25-26 Key Data and Recommendations

Suicide Prevention in El Paso County: Key Data and Recommendations

A report from the Data and Impact Measurement Action Group, Suicide Prevention Collaborative of El Paso County

Executive Summary

Through extensive community and stakeholder engagement, the Suicide Prevention Collaborative of El Paso County (the Collaborative) identified a critical need for more data-informed decision-making to guide strategy, education, and awareness efforts across El Paso County. In response, the Collaborative convened a Data and Impact Measurement Action Group led by Brittany Riffle, MSW (El Paso County Public Health), Ann Rush, PhD (Status Code 4, Inc.), and Sophie, RN, BSN (Common Spirit Health). Drawing on their collective expertise in public health, data analysis, and clinical care, this Action Group conducted a thorough review of suicide-related data specific to El Paso County to identify gaps in existing protective factor activities and translate those findings into actionable strategy.

The Action Group’s review identified gaps across several protective factor domains, including connectedness, education and awareness, economic stability, safer suicide care, lethal means safety, and postvention. These gaps informed a closer examination of six key data themes: firearms, emergency room touchpoints, substance use disorders, 988 utilization, two-week crisis contributing factors, and occupational risk. For each theme, this report presents supporting data alongside targeted calls to action directed at relevant populations and sectors, with the goal of guiding coordinated, evidence-based decision-making among the Collaborative, community partners, and stakeholders to strengthen suicide prevention efforts throughout El Paso County.

Recognized Gaps in Protective Factor Activities

The Action Group’s review identified gaps across six key protective factor domains:

1. Connectedness

Limited transportation options for at-risk individuals
Decreased mobility among older adults

2. Education and Awareness

High cost of training programs
Limited availability of qualified trainers

3. Economic Stability

Cuts to financial safety net programs
Rising cost of living

4. Safer Suicide Care

Persistent stigma among healthcare providers
Inconsistent adoption of safer care practices

5. Lethal Means Safety

Politicization of firearm safety discussions
Provider hesitancy to discuss lethal means

6. Postvention

Limited connections between hospitals and communities
Gaps in follow-up care after a crisis

Additional Areas Identified for Further Attention

Firearm access and safety among older adults
Effective use of emergency room touchpoints following a suicide-related visit
Intersection of substance use and toxicology findings in suicide deaths
Contributing factors within the two-week period preceding a crisis
Public hesitancy around 988 utilization due to fear of what happens after calling
The often-underrecognized relationship between occupation and suicide risk

Themes, data points and calls to action for suicide prevention in El Paso County
Theme	Data points	Call to Action (Population)
Firearms	Deaths by age (see Figure 1) 60% of deaths by suicide with a firearm as the method Presence of a loaded firearm in the home (see Figure 2)	Promote safe storage and training for key stakeholders (healthcare providers, first responders, gun ranges and sellers, Extreme Risk Protection Orders and legal education), the roles that interact with high-risk individuals. Collaborative to host and facilitate CALM training for key stakeholders. Partner with the Firearm Injury Prevention Initiative (FIPI) and the CDPHE Office of Suicide Prevention.
ER touchpoints and attempts	1,295 ER visits for suicide attempt (2020 to 2024, ages 18+) 7,034 ER visits for suicidal ideation (2020 to 2024, ages 18+) 3,215 ER visits for non-suicidal self-injury (2021 to 2024, ages 18+)	How can we make these touchpoints matter? Hospital staff, community organizations, first responders, educators and non-profits (Collaborative partners). Encourage and support education for professionals interacting with persons at risk for suicide.
Substance use disorders	Of individuals who died by suicide in 2019 to 2023, toxicology was positive for: Alcohol, 38% Opiates, 15.9% Marijuana, 22.7%	Bring awareness to the community about what substances have been found with suicidal individuals. Address suicide awareness (the overlap between suicide and substance use disorder) and prevention (interventions that equip peer supporters with gatekeeper behaviors) within substance use care models.
988 use and fear of what happens next	Fewer than 1% of calls involve police or medical assistance Diverted to mobile crisis response, 0.95%. Diverted to police, 0.02% Number of contacts that are not crisis calls See Figures 5 and 6	Encourage others to call 988 and continue to normalize and increase awareness. Create general population campaigns that are creative, regional and targeted. Encourage businesses, non-profit and for-profit, to publish the 988 web address on their websites and add messaging to pay stubs.
Two-week crisis and contributing factors	Two-week contributing factors: Intimate partner Job problems Financial problems and housing Percentage of occurrence (see Figure 3)	Offer training and awareness on how to check on people, recognizing that these risk factors lead to increased suicide risk. Reach agencies that support food banks, social determinants of health organizations, thrift stores, courts and probation, banks and mortgage servicers, and utility services (family law, social services and the general population). Kindness is suicide prevention. Check in with your friends, coworkers and loved ones.
Occupation and the workplace	Percentage of deaths by occupation Suicide deaths by injury and sex (see Figure 4)	Recommendations for business owners, employers and HR staff: Visit the state dashboard to research data and facts specific to your profession. Attend suicide awareness trainings and other mental health classes. Stay informed about local and national resources, and share that information with employees.

Figure 1

Source: BRFSS – Data Request

Figure 2

Source: BRFSS – Data Request

Figure 3

Suicide deaths by circumstances that contributed to death in adults, El Paso County residents, 2019-2023

Source: Colorado Violent Death Reporting System, Colorado Department of Public Health and Environment.

Circumstances preceding suicide deaths, number of deaths and share among total suicides with known circumstances
Circumstances	No. of deaths	% among total suicides with known circumstances
Current diagnosed mental health problem	459	56.3%
History of suicidal thoughts or plans	442	54.2%
Crisis two weeks prior to death	382	46.9%
Ever treated for mental health problem	351	43.1%
Contributing intimate partner problem	329	40.4%
Current depressed mood	300	36.8%
Left a suicide note	294	36.1%
Current mental health treatment	238	29.2%
Problem with alcohol	231	28.3%
Recently disclosed suicidal intent	230	28.2%
Argument preceded death	221	27.1%
Previous suicide attempt	208	25.5%
Contributing physical health problem	173	21.2%
Problem with a substance other than alcohol	157	19.3%
Contributing job problem	148	18.2%
Family relationship problem	133	16.3%
Contributing criminal legal problem	120	14.7%
Contributing financial problem	113	13.9%
Non-suicide death of a friend or family member	109	13.4%
Suicide death of friend or family	80	9.8%
Precipitated by a crime	71	8.7%
Contributing civil legal problem	48	5.9%
Eviction or loss of home	45	5.5%

Figure 4

Source: Colorado Violent Death Reporting System, Colorado Department of Public Health and Environment.

Figure 5

Source: 988 Public Dashboard

Figure 6

Outcomes of calls by El Paso County Residents

When El Paso County Residents called 988, 83.6% of interactions were stabilized with the client and a 988 care specialist, and only .04% were diverted to law enforcement.