suicide risk assessment, management and treatment. Accrediting and certification bodies that would have standards and guidelines related to suicide prevention. Continuity of care during high-risk transition times such as discharge from in-patient units and emergency department would be assured, including proactive outreach. Deaths by suicide and nonfatal suicide attempts would be routinely monitored and reviewed to help guide suicide prevention efforts, that there be continuous quality improvement efforts focused on suicide prevention. So those would be some of the examples. But I also want to point out that there are significant steps forward that major systems have taken. For example, the Joint Commission has launched a National Patient Safety Goal, focusing on suicide prevention, and that was about five or six years ago. Very important step for them to take. And the Veterans Administration has made suicide prevention a major priority across their healthcare systems. Every VA medical center now has a suicide prevention coordinator, and everyone who is identified at high-risk receive what's called an enhanced care package of services that they've shown to have been able to reduce repeated suicide attempts. Just a couple of other points, and then I'll close. One of the other areas that we incorporated in the National Strategy, and one of the voices that historically has been silent in the field of suicide prevention, has been the voice of survivors of suicide attempts, or people who have struggled with suicidal ideation themselves, for them to tell us what they feel they need and what they feel would have helped them. And we are now doing much more of that work. This is a quote from Eduardo Vega, who was part of our taskforce to revise the National Strategy. And so, a very important voice in that, that is integrated in the National Strategy and needs to be continued to be integrated in our efforts moving forward. And the faith-based area is also important, because there are people who may never come to see a clinical psychologist such as myself, but maybe they will talk to a peer and maybe they will talk to their minister or priest or rabbi or pastor, and we need to take these things into consideration and make sure that those options are available for people as well. Jerry mentioned the National Suicide Prevention Lifeline as a resource, so I won't review that. I will mention that on the Lifeline website, there is also now a crisis chat feature that can be utilized, so that people can access care that way in addition to the telephone. And then I just want to let you know that there are a lot of resources out there that can be utilized in various settings, and that these are all available from SAMHSA and typically for free and in bulk. You're welcome to contact us and we'll get them to you. For schools, preventing suicide, a tool kit for high schools exists, and we worked together with the Department of Education around disseminating this. But if you work in a school-based setting, this is a wonderful encapsulation of school-based approaches to suicide prevention. In tribal communities, this is a resource called "To Live to See the Great Day of the Dawns." And so, this also brings together resources and information about suicide prevention in tribal areas. And I should say that one of our speakers today, Teri [1:01:35] has some of her work is actually in both of these tool kits. In primary care practices. This is a tool kit by the SPRC for rural primary care practices, but much can be applied in nonrural primary care practices, as well. SAMHSA has what's called a TIP-50, Treatment Improvement Protocol for Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment. Again, this is also available in bulk and free from SAMHSA, called "the safety cards." These are cards that can walk a provider through doing a suicide risk assessment. And we'll go over it in detail just so you're aware that it exists, it's for free. It's very good and we're happy to get it to you. And then, finally, warning signs have been mentioned. These are cards that have the National Suicide Prevention Lifeline number on the outside, and the warning signs for suicide on the inside. Again, we would be happy to get these to anyone who needs them. And so, with that, I will stop. Thank you. [applause] Thank you very much, Richard. We're going to keep moving along here, and we'll save questions for you for a little bit later. But that's great for people developing their action plans. Next I'm going to bring up our next speaker. We have an individual here who has been gracious enough to come and share his own personal story for us: Pat Risser (?) represents a group that has the highest rate and incidence of suicide -- men in the middle ages. He's been a tireless advocate for mental health consumers for more than 25 years. Diagnosed in 1973, suffering through many years of mental illness and hospitalizations and suicide attempts, he's here to share his personal story with us today. Thank you very much, Pat, come on up. [applause] Thank you. I'm Pat Risser, and I'm one of those people who came to in a hospital and thought, "Damn, I can't even do that right." I felt that deep, soul-crushing despair, that invisible, gut-wrenching agony of wanting to die -- a feeling such great pain that I don't think I ever thought of death as dying. All I ever thought of it was, no more pain. I just wanted to stop hurting. Sort of like Churchill and his black dog. I want to talk to you about three things that helped. I was on a path of self-destruction, and I want to tell you about the three things that I believe helped to divert me from that path. William James -- I was a philosophy major, one of those strange folks in college -- said, William James said, "I take it that no man is educated who has never dallied with the thought of suicide." I believe that. I believe that those thoughts, those feelings, are normal. But we have to figure out how to get past them, through them, not let them be so strong that they take us away. William James also said, "Be not afraid of life, believe that life is worth willing, and your belief will help create the fact." For any of you psychology majors around, that is cognitive therapy in a nutshell. It's considered the best treatment for suicidal behavior, and it came from William James, a man who dabbled himself and fought with thoughts of suicide. So, he was a peer. The first thing that helped to divert me from that path, I lay on my couch, literally unable to get up and engage with life. The depression was deep. I was fighting those demons that I knew nothing but despair, and I literally could not get off the couch. And a friend came over, and he physically picked me up and dragged me out of the house, and said, "We are going to go engage life." He said, "I cannot in good conscience sit by and watch you do this." He took me to automobile races. And the sights, the sounds, the smells, the outdoor sun on my body, my senses were so overwhelmed that I couldn't have my thoughts turned inward onto that despair. I got a break from all of that depth of agony that was going on inside. I had to be focused outside with all of that overwhelming stuff bombarding my senses. It wasn't the cure, but it was a step in the right direction -- finding a break, knowing that there is a light at the end of the tunnel, and it's not an oncoming train. Lincoln, too, had friends, Lincoln had friends who took his knives and pistols away from him. Lincoln was at one point so afraid to pick up a knife, because he thought he would hurt himself, try to end his life, if he had a knife. The second thing that helped me was I had a therapist who taught me the difference between feelings and actions. I don't know where I got it, but I've talked to a lot of people who got this weird notion that seems like we have to be somehow congruent in our feelings and our actions. I grew up thinking that if I'm angry, I had to act angry; and if I'm sad, I had to act sad; and if I'm happy, I had to act happy; otherwise, I'm being phony and not real. So, of course, if I have the suicidal feeling, "Oh, crap, now I've got to go home and take an overdose." What's with that? I mean, if I was going to be honest as a human being, I thought that my thoughts and my feelings had to somehow be congruent. So I'd go into therapy. I used to tell those therapists, "Oh, I'm feeling suicidal," and those poor therapists, they just couldn't seem to handle it -- they'd panic and lock me up. Finally, I got a therapist who said, "Wait a minute. Okay, now, if you think you're going to go out and hurt yourself, I've got certain legal obligations and I've got to try and stop that. But welcome to the human race: You're having a feeling. Now, if you think you won't go out and hurt yourself, well, then we can sit and talk about this feeling." And I was, like, "Whoa, really?" I didn't know that you could actually do that. I thought if I was feeling suicidal, I had to go act suicidal. Here she was telling me: "No, you can have a feeling, and you don't have to act that way." I was blown away. We sat and we talked about the feeling, and I felt better. And I realized I could have a loaded gun, I could put it to my head, but if I've got that much control over my body I don't have to pull the trigger. I can do something else. I can talk about it. I can find help for it. Wow, feelings. Amazing things. And they come and they go, and if you don't like the one you're having now, hang on a while, you'll get another later, you know? Feelings are -- But, really, I don't know where it came from, but a lot of people are sort of stuck in that groove. The third thing that helped me was service to others. Get out of yourself. Pay it forward. Be a peer. Be [1:11:07] sensitive and invite discussion -- not, "What's wrong with you?" "Tell me what happened to you. Tell me what's going on with you." Be that support to somebody else, like the guy who dragged me off the couch. Be that to someone else. I found that giving to others is a way of turning that focus -- that I have outward instead of focusing inward on all of that hurt that was going on. It wasn't the cure, again, but it was a step, because if I could turn it outward and help somebody else for a little while, and put that focus out there, it gave me a break from that hurt that I was feeing inside. And those little breaks add up. It's like a vacation, to have that little break, to not have to have that feeling and that pressure all the time. I could talk so much more, but I want to tell you: Go to a comedy club with some friends, have a few good belly laughs. It's not the cure. But I contend you cannot hold onto those suicidal feelings while you're having a belly laugh. I don't think it's possible. Lay on the floor with some puppies or kittens. Honest to God, if you can feel that emotional hurt while puppies are licking your face, you're hurting more than I could ever imagine. Play with a baby. I don't know how we can hold a newborn baby and not feel hope. I think it's part of the human condition. And know that these things that I offer today, the agony, the hurt, the pain, the despair, you can make it through. I haven't given you any cures, any answers. I don't have any, certainly not for anybody else. I struggle to find my own. But it's true: One day at a time; and if not that, one hour at a time; and if not that, one minute at a time. And if not that, one moment at a time. Keep breathing, keep hope. Because there's somebody who cares about you, and there's other people that you need to care about. Thank you. [applause] Wow, Pat, that was really amazing. Thank you for your courage and your strength, and your advocacy for so many, and for all of those incredible tips you gave to all of us. We have a question here that I wanted to pose to you. Out of all the things that you talked about, that helped you the most, when you sit here today and say all the things that federal partners are doing and the state partners are doing, what would you want them to know? You talked about what would help the person who is really hurting. What would you want the rest of us in the room to know, that are going to develop all these action plans? Let someone know that you're hurting. Let somebody -- My friend couldn't have dragged me off the couch if I hadn't let him in the door. Let somebody know and let somebody in that door, and to partner with you in finding a way out of that hole. And what about the federal people that are here, the people that work for the government -- what would you tell them? Oh. They're doing the right things. Richard said, engaging those of us who have been in that depth of despair, and asking us what worked, what helped. By engaging those people who have been there and been on that path, we can more readily articulate those things that have helped to divert us from that path of self-destruction. And that's why the peer support is so important -- somebody who has been through it can offer so much to help another person down the road. I mean, that service to others is very important. Thank you again. Thank you very much. Thank you. Alright, we are going to keep moving along with our agenda. Yes, you can clap, if you'd like to clap for him. [applause] Our panel is going to switch up here, and now we're going to move on to another group of people -- the High Risk Groups and Promising Practices panel. I'd like to invite them to come on up here. We all know that suicide affects many people throughout our country, and that the tragedy of suicide isn't specific to just one group. However, it's imperative that we recognize there are certain populations that are at higher risk, and those needs must be addressed for those populations. Today we're talking about just three of those particular populations, and this is in no way exhaustive. Instead, it's a selection of high-risk groups in particular who have expertise here, that can share with us some things to help us move that forward and for you to think about in your action plans. Today we have with us Chaplain Hines of the Illinois Army National Guard, Dr. Teresa LaFromboise is professor of Native American studies and developmental and psychological sciences at Stanford University, and National Strategy Taskforce member Abby Lan, the executive director of the Trevor Project, the leading national organization focusing on suicide prevention among lesbian, gay, bisexual, transgender and questioning youth. Please welcome them as they've joined the stage. [applause] Chaplain Hines, we know we're going to start with you, and as we know the statistics regarding suicide among the veteran and active duty military populations, it's been staggering and it's been played out a lot in the media. We'd like to invite you to come up here and share with us what you know about that, what your work has been to date, and what you're doing to prevent suicide among that population -- Chaplain Hines. [applause] Well, good morning. I'd first like to mention that the population which I service is the Illinois Army National Guard, and so this piece in terms of the action plan or what we do in the Illinois National Guard for our members in terms of [1:18:07] specific to that population. Partners in Care, just in brief, is a partnership between faith-based communities and the National Guard, and with this initiative our goal is to reach out to faith-based communities, develop a memorandum of understanding, a collaborative network with them, to be able to serve military members as the need, as the need arises. I should state at the forefront that while we have a diversity of faith populations among our service members in the National Guard, and so Partners in Care is not limited to one particular faith group. What this is about is situating, service members, we all live in specific communities while active duty components, while they may stay in an active installation, for National Guardsmen such as myself, I live in the Beverly-Oakland-Washington Heights Community, in Illinois. So, those around me provide the level of support and collaboration and community connections that I need. And in addition to that, I belong to a faith-based community or congregation and church. And my experience is very common to other service members. And it's those faith-based communities that we reach out to when service members might have needs. For the National Guard, our goal is to prevent suicide. As mentioned before, I've seen in the media there are so many concerns about ideation and suicide completions. Our goal is to look at the human experience, that perspective of service members such as their lifestyle, their income, financial issues that service members are dealing with, partnering with some of the congregations to assist service members in their time of need. What we have learned through our own internal research and investigation, service members present to us issues of finances, family issues, certain pathologies and dysfunctions that might exist, and what that looks like is that we contact some of our partners, and they assist us. Let me give you some practical examples of what that might look like. We had a service member who was incarcerated, and while we had a chaplain who is the program manager for Partners in Care to reach out to him and visit with him, that service member actually wanted some religious material to assist him through his journey. Being a prior service member, or still a service member, and then having the issue being incarcerated in an institution kind of, that's the dual perspective that some of the prisoners mentioned earlier what most people who have ideations, some of their issues that they extend from. This particular service member, we couldn't bring materials to him, so we reached out to one of our faith-based partners in care, who was able to contact a chaplain within that community, so that the service member could get the materials that they wanted. Other examples about how faith-based communities have assisted Illinois Guard service members, we had a service member who was about to be evicted, and, in fact, his wife was nine months pregnant. Also, the service member did not have employment. And with that level of heightened stress, expecting a child, about to lose your home, unemployed, statistically we know that sometimes these issues lend themselves to ideations and sometimes attempts for service members. We reached out to one of our Partners in Care. They were able to assist that service member with finding a home. That particular faith-based community also had a job fair in which they were able to assist the service member, and a family, and that family, in fact, is doing quite well. That was one of our partners [1:22:16], I'm sorry, in Hanover Park. So, when we think about action plans in terms of prevention and with suicide prevention, in terms of Partners in Care, our goal is to partner with these faith-based communities, so that they can be a resource and outreach to service members in the communities in which they live. The Illinois National Guard has over 10,000 service members, and there are only about 22 chaplains that serve all of those service members. And so, we see the necessity of having our faith partners as a resource for outreach to assist us in meeting the needs of the service members across the state. And I'll end my presentation there, because there may be some questions at this point, or I'll just -- Okay. [applause] Thank you very much, Chaplain Hines. We're going to keep moving on with our panel, and then if we have time for questions at the end, we'll come back to that. Prof. LaFromboise is a counseling psychologist with clinical and teaching expertise in a wide variety of university and American Indian, Alaska Native settings. The professor has worked with a number of different ethnic minorities to survive acculturation process, cultural adjustment, discrimination, major life transitions and other stresses that are often typical and also neglected among children and adolescents. The professor is going to come up and share with us her information. Thank you very much. [applause] Okay, thank you, Dan. And thank you all for being here. It's really very exciting that so many people care about this topic at this time. As Dan mentioned, I'm chair of Native American studies for 10 years at Stanford, and I've worked a lot in the area of Native American mental health and particularly in the area of suicide. So, and when Dr. Reed was talking about these wonderful events in your life, and milestones, I mean, I really think that having the invitation to develop a suicide prevention curriculum from the leaders of the Pueblo of Zuni has certainly been a very, very important experience in my life. When I was at Stanford in the late '80s., we had a committee. It was called the Zuni-Stanford Committee. It was a group of faculty members and leaders of the Zuni Pueblo who worked together, and basically the faculty members were there to respond to the requests of Zuni. So it wasn't people looking to have sites for their studies. It was people being responsible to the requests of Zuni. As it turned out, in one of the meetings, I sat at a dinner next to the superintendent of schools, and he asked me, he said, "What do you know about suicide prevention?" I said, "Well, you know, I worked on a crisis line when I was working on my doctorate, and I had just written an article on cultural and cognitive considerations of Indian youth suicide, with Dolores Bigfoot." And I said, "That's about what I know." And he said, "Well, we have a problem, and we've been trying to decide within our community for a year now, in a number of meetings, whether or not to ask anyone from the outside to help us." And he said, "We're not solving it on our own, and so we are interested, if you might be interested, in working together." And so, of course I ended up on my way to Zuni, and I was able to get some support from the School of Education and the Zuni Tribe, and over a period of three years we developed and evaluated a curriculum that's called "Zuni Life Skills," and then later it was adapted for a number of different tribes, and we have sort of an ethnic [1:26:28] American Indian Life Skills Curriculum. But I like to tell that story because I think it's very important. I think we have sort of these images at times of victimization of native people, and I'm going to talk about that a little bit in this presentation. But here what we have is really a very interesting community organizational effort that made a big difference, and it was not a major grant. It was supported by a little bit of money from the School of Education at Stanford, then some money from the Henry Kaiser Foundation, and then almost equally those entities and the Zuni Tribe. So, as we worked along for three years, we collaborated, and I think that probably is the reason it was so developed and successful. So, the bar graph that you see was published in The American Psychologist a number of years ago. It was an article on culture and youth suicide, and the bars you see represent different cultural groups -- Native American, African-American, Latino-Hispanic, Asian-American, Pacific Islanders, and Anglos. And just want to point out that the tallest bars among males and females are Native Americans. So, while we have great things happening, we have great challenges, as well. Over the years with this work I've tried to come up with what I thought was a theoretical orientation. I very much try to approach this, since this is a school-based and sort of a learning-based approach, look a lot at social learning theory, but, really, this has sort of morphed into a cognitive behavioral intervention. And what you'll see on this image, to the left are a number of risk-factors. And you could have any number. But I've selected these because in developing this model this comes from the research that now does exist on risk factors with Native American adolescents. And so, I have sort of clustered the risk factors into ecological factors, social factors, and then of course individual factors that we think of many times. And I'll go over it a little bit more, because, fortunately, in this invitation, I've been invited to be able to talk about the importance of culture and suicide prevention, so I feel happy to be able to do that. So, let's see if this works or not -- alright. So, according to this idea, there's an array of risk factors that someone could be vulnerable to, and a stressful event happens, and people have options about the way that they can respond. One might be avoidant coping and another would be approach coping. The reason I chose this dichotomy -- avoidant and approach coping -- is because in the work over the years, that seems to be what I see and hear a lot about, in Native communities. This is sort of just like opting out, removing oneself from the situation, doing a lot of self-isolation, perhaps drinking and not engaging with other people, and then eventually attempting or taking one's life. And so, I want to work at developing approach coping. And so, we have this option, approach coping, and if you ask what might be active ingredients, if there was any way to really determine in this kind of an intervention, I would say that what we do continuously is emphasize positive thinking and effective problem-solving. So it's very much cognitive in that respect. And of course we're building skills, and we believe that it would eventually lead to, instead of suicide, something like resilient adaptation -- just handling the opportunities that come before us. Now, I just want to point out, this is a culturally-based intervention, but it also is based on psychological theory, and what we believe works well. And so, the American Indian Life Skills is this social, cognitive approach, and I'll go into it in a little bit more detail. But when you do something like that, I think we know in the literature, if we look at just the field and some beginning results now coming out from meta-analyses about how important is it to culturally tailor something, we know that if we were going to do that, we have to think, "Well, what are the unique risk factors for that particular cultural group?" So I just want to mention a few here that I would say are very critical with Native Americans. And you can't be involved in American Indian mental health research or services and not hear about historical trauma. This is a theme that prevails in the field. And I also think that a picture is worth a thousand words. And so, this is an image of Native children at Carlyle Indian School, which was one of the first boarding schools in Pennsylvania. So, imagine children being forcibly removed from their homes in order to go to school, the assimilation goal was, it was too difficult to change the adults when people were moved to reservations, and so, therefore, "Let's take the children away" -- kill the Indian, save the man kind of thing. Now, how does that affect people today? Well, Les Wittbeck's (?) research will tell us that we do know that for Native youth that almost one out of five have daily or more thoughts about the tribe's loss of land. There are many other items in this historical trauma scale, but this is a good example. And the other thing is, though, is if you ask about, and this is middle school aged children, if you ask about the parents' historical trauma, they don't think about it as often. So, I think this points to the developmental issues that at this point in time people are becoming very astute politically. Another: acculturation stress. Well, many groups struggle with change, and of course that's been the mantra for Native communities for a long, long time. But we do have, you know, a few studies now that point to the association between pressure to acculturate and suicidal behavior, and we know now increasingly more that when people can engage in enculturation (?), which is the opposite, being more knowledgeable about one's culture, that it works, you know, it certainly helps improve, certainly bolsters resilience, it helps motivation for school and a number of other things. But definitely we see an association. Again, this is something that is important in the work that I do, because many SAMHSA funded projects have funded what we call GONA, which is a gathering of Native Americans, and of course the first thing that they would do is emphasize and help raise awareness about the historical trauma that people have gone through, and so that they can heal and move on. And so then we, that becomes sort of the backdrop, the beginning of our work. And of course you've mentioned over and over again the important role of substance abuse. And this is the last one that I think is really unique to Native American population, of those lists, and that is, community violence. We now know that Native Americans are victims to a lot of interpersonal violence, often on the part of non-Native people. And this is a fact from some work of Don Michenbaum (?) many years ago, when he worked with an Inuit village, and he is showing the rate of suicide among those that were sexually abused by a teacher versus those in that area, who were not affected. So, community violence. So, anyway, I think about these things. I think these are unique to Native American population, that should be factored into the kind of work that we do. So, we have this curriculum. Under test conditions, it was offered three days a week for a semester, so for a full school year, but now we have it down to a semester. And, really, we're teaching coping skills, as I mentioned, approach coping skills. So you could say, well, that's cultural about that? Well, what's cultural about it is that we did engage the consumers in the development of all of the scenarios, so it's very realistic to reservation life. And what we're trying to do, in doing this, of course is we want engagement, and I see a real resistance to just wanting to pick up the latest one that's standardized on mainstream US populations rather than that's Native-specific. So, people seem to like this. The other thing is, is with all the work that's been done in suicide prevention, now you have people that are in the trainings that have been through gatekeeper training, they've been through, they work with [1:35:31] of suicide. They work with many. So they really have this tool kit of interventions, and they know more what to do. So, just in terms of the effectiveness, we've seen that it reduces hopelessness, it increases efficacy, self-efficacy to manage anger. In a behavioral video taped role play study we see that it improves suicide intervention skills, problem solving skills. And this is a chart where you see significant reductions in suicide. This is the work of Phil May, when the American Indian Life Skills was used in a comprehensive approach where they improved surveillance, and worked with natural helpers, and basically the behavioral health, et cetera, but they really improved everything, and ours was just a little part of it. And then this is an independent study that was done in northern New Mexico with the Navajo Nation, and this is just 10 sessions from the curriculum. It's not a treatment versus control group design. It's pre-post only, but we did see some really nice benefits there. So, I think, in closing, what I would like to say is that I am fortunate to have been able to be invited to do this training in a number of SAMHSA funded projects. I think it has improved my life a lot. I know in terms of families, my daughter is the one that keeps encouraging me, because she worked in a psychiatric hospital in South Dakota with many people from all over the state of South Dakota, and actually used it with her own, with her patients. And she said, "You know, you really need to market this more and get it out a lot more." And the other thing I would say is that, it's exciting to work with communities when they're developing their own. We have used this in east Palo Alto, which is a community of largely immigrant populations, Samoan, Tongan, Latino and African-Americans -- no Native Americans. But what we did is we just changed the context to East Palo Alto, to an immigrant population. So it's exciting, it's exciting work, and I'm just very thankful to have had the support to be able to do what I've been able to do. Thank you. [applause] Thank you very much, Professor, that's really critically important information for all the various cultural groups that can take this and modify the program, and the excellent work you've done. Moving right along, we want to bring up Abby Lan, the executive director of the Trevor Project. Abby, your population has very unique things that are taking place in terms of their needs for social supports, and we'd like you to come and tell us a little bit about what you know about that, thank you. [applause] Thank you very much. Thank you for having me, and what an exciting time, actually, to be here to talk about the work that the Trevor Project is doing. As many of you might have heard yesterday, the Supreme Court made a monumental ruling on marriage equality, so that marriage equality is now a reality again in California, and the striking down of DOMA is such, just really such a powerful statement for those in the LGBT community, and it was really great. And as I was listening to the speakers today, I think it's really important to recognize the importance of the National Strategy on Suicide Prevention. I think if you had asked many people in the gay rights movement 20, 30 years ago, would marriage be a reality in their lifetime, I think many people would have said no. And in a very short period of time, it is a reality, and it goes to show the importance of people working together, of keeping their eye on the target and what they want to do, and, candidly, not taking no for an answer. So, I think it's inspiring that we're here today, because we really can make a dent in suicide prevention, and it's really an honor to be here. So, as we talk about suicide prevention for LGBTQ youth, and we're talking about youth having an opportunity for a brighter future. And yesterday's message says a lot to youth, it gives them a chance to think that, yes, there is going to be a happily ever after. But for young people of any age, the future is so far away, and what's really important is that there are still role models for young people, and especially for gay, lesbian, bisexual, transgender youth, for them to see that there are people, people like them, that are achieving in sports and music and religion. It's just a very important thing, and our young people really need that. At the Trevor Project -- let me see, did we get to the right slide -- I want you to understand kind of the university for our LGBTQ youth. Suicide is the second-leading cause of death for young people, as young as 10, and that is really something that we all know and we all want to change. But what we don't know is that, we don't know the actual number of how many LGBT youth complete suicide, but we certainly know that they have many attempts. And we don't know the number, because on death certificates sexual orientation is not listed, and we don't know quite yet how to get that information. But we'll work on that. But we do know that suicide is something that young people in the LGBT community do attempt quite often. And as you can see, for young people, LGBT young people are three to four times more at risk for suicide. If you come from a rejecting family, you're eight times more at risk for suicide. And for transgender youth, 25 percent have attempted suicide, and even more have considered it. So we have a lot of work to do at the Trevor Project. The CDC recently recognized LGBT youth as a priority population, and so that means that special work is being done. What you need to think about when we think about LGBT youth and their risks -- So, 40 percent of the homeless population of youth say that they are lesbian, gay, bisexual, or transgender. Forty percent of homeless youth. And, really, probably the LGBT population is about 10 percent of the general population. So, the fears that people have, young people being kicked out of their homes, really puts so many young people at risk. We also know that eight out of 10 LGBT youth experience bullying or harassment at school. That's almost every kid who identifies as gay, lesbian, bisexual, transgender, they get bullied and harassed at school. And we know that for every incident of bullying, it potentially increases someone's self-harm by about 2.5 percent. So, that's every incident. So, LGBT people are really at risk for suicide. But that's when an organization like the Trevor Project comes in, and organizations in different communities. We are the only national organization working on crisis intervention for suicide, for gay, lesbian, bisexual and transgender and questioning youth, and we do a number of services to help. Our crisis intervention services start with our lifeline. It's a 24/7 lifeline, so young people can call us and talk to a trained volunteer counselor, and talk about their fears and talk about what they are going through. And though we are an organization that focuses on LGBT youth, we have about 14 percent of our calls also come from youth who identify as straight. They need someone to talk to, and I think they feel that they can certainly say whatever they need to say to any of our counselors. We also have Trevor Chat. It's our instant messaging. We do that five days a week, almost, hope to be at seven days a week by August, and that is a very important way for young people, we focus our work on young people, 13 to 24, and for any of you who deal with young people you know they're always connected to technology. So, being able to chat with young people is rally important. And then we are piloting Trevor Text, so young people can reach out to us via their phones, because they're always texting each other. I don't think young people talk to each other anymore. Along with our crisis intervention, we know that we have to do prevention, because actually we'd like our phones never to ring, we'd like no one to ever be chatting with us, and that's where the prevention part comes in, that's what we've been talking about some this morning. We have a couple of ways of doing prevention. We have our Trevor Education programs, and we are so excited: the cornerstone of our Trevor Education program, our Lifeguard Workshop, was just admitted into the best practice registry for suicide prevention. It was the first LGBT focused curriculum, which is really great. And that's a great resource, and we have that, and we are making a DVD of that, so soon that workshop will be available to classrooms all across this country. We also have the largest social networking site, Trevor Space, for LGBTQ, and their straight allies, to talk with each other. Because there are many parts in this country where people feel they're the only gay people in their community, the only person like this, and they can come onto Trevor Space and they can talk to, now, over 61,000 young people, so that they feel like they have friends and their supported, and it's really wonderful. And then we have Ask Trevor. And Ask Trevor are letters that people write to Trevor, and we have trained folks who answer those. And all the questions and answers are posted on our website, so it's an amazing resource for people to have. But even with all of our services and things that are going on in the country, there's still so much that has to be done. As you can see from this map, there are still many states where you can't even talk about gays and lesbians and bisexuals and transgenders, because it's just not something that school curriculums will allow. And that's why we actually need all of you to be working on this important issue, because every community has young people who are gay, lesbian, bisexual, transgender, or they're just questioning who they are, and you need to make it okay for them. You need to know that each one of us, whether we're an individual or an organization, we need to make it okay that young people know they can ask us for help. And I'd like to ask now, we have a video that we've just done, it's a new public service campaign that we are going to be doing starting in August, "Making it OK to Ask for Help." So, can we play that video? Thank you very much. So, "Ask for Help." It is our newest campaign, because we really want to normalize for a young person that it is okay to ask for help, and we will have that public service announcement across the country. We will have billboards, we will have materials. We're debuting it at 25 different pride celebrations this month. And it's really, really important. And this is something you can do in your communities -- not only can you play our video, but you can come up with ways to make sure that young people know they can ask for help, and they can ask anyone for help. As we know from the National Strategy, just talking to one person can make all the difference for someone who is feeling sad and depressed, and thinking about suicide. We also have another -- I hope this gets to it -- Well, I don't know. So, let me tell you about this other thing that we have. Well, I have a really great slide, but I just can't show it to you. But it's called "Talk to Me," and "Talk to Me" is a campaign that we also, again, encouraging people to talk to each other. You don't have to be trained -- Oh, there it is, thank you very much. Gosh, I'm good. You don't have to be trained to be someone to talk to. You just have to be open to that. And this is something that we've been doing every September. So as you think about what you want to do towards September 10th and Suicide Prevention Day, we actually use September as suicide prevention month, and we do a number of activities. And "Talk to Me" is important. You can have people go to our website, and join "Talk to Me," and it gives different things to do in your community. It's about engaging people and, again, about normalizing for young people that it is okay to ask for help, it is okay to "Talk to Me." So, just to summarize, as you think about what you can be doing, LGBTQ young people, they face prejudice, they face fear, they face hate, and it's only because of who they are. And we've got to take away these negative factors. We have to let people just be whoever they are, and shine and accept them. And at the Trevor Project, that's what we do all the time. We know when we accept people for who they are, it is a big step in letting them accept for who they are. And then to make sure that we offer these different strategies, I think that, together, we really can make it a brighter future for LGTBQ youth and really let them have that happily-ever-after that we all want. So, thank you so much for having us here today. [applause] Wow, thank you, and incredible presentations from our panel. I've been told that we're getting questions from everywhere, from Alaska down to Florida, from kids in high schools and from states all over the country, and they're trying to sort through all of them. And we're going to work to respond to all of them, not today. But I want to take and just ask one question to the two panelists, and give a 15-second response, to the chaplain and to Teresa. And this came from one of the echo sites. What would you say, in 15 seconds, for places that don't have mental health professionals, behavioral healthcare professionals that have access to them? Where would you say to turn for help? There's always crisis lines and help lines that are out there to assist individuals who are in need, and there are also the peer relationships that are out there, that can assist. We encourage people, because some of the communities I work in, it may be that kind of situation, to really identify who are the trusted adults within their network of friends, people that they respect, they feel would be confidential, and that they want to go to. So we really have them prepare for that. So, more training for those trusted adults when they go to them. Abby, you want to add anything? I think that it's just important that people know that if there's not a mental health professional, they should talk to somebody and let someone know that they need help. That's great, and I think that that really does sum up a lot of the messages that you heard today, that we're all in this together. This is a unified effort that takes everybody to save people's lives. So I want to thank the panel again. I appreciate their time and being up here, you can thank them. [applause] So, what's going to be happening next? For those of us here in Chicago, we're going to be taking a break and then going into our action steps. We ask that you do that on your echo sites, as well. You can continue to submit questions and we will be responding to those in due time. I can't stress this enough, that the tools that you learned about and heard about today in your professional experience, use those to create the plans that are going to help save lives across the country. While we're not going to be collecting them, we ask that you use them, and they don't have to be neat or clean, they just have to be something that gives you a goal, something to reach for and strive for. What we care about is that you provide yourself or your organization with a clear action plan and useful tools that are available to you, as you heard about earlier today. Now is the time. There's never been a better time to plan for suicide prevention. Every moment counts in saving people's lives. It's been a pleasure being here today, working with all the experts that spoke first, and all the panelist members. I want to bring up Dr. Cody, who is going to close for us. [applause] Today we have learned how suicide is one of the top public health issues in our country. But our nation is no stranger to public health achievements. In the 20th century alone, we made significant improvements in areas such as vaccination rates, motor vehicle safety, control of infectious disease, and infant mortality. These public health topics and their success share two factors: a public health approach and community action. However, sometimes topics like suicide, mental illness and addictions, they're seen as social problems as opposed to public health issues. And the communities and governments, they respond to a social problem as opposed to the health needs of our communities. Responding to a social problem as opposed to a public health issue fosters individual blame and misunderstanding. It leads to discrimination, prejudice, and social exclusion. We end up focusing on the symptoms and not the root public health issue. The National Strategy provides us a public health framework for suicide prevention. It is based on facts, science and data, and has a common message. It focuses on the health of our communities, and it is committed to the health of everyone. In turn, the strategy calls for us to engage everybody. The general public, elected officials, schools, parents, houses of worship, health professionals, researchers, individuals who have been directly affected by suicide in their families. The National Strategy provides us with one of the key components that is necessary to decrease suicides: a public health approach. But the other necessary factor to achieve success in suicide prevention will be community action. And when communities take action, we will see results. Fostering a national dialogue and building public support for suicide prevention will be the result when the individuals in this room take action. Promoting changes in systems and policies and environments that will support suicide prevention will be the result of participants on our webcast take action. Addressing the needs of vulnerable groups to eliminate health disparities will be the result when our echo sites take action. Transferring knowledge so that families and individuals know the signs of suicide, mental illness and addiction, know what to do about them, where to go for help for themselves and their families, will be the result when communities take action. We have the necessary components to reduce suicides in this country. We have the strategy, the programs and the tools. But it will ultimately be the action of the community that turns the strategy into something meaningful over the next 75 days and beyond, so that by National Suicide Awareness Day on September 10th, we will have strategically advanced suicide prevention in our communities. On behalf of the HHS Region 5 Work Group members, I would like to thank everybody in person, on the webcast and at the echo sites, for participating in today's event. I would like to thank our presenters, and we urge everyone to complete your action plans and take those next steps forward, so that we'll have an impact in our country on suicide prevention. Thank you again for your time. [applause]

Contents

Sunday

Network 7:00 PM 7:30 PM 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM
ABC Fall America's Funniest Home Videos America's Funniest Home Videos Lois & Clark: The New Adventures of Superman The ABC Sunday Night Movie
Winter Lois & Clark: The New Adventures of Superman America's Funniest Home Videos America's Funniest Home Videos
Spring America's Funniest Home Videos America's Funniest Home Videos Various programming
Summer Second Noah America's Funniest Home Videos America's Funniest Home Videos
CBS 60 Minutes (#11/13.3) Touched by an Angel (#10/13.6) CBS Sunday Movie (#14/12.1)
Fox Fall Big Deal FOX Sunday Movie / MLB Playoffs and World Series Local Programming
November Married... with Children Married... with Children The Simpsons Ned and Stacey The X-Files (#20/11.4)
(Tied with Cosby)
Winter Various FOX Specials King of the Hill
Summer Beyond Belief: Fact or Fiction
NBC Dateline Sunday 3rd Rock from the Sun (#27/10.8)
(Tied with Law & Order)
Boston Common NBC Sunday Night Movie (#18/11.5)
(Tied with The Drew Carey Show)
The WB Fall Kirk Brotherly Love The Parent 'Hood The Steve Harvey Show Unhappily Ever After Life with Roger Local Programming
Follow-Up Brotherly Love
Winter Nick Freno: Licensed Teacher

Monday

Network 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM
ABC Fall Dangerous Minds Monday Night Football (#7/16.0)
Winter The ABC Monday Night Movie
Spring Spy Game
Follow-up Relativity
CBS Fall Cosby (#20/11.2)
(Tied with The X-Files)
Pearl Murphy Brown Cybill (#30/10.5)
(Tied with Chicago Hope and Dateline NBC – Friday)
Chicago Hope (#30/10.5)
(Tied with Dateline NBC – Friday and Cybill)
Follow-up Ink
Spring Everybody Loves Raymond Cybill Ink
Fox Fall Melrose Place Party Girl Lush Life Local Programming
Winter Ned and Stacey Married... with Children
Follow-up Various
Spring Married... with Children Pauly
Summer Various Programming Roar
NBC The Jeff Foxworthy Show Mr. Rhodes The NBC Monday Movie (#23/11.0)
(Tied with Walker, Texas Ranger, Mad About You and Caroline in the City)
UPN Fall In the House Malcolm & Eddie Goode Behavior Sparks Local Programming
Winter Sparks Goode Behavior
The WB Fall 7th Heaven Savannah
Spring Buffy the Vampire Slayer

Note: On CBS, the debut of Ink was delayed by a month due to production problems, resulting in another new sitcom, Pearl, which aired temporarily in its slot before moving to its own originally designated Wednesday time period in late October.

Tuesday

Network 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM
ABC Fall Roseanne Life's Work Home Improvement (#9/14.0) Spin City (#17/11.7) NYPD Blue (#13/2.5)
Winter Ellen (#29/10.6)
Spring Home Improvement (repeats) Soul Man The Practice
Summer Roseanne Life's Work NYPD Blue (#13/12.5)
CBS Promised Land CBS Tuesday Movie
Fox Fox Tuesday Night Movie Local Programming
NBC Mad About You (#23/11.0)
(Tied with Walker, Texas Ranger, Caroline in the City and The NBC Monday Movie)
Something So Right Frasier (#16/11.8) Caroline in the City (#23/11.0)
(Tied with Walker, Texas Ranger Mad About You and The NBC Monday Movie)
Dateline Tuesday (#20/11.4)
UPN Fall Moesha Homeboys in Outer Space The Burning Zone Local Programming
Spring Social Studies
Follow-up Homeboys in Outer Space

Wednesday

Network 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM
ABC Fall Ellen (#29/10.6) Townies Grace Under Fire The Drew Carey Show (#18/11.5)
(Tied with The NBC Sunday Night Movie)
Primetime Live (#15/11.9)
Winter Grace Under Fire Coach The Drew Carey Show (#18/11.5)
(Tied with The NBC Sunday Night Movie)
Ellen (#29/10.6)
Spring Arsenio
Follow-up Ellen (#29/10.6)
CBS Fall The Nanny Almost Perfect CBS Wednesday Movie
Late October Pearl Almost Perfect Public Morals EZ Streets
Follow-Up CBS Wednesday Movie
Winter Various programming Orleans
Spring Temporarily Yours Feds EZ Streets
Follow-up Dave's World CBS Wednesday Movie
Fox Fall Beverly Hills, 90210 Party of Five Local Programming
Spring Pacific Palisades
NBC Fall Wings The John Larroquette Show NewsRadio Men Behaving Badly Law & Order (#27/10.8)
(Tied with 3rd Rock from the Sun)
Follow-up Various programming
Winter Chicago Sons
Spring NewsRadio Wings Just Shoot Me! Prince Street
Follow-up The Single Guy Men Behaving Badly Law & Order (#27/10.8)
(Tied with 3rd Rock from the Sun)
UPN The Sentinel Star Trek: Voyager Local Programming
The WB Fall Sister, Sister Nick Freno: Licensed Teacher The Wayans Bros. The Jamie Foxx Show
Spring Smart Guy The Jamie Foxx Show The Wayans Bros.

Note: On CBS, due to the effect of the debut delay of Ink on Monday, the first month of the new season on this night aired Almost Perfect at 8:30 p.m., followed by CBS Wednesday Movies at 9 p.m. The originally planned fall Wednesday lineup took shape at the end of October with Pearl taking over at 8:30 p.m., Almost Perfect moving to 9 p.m., Public Morals debuting at 9:30 p.m., and EZ Streets debuting at 10 p.m. This lasted for only one week in late October. CBS cancelled Public Morals after it aired the 1st, and only, episode. This meant Almost Perfect would soon be cancelled. EZ Streets would be given a 2nd chance in the spring.

Thursday

Network 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM
ABC Fall High Incident Murder One Turning Point
Winter The ABC Thursday Night Movie
Spring Vital Signs Turning Point
CBS Diagnosis: Murder Moloney 48 Hours
Fox Martin Living Single New York Undercover Local Programming
NBC Fall Friends (#4/16.8)
(Tied with The Naked Truth)
The Single Guy (#8/14.1) Seinfeld (#2/20.5) Suddenly Susan (#3/17.0) ER (#1/21.2)
Winter The Naked Truth (#4/16.8)
(Tied with Friends)
Spring Suddenly Susan (#3/17.0) Law & Order (#27/10.8)
(Tied with 3rd Rock from the Sun)
Follow-Up Fired Up (#6/16.5) ER (#1/21.2)

Friday

Network 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM
ABC Fall Family Matters Sabrina the Teenage Witch Clueless Boy Meets World 20/20 (#12/12.8)
Follow-up Boy Meets World Sabrina the Teenage Witch Clueless
Spring Step by Step
CBS Fall Dave's World Everybody Loves Raymond Mr. & Mrs. Smith Nash Bridges
Winter JAG
Spring JAG Orleans
Summer Dave's World Life... and Stuff JAG
Fox Sliders Millennium Local Programming
NBC Fall Unsolved Mysteries Dateline Friday (#30/10.5)
(Tied with Chicago Hope and Cybill)
Homicide: Life on the Street
Follow-up Crisis Center
Spring Homicide: Life on the Street

Saturday

Network 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM
ABC Fall Second Noah Coach Common Law Relativity
Winter The ABC Saturday Night Movie
Spring Dangerous Minds The ABC Saturday Night Movie
Midseason Lois & Clark: The New Adventures of Superman Leaving L.A. Gun
Summer Family Matters Hangin' with Mr. Cooper Dangerous Minds Spy Game
CBS Dr. Quinn, Medicine Woman Early Edition Walker, Texas Ranger (#23/11.0)
(Tied with Mad About You, Caroline in the City and The NBC Monday Movie)
Fox Fall COPS COPS Married... with Children Love and Marriage Local Programming
Winter America's Most Wanted
Spring America's Most Wanted Lawless
Late spring COPS America's Most Wanted
NBC Dark Skies The Pretender Profiler

Note: America's Most Wanted would debut in November at 9:00 on Fox. Married... with Children moved to Sundays at 7-8pm in November, Mondays at 9:30 in January, and Mondays at 9pm in February. Lawless was canceled after one episode.

By network

ABC

CBS

Fox

NBC

UPN

The WB

References

  1. ^ Highest-rated series is based on the annual top-rated programs list compiled by Nielsen Media Research and reported in: Brooks, Tim & Marsh, Earle (2007). The Complete Directory to Prime Time Network TV Shows (9th ed.). New York: Ballantine. ISBN 978-0-345-49773-4.
This page was last edited on 16 June 2019, at 05:01
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