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• Indicating feeling hopeless, isolated and extremely Cardinal Innovations Healthcare lonely El Futuro • Withdrawal from family, friends or activities Faith Connections on Mental Illness • Extreme mood swings Freedom House Recovery Center • Acting recklessly National Alliance on Mental Illness (NAMI) • High anxiety or agitation National Suicide Prevention Lifeline • Increased alcohol or drug use NC Injury and Violence Prevention Branch From 2007 to 2016, 3,157 NC youth, ages 10 to 24, died as a result of violence. Of these violent deaths, 1,505 Orange County Behavioral Health Systems Analysis (47.7%) were suicides. Regardless of age, males consis- UNC Center for Excellence in Community Mental Health tently had a higher number of deaths by suicide than females. The number of NC suicides peaked for males Substance Use at age 22 with 171 suicides, and for females at age 23 with 38 suicides. 73%of all youth suicide victims were Substance abuse is generally defined as a harmful pat- identified as non-Hispanic White, 16.3% were identified tern of use of any mood-altering substance. Substances as non-Hispanic African American, 6.2% identified as include alcohol and other drugs, whether legal or illegal. Hispanic/Latinx, and 4.5% identified as belonging to Included in this section will be information on the use, another racial/ethnic group. Overall, the most common misuse and/or abuse of the top three most misused/ method of suicide among youth is firearms27. abused substances - opioids, tobacco and alcohol. Figure 4: Method of Death: NC-VDRS, 2007-2016 Among survey responders: -N.L owi of Public fth N.L.vlale Dt hRepg SysKVP— • 8%stated that substance use was an issue with con- Firearm 53% cerns around alcohol, drugs and tobacco. Hanging 35% opioids Poisoning . [% America's opioid and heroin epidemic claimed nearly 64,000 lives in 2016 - more than guns, car accidents, Dine,. , 6% homicides, or HIV/AIDS. Opiate-related overdoses are now the leading cause of death for Americans under the 0% 25% 50% 75% 100% age of 5029. Percerd of SukWa Opioids are a large cause of unintentional drug over- Healthy Carolinians of Orange County (HCOC) adopted dose deaths. When it comes to opioid overdose, the#BeTheOneTo campaign with hopes that together Orange County has a rate of 6.6 per 100,000 (shown lives can be changed. There are five evidence support- below). In 2015, over 1,100 North Carolinians died due ed steps for communicating with someone who may be to opioid-related causes, which was a 73% increase over suicidal. Those steps are: 1)Ask, 2) Keep Them Safe, the past 10 years3o 3) Be There, 4) Help Them Connect, and 5) Follow Up. Though rarely talked about or reported, suicides out- Among survey responders.- number homicides two-to-one, resulting in nearly 1,200 suicides in NC each year28. Preparing communities, ' 89%said they would refer their friend or family organizations, and individuals to skillfully reach out to member to a doctor or private counselor for coun- help others in need is an important responsibility, and seling. one that Orange County and NC takes seriously. To help A 2016 report found that people who use opioids are do this, NC has the 2015 Suicide Prevention Plan . more likely to live in the rural south than anywhere else Below is a non-inclusive list of local and state programs in America. Of the 25 most addicted American cities, and initiatives to help address mental health. four are located in NC. Fayetteville ranked 1811 (79%) Jacksonville ranked 121h (8.2%), Hickory ranked 51h (9.9%) and Wilmington is at the very top with more than 11.6% of its population abusing opiates31. 12 2019 COMMUNITY HEALTH ASSESSMENT