Description
From Triage to Tomorrow Suicide deaths have increased dramatically in recent years to 40,000 Americans annually, a leap that has been attributed variously to the Great Recession, wars in Iraq and Afghanistan, and access to guns and prescription pain killers – but what about medical error?
Timothy Spruill – Disarming the Suicidal Mind: Evidence-Based Assessment and Intervention
Thirty-nine percent of suicide completers have been seen in an ER within the past year (many for mental health complaints and self-harm), while 59% of ER patients with injuries from deliberate self-harm do not receive a psychiatric assessment. Despite these trends, graduate training in assessment of imminent self-harm is often limited, offering little practical experience in counseling labs due to intake policies designed to avoid liability.
This recording offers a revealing look inside the complex and rapidly expanding knowledge-base concerning the epidemiology of suicide and self-harm, while exploring the most effective measures you can take to save your patients’ lives. Learn to recognize risk factors associated with suicide attempts, as well as long-term and imminent warning signs, and accurately assess self-harm and suicide risk. Discover evidence-based interventions and explore the challenges of treatment across populations, including patients with addictive behaviors. Finally, we will deconstruct the emergency mental health protocols of today and identify common thinking errors leading to diagnostic and intervention mistakes that actually worsen crisis situations.
Handouts
Manual – Disarming the Suicidal Mind (8.41 MB)
56 Pages
Available after Purchase
Outline
INTRODUCTION TO THE GROWING PROBLEM OF SUICIDE IN AMERICA
Need for concern: statistics revealing the increasing trend in suicidal ideation, attempts, deaths
National data
State-specific data
Career risks for the professional counselor
Factors contributing to the failure of adequate assessment and triage
Inadequate training of physicians and professional counselors
Inadequate funding for mental health (despite numerous parity laws)
Shifting of the burden of assessment to emergency rooms
Poorly trained law enforcement officers initiating involuntary admissions
EPIDEMIOLOGY — CONTRIBUTING FACTORS
Risk factors
Demographic risk factors (age, gender, ethnicity, etc.)
Environmental risk factors (adverse childhood experiences)
Addictions
Mental illness
Economic risk factors (employment)
Warning signs
Feeling alone—isolated from family/friends
Feeling like a “burden†to others
Little or no fear of death
Red herrings
Suicide notes
Contingent suicide threats
Cutting
Pending divorce
Limitations of the research and potential risks
ASSESSMENTS/MEASURES TO AID IN DETERMINING RISK LEVEL — A COMPREHENSIVE STRATEGY
Mental status exam
Collateral information
Adults
Relative lethality of plans/attempt (Risk/Rescue Scale)
Hopelessness (Beck Hopelessness Inventory)
Reasons for living (Brief Reasons for Living Scale)
Adverse childhood experiences (A.C.E. Questionnaire)
Teens and children
Predictive/protective factors identified in the research
Special populations
Veterans
LGBT
Promising, novel methods for assessing risk
Implicit cognitions—measuring implicit associations with death and suicide
COMMON INTERVENTIONS, MISTAKES, THINKING ERRORS & ETHICAL ISSUES
Our natural tendencies to err
Feelings of “rightness†are not reliable indicators
External factors contributing to errors
Internal factors contributing to errors
Self-care is critical
Two types of thinking (fast and slow)
Dangers of lazy, “fast†associative thinking
Substitution of easy-to-answer question for more difficult and complex question
Type 1 vs. Type 2 errors (legal liability and ethical issues)
Patient autonomy and self-determination
Confidentiality limits
INTERVENTIONS AND TREATMENT PLANNING
Non-judgmental, empathic listening
Acknowledging reason for concern
Taking advantage of ambivalence
Evidence-based interventions to reduce subsequent suicide attempts
DSM-5® new definitions and terminology
Assess suicidal ideation at the start of every visit
DSM-5 level one screening questionnaire
Suicidal Behavior Disorder
Non-Suicidal Self-injury
CHALLENGES TO ACHIEVING SUCCESSFUL TREATMENT OUTCOMES
Means restriction
Social support — supervision
Follow-up counseling
Exploring alternative responses should suicidal thoughts increase in frequency/intensity
WHEN LOSING A PATIENT TO SUICIDE — REMAINING RESILIENT AND MOVING FORWARD
