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Public Health Essentials

A place to highlight the work of the Snohomish Health District as well as share health-related information and tips. Have an idea or question? Drop us a line at SHDInfo@snohd.org.

Jul 12

"Say the words:" Suicide prevention training reaches three tiers at Jackson High School

Posted on July 12, 2019 at 3:57 PM by Kari Bray

One conversation can help someone stay alive.

That’s the takeaway for Lyn Lauzon, an intervention specialist at Henry M. Jackson High School in Mill Creek. 

“I used to think that if someone was suicidal, they needed to get inpatient care and intensive help,” Lauzon said.

Now, she wants people to understand that saving a life can be a matter of asking a question and listening. 

That doesn’t mean the person won’t need professional help in the future to overcome the underlying causes of their suicidal thoughts. 

But when it comes to stopping a suicide, anyone can help. They just need to know how.


Lyn and Alyssa in a posed photo receiving their Health Champions awardLauzon and Alyssa Campbell, a family support advocate at Jackson High School, have coordinated suicide prevention trainings for the school’s parent night, students in the Gay Straight Alliance, and all high school staff. The two women were recognized by the Snohomish Health District in April as Suicide Prevention Champions. 

They wanted something that was easy, practical and memorable, they said – particularly for educators, who are used to being in front of the class rather than part of it.

“I think that our nature is to avoid these tough topics,” Campbell said. “There’s that fear: ‘I don’t want to say the wrong thing. I’m not an expert.’ I think the best trainings alleviate that fear. You don’t have to be an expert. We’ll find an expert if we need one. You just have to show you care.”

Wendy Burchill, a healthy communities and injury prevention specialist with the Health District, presented QPR suicide prevention trainings at Jackson High in 2018. She also leads “Words Matter” trainings on how to report on suicide for journalists, bloggers, students, social media users, and anyone else interested in how to talk about suicide appropriately and accurately.

The all-staff QPR training at Jackson was the largest group she’s ever taught. QPR focuses on how to recognize warning signs of suicide and how to question, persuade, and refer someone to help.

Reaching three tiers in a school community – parents, students and staff – is a big step for suicide prevention, Burchill said. And it comes at a time when big steps are needed. 

The 2018 Healthy Youth Survey results came out in March. According to the survey, one in four high school seniors in Snohomish County has seriously considered suicide, and one in five has made a plan. For every 100 seniors, 44 of them reported signs of severe depression.

That jumped out at Burchill: 44 percent of seniors battling depression.

Campbell suspects the percentage may be higher. “Those are just the ones who put it on the survey,” she said.

Campbell lost a friend to suicide. She stresses the importance of mental health awareness. Now, she can look back and identify warning signs she didn’t know to look for at the time. 

Suicide prevention trainings should be something that is available at every school and workplace, she said. For schools like Jackson where staff have been trained, she’d like to see annual refreshers. Repetition is crucial, particularly when the topic is one most people are uncomfortable addressing.

“It’s a matter of practice and time,” she said. “You just have to be bold. Say the words.”

I care about you and I’m worried about you. Are you planning to kill yourself?

Suicide doesn’t care how much money someone makes, or where they live, or what they drive or wear. Depression and anxiety affect people regardless of their race, religion, age, gender, sexual orientation, or economic situation. Some groups are at higher risk, including young women and the LGBTQ community, but no group is immune.

“A lot of parents still think, ‘Not my kid,’” Lauzon said. “For the parents, training is crucial. If the parents aren’t educated, they won’t know what to do. They are going to see things more than we will.”

And Lauzon and Campbell see a lot. 

walking with backpackSpecifically, they see teenagers under pressure. There are academic expectations from their parents, their teachers, their schools, the colleges they want to attend. There are social demands from friends and family – both in person and in the fraught virtual world of social media. Meanwhile, their brains are still developing, as are their coping skills. Those who face a crisis such as poverty or homelessness outside of school may hide it from their peers, afraid to be singled out. Emotions run high. Failures or losses seem insurmountable. 

It’s essential for adults to acknowledge the struggles young people face rather than minimize them, Lauzon said. If someone is in crisis, it helps to shift their focus to the reasons they have to persevere.

“Talk about what’s worth living for right now, today,” Campbell said. “That’s what I’ve taken away from these trainings. Just talk about it. If you ask what’s worth living for and the only thing they can think of is their dog, well, OK, their dog is absolutely worth living for. Their dog needs them.”

It is not unusual to suffer from depression or anxiety. Asking someone whether they are considering suicide does not plant the idea in their head; it might be the opening they need to talk.

Anyone who is having thoughts of suicide or is worried about a loved one can call the Volunteers of America Western Washington Crisis Chat at 800-584-3578 or chat online at www.imhurting.org. These resources are available 24 hours a day.

Warning signs of suicide can include:
  • Comments about being a burden to others, feeling trapped, or having no reason to live.
  • Unusual irritability, rage, humiliation, or a sudden loss of interest in activities they used to enjoy.
  • Increased reckless behavior, alcohol and drug use, sleeping too much or too little, giving away prized possessions, or visiting or calling people to say goodbye.  
 
If you have firearms in your home and suspect someone who lives there or visits may be struggling with depression, remove all firearms from the household. More safe storage information is available at www.snohd.org/lok-it-up.

The next “Words Matter” suicide reporting training is set for Tuesday, July 23, from 1:30 to 3 p.m. at the Health District, 3020 Rucker Ave.

To request a QPR suicide prevention training, go to www.snohd.org/QPRrequest and fill out the form. 

Additional resources:
Jun 27

Six Questions to Ask Before You Commit to a Caterer

Posted on June 27, 2019 at 1:42 PM by Kari Bray

You’re planning the special day. Invitations, venue tours, fittings, song lists, photos, decorations, paperwork. All through the whirlwind, the clock ticks closer to the moment you’ll say, “I do.”

Don’t worry. Those butterflies in your stomach are normal.
wedding table

But let’s keep it at butterflies.

The last thing you want on your wedding day is a feast that leaves you and your guests sick to your stomachs.


So here we are, in the thick of wedding season,* with a bit of advice to help plan your big event – or at least, the food. (It’s good advice for other events, too. Think family or class reunions.)


If you are hiring someone to handle the food at your wedding, here are a few key questions to ask that may help protect you and your guests from a foodborne illness.

  1. Does the caterer have a permit with their local health department?image of food establishment permit

    If they’re based in Snohomish County, the permit comes from the Snohomish Health District. You’ll see our logo on the “Permit to Operate,” which also shows the name and address of the business and the permit’s expiration date. Don’t be afraid to ask to see your caterer’s permit. Make sure it’s current. 

    That’s not just for the people catering your main course. Caterers include businesses that prepare cakes or other sweet treats for events.

    If your caterer is based in another county, that’s fine, but they still should have a permit from the health department in their home county.

    Remember: A business license and/or food handler’s card is not the same as a food permit through the Health District. Our permit means the business prepares their food out of a kitchen that is routinely inspected, and the staff is trained in safe food handling practices. You can find past inspection results online at the Health District website.

  2. If you’re purchasing a cake or other baked goods from an at-home baker, does the baker have an appropriate permit?

    The Snohomish Health District does not inspect or permit businesses that prepare food out of residential kitchens. 

    However, people can usually bake and sell their goods from home, they just need a different permit. In this case, it’s generally a cottage food permit through the Washington State Department of Agriculture. This permit allows for preparing and selling food out of the home as long as that food isn’t high-risk.

    Once again, it’s OK to ask to see your baker’s permit.

  3. What is the kitchen set-up at your venue? Can your caterer fill any gaps?

    To handle food safely, your caterer needs sinks with running water and equipment to keep hot food hot and cold food cold. Your wedding venue may have a kitchen – some even have a commercial set-up, similar to restaurants.

    washing hands and veggies in sinkHowever, not all venues come with everything your caterer needs. Make sure they know what the arrangement is and what they will need to provide, whether it’s additional food warmers or the entire kitchen.

    If your venue doesn’t have a kitchen with sinks, ask where or how the catering crew will be washing their hands.

  4. Thinking of hiring your favorite restaurant to cater your wedding? Does the restaurant have a catering endorsement?

    A business with a permit to operate as a restaurant does not necessarily have permission to cater. 

    When the Snohomish Health District permits a restaurant, we give the green light to prepare and serve food on-site. That doesn’t mean the business has approval to prepare food off-site or transport food from the restaurant kitchen to serve at another venue. 

    Restaurants that cater require an additional permit, called a catering endorsement. Most restaurants in the county do not have this endorsement.

  5. Can a food truck provide the wedding day meal?

    Yes. Unlike restaurants, food trucks do not need an additional catering endorsement because the food truck is a mobile kitchen. 

    A mobile food vehicle permit is different from a restaurant or catering permit, but it is still issued by the local health department in the food truck’s home county.

  6. Maybe you don’t plan to have a caterer at all. Is it OK for family or friends to prepare food for your wedding?

    Yes. If you have chefs or bakers in your life, or if you want to do a potluck-style event, go for it. 

    That said, anyone who is preparing or serving food should handle it safely. Wash hands thoroughly and frequently. Don’t leave food out at room temperature for more than two hours. Keep your hot dishes hot, your cold dishes cold, and always cook meats to a safe internal temperature. 

More info:
- Find more about food permits.
- Learn more about food preparation and foodborne illness
- Watch a video about Snohomish Health District food permits.

*Fun Fact: The popular wedding planning and registry website The Knot estimates that roughly three-quarters of weddings take place between May and October.
Jun 07

Looking back and moving forward

Posted on June 7, 2019 at 3:55 PM by Kari Bray

January 1, 1959.

“Gunsmoke”
was the must-see television show.

Iowa beat California in the
45th Rose Bowl.

People were grooving to
“The Chipmunk Song.” (Yes, the holiday jam with a plaintive squeak of “I still want a hula hoop” topped the charts.)

Photo of timeline headingAnd the Snohomish Health District had just been born.

Two months earlier, in November 1958, the Board of County Commissioners passed a resolution to merge the Snohomish County and Everett health departments. That change took effect on the first day of the new year.

To be clear, this wasn’t the birth of public health in the county. That’s been around for more than a century.

The first public health nurse – Mrs. Lavinia Gordon – arrived here in 1913 to focus on stopping the spread of tuberculosis, then called “consumption.” Public health efforts also were underway to curb the Spanish Influenza epidemic in 1918, to inspect dairies and slaughterhouses in the 1940s and 50s, and to respond to a deadly smallpox outbreak in 1946 – the jail and hospital were quarantined and vaccination stations set up around Everett, along with an isolation ward at Paine Field.

Investigating, containing, and preventing outbreaks remain core tasks of public health today. Our team of nurses and other disease investigators would no doubt have made Mrs. Gordon proud with their work on
the measles outbreak that has affected multiple counties in Washington.

So, no, public health wasn’t new in 1959.

Dr. Roger KnipeThe new part was having a single agency serve the entire county. The District was housed in an old apartment building off Rockefeller. Dr. Roger Knipe (in photo) served as health officer, with Dr. Clifford Anderson taking over after Knipe’s death three years later.

When the District first formed, the county’s sanitary codes were new and the environmental health team was growing. As late as 1955, there were no septic tank regulations, solid waste regulations, county plumbing code or sanitary code to enforce. As time went on, the link between our health and the health of our environment became more clear. Environmental Health is now a key piece of our work: food safety, clean water, safe septic systems, hazardous waste management, and more.

During its first decade, the Snohomish Health District stayed busy. Staff started a program to license sewage disposal designers, finished plans for an immunization clinic in the south part of the county, and helped establish the first birth control clinic in the county. The District moved to offices in the newly finished county courthouse addition, but would later outgrow the space and scatter across multiple buildings in Everett.

A new health officer, Dr. Claris Hyatt, took over in 1970. She served 16 years and left behind a 41-page report reflecting on her time. She was there when the first satellite offices opened in Lynnwood and Sultan, and when staff vaccinated more than 33,000 children against Rubella as part of a national campaign to reduce birth defects. For a while, the Health District managed the county’s detoxification facility at Paine Field. Dr. Hyatt also saw the end of tuberculosis sanatoriums thanks to advances in treatment.

“It is my hope,” Dr. Hyatt wrote, “that the Board and staff will look to the future with enthusiasm and forge ahead to levels of new achievement under the leadership of the new health officers.”

Another longtime employee, David Stockton, wrote about his time at the Health District in “A Special Book for a Special Time.” When he retired in 1985, he was the only employee who had been with the Health District since it formed.

“I represented the end of an era,” he said in an interview earlier this year. He’s now in his 90s and living in Oregon.

Stockton spent nearly 30 years at the Health District. He started as a sanitarian hired to tackle a hefty backlog of inspections. He retired as deputy administrator. One of his proudest achievements was working with County leaders and the Emander Community Club to clean up a landfill and create McCollum Park.

SHD building

Dr. Ward Hinds took over as health officer in 1986. Five years later, the District moved into its new Everett headquarters at 3020 Rucker Ave. The District purchased the building – where it remains today – for $5.1 million, with some financial support from the county, cities and towns.

Around 1997, the Board of Health took its current form, with 15 members – all five County Council members and 10 city representatives.

Dr. Hinds was the longest serving health officer to date. Dr. Gary Goldbaum replaced him in 2007, which brings us to the District’s more recent years.

There was the H1N1 influenza (Swine Flu) outbreak in 2009, when the District helped distribute vaccines for 26,000 people over the course of three days. Our first Community Health Assessment – a report that looks at health-related issues in the county – was completed that same year. The second such assessment wrapped up in 2013, identifying youth physical abuse, suicide, and obesity as top concerns. In 2014, a Community Health Improvement Plan was implemented to address those issues. That was also the year of the devastating mudslide near Oso, where 43 people died; Health District staff and volunteers responded.

Public health staff respond to Oso mudslide 

Another busy year in 2016: multiple cases of Zika, an
E. coli outbreak involving a child care facility, and the Board of Health became the second in Washington to require that manufacturers and distributors pay for safe disposal of unused medications.

Dr. Goldbaum retired in 2017. Given the growth in Snohomish County, and the complexity in disease response and emerging threats, his position was split in two. Jefferson Ketchel was named the agency’s first administrator, and a new health officer was hired, Dr. Mark Beatty.

Opioids have become a significant health and safety issue. In the summers of 2017 and 2018, the Health District conducted surveys to capture the number of opioid overdoses in a single week. The District has joined
a multi-agency emergency effort to address the opioid epidemic. Recently, the Health District released a report based on months of in-depth research to estimate the number of people in the county who are misusing opioids or suffering from opioid use disorder.

Expect research, data and partnerships to continue to play major roles for the Health District as we look to the future.

For 60 years, we’ve been proud to serve the people of Snohomish County. Moving forward, we’ll focus on finding the most effective ways to address health concerns and connect with the community.

Speaking of connections: Welcome to our new blog!
Public Health Essentials is a place to highlight the work of the Snohomish Health District as well as share health-related information and tips. But we promise not to spam your inboxes. Look for new posts just a few times a month.

Subscribe or check back for updates about the big stuff—yeah, we’re looking at you, measles outbreak—and a variety of other content, too. Have an idea for a topic, or a question that you’d like to see answered? We’d love to hear from you! Drop us a line at
SHDInfo@snohd.org.

Public health covers a lot of territory, and we have a lot of stories. We can’t wait to share them with you.

For more from the Snohomish Health District: