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Beset by record number of suicides, South Dakota scrambles for a new approach

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SIOUX FALLS, S.D. South Dakota has a suicide problem, and state officials are readying a united effort to confront it.

In a new collaboration on the issue, numerous state departments and tribal leaders in South Dakota have quietly been working together on the framework of a five-year suicide prevention strategic plan for 2020-2025, responding to a rise in the rate of completed suicides in South Dakota in recent years.

The number of suicides each year in the state has risen significantly in the past decade or so, up about 37% from 2008 to 2018, when the state's previous five-year plan to address suicides lapsed. In 2017, there were more suicides in the state that in any other recorded year, with 192.

The state has made big strides in recent years in understanding suicide in South Dakota, said Kim Malsam-Rysdon, secretary of the state Department of Health, who is spearheading the creation of the new prevention plan, planned for release by the end of the year.

"Our data has changed since then. We have a lot more information about some of the nuances around suicide in our state, and we really want to put that data to work and use that data to have things that can be more impactful," said Malsam-Rysdon. "We’re much better poised in that regard."

In South Dakota, state officials say suicide was the second leading cause of death of those between the age of 15 and 34. The Native American suicide rate is two-and-a-half times higher than the white suicide rate, and 78% of suicides were male.

Unique bevy of agencies tackle problem

Malsam-Rysdon, and a bevy of state departments and tribal representatives have worked through the summer into the fall on the plan, a draft of which was opened to public comment in October. Departments working on the plan include Health, Social Services, Tribal Relations, Education, Agriculture and Veterans Affairs, in collaboration with the Great Plains Tribal Chairmen's Health Board.

The broad-based approach was a new one for suicide prevention planning, said Janet Kittams, CEO of the Helpline Center. The Helpline Center serves as a significant portion of the state's front line on suicides, answering crisis calls, responding to help families after completed suicides and holding classes to help survivors.

“I think what has been unique about the past couple of years is the state departments have joined together to work on suicide prevention, whereas before it was a siloed approach,” Kittams said. “I think there’s power in bringing the departments together because they all touch suicide prevention, just perhaps in a different way."

Including tribal voices, including the Great Plains Tribal Chairmen's Health Board, and gathering community input, has been a vital addition to the development of the current plan, said Dave Flute, Tribal Relations Department secretary, a member of the Sisseton-Wahpeton Oyate and former chairman of the tribe.

"For this administration, Kim (Malsam-Rysdon) really got everyone together, reached out to our office and got our inclusion and our input," Flute said. "As a former tribal leader, I’ve dealt with suicide on my reservation, so I felt very honored that Kim reached out and we were able to engage on that initiative."

Prevention plan, help for youth

The emerging plan is a broad-based plan centered on the use of data, education and training to confront the issue of suicide on multiple fronts, including within the farming community and in schools, with a keen eye to prevention.

"Suicide is not only a mental health issue. Suicide is an issue that involves folks who oftentimes have not had any contact with the mental health system and many times don’t have a mental health issue, but they’re reacting to some crisis in their life," said Malsam-Rysdon. "So understanding that and thinking about prevention in those situations is a new thing we’re going to be working on."

Ben Jones, secretary of the state's education department, came to the job from the world of higher education. He said he was struck by the profound need to address suicide and mental health issues at younger and younger grades.

“The notion that this is reaching down into middle school, or fifth or fourth grade, just takes a little while to wrap your mind around what’s going on," he said.

Jill and Kelsey Johnson in Sioux Falls said they welcomed a deeper conversation about the new state plan, although the plan framework is currently only publicly available in a one-page draft form. They had several ideas and thoughts they contributed to the plan during the open comment period in October. Their husband and father, Chad, completed suicide close to Christmas last year.

Kelsey Johnson said she found good support at her then-school at the Creighton University in Nebraska through a grief support program, but was concerned to not find something similar in South Dakota.

"It's just a similar bond of grief in our age group, and there's nothing even remotely like that in South Dakota," she said. "That could be an outlet for even just friends of people who have lost friends or family or a distant relative to suicide."

Jill Johnson said she initially experienced a lot of social isolation after Chad's completed suicide, and they had to find a lot of the resources they needed themselves. She said she'd strongly support a plan that included more proactive ways to reach out to survivors and sees the plan's attempts to provide more resources in schools as crucial.

"If you're going to be in schools, be in schools. Have a presence and teach kids when they're young how to have open communication in all these areas, so if it happens to them or someone around them, there's not a stigma," she said. "People, I think, don't understand. They look to blame."

Suicides in South Dakota

2018: 168

2017: 192

2016: 161

2015: 173

2014: 141

2013: 147

2012: 135

2011: 125

2010: 139

2009: 128

2008: 123

Source: South Dakota Department of Health