These summits will encourage congregations and faith-based organizations to sign up for the National Guard’s Partners in Care program, which coordinates support for National Guard members and their families through partnerships with local faith communities. Each event will feature suicide prevention gatekeeper training by the Department of Veterans Affairs, presentations on understanding military culture, and opportunities to learn more about local National Guard initiatives. The no-cost, one-day summits, Connecting and Equipping Faith-Based Communities to Support Service Members, Veterans, and Their Families, will be held in four states.
The Weekly Spark: Friday, May 4, 2012
Announcements
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SAMHSA, Action Alliance and State National Guard Chaplains Offices sponsor faith-based summits focused on providing care for service members
Information and registration for the first two of the summits are as follows.
Oregon, Camp Withycombe, Clackamas, May 8, 8:30-3:30, www.wciconferences.com/oregon-2012; for questions and registration contact Ms.Élan Lambert Elambert1@aol.com or 503-584-2270.
Virginia, Regional Training Institute at Fort Pickett, Blackstone, May 14, 9:00-3:00, for questions and registration contact Chaplain J. D. Moore jd.moore1@us.army.mil
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Centre for Research and Intervention on Suicide and Euthanasia (CRISE) holds 9th Summer Institute, New Technologies and Suicide Prevention - May 30-June 1, 2012, Université de Montréal, Quebec
This summit presents a unique opportunity to explore the use of new technologies in the field of suicide prevention. Researchers and practitioners from Quebec and around the world will be sharing their innovative approaches. There will be three days of activities, including two days with plenary presentations (conferences and discussions) with simultaneous translation. The other day will provide half-day and full-day workshops for practitioners to address the specific skills needed to work with these new technologies.
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Unified Community Solutions and National Suicide Prevention Lifeline Consumer Survivor Subcommittee launch free online resource for caregivers on suicide grief support
Reviewed by grief and trauma experts, suicide bereavement support volunteers, crisis center directors, and survivors of suicide loss, the online Suicide Grief Support Quick Reference is now available for crisis workers, other caregivers and grief support practitioners who work with people bereaved by suicide. It provides practical guidance and links to resources for survivors and child survivors, as well as online support for survivors and direction for caregivers on how to be helpful to people coping with grief after suicide. It includes a “how-to” video to aid in navigating the resource.
Research
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Assessing Patients for Self-Harm
A pair of researchers in the United Kingdom suggest that suicide assessments can be more reliable if clinicians focus on the need for additional assessment and the presence of risk factors associated with initial, continuing, re-occurring, and escalating suicidal behavior rather than rating risk using ambiguous terms (such as low, medium, and high) and failing to distinguish between types of suicide events for which the patient may be at risk.
Social workers and clinical psychologists from community mental health teams were given reports about hypothetical patients referred by general practitioners after an incident of self-harm. Each clinician assessed the patients for suicide risk (using the categories of high, medium, and low) as well as the probability that the patients would engage in self-harm within the next six months. They also provided a recommendation of the need for additional assessment. The cases were defined (and the assessments analyzed) on the basis of 10 “cues” included in the referral letters that professional guidelines agree influence the risk of self-harm. These cues were: 1) sex (male or female), 2) age, 3) substance abuse, 4) a precipitating event (trigger), 5) social support, 6) a major adverse life event, 7) current mental state (hopeful or hopeless), 8) a suicide plan, 9) how well the patient managed a previous episode of self-harm, and 10) the seriousness of that episode.
The clinicians’ assessments of suicide risk and need for further assessment were “consistent with practice guidelines.” Each clinician was generally consistent in his or her assessments, although more experienced providers were more consistent than younger clinicians. There was less agreement among assessments by the clinicians, especially in the assessments of patients whose risk was judged to be low. The research team concluded that these differences reflected differences in defining ‘low,’ ‘medium,’ and ‘high’ risk as well as how the clinicians interpreted the term “risk.” They theorized that some clinicians think of risk as a measure of probability (that is, how likely is a person to harm him- or herself in the future) while others interpret risk as a measure of probability and a measure of the severity of the potential self-harm. The group that includes severity in risk is more likely to prioritize additional assessment for patients judged to be at risk, since they anticipate that the risk will have severe consequences.
The authors suggest that better definitions of risk would reduce these inconsistencies as well as inconsistencies caused by differing interpretations of the impact of some risk factors. For example, despite the fact that research has demonstrated that major adverse life events raise suicide risk, clinicians assessed patients who had undergone such an event to be less at risk, and less in need of additional assessment, than others. The authors speculate that the clinicians believed that the patients who had engaged in self-harm during an adverse life event would be less at risk in the future as the effects of the event dissipated. They suggest that it is important to use appropriate criteria to assess the probability of initial, continuing, re-occurring, or escalating suicidal behavior (given that each is associated with different risk factors).
Combining results from two or more participants to simulate assessment teams did not significantly improve overall assessment results. Nor were the assessments produced by these teams more reliable than the most reliable individual assessors (that is, the assessors who were most consistent in applying criteria for assessing risk and prioritizing follow-up). However, any combination of participants tended to be more consistent than the least reliable individual clinicians. The authors suggest that this finding provides support for using teams to assess suicide risk.
Cahill, S. & Rakow, T. (2011). Assessing risk and prioritizing referral for self-harm: When and why is my judgement different from yours? Clinical Psychology & Psychotherapy. doi: 10.1002/cpp.754.
News
National News
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Stressed physicians reluctant to seek support
This article in American Medical News looks at stress, burnout and depression, and suicide among physicians. A study of doctors at Brigham and Women’s Hospital in Boston (published in Archives of Surgery) found that nearly 80 percent had experienced a personal crisis within the past year, but most said they would not be willing to seek support from physician-health services or employee assistance programs. Reasons for not getting help included lack of time (cited by 90 percent) and concerns related to confidentiality (68 percent), negative career impact (68 percent), and stigma related to mental illness (62%). Almost half said they feared legal consequences or thought that “using services means I am weak.” According to previous studies cited by the Archives of Surgery article, between 15 percent and 75 percent of physicians are under severe stress or suffering from burnout, and as many as 30 percent are depressed. According to data from the American Foundation for Suicide Prevention, physicians are more likely to die by suicide than others of the same gender and age who are not doctors. At Brigham and Women’s, Jo Shapiro (lead author of the Archives of Surgery study) and her colleagues have instituted a one-to-one physician support program. “We do not wait for people to ask. We do a reach-out call,” said Shapiro. “The reason for that is to normalize the whole process.”
Apr 30, 2012 -
Can letters prevent military suicides?
The Caring Letters Project is a pilot program in which brief, personalized follow-up letters are sent to patients considered to be at high risk for suicide following discharge from military medical center inpatient psychiatry units. The program is based on the Caring Letters concept developed and evaluated by psychiatrist Jerome Motto and clinician Alan Bostrom, who studied patients discharged from inpatient psychiatric facilities in San Francisco. The Caring Letters Project pilot is designed to test the feasibility of extending the Caring Letters model to other military treatment facilities; to collect preliminary outcome data; and to evaluate the method of letter transmittal (email versus postal mail). The Caring Letters Project was established by the National Center for Telehealth and Technology (T2) and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.
Apr 24, 2012
State News
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Bernard Mayes to be honored as lifeline to suicidal
Fifty years ago, Bernard Mayes, an ordained Episcopal priest, created the first suicide hotline in the United States. At first, Mayes advertised on city buses under a pseudonym (“Thinking of ending it all? Call Bruce, PR1-0450, San Francisco Suicide Prevention”) and answered all the calls himself. San Francisco Suicide Prevention now has 100 volunteers and 10 paid staff members; call volume has increased from 200 calls per month to 200 calls per day. The organization’s fiftieth anniversary was recently celebrated at a gala event[l1] [l2] [SL3] .
Apr 28, 2012
International News
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B.C. bridges still lack suicide prevention barriers
CanadaAs government officials in British Columbia consider how to prevent suicides on bridges, the aesthetics, expense, and efficacy of suicide prevention barriers are all part of the discussion. New bridges are being constructed with suicide barriers as part of the design, but existing bridges can be expensive to retrofit (suicide barriers for the iconic Lions Gate suspension bridge may cost up to $35 million). It can also be difficult to create a barrier that visually harmonizes with the bridge’s design. More than three years ago, the B.C. Coroners Service recommended installing barriers on the Lions Gate and four other bridges in the Vancouver area. A literature review conducted for the local government supported the efficacy of barriers, but after weighing the options, officials decided to install six telephones on the Lions Gate bridge at a cost of about $4,000 per month. Critics contend that the number of suicides from the bridge has not decreased since the phones were installed, and that a barrier is still needed.
May 1, 2012
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