Suicide is one of the leading causes of death in the U.S., with more than 48,000 people dying by suicide in 2021. This is equivalent to one death every 11 minutes.
What are the gaps in suicide prevention? The question was posed during a recent panel discussion at HLTH 2023 held in Las Vegas.
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Dr. Myra Altman, chief clinical officer of Brightline and a panelist, said there are gaps across the full spectrum of prevention care, from primary prevention to secondary prevention to tertiary prevention. Primary prevention refers to the prevention of mental health disorders before they occur, while secondary prevention is when a patient already has a mental health disorder and care is focused on detecting it early and intervening. Tertiary prevention, meanwhile, is focused on the period after a mental health disorder or crisis takes place.
To address these areas, there needs to be better access to the right care and better screening for mental health. But patients also need help understanding their thoughts and emotions, Altman said. She noted that when she was in clinical practice, she worked with patients who had severe suicidal ideation.
“Their brains would tell them, ‘You will be better off, everyone else will be better off if you’re not here.’ And unless you understand what your brain is telling you, what depression is telling you, you believe that. You start to think that is your only option,” Altman said. “And so a lot of the work I did with cognitive behavioral therapy and acceptance and commitment therapy was helping people see their thoughts as just thoughts.”
She went on to say that by helping patients recognize these thoughts, they can start to realize that the thoughts are not true and that “there are people who love me, there are people who I bring joy to their life.”
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“If you can give people those skills and tools to understand their emotions, understand their thoughts, we’re just setting them up for a lifetime where they know a bit more and they can handle the things that will come up because things will come up,” Altman added.
Another panelist, Dr. Shairi Turner, chief health officer of Crisis Text Line, listed several gaps in suicide prevention care, echoing Altman’s comments on the need for better screening and better access to care. But she said the industry also needs to have a better understanding of the needs of different communities.
“We have to get granular with different groups because a gap for one age, race, gender is different,” Turner said. “We have to be willing to understand the needs of every single group who’s struggling with suicide.”
One group in particular that is struggling is LGBTQ+ youth, said Nova Bright, head of internal training at The Trevor Project, a nonprofit organization focused on suicide prevention for this population. LGBTQ+ individuals battle severe discrimination, and it’s from adults most of the time.
“One of the interesting things that we find is that it’s not necessarily young folks who are messing it up for each other. It’s adults. It’s laws and policies that are targeting individuals with certain identities. It’s adults teaching their children this biased, hateful behavior and then that gets carried on from generation to generation,” Bright said.
Another panelist added that mental health clinicians are “generalists” and that suicidology should be a subspecialty of mental health. He noted that the mental health industry should take a page from cardiology.
“You cannot expect psychiatrists, psychologists and social workers to know how to and effectively treat suicidal patients who are at risk of an attempt, just like we don’t expect cardiologists to be electrophysiologists,” said Dr. Seth Feuerstein, faculty of Oui Therapeutics.
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