A small team is learning how to prevent a tragedy in the basement of a Butler County office building. They鈥檙e a part of LOSS/DOSS, Local Outreach Suicide Survivors and Drug Overdose Survivor Support Team.
Program director Jennifer MacLean tells the group those who lose loved ones to suicide are more at risk of suicide themselves.
鈥�We couldn't help those who died, but our hope is that we can help those who are left behind,鈥� MacLean said.
Volunteer William Vetter Jr. understands the risks first-hand.
鈥淚 lost my brother to suicide in 2009, and that was motivation even 15 years later to be involved because I knew of that dark place that it threw me,鈥� Vetter said.
So he, with the larger LOSS/DOSS team, will respond to the scenes of suicide and fatal overdoses, hoping to help those left behind and prevent future deaths.
That prevention approach sets it apart from the majority of the programs that Butler County鈥檚 Mental Health and Addiction Recovery Services Board funds. The state hopes to change that.
Twelve boards, like Butler County鈥檚, have undergone training through the Ohio Department of Behavioral Health to better understand how they can stop crises before they begin. These Alcohol, Drug and Mental Health boards, or ADAMH boards, now have a prevention specialist to guide funding decisions.
A history of overlooking prevention
ADAMH boards fund behavioral health services for a county. The majority of their budgets focus on treatment: addressing a health issue after the fact through things like group therapy, rehabilitation facilities and sober-living houses.
But, Megan Roberts, Ohio State University professor of health behavior and health promotion said, in an ideal world these crises wouldn鈥檛 happen in the first place.
鈥淪pecialists focus so much on treating symptoms rather than, 鈥楬ow do we keep people from reaching a point of crisis?鈥欌�� she said.
Roberts said it鈥檚 often more cost-effective to prevent health crises than to treat them. Tobacco education programs, for example, are cheaper than chemotherapy for lung cancer.
鈥淏ut it just takes time,鈥� Roberts said.
It also takes money. Unlike treatment programs, one cannot bill Medicaid or private insurance to help cover the costs of a suicide prevention program, like LOSS/DOSS.
It鈥檚 also more difficult to prove prevention programs鈥� success: it鈥檚 easy to count the number of people who鈥檝e gone through rehabilitation for drug addiction. It鈥檚 more difficult to quantify the number of addictions or suicides you鈥檝e prevented from happening.
鈥淲hen you're trying to report back to funders, when you were trying to show evidence or even make a splash in the news or on the media, the treatment is just so much more instantly gratifying,鈥� Roberts said.
Maximizing prevention dollars
All of these challenges can make ADAMH boards hesitant to invest in prevention initiatives.
The state wants to change that. The Ohio Department of Behavioral Health launched a pilot program last year to add a prevention specialist to ADAMH boards. Rachel Canepa participated on behalf of Butler County.
鈥淚 didn't really know a lot about prevention,鈥� Canepa said.
Her board had already been funding programs like LOSS/DOSS. But the certification process helped her better understand how and why those programs worked.
She attended community listening sessions and partnered with a prevention 鈥榗oach鈥�. She began looking at county data to identify gaps. At the end of the six months, she said she had a clearer picture of where efforts were falling short.
鈥淲e can see, 鈥極kay, we're still having this amount of suicides: What can we do more in the suicide coalition to kind of help that? Who can we make connections and partnerships with?鈥欌�� she explained.
The program鈥檚 lessons are already shaping local priorities. Canepa said she鈥檚 pushing for more dollars to prevent isolation in older adults. She鈥檚 also applying for grants to support families impacted by substance use, in hopes of curbing addiction.
It may be a while before those efforts translate into fewer suicides or overdoses. But state officials believe the impact could be far-reaching.
They plan to certify another 10 counties in prevention next month.