Introduction
Plainfield is a city in the New Jersey with a population of 46,318 and a population density of 7690 people per square kilometer. It has over 15180 households and about ten thousand families living in the city. The city is racially diverse with African Americans being the dominant race, accounting for 50 percent of the population (Onboard, 2011).
The white population in Plainfield is 23 percent, Native Americans account for 0.91 percent, 0.05 percent of the population are Pacific islanders and 0.95 percent are other races. Children account for 35 percent of the population while married population account for 37.9 percent. Women head 24 percent of the families in Plainfield while 21 percent of the populations are non-families (Onboard, 2011).
The average family size in the city is 3.60 .Plainfield city has a unique age distribution system. 25 percent are children under the age of 18 .10 percent of the population is aged between 18 and 24 while those aged between 25 and 44 account for 30 percent of the population. 9.5 percent of the population is aged between 45 and 64. Those aged over 65 are 9.5 percent of the population. The median income for households in this city is 112308 with males having a higher median income than females. Only 2.7 percent of the population of the city lives below the poverty line onboard, 2011).
The city is located in central region of the state of New Jersey and has a humid continental climate of very cold winters and hot summers. The city has a total area of 15626 km2 of which 15.5999 of it is land while 0.01 square miles of its area is water. The city lies in the Raritan valley and borders nine municipalities all located in the Middlesex county of United States (Onboard, 2011).
As with any other cities in the United States, Plainfield has its own share of social and health problems. The health status of the city falls short of the stipulations of the guidelines of a health community. According to the California department of public health, a healthy community is the one that has high standards of health social equity and supportive social relationships in the community (2010).
The city does experience a significant number of suicides every year. Some significant health disparities in the community limit health access in the population. These health disparities are all related to the social economic dynamics like high levels of unemployment and low level of incomes (Onboard, 2011).
The problem of suicide in Plainfield, New Jersey
According to data obtained from the New Jersey Department of Health And Senior Services, about seventy percent of the population in Plainfield attempt committing suicide. Among these suicidal attempts, nearly forty percent of these suicide attempts are associated with previous suicidal ideations and mental health problems (OISP, 2007).
In Plainfield, New Jersey, there are clusters of suicide attempts and suicidal deaths that have been reported. These suicide attempts all result in some significant medical and non-medical costs that include emotional, psychological and physical damage to the victims and their families. Suicides among the young adults and adolescents are high in Plainfield when compared to other age groups. There is a huge difference between the propensities to engage in fatal suicide behavior in Plainfield, New Jersey. The youth and the adolescents are more likely to engage in fatal suicide behavior as compared to adults (Katherine, 2002).
Most females in Plainfield New Jersey normally do not complete suicide. There are more suicide attempts in females than there are completions. The ratio of non-fatal to fatal suicides is high in females. As females age, their suicide rate decreases. However, females record more suicide attempts and completion than males (Goldstein et al, 2012).
According to data released by the New Jersey Violent Death Reporting Systems, there is a tendency among adolescent’s suicides to be preceded by some crisis like family/ relationship breakups, family arguments or arrests. This trend is more common with males than females. Nearly forty percent of suicides attempts and completions reported in Plainfield, New Jersey are because of mental illnesses. Thirty percent of all suicides are completed by individuals with a history of mental illnesses for all types of suicides (Goldstein et al, 2012).
The Methods used in completing suicide in Plainfield New Jersey differ. The most common methods are suffocation, hanging and the use of firearms and poisoning respectively. Most non-fatal suicide attempts involve cases of poisoning or overdose of prescription medicine. The adolescents in urban areas of Plainfield record higher suicide rates than their counterparts in the rural parts of the city. Adults in rural Areas of the city are the ones that record higher suicide attempts and completions than those in the urban areas. This is attributed to the presence of more firearms in these areas (Katherine, 2002).
Some areas of the city record a higher rate of suicide than other parts of the city. Northern parts of the city have a higher suicide rates than the southern parts of the city. This difference is a result of discrepancies in access to hospital and the rates of hospital use. Ten percent of high school students in the city of Plainfield New Jersey report having attempted suicide or having suicidal ideation. However, there is a discrepancy in the number of students having suicidal ideations and suicidal attempts and the number of actual suicidal attempts reported. This is associated with the fact that most suicidal attempts do not need any hospitalizations (Katherine, 2002).
Population affected by the suicide problem in New Jersey.
Males in Plainfield, New Jersey have a higher rate of completion of suicide than female’s .Suicide rates rise at the age of 75 for both males and females. The suicides rates lower increase during the middle years and then remain stable in the later years for women. The most common method in suicides for men is firearms while women it is poisoning. The risk factors for men associated with suicide include depression, alcohol, and isolation (Goldstein et al, 2012).
Divorced and widowed men are the ones more at risk of committing suicide. Males also commit suicide due to socio economic and economic status compared to females who mostly commit suicide due to social environmental stability. Depression is a precursor for suicide that causes men to use alcohol and prescription drugs .This behavior is associated with suicide. The elderly people with chronic pain are also people at risk of committing suicide (Goldstein et al, 2012).
In the whole of New Jersey state, suicide case are highest in non-Hispanic white males especially those who are aged over 65 years. Suicide rates are higher in males than in females for all races. Females record a higher suicide attempt cases than males. The main causes of suicide in Plainfield, New Jersey are mental illnesses, depression or adverse situations like job losses and family breakups. In adults, suicide is associated with depression while in young adults impulsive and communicative acts result to suicide (Katherine, 2002).
Older adults mainly use lethal means like firearms in suicide attempts compared to adolescents who prefer other methods. Other factors associated with the suicide in Plainview New Jersey are the high levels of unemployment, residential instability and low levels of social integration (Goldstein et al ,2012)..
Community partners involved in Prevention efforts of suicide in plains view New Jersey
In Plainview and most of New Jersey State, suicide prevention efforts consist of suicide crisis services like suicides hotlines and mental health treatments to individuals at risk of suicide. Preventive efforts of suicide are also increasingly being used to prevent suicide like the restriction of gun ownership to individuals with a history of mental illnesses. One group that offers preventive and treatment services for suicide is TLC (Katherine, 2002).
TLC runs programs aimed at promoting public awareness that suicide is a preventable health problem. Other organizations offering suicide prevention services in New Jersey are Suicide Prevention Resource Center, The American Foundation for Prevention of Suicide and the New Jersey Commission on Youth Suicide Prevention. UCPC behavioral healthcare in Plainfield and New Jersey, the united family, and children’s society also treats suicide ideations and related mental disorders. Other organizations that provide preventive and treatment centers for mental patients in New Jersey are Northeastern Injury Prevention Network and the American university of medicine and dentistry in New Jersey (Katherine, 2oo2).
The state of New Jersey has a proactive mental health system that provides health care to people with mental illnesses. The New Jersey department of children and family division of child behavior health services runs the Traumatic Loss Coalition (TLC). Traumatic Loss Coalition focuses on adolescent suicides mitigation in the city of whole of New Jersey. The collation offers traumatic stress management professional, which is a risk factor in suicide. The program also trains all the people involved in youth development on dealing with mental problems (Guild, 2012).
There is a school-based program in the whole of New Jersey that encompasses the inclusion of suicide prevention programs in comprehensive health and physical program. The Mobile response stabilization services run by the division of child behavioral offers in home and community response, crisis interventions clinical services and any additional followers of suicide victims. The program runs crisis plans with each youth and family to avoid the disruption of teenagers’ way of life (OISP, 2007).
Detention centers run by the department of children of New Jersey also provide mental health and counseling services in mental detention centers to vulnerable youth. There are also many screening and emergency centers in Plainfield community hospitals that provide emergency services to youths that may have mental disorders. There are many Suicide Crisis Centers in community hospitals at Plainfield that offer stabilization; screening and short-term treatment programs (Katherine, 2002).
Aspects of suicidal ideation and mental health problems not addressed by the existing intervention programs
Despite the many existing prevention and treatment strategies of suicide in Plainview, New Jersey, These strategies do not address all the problems associated with suicide in Plainfield. For example, population aged over 65 years is at a high risk of committing suicide in Plainfield. This is attributed to reluctance and lack of awareness of suicide prevention services. There is no program at the moment that specifically targets this group. There is a need for new programs targeted to this unique group of the population at risk of committing suicide (Guild, 2012).
Many old people suffer from untreated mental illnesses like depression. The suicide prevention strategies for old people should focus on peer counseling, raising awareness of the risk factors of suicide and encouragement of the use of suicide prevention services. These programs should include frequent visits by nurses and other health aides to aging populations (Katherine, 2002).
Another major problem with the suicide prevention and mental health treatment programs in Plainfield is fragmentation of services that makes it hard to follow up some patients. Although there are many mental health treatment and suicide crisis prevention programs in Plainfield, the services are not adequate and do not reach all the people affected with mental illness (Goldstein et al, 2012).
There is a need for widening the reach of intervention programs to at risk groups to make more people access suicide prevention strategies. Reduction in gun ownership policies in New Jersey may not have an effect on the suicide rates because the New Jersey state already has a stringent gun control laws. However, more background checks can ensure that firearms are not sold to at people with suicidal ideations and mental problems. The effective policy recommendations for firearm access can only include strengthening of gun control laws in Plainfield (Katherine, 2002).
Outcomes of improvement and additional of existing suicide intervention programs
The expected outcomes of improvement of the existing suicide prevention and mental disorders treatment programs are reduction in the cases of suicides attempts and completion reported in Plainfield increase in the number of mental appertains accessing suicide prevention services. Other outcomes expected out of improvement and additional of suicide intervention programs include wider reach of intervention programs and increase in the awareness of suicide prevention services.
Planning for better suicide intervention services at Plainfield city
1) Enhancing partnerships between the organizations involved in suicide prevention. This strategy can enhance better follow-up and wider reach of intervention programs for individual patients. This strategy can also reduce fragmentation of mental health care services in the city and enhance nurse visits to individual patients
2) Suicide prevention strategy for those aged 65 years and above
This strategy should incorporate guidance and counseling to make this population aware that suicide is a treatable and preventable health problem.
Nursing actions that can improve suicide prevention efforts in Plainfield
1) Advocacy
The nurses involved in handling victims of suicide should continually advocate for the formulation of programs and policies of dealing with suicide in Plainfield New Jersey. These programs should be broad based focusing on both individuals and the entire population. Nurses should direct their advocacy efforts to public health stakeholders to hospitals and the government and the community
2) Better referral programs and follow up
Many cases of suicide completions reported in Plainfield New Jersey are associated with people with previous mental problems (Goldstein C. et al, 2012).. There is therefore a need for better follow up of all mental patients by nurses after treatment to ensure that suicide victims are kept out of danger of suicidal ideations through continued follow-up and counseling
3) Better collaboration building
The provision of mental health services in Plainfield is very fragmented (Goldstein C. et al, 2012). Nurses working in hospitals in Plainfield can improve the collaboration between different mental health centers through forming good links and partnerships with other health organizations.
4) Outreach programs
Comprehensive outreach programs for both individuals and the community by nurses at Plainfield can improve the awareness of suicide prevention efforts and treatment in the city of plain field.
5) Marketing initiatives
Nurses in the city of Plainfield can improve the awareness of suicide prevention efforts through marketing suicide prevention efforts in the social media like face book and twitter.
6) Expansion of surveillance efforts
Since the provision of mental health services in the city of Plainfield is fragmented, nurses can improve the reach of mental patients by carrying out more surveillance to people at risk of suicide.
7) Case management
There is a need for all the nurses to handle each case of suicide in an appropriate manner like provision of adequate counseling services and follow up. There should also be continued screening of at risk populations for suicidal ideations to ensure timely handling of all suicide cases in Plainfield.
8) Community organizing
Nurses in Plainfield city should also consider organization community seminars and other outreach programs for sensitizing the community about the ways of handling suicide.
Secondary and primary preventive strategies that can be used by nurses in Plainfield
1) Public awareness and education initiatives
At any point of interaction with the community, nurses should take an opportunity of explaining to the Plainfield community that suicide is a treatable mental health problem. Nurses should also provide information about the availability of mental illness treatment centers to the community
2) Survivor support
Nurses can also provide unlimited support to victims of suicide to ensure that they can be able to handle risk factors to suicide appropriately through counseling and outreach programs.
3) Linking at risk people to suicide mental health programs
This initiative can help limit improve the number of mental health patients accessing mental health services.
Potential public private partnerships for organizations involved in preventing suicide in Plainfield
1) Enlisting the faith communities in the process of suicide prevention
Faith based communities also play a significant role in suicide prevention. These organizations can be used to reach people in distress and linking them to other suicide prevention programs can widen the reach of mental health services.
2) Establishment of resource centers for preventing suicide
Establishing resource centers for perverting suicide by the organizations involved in prevention of suicide can reduce the fragmentation in the delivery of mental health services in the city of Plainfield.
Overall objectives of these nurses’ intervention programs
The suicide prevention of the suicide intervention and prevention programs is reducing the cases of suicides at the city of Plainfield. These programs also seek to improve the access of mental health services by a rate of 95 to 99 percents of all the mental patients in the city of Plainfield. Another objective is increase in awareness of suicide prevention programs in the city of Plainfield.
Evaluation strategies
The tools that can be used to monitor the effectiveness of the suicide intervention strategies at Plainfield city include a reduction in the number of suicide attempts and completion. An increase in the number of mental health patients accessing suicide prevention services and an increase in the reach of intervention programs to mental patients are also appropriate monitoring tools.
Timeline of expected yearly outcomes from the nurse’s suicide intervention programs
- Intervention program
- Year one
- Year two
- Year three
- Advocacy programs
- Increased awareness on general public on suicide prevention programs
- Increased awareness on general public on suicide prevention programs
- Increased awareness on general public on suicide prevention programs
- Collaboration and outreach efforts
- Ten percent reduction in suicide attempts
- Twenty percent reduction in suicide rates
- 50 percents reduction in suicide cases
Marketing initiatives
- Increased awareness on general public on suicide prevention programs
- Increased awareness on general public on suicide prevention programs
- Increased awareness on general public on suicide prevention programs
- Better case management
- Ten percent reduction in reduction of suicide attempt repeats.
Community organizing
- More public awareness of suicide prevention efforts
- Greater access of mental health services to at risk populations
- More public awareness of suicide prevention efforts
- Greater access of mental health services to at risk populations
- More public awareness of suicide prevention efforts
- Greater access of mental health services to at risk populations
- Expected outcomes of the suicide prevention initiatives
Conclusion
The city of Plainfield has lower rates of suicide compared to the national data of suicide in the United States. The low rates of suicide can be attributed to promising intervention programs by the state of New Jersey in preventing suicide. The school based intervention programs that incorporate suicide awareness co-curricula, firearm control and timely clinical interventions have all contributed in the reduction of suicide cases in the city of Plainfield, New Jersey. However, some factors such as stigma, fragmentation of prevention strategies and high cost of running intervention programs have limited the reach of intervention programs in the city of Plainfield.
To ensure greater reduction in suicides rates in the city of Plainfield, there should be better coordination and linkage of all mental health programs in the city of Plainfield and avoiding overreliance on just few strategies. Expansion of these services can limit the number of suicides currently witnessed at the city of Plainfield. There should also be formulation of suicide prevention programs that target those over aged over 65 years.
References
CDPH (2010). What is a health community? California: Author Goldstein C. et al (2012). New, New Jersey suicide prevention plan 2011-2014. New Jersey
Department of children affairs Guild P. (2012). Best practices for preventing adolescent’s suicide what can we learn from
New Jersey. Chapel Hill: University Of Northern Carolina.
Katherine H. (2002) Topics in Health Statistics New Jersey. New Jersey: New Jersey Department of Health and Senior Services.
OISP (2007) Adolescent Suicide in New Jersey. Author Onboard informatics (2011) Plainfield. Retrieved from http://www.city-data.com/city/Plainfield-Connecticut.html
Ryan K. (2007) Adolescents suicide in New Jersey data overview and prevention strategies.
New Jersey: Department of Children and Families
