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Q&A: Expert discusses research to mark National Suicide Prevention Month
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Suicide is the 10th leading cause of death in the United States and is increasing, according to the CDC.
In a recently issued Morbidity and Mortality Weekly Report, the CDC reported that suicide rates rose significantly between 1999 and 2016 in the U.S., with about 45,000 deaths by suicide reported in 2016. Furthermore, the findings also suggest that 54% of those who died by suicide did not have a known diagnosed mental health condition.
Understanding the trends and factors that contribute to suicide can help inform how clinicians and public health officials can address suicide in the United States as a whole and in smaller, local communities.
To mark National Suicide Prevention Month this September, Healio Psychiatry spoke with Michele Berk, PhD, assistant professor in the department of psychiatry and behavioral sciences, division of child and adolescent psychiatry at Stanford University, on suicide prevention research, trends and recent findings and implications from pivotal studies. – by Savannah Demko
A report from the CDC showed that suicide rates are increasing in the U.S. What are the larger implications and how can clinicians respond?
The increasing rate of suicides in the United States underscores the urgent need for additional research and resources focused on suicide prevention. Suicide is a complex and multi-determined behavior; hence, suicide prevention efforts need to take place on multiple levels and across multiple settings. In addition to continuing to identify and disseminate effective mental health treatments to those who have entered the mental health system, broader-based strategies such as restriction of access to lethal means, responsible media reporting and use of social media to reduce suicide contagion and early prevention and intervention efforts in schools and primary care settings are also needed.
A recent JAMA Psychiatry study showed the efficacy of dialectical behavior therapy for reducing self-harm and suicide attempts in highly suicidal self-harming teenagers. What are some interventions that can help youth with suicidal behavior or history of self-injury ?
Dialectical behavior therapy (DBT) has been shown to be effective at reducing self-harm behaviors in adolescents in two separate clinical trials, one conducted in the United States and one conducted in Norway. DBT is a comprehensive treatment package that includes weekly individual therapy, multifamily group therapy (in which teens and parents attend group sessions together, along with other families), availability of telephone coaching by the therapist, and family and parent sessions as needed. DBT focuses on helping teens "build a life worth living" and teaching behavioral coping skills to manage strong negative emotions instead of engaging in self-harm.
A research letter published in JAMA Pediatrics found that black children were nearly twice as likely to die by suicide when compared with white children of the same age. What can health care professionals do to address race-related differences and to develop more effective suicide detection/prevention efforts for minorities?
Additional research is needed to understand the reasons for this race-based disparity in suicide rates to inform intervention approaches and consideration of cultural and societal factors is critical. Health care professionals should be made aware of the increased risk of suicide among black children ages 5 to 12 years in order to target prevention and intervention efforts toward this group.
How can different medical specialists (psychiatrists, pediatri cian s, primary care physician s , etc.) work together to collaboratively address suicide prevention?
Primary care presents a window of opportunity for identifying youth at risk for suicide and linking them to mental health services. Research has shown that far more youth with suicidal thoughts will be seen by their pediatrician than will be seen by a mental health provider. Primary care physicians can be trained to ask questions about suicide risk as well as having patients complete short questionnaires that measure this. Once a teen is identified as being at risk, linkage to appropriate mental services is critical. Close relationships between primary care and local mental providers is one means of ensuring individuals at risk receive care. Embedding mental health care within primary care practices has also been studied and shown promise.
References:
Stone DM, et al. MMWR Morb Mortal Wkly Rep. 2018;doi: 10.15585/mmwr.mm6722a1.
Disclosure: Berk reports no relevant financial disclosures.