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Suicide prevention and partnerships between law enforcement and mental health providers were the focus of talks delivered in a Zoom Session, on May 11, hosted by Saint Leo University’s East Pasco Education Center.

Sarah Shirina, licensed supervisor of behavioral health with BayCare Behavioral Health, shared her expertise on the topic of suicide prevention, while also discussing local services that are available to help people struggling with mental illness.

Shirina is the supervisor over BayCare Behavioral Health’s mobile response team in Hernando County.

She’s also an adjunct professor for Saint Leo University, with a bachelor’s and master’s degree in social work from the university.

She began by sharing national suicide data from the Centers for Disease Control and Prevention.

“Suicide, unfortunately, is one of the leading causes of death in the United States. It is the 10th leading cause of death in the United States, claiming over 48,000 lives.

“Suicide was the second-leading cause of death in individuals, between the ages of 10 and 34, and the fourth leading cause of death, among individuals between the ages of 35 and 54,” she said.

“There were actually 2½ times as many suicides in the United States as there were homicides, in 2018.

“So, what does that look like for our state? In 2019, Florida had a total of 3,427 deaths by suicide.

“In Florida, suicide is the eighth-leading cause of death,” Shirina said, adding the age group of 55 to 64 is most affected.

Shirina shared information derived from a research project by BayCare Behavioral Health and the University of South Florida, focusing on suicide in the Tampa Bay region.

Hot spots have been identified in all five counties in the Tampa Bay area, Shirina said.

“Hernando, Pasco and Pinellas, unfortunately, are all ahead and have higher averages of suicide deaths than the state of Florida.

“You’ll see that all of Florida had a total of 15 deaths per 100,000. And Hernando, Pasco and Pinellas are all in the 20s (per 100,000),” she said.

“Suicide affects men at a much greater percentage than it does women.

The study found that from 2010 to 2016, the suicide rate for men was twice as great as it was for women, she said.

“As our age groups increase, our military population is at a greater risk to be affected by suicide,” she added.

One of the big conclusions of the research was that Pasco, Hernando and Pinellas bear a disproportionate burden of death by suicide, in comparison to the state and surrounding counties, Shirina said.

Another conclusion: These are the same counties that bear the burden of the opioid addiction crisis.

She also noted that “80% of people who died by suicide had never had an involuntary examination, also known as the Baker Act.

“This, to me, was an alarming statistic,” Shirina said.

Among those who had undergone a Baker Act examination, 60% of those who died by suicide did so one or more years after their involuntary examination.

The study also found that middle- and older-aged white men had the highest rates of suicide, and among those who died by suicide, many had military backgrounds.

The research showed that guns were the most common method of suicide by men in all five counties.

By comparison, in Hillsborough, Pasco and Polk counties, more women died by overdose than did by guns, Shirina said.

“So, what can we do to help those who may be struggling?” Shirina asked.

Safety planning can help.

“When we’re safety planning with someone, we’re identifying their warning signs, their triggers and their stressful events that could lead to a crisis. We’re discussing with that person what they can do, what coping skills they can use to feel better.

“We’re discussing their support network. Who can they call when they need help? Who can they lean on?

“If possible, we often use that support network, when we’re creating these safety plans,” she said.

“We talk about what they look forward to in the future. What is important to them and what is worth living for? This is a great reminder, when someone is having these deep thoughts, that there are things in their future that they look forward to, and really, what is worth living for?

“We give a copy of this plan to them and to their support system, if possible, and we encourage them to keep it somewhere safe, so they can use it when they’re feeling upset,” Shirina said.

Dawn Wever, the second speaker during the session, is a practicing mental health counselor.

She’s been an instructor in Crisis Intervention Team training for a number of law enforcement agencies. She’s also been a presenter on the topic at state conferences, is a former board member for National Alliance on Mental Illness (NAMI) Hernando and has done considerable research on collaborations between law enforcement and mental health professionals.

One in five Americans are affected by mental illness in any given year, according to statistics from NAMI, Wever said. That equates to approximately 57.7 million Americans living with mental illness. Of those, just 41% will receive treatment in any given year.

Research also shows that the average length of time from initial diagnosis to the onset of treatment is 10 years, she said.

She shared the story of the Memphis Police Department Crisis Intervention Team, which in later years came to be known as the Memphis Model.

The model stemmed from a 1987 incident in which police officers were called to an area of public housing in Memphis, where a young man was threatening with a knife, she said. Police officers ordered him to put down the knife. He refused. Eventually, police opened fire and the man was killed, she said.

“The mayor of Memphis turned to local advocates from NAMI and enlisted police, community mental health professionals, university leaders, hospital administrators, church officials to find a new approach to working with persons with mental illness, who are in crisis,” she said.

The approach involves a 40-hour, weeklong training for officers, deputies, detention personnel and dispatch, as well, regarding the recognition and understanding of signs and symptoms of mental illness, and focuses on verbal, de-escalation techniques, said Wever, who holds a master of arts/psychology from Saint Leo University.

Encounters between police and the mentally ill began increasing after the deinstitutionalization of psychiatric facilities began happening in the 1980s and 1990s, she said.

The expectation was that community-based mental health care facilities would provide treatment to those individuals released from psychiatric hospitals. Instead, county jails have become the largest mental health facilities in the country, added Wever, who has been in private practice since 2012.

The Rand Corporation estimated in 2020 that 15% of the men and 31% of the women incarcerated across the country have a serious and persistent mental illness, Wever said.

According to NAMI estimates, at least 400,000 currently behind bars in the United States suffer from some type of mental illness, Wever added. The organization also estimates that 25% to 40% of all mentally ill Americans will be incarcerated at some point in their lives.

She told Zoom listeners about a mental health unit operated by the San Antonio (Texas) Police Department .

“That’s regarded as one of the best law enforcement-based mental health units in the country,” she said.

“It was established in 2008 and to date, they have maintained zero use of force in a mental health call for service,” Wever said.

Shirina and Wever gave the final two presentations during a Social Services Speaker Series, which began on April 13.

Besides being informative, the series was intended to give participants exposure to a wide range of career opportunities in the helping professions.

To find out more about Saint Leo University’s East Pasco Education Center, email Derek Saunier, center director, at  or call 352-588-7451.

Warning signs of suicide

• Increased alcohol and drug use
• Aggressive behavior
• Withdrawal from friends, family and community
• Dramatic mood swings
• Impulsive or reckless behavior
• Collecting and saving pills or buying a weapon
• Giving away possessions
• Tying up loose ends, like organizing personal papers or paying off debts
• Saying goodbye to friends and family

Suicidal behaviors are a psychiatric emergency. If you or a loved one exhibits these behaviors, seek immediate help from a health care provider or call 911.

If you are unsure, a licensed mental health professional can help assess.

Source: National Alliance on Mental Illness

Suicide Myths
Sarah Shirina, licensed supervisor of behavioral health with BayCare Behavioral Health, discussed some myths about suicide during a recent Zoom presentation hosted by the University of Saint Leo.

Here’s an excerpt from what she shared:

Myth: Talking about suicide or asking someone if they feel suicidal will encourage suicide attempts.

Fact: Talking about suicide provides the opportunity for communication. Fears that are shared are more likely to diminish.

Myth: People who talk about suicide never attempt or die by suicide.

Fact: Talking about suicide can be a plea for help, and it can be a late sign in the progression toward a suicide attempt. Those who are most at risk will show other signs, apart from talking about suicide.

Myth: If a person attempts suicide and survives, they will never make a further attempt.

Fact: A suicide attempt is regarded as an indicator of further attempts. It is likely that the level of danger will increase with each further suicide attempt. Just because someone has attempted suicide previously does not mean they are no longer at risk of attempting in the future.

Myth: Once a person has suicidal intent, there is no way of stopping them.

Fact: This is so far from the truth because suicides can be prevented. People can be helped. Suicidal crises can be relatively short-lived. Immediate practical help, such as staying with the person, encouraging them to talk and helping them build plans for the future can avert an intention to attempt or die by suicide. Such immediate help is valuable at the time of a crisis, but appropriate counseling also will be needed.

Need help?
Call the National Suicide Prevention Lifeline: 800-273-8255.
Call 2-1-1 for additional resources.

Want to help?
BayCare offers free Mental Health First Aid Training. To find out more, call 800-878-5470.

Published June 09, 2021