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Louisiana Department of Health Seeks to Destigmatize 988 Use

In a September 13 press release, the Louisiana Department of Health (LDH) said it is launching a new marketing campaign aimed at raising awareness, destigmatizing the need for mental health treatment and services, and increasing Louisiana 988 usage statewide.

A key goal of the campaign is reaching vulnerable populations about the services available through 988, including individuals who are Black, Indigenous and People of Color (BIPOC), LGBTQ+ people and veterans.

A series of historic storms, the COVID-19 pandemic and other traumatic events have taken a major toll on the mental health and emotional well-being of Louisianans of all ages in recent years, said the officials. Because of these challenges, the message from LDH has been clear: It’s OK to not be OK, and Louisiana 988 has counselors ready to assist anyone seeking help.

“LDH recognizes that stigma and even fear may deter individuals from seeking support from 988. This campaign is designed to address those barriers and encourage Louisiana residents to reach out whether they are in a mental health crisis or just having a bad day,” said LDH Secretary Stephen Russo.

“Our hope for this new marketing initiative is to reach a wider audience, including vulnerable communities, so that all Louisianans know how to utilize 988 and what to expect. All of us need help sometimes, and LDH is committed to eliminating the stigma around mental health and substance use. The 988 helpline ensures everyone has easy and confidential access to high-quality emotional support, regardless of why the support is needed.”

According to the announcement, one in five adults in the U.S. lives with a mental health condition. Death by suicide is the 14th leading cause of death in the state, and it is the third leading cause of death for Louisianans ages 10-34. According to the National Center for Health Statistics, 689 Louisianans died by suicide in 2021.

LDH noted that their campaign is informed by field research that identified three primary barriers to individuals contacting 988: Not knowing what to expect when calling 988; Fear of being let down when someone is feeling most vulnerable; and Fear of overstepping personal boundaries or making things worse for someone else when calling for help.

Key components of the campaign include an aggressive paid media strategy starting with social media advertising, a new website — Louisiana988.org — for people to learn more, and a platform for community partners, advocates and local influencers to generate their own 988 promotional materials. To help kick off the new marketing campaign, and in recognition of National Suicide Prevention Awareness Month, the Governor’s Mansion lit up in purple on the evening of Wednesday, September 13.

In July 2023, Louisiana, along with other U.S. states transitioned to using the 988 dialing code to strengthen and expand the existing Lifeline. The Substance Abuse and Mental Health Services Administration (SAMHSA) sees 988 as a first step toward a transformed crisis care system in America, said the officials.

LDH believes 988 to be an important resource for residents to get immediate support when they need it. According to national studies, the helpline works — individuals who contact 988 are significantly more likely to feel less depressed, less overwhelmed and more hopeful after speaking to a counselor. Almost 98% of people who call, chat or text the 988 helpline get the support they need and do not require emergency services in that moment, according to SAMHSA.

Dr. Claire Houtsma Recognized for Early Career Contribution in Suicide Prevention

Dr. Claire Houtsma, a research scientist in suicide prevention, was honored this spring by the Louisiana Psychological Association with their Early Career Psychologist Award.

Dr. Houtsma is the Suicide Prevention Coordinator at Southeast Louisiana Veterans Health Care System. She is a licensed Clinical Psychologist and the Core Investigator at South Central Mental Illness Research, Education and Clinical Center.

Dr. Houtsma is also Adjunct Assistant Professor in the Department of Psychiatry and Behavioral  Sciences, Tulane University, School of Medicine, and Research Assistant Professor in Section of Community Population Medicine, Louisiana State University Health Sciences Center, School of Medicine.

The Times asked Dr. Houtsma what she views are her most important contributions at this point in her career.

“My most important contributions have probably been in the area of firearm suicide  prevention,” Dr. Houtsma said. “My research related to firearms has been designed to clarify  contexts under which risk for firearm suicide is heightened, as well as to develop and test  interventions that reduce risk for firearm suicide. I am particularly proud of my projects that  have involved active collaborations with Veteran and civilian firearm owners,” she said.

“Through my work with the Veteran-Informed Safety Intervention and Outreach Network  (VISION), I collaborated with firearm owning Veterans and civilians to create a suicide prevention learning module, including a PowerPoint slide deck and brief video, that can be used in Louisiana firearm training courses,” said Dr. Houtsma. “I am currently working with a number of firearm course instructors to test the acceptability and effectiveness of this learning module.”

Spokesperson for the Louisiana Psychological Association, Dr. Amanda Raines, said, “The impact that Dr. Houtsma will make on the field of psychological science is best reflected in her timely  and innovative program of research. At a time when suicide remains the 11th leading cause of  death in the United States, her program of research aims to identify and examine risk factors that underlie firearm suicide,” Raines said. “In addition, her body of work focuses on the  development and dissemination of novel methods of prevention and intervention. To date, Dr. Houtsma has published 28 peer-reviewed articles and presented her work at various local and  national conferences. Further, she serves as a co-investigator or principal investigator on six  federally funded projects.”

Dr. Houtsma’s work is ongoing. “I am also in the midst of recruiting for a study that will examine the feasibility and acceptability of peer-delivered lethal means counseling among  firearm owning Veterans,” Dr. Houtsma said. “This study will evaluate whether conversations about implementing safer firearm storage practices are acceptable among Veterans and  whether they actually lead to behavior change. I feel these projects are among the most important contributions I have made so far because they focus on a population at high risk for firearm suicide, use a partnered approach in research design and implementation, and provide  practical outcomes that may help save lives now,” she said.

Dr. Houtsma has authored numerous important studies. For her article, “The Association  Between Gun Ownership Dr. Claire Houtsma Recognized for Early Career Contributions in  Suicide Prevention, continued and Statewide Overall Suicide Rates,” the aim was to “expand on extant research by examining the extent to which gun ownership predicts statewide overall  suicide rates beyond the effects of demographic, geographic, religious, psychopathological, and  suicider-elated variables.” According to the abstract, “By extending the list of covariates utilized,  considering those covariates simultaneously, and using more recent data, the study sought to present a more stringent test. Gun ownership predicted statewide overall suicide rates, with the full model accounting for more than 92% of the variance in statewide suicide rates. The correlation between firearm suicide rates and the overall suicide rate was significantly stronger  than the correlation between non-firearm suicide rates and the overall suicide rate.”

Another article by Dr. Houtsma, “The Association Between State Laws Regulating Handgun Ownership and Statewide Suicide Rates,” examined the impact of three state laws––permit to  purchase a handgun, registration of handguns, and license to own a handgun on suicide rates. According to the abstract, “They used 2010 data from publicly available databases and state  legislatures to assess the relationships between the predictors and outcomes. The Results  largely indicated that states with any of these laws in place exhibited lower overall suicide rates and suicide by firearms rates and that a smaller proportion of suicides in such states resulted  from firearms. Furthermore, results indicated that laws requiring registration and license had significant indirect effects through the proportion of suicides resulting from firearms. The latter  results imply that such laws are associated with fewer suicide attempts overall, a tendency for  those who attempt to use less-lethal means, or both. Exploratory longitudinal analyses indicated a decrease in overall suicide rates immediately following implementation of laws  requiring a license to own a handgun.”

In Dr. Houtsma’s “Moderating Role of Firearm Storage in the Association Between Current Suicidal Ideation and Likelihood of Future Suicide Attempts Among United States Military  Personnel,” researchers hypothesized that how soldiers store their firearms would moderate  the relationship between suicidal ideation and the self-reported likelihood of engaging in a future suicide attempt, and that this relationship would be explained by fearlessness about  death, noted the abstract. “There were 432 military personnel who endorsed current ownership of a private firearm and who were recruited from a military base in the southeastern United States (94.5% National Guard). Firearm storage moderated the relationship between suicidal  ideation and the self-reported likelihood of engaging in a future suicide attempt, but this relationship was not explained by fearlessness about death. Individuals who reported keeping  heir firearms loaded and stored in an unsecure location exhibited higher mean levels of fearlessness about death. Findings highlight the need for research examining contributors to  suicide risk in the context of firearm storage and provide support for suicide prevention efforts  involving restricting means.”

Dr. Houtsma regularly shares information and research at conferences across the country. Examples include:

Houtsma, C., Powers, J., Raines, A. M., Bailey, M., Constans, J. I., & True, G.  (November, 2022). Adaptation and evaluation of a lethal means safety suicide prevention module for concealed carry courses. Symposium talk submitted to the National Research  Conference on Firearm Injury Prevention, Washington, D.C.

Houtsma, C., Sah, E., & Constans, J.  I. (November, 2022). The firearm implicit association test: A validation study. Symposium talk  submitted to the National Research Conference on Firearm Injury Prevention, Washington, D.C. 

Houtsma, C., Tock, J. L., & Raines, A. M. (November, 2022). When safe firearm storage isn’t  enough: Comparing risk profiles among firearm suicide decedents. Symposium talk accepted at  the annual meeting of the Association for Behavioral and Cognitive Therapies (ABCT), New York  City, New York.

Houtsma, C., Anestis, M. D., Gratz, K. L., Tull, M., Butterworth, S. E., Richmond, J., & Forbes, C.  (November, 2021). The role of opioid use in distinguishing between suicidal ideation and attempts. Symposium talk presented at the annual meeting of the Association for Behavioral  and Cognitive Therapies (ABCT), Virtual Conference.

Houtsma, C. (August, 2021). Feasibility and acceptability of Caring Contacts for suicide prevention among veterans recently separated from military service. Symposium talk presented at the Mississippi Health Disparities Conference, Biloxi, Mississippi.

Dr. Houtma is the investigator or coinvestigator for numerous grant projects including: Demonstration Project – Office of Mental Health and Suicide Prevention (OMHSP) Title: Measuring Feasibility and Effectiveness of a Lethal Means Safety Suicide Prevention Module in  Concealed Carry and Firearm Safety Classes, and Veterans Rural Health Resource Center FY22  Project – Office of Rural Health (ORH) Title: Preventing Firearm Suicides Among Rural Veterans  by Engaging Military Caregivers.

In her career so far, what is she most thankful for?

“I am endlessly thankful for the mentors who have helped me reach my goals,” Dr. Houtsma  said. “My graduate school mentor, Dr. Michael Anestis, provided me with the skills, encouragement, and support I needed to become a successful, research-oriented graduate  student. He has continued to be a mentor to me after graduate school and I am so grateful to know I can reach out to him for guidance as I navigate my career. I am also thankful for the  mazing mentors I gained during my clinical internship year. Drs. Amanda Raines, Laurel Franklin, Gala True, and Joseph Constans were critical in Dr. Claire Houtsma Recognized for  Early Career Contributions in Suicide Prevention, continued helping me transition from trainee  to early career psychologist,” she said.

“The Department of Veterans Affairs (VA) is a fantastic workplace,” Dr. Houtsma said, “however,  it is not always clear how to forge a research career in this setting. My mentors at the Southeast Louisiana Veterans Health Care System have provided invaluable assistance, reassurance, and  support in moving my research program forward within VA. I feel very lucky to have such amazing people on my team and I wouldn’t have achieved success as an early career  psychologist without them,” she said.

Does Dr. Houtsma have any advice for other early career psychologists?

“I would encourage other early career psychologists to stay in close contact with their mentors,” she said. I have found it immensely helpful, not only in navigating the minutia of research  studies, but also in determining how to balance work-life priorities. I realize not everyone has  the opportunity to gain desired mentorship in a naturalistic way, so I would encourage early  career psychologists to reach out to others in your field who have careers you admire. I have  gained mentorship from individuals at other institutions, simply by reaching out via email or  Zoom. It’s very hard to make it on your own in this field and the good news is, you don’t have  to!”

What has Dr. Houtsma enjoyed the most?

“Working with and learning from Veterans and firearm owners,” she said. “My work with VISION  as exposed me to the world of community-engaged research and I have found this to be an  extremely informative and rewarding experience. Being able to connect with individuals for  whom firearm suicide is a very real and personal experience reminds me why I’m doing this  work and reinforces my passion to find solutions,” said Dr. Houtsma.