GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 2015

H                                                                                                                                                    2

HOUSE BILL 451

Committee Substitute Favorable 6/2/16

Short Title:      LRC/Study Suicide Prevention.	(Public)
Sponsors:
Referred to:

April 2, 2015

A BILL TO BE ENTITLED

AN ACT directing the legislative research commission to examine ways to prevent suicide among minors, veterans, and emergency responders in north carolina.

Whereas, suicidal behavior is a serious and persistent public health problem with devastating effects on victims, families, and communities; and

Whereas, suicide resulted in more years of potential life lost than other common causes of early death in North Carolina, including homicide, congenital abnormalities, cerebrovascular disease, human immunodeficiency virus (HIV), and diabetes mellitus; and

Whereas, hospitalization charges for self‑inflicted injuries in North Carolina totaled three hundred fifteen million dollars ($315,000,000) from 2004 to 2008; and

Whereas, suicidal behavior in youth and young adults (ages 10 to 24 years) is a significant concern because this age group has the highest rates of self‑inflicted injury requiring hospitalization or a visit to the emergency department; and

Whereas, suicide is the third leading cause of death among youth in North Carolina; and

Whereas, according to a national study, there has been an increase in the suicide rate of firefighters, law enforcement officers, and emergency medical services personnel as compared to the general population; and

Whereas, a national study indicates that fighting fires, responding to emergency law enforcement situations, and responding to emergency medical situations negatively impacts the mental well-being of these responders, putting them at greater risk of developing behavioral health issues as compared to the general population; and

Whereas, according to a national study, veterans also face an elevated risk of suicide as compared to the general population; and

Whereas, a total of 1,148 North Carolina veterans died from suicide during the time period from 2004 to 2008, resulting in a veteran suicide rate (29.6 per 100,000), twice the overall suicide rate in North Carolina (14.0 per 100,000); and

Whereas, research continues on how the effects of wartime service and injuries, such as traumatic brain injury, posttraumatic stress disorder, or other service‑related conditions, may increase the number of veterans who attempt suicide; and

Whereas, approximately ninety percent (90%) of people who die by suicide had a diagnosable psychiatric disorder at the time of death, such as depression; and

Whereas, most suicide victims exhibit warning signs or behaviors prior to an attempt; and

Whereas, suicide risk factors cut across multiple disciplines, psychological, biological, and social, suggesting that successful prevention efforts must reflect collaborative efforts across a broad spectrum of agencies, institutions, schools, and community‑based organizations; and

Whereas, adults that are regularly in contact with people at risk for suicide need to be trained in order to be able to recognize factors that may indicate thoughts of suicide; and

Whereas, due to the strong association between suicidal behavior and mental illness, substance abuse, or both, in all age groups, prevention and treatment services for mental illness and substance abuse must be available when and where people need them; and

Whereas, despite the increased recognition that suicide is a public health problem, studies indicate that adults who are regularly in contact with people at risk for suicide are not adequately trained to recognize factors that may indicate thoughts of suicide and that many health care providers are not adequately trained to provide proper assessment, treatment, or referrals; and

Whereas, improved training and education in suicide assessment, treatment, and management have been recommended by a variety of organizations, including the United States Department of Health and Human Services and the Institute of Medicine; Now, therefore,

The General Assembly of North Carolina enacts:

SECTION 1.  The Legislative Research Commission (LRC) shall study the role of health care providers and other key gatekeepers in suicide prevention, particularly among individuals under age 25, firefighters, law enforcement officers, emergency medical services personnel as defined in G.S. 131E‑155, and veterans. The study shall include an examination of at least all of the following:

(1)        The effect of evidence‑based suicide assessment, treatment, and management training on the ability of a licensed health care provider to identify, refer, treat, and manage patients with suicidal ideation. In conducting this examination, the Commission shall, at a minimum:

a.         Review available research and literature regarding (i) best practices in assessing, treating, and managing patients with suicidal ideation and (ii) the relationship between completion of training in these best practices and patient suicide rates.

b.         Assess which licensed health care providers are best situated to positively influence the mental health behavior of individuals with suicidal ideation.

c.         Evaluate the impact of suicide assessment, treatment, and management training on veterans with suicidal ideation.

d.         Review curricula of health care profession programs offered at the State institutions of higher education regarding suicide prevention.

(2)        The categories of licensed health care providers in this State that should be required to complete training in suicide assessment, treatment, and management as part of their continuing education requirements.

(3)        For each category of health care providers identified pursuant to sub‑subdivision b. of subdivision (1) of this section, (i) the minimum number of required hours and the specific elements of any suicide prevention training the Department determines would be beneficial and (ii) any recommended exemptions from the proposed minimum training requirements.

(4)        The feasibility and effectiveness of providing training to school personnel, clergy, and law enforcement personnel on how to recognize at‑risk behavior and how to make appropriate referrals for treatment.

(5)        Methods for credentialing and identifying, through a badge or other form of identification, all persons trained in recognizing at‑risk behavior and how to make appropriate referrals for treatment.

(6)        Methods for ensuring that nonidentifying information derived from suicide investigations is shared for statistical, research, and other purposes consistent with State and federal confidentiality laws with relevant stakeholders, including health care providers; educational institutions; organizations representing firefighters, law enforcement officers, emergency medical services personnel, and veterans; community‑based organizations that provide mental health services to individuals with suicidal ideation; State agencies, including the Department of Health and Human Services; and the Child Fatality Task Force.

(7)        Any other issues the Commission deems necessary to complete its report.

SECTION 2. The Legislative Research Commission shall make its final report, including any proposed legislation, to the 2017 General Assembly when it convenes.

SECTION 3.  This act is effective when it becomes law.