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And the United Black, Fond of Greater Cleveland, Inc.. Good afternoon and welcome to the City Club of Cleveland, where we are devoted to conversations of consequence that help democracy thrive.

It's Friday, May 31st, and I'm happy by Habeebah Grimes, CEO at the Positive Education Program and a member of the Woodrow Foundation Board of Trustees.

It's my privilege to introduce today's forum according to the substance, to Substance Abuse and Mental Health Services Administration.

More than half of suicides are by firearm, and nearly 90% of suicide attempts involving firearms are fatal.

This is compared to only 5% of all other suicide attempts by other means.

Suicidal ideation or thoughts of suicide.

Thinking about suicide to action can be as short as 10 minutes.

Making access to lethal means a key focus, and tackling increasing suicide rates in our communities.

Reducing the Center for Health Affairs launched the Social Determinants of Health Innovation Hub, which aims to address structural racism, poverty and behavioral health crises.

In their work, they found a correlation between suicide by firearms and historically red redlined neighborhoods.

Poverty and race analysis also showed that firearm suicide among among youths as young as 12 years old are rapidly increasing.

In northeast Ohio, highlighting the critical need to address structural barriers such as unemployment, lack of housing, lack of reliable and affordable transportation, and inadequate lack access to culturally responsive mental health and addiction services.

Today, we will hear from leading experts about the ways we can improve suicide prevention and increased mental health resources for our most at risk communities.

Joining us on stage are Charise Briggs, Suicide Prevention and Community Engagement and partnership coordinator at the U.S. Department of Veterans Affairs.

Tony Coder, executive director at the Ohio Suicide Prevention Foundation.

Erin DiVincenzo, director of Prevention and Children's Behavioral Health Programs at the Adams Board of Cuyahoga County.

And Daniel Lettenberger- Klein.

I'm sorry.

Daniel Lettenberger.-Klein, Chief executive officer at Stella Maris.

Moderating the conversation is Brian Lane, president and CEO at the Center for Health Affairs.

If you have a question for our panelist you can text it to 3305415794.

That's 3305415794.

And City Club staff will try to work it into the second half of the program.

Before we begin, I want to acknowledge that the subject matter of firearm suicides may be disturbing for some members of our listening audience.

If you or someone that you know is experiencing feelings and thoughts about suicide, we urge you to dial nine, eight, eight to seek support.

A veteran crisis line is also available by dialing nine, eight, eight and then pressing one to be transferred to veterans assistance.

Now, members and friends of the City Club of Cleveland, please join me in welcoming Cherise.

Tony, Aaron, Danielle and Brian.

Well, well, here we go.

Well, thank you all for being here today.

We have a pressing and complex issue before us, one that requires insights from various sectors of our community.

That's our our robust panel here.

Each of you brings a unique perspective that is crucial for addressing the intertwined challenges of both structural inequality, mental health, as well as firearm violence.

The subject matter on firearm suicides may be disturbing, as has been announced to you before.

If you or someone that you know is having feelings and thoughts about suicide, we urge you to contact nine, eight, eight to seek support.

A veteran crisis line is also available at nine, eight, eight and select one for being transferred directly to the veterans assistance.

We currently do have a health care professional in-house today.

If you need to speak with someone immediately.

So according to the Substance Abuse and Mental Health Services Administration, more than one half of the the suicides are by firearm, and nearly 90% of suicide attempts involving firearms are fatal compared to 5% of all other suicide attempts.

So with that, what I'm going to do is I'm going to open it up for the questions and dig into the specific individuals for their inputs around our our findings.

So with that, in in our research, we initially focused in on firearm violence and behavioral health with our SDH Hub.

And we pulled data from 2017 through 2022 from the Cuyahoga County Medical Examiner.

And during this period, we found that there were 1006 suicides within the county.

And of that total suicides, 535 were with firearms.

535 So the analysis found firearm suicides accounted for 58% of all suicide deaths among residents of Cleveland and Northeast Ohio.

And that is 8% higher than the 50% status on a national level.

So firearm suicides among African-American males are even higher, at nearly 70% of suicide fatalities.

Further, the analysis finds that these alarming high rates of deaths by suicide, especially among adults under the age of 30, are acts of despair due to long term poverty, lack of stable housing, unemployment and access to transportation.

Higher rates were identified in three primary zip codes as an opportunity to exchange our engage and focus interventions within these neighborhoods which are ongoing.

Thank you to Scott's team for for some of that work.

44102.

The Detroit sure way 44105 which is South Broadway and the Slavic Village and then 441a la Glenville and Forest Hills.

So we're going to now open it up for those questions.

And I'm going to start with Aaron and then go to Tony, if you wouldn't mind.

Please provide the audience with an additional information and related to the prevalence of youth, as well as adolescent suicides and the scope of the problems in the county.

In a statewide perspective.

So to begin, it's been identified that within our county specifically, it's an increasing need for youth to have an awareness of youth prevention, especially around suicide, but as also behavioral health in general.

We're seeing it become the second leading cause of death for children statewide.

Unfortunately, our county was also identified as having higher rates of suicide, and we were actually invited to apply for a grant for Youth Suicide Prevention Cert, which we were awarded for our county's suicide Prevention Coalition.

So unfortunately, it really is a growing need there spot that it might be related to to COVID.

Of course, the pandemic, the closing of schools, the closing of communities, the closing of all those things that helped create that village around children, that isolation and lack of ability to create connections and be with others.

It was thought to increase that sense of hopelessness and helplessness that sometimes accompanied with suicidal ideation and thoughts.

So first and foremost, you know, as is prevention, we always want to create that outlook that there is there is hope, there is a chance, and that there are people to contact that for help.

So I think in general, we are seeing there is an increased need.

Something that's unique and unusual is that we're also seeing higher rates, like you said, using firearms.

And something that's happening right now with some of the struggles around workforce is that in some communities, unfortunately, it's easier to access a gun than it is to access the services that you might need to help prevent those thoughts and feelings from taking an action that, unfortunately, is it's hard to prevent that action from becoming fatal.

So that's that's pretty much the scope of the problem from where we are now.

But for I'm the director of prevention for a reason because I always believe in resiliency and hope, especially when there's a chance to include and envelop a community around children because that's what children and youth need for support and growth.

Tony.

We lose five people a day in Ohio to suicide.

We lose a child every 34 hours to suicide.

I've been to a lot of funerals and I and I work, quite frankly, in our environment that we have in the state of Ohio and quite frankly, across the country.

We have to have better conversations about firearms in this in our society.

One of the things that we do at Ohio suicide Prevention Foundation is we actually work with gun shops on how to how to help some identify folks who might be suicidal.

You know, are there signs we encourage safe storage?

Uh, I do go to a lot of funerals and one funeral of a 13 year old little girl who took her life.

You know, the parents did not secure the firearm.

And it was a very quick decision and it was within a few minutes.

So we encourage safe storage to not just, you know, we know that firearms are often used for protection and things like that.

But having just that extra barrier has been shown by research to be able to help save lives.

So why don't we encourage that have open conversations?

Because that was the most shocking thing that I found working with gun shops, how open they were that they don't want to lose people to suicide either.

So how do we encourage those types of conversations and stop getting this into this political debate of I'm I'm pro-gun, I'm anti-gun and those types of things?

It's great that people who he was also very good.

Daniel, first, let me thank you for working with the Social Determinants of Health.

SDH Advisory Council.

At the very beginning of our work and 2020 to 2023 as a co-chair of the Sdoh Behavioral Health Work Group that helped lead the work in addressing the link between firearms, suicides and conditions like long term poverty and unemployment.

What role can substance use programs play in not just treating addiction, but also in being a part of a much broader strategy to combat these underlying social determinants, particularly for people living in historically redlined and under-resourced source neighborhoods.

Thank you.

And it's an honor to be here today, and thank you to everybody who's here, because it's a very neat room of people.

There's a lot of writers.

There's a lot of support, a lot of funders in the room that have made this issue.

While it is great and something we need to be talking about today on the stage and talking about outside of this room, there is a lot of people in here for a reason.

So thank you all.

The behavioral health care system was strained prior to the pandemic.

We knew that there was a demand for funding.

There was a demand for access.

There was a demand for providers.

There's a workforce shortage.

We've had a number of barriers to access for a long, long time.

And so for whether it's an addiction treatment provider, behavioral health provider, ultimately continuity between providers, between systems makes the difference, right?

We can be doing great work, but if it's uncoordinated across the county, across the region, it's only as good as the person forgetting or not picking up the phone and making the referral or doing the follow up call.

So a coordinated behavioral health care system is something that is essential.

It is something that is challenging.

There is no universal answer to make it simple.

It's complex.

And there's a number of people like the Adams board in the county and so many others that have worked diligently to try to create those connections and make sure that we have access to one another and are held accountable to access to one another.

But ultimately, we need to do a better job as providers to leverage the care we provide and the network.

We have to make sure people don't fall through the cracks.

And with that, it's not just making sure the people who are caring for that want to get well, have a referral network that's talking, but it's data sharing.

It's knowing what's happening in each neighborhood, knowing that in these zip codes, we need to do a better job.

I need to know what's happening in that neighborhood so that when somebody hits our door, it still emerges from the neighborhood.

We know what is accessible when they leave, what is not accessible, what we need to refer to, and how we make just an integrated network for everybody that comes to get well or wants to get well or doesn't know yet how to get well.

And as the Hub has been a really wonderful project and thank you to the Center for Help Affairs for being brave enough to do the work and getting everybody together.

Because, you know, we've we've got 260 partner organizations working on this project at different levels.

And so, you know, it really shows that when we come together, we can we can start to have a conversation.

But now it's time for more action.

Right.

And all of us need to do something with with the platform we have and make sure that we have something that comes out of the discussion.

Make sure we include the people that we're talking about in the discussion and make sure that we are working in the direction of trying to lift the entire community because we know that suicide is preventable.

Right.

So I think platforms like this help to make that change.

So thank you.

Thank you.

Aaron, I'm going to come back to you quickly here.

The cycle of poverty and lack of opportunity can lead to the utmost despair.

What are some community based programs or initiatives that our community can support and rally around that can empower youth, build resilience, and provide them for hope for the future?

And thank you for the reminder.

I was so nervous.

I forgot to thank everybody for being here and the honor it is to be speaking here and humbled by the topic.

I think the first thing about resilience is that all children and youth and humans have inherent resilience within them.

Some of the things that get in the way of that resilience is limited access to all the things, all those basic needs that we need to to survive and create a stable, connected, safe community for not only our families, but for all of our families.

We are just so interconnected and we have to realize that while we are an individualistic society, we do have to come together in order to to really solve some of these big problems.

Like like you were saying, with having a coordinated system, we have a very fortunate to have a lot of resources and services here.

We have a great network of providers, all have a front door access to nine, eight, eight who not only use crisis but also referral and linkage.

We have school based prevention and consultation programs in over 200 schools that can provide support not only for teachers, but also our students.

A lot of our behavioral health prevention focuses on youth led prevention.

Many of those providers do a wonderful job, and I've been doing it for years.

And more recently we've supported bringing youth move back to our our community or county to kind of bring some of those youth led prevention groups together.

Unfortunately, our county was also identified, like I mentioned, as having that increased need.

But fortunately, we were granted that that award through our Community Suicide Prevention Coalition, which is open to the entire community, anybody who is interested and want to be a part of that.

It's more than welcome to come and become a part of that initiative.

We do have two providers that are leading that grant, which is going to be a small pilot program focused in right into Cleveland at a couple rec centers that will be focusing on youth prevention, targeting specific to black and African-American youth whose numbers are of death by suicide or have been increasing at.

Really and I'd be remiss if I didn't mention also the youth to use homicides that are occurring in our county, because to me they're very fact that there's a similar feeling therapeutically of that loss and that despair.

And that, I think, goes with that impulse of act with a gun.

So we have a wealth of of programs and services.

But, you know, I think more than anything, are youth and children really need to know that everyone cares.

So, you know, if anybody has a child or has a youth around them or any adult stopping and listening, checking in on them, seeing how they're dealing, getting them involved not only in behavioral health or mental health, but also making sure that, you know, are they accessing their physical health care?

Are they reaching out?

Are they able to identify all their needs?

You know, that's kind of where resilience starts, making sure we have our physical health and everything else in place can help us create that and access to opportunities for our youth as well to positive things and feedback.

And that's one of the reasons why there are so much youth led prevention.

So there's there's so much that we can do to really encourage and facilitate youth resiliency.

But they do need adults to model and be role models to in that as well.

Thank you.

Cherise, I've got a question for you.

Ready?

Yes.

All right.

Given the high rates of firearm suicides, particularly among African-American males, and considering the unique challenges faced by veterans such as PTSD and reintegration into civilian life, which is tough in itself, how can the broader community work with the V.A.

in addressing the behavioral health needs and socioeconomic conditions that contribute to despair?

It's a big one.

It's a big one.

And in an effort to not say the exact same thing that all the other panelists said.

I will echo a few things that really just come to mind, because this is not only my role with the VA.

I work with community providers specifically, but I'm also a veteran.

My oldest son is an active duty military member, so this is also very much a passion for me.

We one what Tony mentioned about being able to have conversations about firearms, being able to identify that safe storage means different things to different people.

And we need to be sensitive to that.

Firearms are here.

They're not going anywhere.

We can stay away from the Second Amendment stuff and just have conversations about what we're working with, and that's what we need to do.

So a big part of our work that we do with suicide prevention at the VA is training in the community.

I'm training with our own providers also, but in the community with how to talk about how to secure firearms when we need to.

In regard to other things that were discussed, you know, peer to peer work, we hear a large increase and the need for it.

And that's a big part of these conversations.

It is important that community members not just know all of the information.

We know data, we know statistics.

Many of us can speak eloquently to it, but we need to to really work on being able to have conversations with people who are in crisis.

So that's a large part of what we're doing, is we're supporting the community in being able to have these talks with service members, with veterans and their family members.

And we want to identify those individuals.

We want to make sure that we are all connected.

So that ties in with the importance of the consistency and collaboration.

We are not going to solve this problem in silos.

We must be connected.

We have to talk.

It's not an us versus them anymore.

And that's all.

Being in the room together proves that shows that we all have this common interest.

So in relation to veterans, the VA is now taking a very aggressive stance and making sure that our community has access to training.

I can provide my information.

I have a colleague who also does similar work in the community.

We support 21 counties in VA, Northeast Ohio, health care.

That's over 14 facilities for veterans and also doing work with some of their families as well.

So we want to come into your organizations.

We want to have conversations with your staff that talk to veterans.

We want to train.

We want to make sure that our community knows what to do when things are risky and and talks need to be had.

So I think I just everything.

You do great.

All right.

This is going to be my last question.

That that means that all of you need to start be thinking of all of your questions.

All right.

If you know that that's what you know me.

This is how I prompt people and where.

So, Tony, I'm going to ask my last question with you.

So data shows a high rate of firearm suicides correlated to historically underserved communities impacted by structural barriers, especially among young adults.

How can health care leaders and policymakers support proactive solutions that address root causes that lead to despair and hopelessness?

I think it goes way beyond even local leaders.

I'm going to grouchy here.

I was I was in D.C. last week talking to Congress.

Why have we not spent $3.4 billion in mental health care?

It's sitting in the federal government.

Why have only 17% of the funds to support nine, eight, eight, 988 been sent out to local providers?

I don't think this is a provider.

I think this is we've got to get our heads out of our key sectors and DC level and start talking to each other.

We've got to have conversations.

We've got to have conversations and stop focusing on politics and instead focusing on the issues that matter.

130 people in this country are not going to see a sunset tonight because they're going to die by suicide.

We need to stop that in this country.

Instead, we're focused on all of these other things.

So that's where I'm going with that.

I almost forget the question because now I'm fired up.

But local providers, I think we also need to expand.

You know, we need to recognize that, you know, we have peers that can serve individuals in the state that, you know, from a very personal level, I'm in this because my son was a is a suicide attempt survivor.

And he I went from the policy world to a real world and it's entirely different.

I can talk about policy and I can talk about things that need to happen.

But when you're in that moment, he needed someone to listen, right?

Then what happened to him?

He was at a job.

He got.

He drove himself after his attempt because his boss didn't know what to do.

He sat in a an emergency room for two days.

I had no idea where he was at.

We need to do better with our providers on the physical health side to help.

How do we how do we make sure that we make those connections?

He called me from a mental health facility and spent 13 days there.

We need to do better as a system, as a as a health care system, because this is a health issue.

This is not a this is not a character issue.

This is not an issue about where you grew up or anything.

This is a health issue that we should all be involved in.

So everybody needs to care about mental health care and suicide.

So if we can get all of our providers talking and working with one another, we can get Piers involved.

We can get, you know, nurse practitioners.

We can get these folks wherever they need to be.

That's what needs to happen instead of I don't know what to do next.

So sorry, I'm fired up.

No, it was great.

It was wonderful.

All right.

Well, I'm going to wrap things up here.

The social determinants of Health Hub in conjunction with Amazon IWC recommends increased access to behavioral health services, just like Tony stated, especially in school settings for our rural populations and historically underserved communities.

Along with efforts to increase the diversity of the behavioral health workforce, which hasn't been mentioned here.

But I want to put that into our conversations.

Long term recommendations include enacting policies to improve upon economic mobility, encompassing basic income, child care, climate change, digital access, education, food, greenspace, housing, jobs, tax credits, and transportation, as well as policies that support and stimulate the economy of Northeast Ohio.

Before we open it up to the audience Q&A, are there any closing remarks from our panelists today?

Start with Daniel.

Yeah, I, I think thank you all for ever.

The ad Love the fire and it's awesome and it's absolutely necessary, I think, for the the provider network.

I, I don't think that we're not working hard enough.

I think the trouble is how we work smarter, how we use technology to leverage what needs to happen next, and really making sure that we have a community driven approach to how we care for people.

Because having the providers assume that care needs to look a certain way is one of our greatest detriments.

So having the community that we're caring for, involved in care delivery and care creation and treatment planning is essential.

And, you know, I didn't mention it, but what still matters right, to the intersection of substance use, misuse or dependance and suicide is real.

And so when somebody, you know, whether it's a young adult or an older adult is struggling, access to care in real time matters.

We talk about the window of willingness to get well if we don't have the networks and the access and the systems in place to make sure that, wow, that windows open we can get somebody to where they need to be.

We lose the chance and we lose the person.

And very often the ripple effects within the family are generational.

And so we need to be thinking about children and parents and loved ones and friends, family.

It it affects communities, not just families, not just individuals and systems.

So thank you.

Thank you, Aaron.

I think first and foremost, you know, when I think about children, youth and adolescence, what we need most is safety, security and opportunities for positive experiences.

You know, building off this fire like absolutely we need there's no need for all these guns in our community.

And there's very little being done about that.

And I think that's first and foremost.

I mean, first thing you do to make sure your child is safe is you supervise their environment and make sure that anything that they could potentially do to hurt themselves is not there.

And that's that's just common sense for toddlers.

And as we get older, I mean, we learn how to be safe in our environment.

But it still is the responsibility of the adults around our children and adolescents to create a safety safety net, a safe community where they can go down the street, they can play in a playground right down the street.

You know, little things like that make a huge difference.

And there's many communities in our in our community that don't have that.

Neighborhoods that don't have access to simple, everyday things that can make a world of difference.

But they don't they're not simple if you don't have them.

And thank you, Tony.

They're ready for you to.

Um.

I'm.

I encourage every one of you to be a suicide prevention advocate.

I encourage every one of you to know what the signs are, to know what to say.

There was nothing scarier than Saturday morning at 807 when I received that call from my son within within the mental health facility, I didn't know what to do and I'd spent 20 years in it.

I thought I knew everything until it hit me.

Be prepared.

Make sure that you know what to do, where to go, whether that is, you know, whether you have a mental health provider.

Nine, eight, eight, your local church, whatever it is that you might want to refer somebody to.

And sometimes it's just good to listen.

Suicides were like at a decade low in 2020, 20 be cut.

Why?

During COVID we're locked up.

What happened?

Because if you remember the messages back then, go check on your neighbor.

Go make sure that they're okay.

Go do those simple things like that.

Dr. Thomas Joiner, who's a one of the grandfathers of suicide prevention, said suicide is the perfect intersection between loneliness, loneliness and burdensome ness.

If we can help by helping someone feel heard and not a burden, we can all save lives.

So thank you so much, Cherise.

It is.

So in closing, certainly very honored to be here.

I never said that.

Of course, I think that's a given.

I think the most important thing that we can all do at this point is just to begin.

So we have this information.

It's a Friday afternoon now.

And I think we need to be very aggressive about making a plan with ourselves to become trained in how to have these conversations.

If it's something that you want to stay away from, at least know the resources, but know what to say when the circumstance is present.

Because it might be that someone is coming to check in with you because they need help.

So being able to identify the signs of increased suicide risk are very, very important.

But the most important thing that we need to do is to actually begin to do this work.

Thank you.

Thanks.

Thank you.

All right.

Well, we're about to begin the audience Q&A for our live stream and radio audience or those just joining.

I'm Bryan Lane, president CEO for the Center for Health Affairs and moderator for today's conversation.

Here with me today is Cherise Briggs.

Suicide Prevention, Community Engagement and partnership coordinator at the U.S. Department of Veterans Affairs.

Also with her is Tony Coder, the executive director at the Ohio Suicide Prevention Foundation, and Erin de Vincenzo, the director of prevention and children's behavioral health programs at the Adams Board of Cuyahoga County.

Along with all of them is Daniel Stemberger Kline, the chief executive officer at Stella maris.

We welcome questions from everyone city club members, guests and students give praise to the students.

And here at thank you and those joining via our live stream at City Club dot org or radio broadcast at 89.7 W.K.

as you ideastream Public Media.

If you'd like to text the question for our panelists, text it at 3305415794.

That again is 3305415794 and city club staff will try to work it into the program.

May we have the first question, please?

Hello.

Our first question is a text question.

It says, let's talk about the prevalence of suicides, suicide attempts and mental health of our LGBTQ community.

With the Pride Month coming up.

We know that this is a major priority to address in the LGBTQ community.

What trends are you seeing and why?

And what are the best supports out there to meet the unique needs in light of the current political climate in Ohio and our country?

Yeah, that's a great question.

One thing I was remiss to mention is that that grant that we have is not just for African and black American American youth, it's also for LGBTQ youth as well.

Especially the intersectionality of those two populations is where we're seeing the greatest risk for for youth.

So that's where we wanted to do a targeted pilot intervention to try to see if we can address those needs.

Within Cuyahoga County, we do have a few providers who do specialize in LGBTQ plus services.

So we are fortunate that we do have that.

But yes, is a growing need, specific data and prevalence.

I don't want to speak to that offhand, but it is is growing and it's it's known again, it's that isolation and that fear of not being connected or unable to be yourself in some some way, shape or form.

So creating communities around everyone to allow them to be themselves and to feel like you don't there's no reason to ever have to end your life.

There's always something and something more greater.

And we are all we're all supposed to be here.

And there are some great resources.

I know we just literally just last year created a campaign called To Be Me at the Ohio Suicide Prevention Foundation, which is focused on LGBTQ suicide prevention.

We want to encourage you be you be proud of who you are.

We don't say that enough, I don't think, to our kids, no matter where you're at.

Be proud of who you are, what you bring to the table.

Also, the Trevor Project is a great national resource for LGBTQ young people, especially in our country.

They even they have a an LGBTQ lifeline that you can call also on nine, eight, eight.

If you press option three, that goes straight to an LGBTQ helpline.

So we want to encourage those things.

There's a national trans line.

We want to make sure that every life matters in this country and in this state.

So how do we get those resources out?

We need to make sure that that folks feel and that they know where to turn, because sometimes folks are not the most friendly and we need to make sure that we send them to safe spaces and to friendly spaces and spaces that will support them to save their lives.

I will mention when the LGBT center of Greater Cleveland is an exceptional resource and so everybody should be familiar with it and go visit it.

Go see this space.

You know, I again, my primary work is in the suicide space, but it is there's some intersection for sure.

And just the rates of a lack of safety, specifically for the transgender community, transgender youth.

Just the LGBTQ community in general.

We mean not to get political, but are in a climate of divisiveness.

Right.

It's it it's very dangerous.

It just on the streets in our community to identify whether it's on our streets or on the Internet.

We are in an epidemic of loneliness, as we've mentioned in this connection, as a result of cyberbullying and isolation.

It is acceptable, dangerous right now, both online and offline for members of the LGBTQ plus community.

And that only changes with all of us.

That only changes when, as a community, we create safety in every corner with every provider and in every building, every school.

And that starts with community conversations.

That happens with the school systems, that happens with our government entities.

There needs to be we need to think about what we're willing to stand up for and what we're not willing to stand up for and what we're not willing to stand up for.

We need to know why.

And then we need to be looking at those ideas and beliefs in the face and and thinking through what lives are saved through bravery and voice.

So thank you.

So in regard to veterans support, it's important that we're open and that people that are veterans are aware that there is support available.

We have a LGBTQ plus care coordinator who works very closely with our suicide prevention team and our health care system as a whole, who's able to assist, navigate.

We have our Give Clinic, which stands for Gender Identity Veteran Experience, which is specifically for veterans who identify we are changing the culture within our system and it's important that our public, our community and our veterans know that support is there.

Great question.

Hello.

My name is Kyle.

I am a sophomore M.S.

score some high school and I wanted to know that.

Do all of you agree with the statement that we should try to change how interacting with mental health professionals is portrayed in the media?

Because like before, I mean, before I met my amazing counselor, I thought that it was I thought that if I tried to talk to anybody who I mean about my mental health, it would be like, oh, well, we're going to send you to a home and now you to you're never going to see your family.

It was like, I don't want to deal with that, so I just don't talk.

So by having those resources available, that will help, you know, bring down the rates of suicide, not just with guns, but with in general.

So do you guys agree with that statement?

Yeah, I do.

Yeah.

Yeah.

From my past experience working with with youth, I found it to be even though we worked about with tough stuff, I always tried to make it joyful and create humor and laughter and play involved.

I when I was working with 18 year olds, somehow, some way, shape or form of some kind of play because that's how children learn best, is through laughter and learning.

And that's also how we induce healing, is to create that ability to connect over something that, you know, is playful.

Because even though we might be going through some tough stuff, that's a lot of what coping skills and resiliency is all about is, you know, trying to see, you know, notice that there might be a beautiful tree outside even though it might have some, you know, broken limbs, seven limbs that have been cut off.

I mean, it's it reshapes and it forms and it grows towards the light.

Even the the solar eclipse, you know, it only took like a tiny, tiny sliver for all the light to shine through.

And that's all that it really needs for for children and youth and all of us to come back.

So 100% don't be afraid to talk to behavioral health providers.

I think we hear our providers get a bad rap, get a bad rap, too.

And, you know, sometimes our health providers need that light and levity to resiliency and growth, and we all need to take care of ourselves.

And that's really what it's about right.

And we have to let that stigma go.

Yeah, yeah.

Yeah.

I would love that was a great question, really.

And I have to I'm a marriage and family therapist, so I have to focus on the family system.

And so for that, media matters, obviously, but the conversations in the House matter more.

And so ultimately, you know, we're in a Rust Belt city in a tough area where we pride ourselves on our toughness and our grit and getting stuff done and until I think it starts in the schools personally and the community centers and all of that, but until the narrative is consistent in that access and resource is a strength, not a weakness.

Seeking help sharing vulnerability is a superpower, right?

Until we get to that place, community wide, family wide, it will always be that we look to the media to inform our fears.

And so it's all what's happening in the home and in the community.

I think that can really drive the messaging on what support, safety and well-being look like.

And I think I'm going to give you a hug later if you're okay with it.

That was a great question because the stigma is is really it really is an issue.

You know, 80% of our suicides in Ohio are middle aged men.

And why you know, why why do we hear here some of the reasons?

It's because there's a misunderstanding about what the what the behavioral health system is.

They automatically think that, oh, I'm going to be in a jacket, in a rubber room and all of that kind of stuff, you know, the things that media can portray.

Next question.

Mr. Schroeder's I'm glad your son was able to find a brighter day.

Scarcely a day goes by that I don't reflect that the child I was tasked by juvenile court to help could not see a better day, found a gun and shot himself.

And so I have had twice an opportunity to go round to Columbus to talk about what are called red flags laws in which people would be able to go to court and to offer testimony and say that somebody is a risk to themselves or others.

And then they would confiscate.

They would not confiscate, they would remove a gun from a household and then have hearings as to whether the person was a danger to themselves or others.

If there were a danger, they would hold the gun and refer the individual for counseling and other services.

If they were not, they would return the gun.

I wonder if your panelists have any experience with red flags laws and whether you want to comment, because it's not just an issue about schools in Florida, it's not just an issue of movie theaters in Colorado, but the data from Connecticut and Indiana suggest that it discourages suicide.

Suicide as well.

So I wonder if you have familiarity with the red flags laws and whether that might be a good option for Ohio.

I do know about red flags laws and here is and this is from a very personal issue, very personal standpoint.

I do believe that, you know, there should be background checks in some of those things.

My fear is, is the discrimination piece is and I look, I know that, you know, this is not popular.

My son can't get TSA PreCheck because he spent time in a mental health hospital.

That's discrimination.

He got help.

He got the care that he needed.

So to be able, you know, to to I'm I'm worried about that slippery slope.

I am I'm concerned about what that would do to folks.

And look, I I encourage folks that if you don't if you're not feeling safe, if you have someone in your house, it's not safe.

Give your gun to a friend.

Give your gun to the gun shop or wherever.

We have to work in political realities and red flag laws have been tried.

Numbers and numbers of times.

And they just don't work.

So we have to work in a political reality.

And for my son's sake, I do.

I worry about the discrimination piece.

Anybody else?

I just want to speak to that.

How quick it can happen.

You know, a lot of times with the children and adolescents, it really is so quick.

And that's where we come back to that concept of like delay, delay, delay.

The longer it can take for somebody to have access to something that can kill themselves, the more chance they have to have a different thought, have a different idea, have somebody else come in and help them choose a different path.

And so anything that we can do to delay that action is what we want to see happen.

How the best way to do that for Ohio, I don't know.

But we can delay, delay, delay between that thought, that idea and having means to to complete that action is what we want to see happen.

So I don't want to be a broken record, but so with that being able to delay, it's important that we know how to do that.

And how do we know how to do that?

By beginning to have those conversations, by practicing having those conversations with someone in crisis and only take seconds.

And as I mentioned earlier, safe firearm storage safety is different for everyone.

So we have to remove our bias we have to remove our own personal feelings.

And we need to focus on what needs to be said in these conversations.

And we need to begin practicing them.

So when these situations present, we know what to say.

We're actually able to delay the action itself.

So leaving politics out of it and just bringing the human into it, knowing how to have conversations and it begins with us.

And I, I think I'll be the lone panelist who says, I don't know enough to answer the question because they know way better than I do.

But yeah, I think it means to control and create safety matters.

I don't know enough about red flag laws to answer competently.

I'm sorry.

Next question.

Hello.

I'm Eliana.

I'm also with Mrs. Squared Stam.

And how would a kid or.

Like a teenager, talk to their parents about mental health or about suicidal thoughts.

When it is so stigmatized?

It is.

And they're all looking at the child therapist for that one.

It's it's really hard to know because it really depends on what your relationship is with your parent or the adult.

I think the best way to start is to try to pick somebody who you feel comfortable talking with.

And if you don't feel comfortable talking with that part, start talking, you know, try to find somebody who will listen.

And for the adults in the room, if someone if a child or adolescent comes to talk to you about something that is related to suicide or about their mental health, please try to stop and listen.

It sounds so simple, but that's so hard for the adult life.

We have all those things in our mind going on, all those things in our to do list.

We're multitasking all the time.

But when a child adolescent starts to bring up this this topic, it's it's worth our time to stop and listen.

And I think that's that's my message to the adults in the room for the kids, I think, to start talking and hopefully the adults around you or are going to listen because that's what we need to do.

Adults need to listen to our children and adolescents as much as we can.

One Find a trusted adult.

If it isn't your parent, you know, is there an aunt, is there a teacher, is there a professor?

And to your point, quite frankly, I thought my son was just going through a phase that doesn't happen to me.

I did this.

I did that.

The adults have to listen.

So if your parents are not listening, then find a trusted adult who will listen and let them help.

Maybe even guide you in that conversation with your parent.

Maybe they go with you and say, Hey, you know my child or you know, what was your name again, ma'am?

Eliana.

Eliana.

So Eliana is struggling.

I'm here.

I want to support her.

And we want to have a conversation session.

So even if it if since your parent, I think just making sure you tell somebody and then as as that some that adult that maybe could be trusted then let that let take that an adult with you to have that conversation.

I think there's a lot of for parents more so than caregiver in any way whether it's a parent or not.

We not to soapbox it but like are so distracted all of the time.

Right.

We've got so much stimulation all around us.

We have our phone in front of us.

We have headphones in so easily now that we can't even and I talk to people all the time when they have earbuds and I have no idea that earbuds and it's so easy to be disconnected that it's such a necessary skill to be aware.

And so just watching for signs and symptoms of a difference in behavior and a difference and how shy somebody is, whether they're speaking, what their dress looks like, how they're eating their speech, it all matters and it all needs to be seen.

And so from the the caregiver perspective, understanding what to look for, to behavior changes that need to occur to check in.

But also, I think it's really important to use the one resource I was railing against, which is the Internet.

There's a lot of good resources on like how to start the conversation, how to say what to who and what a care system can look like.

Providers need to be in the same space.

So it's really important to know exactly, you know, what your support system can be.

And if you're not sure, just asking.

And then if it's through text, that's better than nothing at all.

If it's in person better than texting, if it's on the phone, you know it is what it is as long as it's support.

So there's a lot of different ways to access care.

So much to Cherise Briggs, Tony Coder, Aaron Vincenzo, Daniel Eisenberger, Kline and Bryan Lane for joining us at the City Club today.

Thank you so much for being here.

I'm Cynthia Connolly, director of programing here at the City Club.

And forums like this one are made possible thanks to generous support individuals like you.

You can learn more about how to become a guardian of free speech at City Club Dawg.

Today's form is in partnership with the Center for Health Affairs, with additional support from the Woodruff Foundation.

Thank you to each of you for making today's conversation possible.

Also, recognizing that today's subject matter may have been difficult for some members of our listening audience.

If you or someone that you know is experiencing feelings or thoughts about suicide, we urge you to dial 98826 to seek support.

Our veterans can dial nine, eight, eight and press one to be transferred to a veteran's assistance.

We would also like to welcome our students joining us from M.C.

Squared Stump High School and the Cleveland School of Architecture Design, as well as our guests at the tables hosted by the Academy of Medicine in Cleveland and Northern Ohio, the Adams Board of Cuyahoga County Bay Partners, Philanthropy, Case Western Reserve University Medical Mutual, Ohio Guide Stone, the Center for Health Affairs and the Woodruff Foundation.

Thank you all for being here today.

Next week at the City Club, we will welcome Dan Kerr, assistant professor of history and author of Derelict Paradise, Homelessness and Urban Development in Cleveland, Ohio.

Sam Allard from Axios will moderate a very important conversation tangential to the one tonight here today.

And you can learn about this forum, get your tickets and learn about others at City Club, Dawg.

And that brings us to the end of today's forum.

Thank you once again to our guests, our members and friends of the City Club.

This forum is now adjourned.

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