CBS News
Decades of national suicide prevention policies haven’t slowed the deaths
If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”
When Pooja Mehta’s younger brother, Raj, died by suicide at 19 in March 2020, she felt “blindsided.”
Raj’s last text message was to his college lab partner about how to divide homework questions.
“You don’t say you’re going to take questions 1 through 15 if you’re planning to be dead one hour later,” said Mehta, 29, a mental health and suicide prevention advocate in Arlington, Virginia. She had been trained in Mental Health First Aid — a nationwide program that teaches how to identify, understand and respond to signs of mental illness — yet she said her brother showed no signs of trouble.
Portia Eastman / KFF Health News
Mehta said some people blamed her for Raj’s death because the two were living together during the COVID-19 pandemic while Raj was attending classes online. Others said her training should have helped her recognize he was struggling.
But, Mehta said, “we act like we know everything there is to know about suicide prevention. We’ve done a really good job at developing solutions for a part of the problem, but we really don’t know enough.”
Raj’s death came in the midst of decades of unsuccessful attempts to tamp down suicide rates nationwide.
During the past two decades federal officials have launched three national suicide prevention strategies, including one announced in April.
The first strategy, announced in 2001, focused on addressing risk factors for suicide and leaned on a few common interventions.
The next strategy called for developing and implementing standardized protocols to identify and treat people at risk for suicide with follow-up care and the support needed to continue treatment.
The latest strategy builds on previous ones and includes a federal action plan calling for implementation of 200 measures over the next three years, including prioritizing populations disproportionately affected by suicide, such as Black youth and Native Americans and Alaska Natives.
Despite those evolving strategies, from 2001 through 2021 suicide rates increased most years, according to the Centers for Disease Control and Prevention. Provisional data for 2022, the most recent numbers available, shows deaths by suicide grew an additional 3% over the previous year. CDC officials project the final number of suicides in 2022 will be higher.
In the past two decades, suicide rates in rural states such as Alaska, Montana, North Dakota and Wyoming have been about double those in urban areas, according to the CDC.
Despite those persistently disappointing numbers, mental health experts contend the national strategies aren’t the problem. Instead, they argue, the policies — for many reasons —simply aren’t being funded, adopted and used. That slow uptake was compounded by the pandemic, which had a broad, negative impact on mental health.
A chorus of national experts and government officials agree the strategies simply haven’t been embraced widely, but said even basic tracking of deaths by suicide isn’t universal.
Surveillance data is commonly used to drive health care quality improvement and has been helpful in addressing cancer and heart disease. Yet, it hasn’t been used in the study of behavioral health issues such as suicide, said Michael Schoenbaum, a senior adviser for mental health services, epidemiology and economics at the National Institute of Mental Health.
“We think about treating behavioral health problems just differently than we think about physical health problems,” Schoenbaum said.
Without accurate statistics, researchers can’t figure out who dies most often by suicide, what prevention strategies are working and where prevention money is needed most.
Many states and territories don’t allow medical records to be linked to death certificates, Schoenbaum said, but NIMH is collaborating with a handful of other organizations to document this data for the first time in a public report and database due out by the end of the year.
Further hobbling the strategies is the fact that federal and local funding ebbs and flows and some suicide prevention efforts don’t work in some states and localities because of the challenging geography, said Jane Pearson, special adviser on suicide research to the NIMH director.
Wyoming, where a few hundred thousand residents are spread across sprawling, rugged landscape, consistently ranks among the states with the highest suicide rates.
State officials have worked for many years to address the state’s suicide problem, said Kim Deti, a spokesperson for the Wyoming Department of Health.
But deploying services, like mobile crisis units, a core element of the latest national strategy, is difficult in a big, sparsely populated state.
“The work is not stopping but some strategies that make sense in some geographic areas of the country may not make sense for a state with our characteristics,” she said.
Lack of implementation isn’t only a state and local government problem. Despite evidence that screening patients for suicidal thoughts during medical visits helps head off catastrophe, health professionals are not mandated to do so.
Many doctors find suicide screening daunting because they have limited time and insufficient training and because they aren’t comfortable discussing suicide, said Janet Lee, an adolescent medicine specialist and associate professor of pediatrics at the Lewis Katz School of Medicine at Temple University.
“I think it is really scary and kind of astounding to think if something is a matter of life and death how somebody can’t ask about it,” she said.
The use of other measures has also been inconsistent. Crisis intervention services are core to the national strategies, yet many states haven’t built standardized systems.
Besides being fragmented, crisis systems, such as mobile crisis units, can vary from state to state and county to county. Some mobile crisis units use telehealth, some operate 24 hours a day and others 9 to 5, and some use local law enforcement for responses instead of mental health workers.
Similarly, the fledgling 988 Suicide & Crisis Lifeline faces similar, serious problems.
Only 23% of Americans are familiar with 988 and there’s a significant knowledge gap about the situations people should call 988 for, according to a recent poll conducted by the National Alliance on Mental Illness and Ipsos.
Most states, territories and tribes have also not yet permanently funded 988, which was launched nationwide in July 2022 and has received about $1.5 billion in federal funding, according to the Substance Abuse and Mental Health Services Administration.
Anita Everett, director of the Center for Mental Health Services within SAMHSA, said her agency is running an awareness campaign to promote the system.
Some states, including Colorado, are taking other steps. There, state officials installed financial incentives for implementing suicide prevention efforts, among other patient safety measures, through the state’s Hospital Quality Incentive Payment Program. The program hands out about $150 million a year to hospitals for good performance. In the last year, 66 hospitals improved their care for patients experiencing suicidality, according to Lena Heilmann, director of the Office of Suicide Prevention at the Colorado Department of Public Health and Environment.
Experts hope other states will follow Colorado’s lead.
And despite the slow movement, Mehta sees bright spots in the latest strategy and action plan.
Although it is too late to save Raj, “addressing the social drivers of mental health and suicide and investing in spaces for people to go to get help well before a crisis gives me hope,” Mehta said.
Cheryl Platzman Weinstock’s reporting is supported by a grant from the National Institute for Health Care Management Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling and journalism.
CBS News
Organic carrots recalled after E. coli outbreak. These are the brands and grocery stores impacted.
A massive recall of organic carrots and baby carrots sold at grocery stores across the country was issued by a California grower after a possible outbreak of E. coli that has already killed one person.
Grimmway Farms, which made and packaged the organic carrots, issued the recall on Saturday after nearly 40 cases were recorded in 18 states. At least 15 people were hospitalized and one person has died, the Centers for Disease Control and Prevention said.
Where were the carrots sold?
A number of stores that sold the carrots across the United States, including Puerto Rico, and Canada are impacted, including Walmart, Kroger, Albertsons, Publix, Food Lion, Target, Whole Foods, Trader Joe’s and Canadian chains Loblaws and Compliments.
“State and local public health officials are interviewing people about the foods they ate in the week before they got sick,” the U.S. Food and Drug Administration said Sunday. “Of the 27 people interviewed, 26 reported eating carrots. The FDA’s traceback investigation identified Grimmway Farms as the common supplier of organic whole and baby carrots in this outbreak.”
What carrots have been recalled?
According to the FDA, the recall did not pull any carrots off the shelves at stores as they should no longer be available for sale, however, they may still be in people’s homes and refrigerators.
Organic whole carrots, which do not have a best-if-used-by date printed on the bag but were available for purchase at retail stores from Aug. 14 through Oct. 23, 2024.
Organic baby carrots with best-if-used-by-dates ranging from Sept. 11 through Nov. 12, 2024.
What brands of carrots have been recalled?
These lists include the brands or store’s brands (and bag size) that sold the carrots.
Organic Whole Organic Carrots
Whole Foods 365 – 1lb, 2lb, 5lb
Grimmway Farms
Bunny Luv – 1lb, 2lb, 5lb, 10lb, 25lb
Cal-Organic – 1lb, 2lb, 5lb, 6lb, 10lb, 25lb
Compliments – 2lb
Full Circle – 1lb, 2lb, 5lb
Good & Gather – 2lb
GreenWise – 1lb, 25lbs
Marketside – 2lb
Nature’s Promise – 1lb, 5lb
O-Organics – 1lb, 2lb, 5lb, 10lb
Grimmway Farms
President’s Choice – 2lb
Simple Truth – 1lb, 2lb, 5lb
Trader Joe’s – 1lb
Wegmans – 1lb, 2lb, 5lb
Wholesome Pantry -1lb, 2lb, 5lb
Organic Baby carrots
Whole Foods 365 – 12oz, 1lb, 2lb
Grimmway Farms
Bunny Luv – 1lb, 2lb, 3lb, 5lb
Cal-Organic – 12oz, 1lb, 2lb, 2pk/2lbs
Compliments – 1lb
Full Circle – 1lb
Good & Gather – 12oz, 1lb
Grimmway Farms
GreenWise – 1lb
Grimmway Farms – 25 lb
Marketside – 12oz, 1lb, 2lb
Nature’s Promise – 1lb
O-Organics – 12oz, 1lb, 2lb
President’s Choice – 1lb, 2lb
Raley’s – 1lb
Simple Truth – 1lb, 2lb
Sprouts – 1lb, 2lb
Trader Joe’s – 1lb
Wegmans – 12oz, 1lb, 2lb
Wholesome Pantry – 1lb, 2lb
What kind of E. coli might be associated with the outbreak?
According to the CDC, the carrots might be linked to an outbreak of E. coli O121:H19, which could cause severe stomach cramps, diarrhea (often bloody), and vomiting. Symptoms usually start three to four days after swallowing the bacteria and most people recover without treatment after five to seven days.
Some people may develop serious kidney problems and would need to be hospitalized, the CDC said.
Already 39 people have been infected across 18 states including Washington, Minnesota, New York, California, Oregon, South Carolina, New Jersey, Texas, North Carolina, Missouri, Pennsylvania, Arkansas, Colorado, Massachusetts, Michigan, Orion, Virginia and Wyoming.
What should you do if you have the carrots?
The CDC and FDA say that any recalled carrots should be thrown away immediately or returned to the store for a refund. People should also clean and sanitize any surface they may have touched.
Washington — President-elect Donald Trump’s Cabinet and senior staff picks are facing an uncertain future as his selections received mixed reviews in recent days even from fellow Republicans — and a handful sent shockwaves through Washington.
Trump’s selection for attorney general in former Rep. Matt Gaetz, a GOP firebrand who was under investigation by the House Ethics Committee for allegations of sexual misconduct and obstruction, has drawn criticism from both sides of the aisle. And Trump’s pick for defense secretary in Pete Hegseth, an Army combat veteran and former Fox News anchor, has also sparked concerns, especially as an investigation into sexual assault allegations against him has been made public. Additionally, former Democratic Rep. Tulsi Gabbard, Trump’s pick for director of national intelligence, doesn’t have a background in intelligence and has drawn criticism for her views on Russia and other U.S. adversaries.
Appearing on “Face the Nation with Margaret Brennan” on Sunday, Democratic Rep. Jim Himes of Connecticut expressed astonishment about those questioning whether experience is necessary when asked about Gabbard, saying “of course it’s necessary.”
“These people are manifestly unqualified, and you know, they’re not prepared to run the very complicated organizations they’ve been asked to run,” Himes said.
But Himes, the ranking Democrat on the the House Intelligence Committee, said that Gaetz’s qualifications should also examined as well as the unreleased House Ethics Committee report.
“How is it that this is what we’re focusing on?” Himes said. “Matt Gaetz is, by any standard, completely unqualified to be the Attorney General, and yet we’re sort of focused on this, you know, cherry on the cupcake of the Ethics report.”
Gaetz’ resignation from Congress after Trump’s announcement came days ahead of a planned meeting and vote by the House Ethics Committee on whether to release a report on its investigation into Gaetz. Speaker Mike Johnson said Friday that he would “strongly request” that committee withhold the potentially damaging report.
Rep. French Hill, an Arkansas Republican who also appeared on “Face the Nation” on Sunday, said Johnson makes “an important point,” warning that “we don’t want to set a precedent where we, under any circumstances, will release documents from that committee.” But he stressed that the decision is the committee’s alone, while noting that on Trump’s selections, the Senate will exercise its advise and consent role through the confirmation process.
“President Trump has the prerogative to nominate the people that he thinks can best lead the change that he believes the American people are seeking in each of the agencies of the federal government,” Hill said.
The Arkansas Republican outlined that when Trump came to office in 2017, there were members of his Cabinet who he had no personal relationship with or working background.
“He wants to correct that this time by finding people that he has a good working relationship with. He knows how they think, they know how he thinks, because he thinks it will lead to better decision making in his administration,” Hill said.
For his part, Himes offered some praise to some of Trump’s other picks.
“I actually had a really good day when Marco Rubio was nominated for Secretary of State, when John Ratcliffe was nominated for CIA and when Mike Waltz was nominated to be national security adviser,” Ratcliffe said. “Those are good nominations, not necessarily the nominations I would have made if I were president, but these are serious people with real experience.”
Still, he cautioned Republicans in the Senate as the confirmation process plays out, saying that he understands “what happens to Republicans who stand up to Donald Trump,” but “history is a harsh judge.”
“The Republican senator who votes to confirm Matt Gaetz or Robert Kennedy or Tulsi Gabbard will be remembered by history as somebody who completely gave up their responsibility to Donald Trump,” Himes said.
Sue Gordon, who served as principal deputy director of national intelligence under Trump and also appeared on “Face the Nation” on Sunday, stressed that vetting will be critical to the process moving forward, amid a New York Times report that Trump’s team may bypass the typical FBI procedure and instead opt to use a private firm to vet his nominees who would be granted security clearances.
“It seems expedient, but I think it will ultimately harm the institution,” Gordon said, noting that a private firm won’t have the same standards. “I know it’s inconvenient, but I think it’s a bad strategy and risky for America.”
Meanwhile, the Partnership for Public Service, a nonpartisan group that assists with presidential transitions, confirmed to CBS News that the Trump team hasn’t signed paperwork that allows for security clearances and background checks, among other things, to occur. Gordon said she can’t think of a “good reason” for the Trump team to forego the transition paperwork, saying that “one of the great falsehoods that’s been perpetrated on America is that our institutions are malfeasant.”
“You’re not protecting anybody by not signing those papers, and especially some of the nominees we have that don’t have the really deep experience base,” Gordon said. “To start your gig without any foundation at all, especially when the institutions are begging to give you that foundation, just seems wrong-headed.”
CBS News
Dr. Deborah Birx says she is “excited” for data-driven discussions in RFK Jr.’s confirmation hearings
Dr. Deborah Birx, former White House Coronavirus response coordinator, said Sunday she is “excited” for the data on key health issues that will surface in Senate confirmation hearings for Robert F. Kennedy, Jr., President-elect Donald Trump’s controversial pick for Health and Human secretary who has spread false information on vaccines and autism.
“I’m actually excited that in a Senate hearing he would bring forward his data and the questions that come from the senators would bring forth their data,” Birx said on “Face the Nation with Margaret Brennan.” “What I know for sure is he’s a very smart man who can bring his data and his evidence base forward, and we can have a discussion that many Americans believe already is a problem.”
President-elect Donald Trump announced Thursday in a social media post that he’ll nominate Kennedy to oversee the Health and Human Services Department, which encompasses multiple agencies and has a $1 trillion budget. The position has to be approved by the Senate, which, come January, will be controlled by Republicans, which could make the nomination process easier but is not a guarantee.
“I am thrilled to announce Robert F. Kennedy Jr. as The United States Secretary of Health and Human Services (HHS),” Trump wrote in a social media post last week. He said Americans have been “crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation” about public health, and Kennedy would “Make America Great and Healthy Again!”
At an October rally, Trump promised to let Kennedy “go wild” on health issues.
Kennedy has criticized vaccines extensively in the past, including spreading misleading claims about their safety. He has also pledged to tackle an “epidemic” of chronic diseases and believes that large drug and food companies are to blame for a broad swath of ailments. Kennedy argues that a number of health issues in the U.S. have worsened, including autism, attention-deficit/hyperactivity disorder, sleep disorders, infertility rates, diabetes and obesity, which he blames on federal inaction.
Kennedy has insisted that he is not “anti-vaccine” and has pledged not to ban vaccines under the Trump administration. Kennedy instead promises to “restore the transparency” around vaccine safety data and records that he accuses HHS officials of hiding. This data is expected to be addressed in upcoming confirmation hearings in Congress, a dialogue that Birx said she believes Americans will benefit from learning more about the differing perspectives on concerns surrounding vaccines.
“So until we can have that transparency and that open discussion from both sides, I know the members have incredible staffers who will bring great questions from their constituents, and that hearing would be a way for Americans to really see the data that you’re talking about,” Birx said on Sunday.
Dr. Peter Marks, the FDA’s top vaccines official, said at an event hosted by the Milken Institute last week ahead of Trump’s decision that he hopes to find common ground with Kennedy and that he is also open to a conversation based on data.
“What I would ask of him is that he keep an open mind. We’re happy to try to show as much of the data as we can. And I think the data are essentially overwhelming, in certain areas, but we’ll just have to engage in the dialogue,” Marks said.
If confirmed by the Senate, Kennedy will be in charge of a giant portfolio, including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the National Institutes of Health (NIH) and the Centers for Medicare and Medicaid Services.
Birx said on Sunday that Kennedy, who ran for president this year but has never held public office and is already facing criticism for his qualifications, would benefit from having an experienced team around him that come from the medical industry.
“So really having a management person at his side, a chief of staff, perhaps that has really come out of industry that would know how to bring and look and bring those individuals together that are running the other agencies, because … HHS is probably one of our most complicated departments,” Birx said.
Trial set to begin in Minnesota in case of Indian family who died trying to cross border
Organic carrots recalled after E. coli outbreak. These are the brands and grocery stores impacted.
Trump’s controversial Cabinet and senior staff picks face uncertain future in Washington
Trial set to begin in Minnesota in case of Indian family who died trying to cross border
Organic carrots recalled after E. coli outbreak. These are the brands and grocery stores impacted.