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Rep. Jessica Karjala (D-Billings)

Rep. Jessica Karjala, D-Billings, introduced House Bill 590 Wednesday, which aims to revise the state's suicide prevention program.

A bill to spend $1 million combating suicide, especially among the youth and American Indian population, received overwhelming support in a committee hearing Wednesday.

According to data from the Montana Suicide Mortality Review Team, Montana had the highest rate of suicide in the United States in 2014 and has been in the top five for almost 40 years.

People providing mental health care and education to Montana’s youth, adults and the American Indian population said the bill was long overdue and would be a step in reversing a mental health crisis.

House Bill 590, carried by Rep. Jessica Karjala, D-Billings, would use $1 million over the biennium from the tobacco settlement trust fund interest proceeds to revise the state suicide prevention program and establish a youth suicide prevention grant program to be administered by the Department of Public Health and Human Services.

“I think all of us in the room know somebody who’s committed suicide,” she said. “This is a problem we‘ve really got to get our arms around.”

Eight bills have already been introduced to directly address suicide prevention in the state. Four are awaiting a vote in committee during a tight budget year when lawmakers are hesitant to create new programs or increase spending. The remaining four either missed a deadline or were tabled in committee.

Sheila Hogan, director of DPHHS, said there have been two suicides in her family and she understands the pain families and communities experience. She said the bill is a vehicle for both collective commitment and action.

“This is hands down one of the most important bills I’ll testify on this session,” she said. “The money is there, the need is there and your communities are there. It’s an opportunity for all of us to mobilize and help our kids.”

Grants would be given if a program is peer reviewed, was adopted by the Montana suicide review team or is a recommended strategy in preventing suicide among American Indian youth. The bill provides examples of programs that would qualify, including a depression screening in schools, prevention activities aimed at building resilience against suicide or online mindfulness based cognitive behavioral therapy.

DPHHS would be required to prioritize programs serving Indian youth and other populations with higher rates of suicide.

The 2016 suicide rate for American Indians was 27.3 per 100,000, while the rate among Caucasians is 22.11 per 100,000, according to the Suicide Mortality Review Team.

Kevin Howlett, director of Health Services for the Confederated Salish and Kootenai Tribes, said there have been five suicides since Thanksgiving in Arlee. He said his community has already implemented gatherings and prayer walks to foster emotional stability and support grieving families.

“I’m not foolish or ambiguous enough to think this is going to solve the problem, but if it bends the arc, if it begins to make a difference, it’s time well spent,” he said.

While effective prevention strategies vary by population, age group and whether people are in an urban or rural environment, the rest of the testimony made it clear the problem leaves no community untouched.

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Dennis Parman, executive director of the Montana Rural Education Association, said there were 25 youth suicides in a 15 month period ending in March 2016, with 11 committed by children aged 14 and younger.

“The devastation that comes to public schools when this occurs among the youth population, if you live there, it lasts almost forever," he said. 

Dr. Eric Arzubi, a psychiatrist at the Billings Clinic, said schools are sadly well-versed in procedure after a suicide. He said he’s consulted national experts to double check that the school has the correct resources in place to support students, families and staff. And although they are utilizing best practices, the scope of programs aren’t broad enough.

Arzubi said two youths and one adult in Billings recently committed suicide in a 10 day period.

“A couple days later, another one. So here we are again,” Arzubi said. “Giving this sort of talk is getting old pretty fast.”

Mona Jamison, a lobbyist for Shodair Children’s Hospital in Helena, said the acute care unit has 20 beds that are almost always full and often have a waiting list.

“Last year we admitted 566 youth to this unit from 30 Montana counties,” she said. “We need to address this problem.”

No one spoke in opposition to the bill.

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