Evidence-based, effective strategies to suicide prevention
September 15, 2022
- Suicide was the leading cause of death in the U.S. in 2020. The number of people who think about or attempt suicide is even higher.
- Health care providers can use evidence-based tools to identify and provide access to life-saving resources to at-risk patients.
- Dr. Virna Little, a nationally recognized expert in suicide prevention, talks about the challenges caregivers face as well as the power they have — to give hope to those who contemplate or carry out self-harm.
45,979 — the number of Americans who died by suicide in 2020.
According to the National Institute of Mental Health, suicide is the twelfth most common cause of death in the U.S. In certain age groups, suicide is a larger contributor to the cause of death. For example, among children 10 to 14 years of age, suicide is the third leading cause of death. Countless others inflict harm on themselves with the intent of suicide. And a prior suicide attempt is the single most important risk factor for suicide.
For health care providers, it’s incredibly common to encounter patients who are afraid to even say the word. Language is important. We need to speak frankly about suicide — even when it’s difficult — and word choice matters, too.
It’s vital for providers and health care leaders to tell their team members: “This is a place where we talk about suicide directly.”
It’s crucial to engage health care teams in understanding the prevalence of suicide and speaking frankly about how many of us are touched by it — and not just in the workplace. Equipped with evidence-based practices, caregivers and providers at every level can help decrease the stigma around behavioral health and provide compassionate, lifesaving care to those at risk.
The increasing prevalence of behavioral health concerns reaches across the health care system. An increasing number of pediatric patients with behavioral health concerns are presenting in primary care settings and emergency rooms. We’re also seeing rising numbers of suicides, particularly in the pediatric and geriatric populations.
Thankfully, there are several tools available to gauge the risk of self-harm: the Columbia Suicide Severity Rating Scale (C-SSRS), the Stanley-Brown safety planning tools and the ASQ (or “Ask”) tool for pediatric patients. All three are evidence-based approaches to discussing suicide that doesn’t require prior qualifications to administer.
Medical assistants, nurses, emergency room physicians, primary care providers and even community members are able to learn how to use the Columbia scale, the ASQ and Stanley-Brown safety planning.
One of the most difficult aspects of caring for individuals at risk for suicide is the risk they could cause to others — including their caregivers. Utilizing evidence-based tools like the C-SSRS can bring light to those risks. These tools can also help caregivers address their own behavioral health concerns, providing a sense of wellness for the person offering the care.
Additionally, when talking to someone who is at risk of self-harm, caregivers and providers can rely on “storage statements”. Storage statements are go-to (yet not impersonal) phrases to use when speaking to individuals who express thoughts of suicide. These statements might include:
- Thank you for telling me you are thinking about suicide
- It took a strong person to come into the emergency room to tell us you're thinking about suicide
Caregivers who don’t have the proper tools may feel powerless and susceptible to burnout; however, utilizing tools like storage statements and standardized assessments can help get the at-risk individual the treatment they need to potentially save their life.
A safety plan is an action plan
When health care providers put a suicide prevention process in place, they can identify more people at earlier stages and lesser stages of risk. Risk identification must go hand-in-hand with safety planning, which is an evidence-based intervention. At Concert Health, we’ve seen an uptick in the number of patients who are identified as being at-risk. That’s a good thing.
Giving patients personalized and specific plans — or a care plan — around what they can do if they are in crisis is vital. A care plan for an individual at risk for suicide is fundamentally the same treatment approach as for someone with physical symptoms.
At Concert, we provide a personalized care plan with all of the tools they need to initiate the treatment process including people they can call and things they can do — helping them cope at home. Specifically, our clinicians will share the Now Matters Now website and the National Suicide Prevention Lifeline (designated as the new three-digit dialing code 988). We even recommend making a playlist of music that can help them in the midst of a crisis.
If someone you know is suffering, don’t wait to get them help. There are a wealth of tools and resources available. Most importantly, one of the best things we can do is offer hope to someone struggling — and the power of hope does not require a degree or a particular background. Remember: Broaching the topic of self-harm doesn’t increase an individual’s risk of suicide. Overlooking it does.
Concert Health provides behavioral health services to primary care providers and organizations across the country. Our care is centered on Collaborative Care, an evidence-based model proven to improve behavioral health conditions, such as depression and anxiety, within primary care and women’s health settings.
We can do more together. Contact us to start the conversation.