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SFSP Blog

Enjoy letters from our staff, messages from clients and volunteers, and other thoughtful essays!
Jeremy shares his path to SFSP - February, 2017 A Letter from the Executive Director - January 10th, 2017.

Suicide Notes Infographic



http://www.socialworkdegreecenter.com/suicide-notes/

Golden Gate Bridge board OKs $76 million for suicide barrier

Updated 8:20 am, Saturday, June 28, 2014

Over the years, hundreds of people have leaped to their deaths from the Golden Gate Bridge into the San Francisco Bay. Photo: Paul Chinn, The Chronicle

Over the years, hundreds of people have leaped to their deaths from the Golden Gate Bridge into the San Francisco Bay. Photo: Paul Chinn, The Chronicle
The decades-long effort to build a suicide barrier on the Golden Gate Bridge succeeded Friday as the transportation district's Board of Birectors OKd funding for nets that will be installed about three years from now.
"We did it," shouted a woman in the midst of a giant group hug, moments after the board of the Golden Gate Bridge, Highway and Transportation District voted unanimously to approve a $76 million funding plan for installation of steel-cable nets 20 feet beneath the east and west edges of the bridge that are intended to deter people from leaping to their deaths or catch them if they do.
Supporters of the suicide net - most of them family members of people who have jumped to their deaths from the bridge - knew that the board was expected to finally approve the barrier after decades of death and debate. Still, more than a dozen, some clutching photographs of their deceased sons, daughters, partners and friends, spoke of the unending pain of losing loved ones to suicide and urged directors to approve the plan.
"The time of healing can only begin when the steady drip-drip-drip of bodies into the raging waters has stopped," said Dana Barks of Napa, whose son, Donovan, jumped to his death in 2008.
According to the Bridge Rail Foundation, which has worked for a barrier, at least 1,600 people have jumped to their deaths from the Golden Gate Bridge, including 46 last year. Many of their family members have joined the campaign for some kind of suicide barrier on the bridge. Some barrier supporters have become familiar faces as they've returned to speak to the bridge board time and again over the years.
After reading a series of Chronicle stories about bridge suicides in the 1970s, Roger Grimes started campaigning for a barrier, walking regularly on the bridge with a sign reading, "Please care: support a suicide barrier," as well as attending numerous meetings.

'It had to happen'

While he was often discouraged by the lack of support, he said after the vote, "I knew someday it would happen. It was so wrong. It had to happen."
Although the funding is lined up and the net is mostly designed, it will take about three years before it is built and installed, said Denis Mulligan, bridge district general manager.

Injured but alive

The net design was chosen out of five potential suicide barriers - the rest were all 10- to 12-foot fences or walls - in 2008. Two nets, made of thick steel cables, will be stretched the 1.7-mile length of the bridge two stories beneath its public sidewalks. The presence of the net, bridge officials hope, will deter anyone from jumping.
But if they do, Mulligan said, they'll probably be injured but alive. The net, suspended from posts, will have a slightly upward slope, and will collapse a bit if someone lands in it, making it difficult for the jumper to climb out. The bridge district will deploy a retrieval device to pluck jumpers from the net.
Nobody voiced any objections to the plan at Friday's meeting, but in the past critics have complained that a barrier would mar the scenic bridge's appearance and that it would simply drive suicidal people elsewhere.

Deter jumpers

Dr. Mel Blaustein, the medical director of psychiatry at St. Francis Hospital, said research shows that people deterred by barriers from jumping to their deaths do not go to other, nearby sites.
"We have scientific evidence of that," he said.
Suicide barriers on other bridges have proved to be successful in deterring jumpers, according to a study released by barrier backers. At the Ellington Street Bridge in Washington, D.C., suicides dropped from 25 in seven years to one in the five years after a barrier was erected. A span in Switzerland with a net saw suicides drop from 2.5 per year to none.
In approving the spending plan, the directors committed to spend $20 million in bridge tolls to the plan, something they had previously opposed. The rest of the money will come from $49 million in federal funds steered toward the barrier by Caltrans and theMetropolitan Transportation Commission, and $7 million in state mental health funds.

'Right thing to do'

Mulligan, in a report to the board, said building the barrier "simply is the right thing to do at this time."
Just before the vote, Director Janet Reilly, who helped campaign for barrier funds, voiced her agreement.
"It's not every day you have an opportunity to save a life, and hardly ever that you have an opportunity to save many lives," she said. "Today is that day."
Michael Cabanatuan is a San Francisco Chronicle staff writer. E-mail:mcabanatuan@sfchronicle.com Twitter: @ctuan

Golden Gate Bridge board OKs $76 million for suicide barrier

Updated 8:20 am, Saturday, June 28, 2014

Over the years, hundreds of people have leaped to their deaths from the Golden Gate Bridge into the San Francisco Bay. Photo: Paul Chinn, The Chronicle

Over the years, hundreds of people have leaped to their deaths from the Golden Gate Bridge into the San Francisco Bay. Photo: Paul Chinn, The Chronicle
The decades-long effort to build a suicide barrier on the Golden Gate Bridge succeeded Friday as the transportation district's Board of Birectors OKd funding for nets that will be installed about three years from now.
"We did it," shouted a woman in the midst of a giant group hug, moments after the board of the Golden Gate Bridge, Highway and Transportation District voted unanimously to approve a $76 million funding plan for installation of steel-cable nets 20 feet beneath the east and west edges of the bridge that are intended to deter people from leaping to their deaths or catch them if they do.
Supporters of the suicide net - most of them family members of people who have jumped to their deaths from the bridge - knew that the board was expected to finally approve the barrier after decades of death and debate. Still, more than a dozen, some clutching photographs of their deceased sons, daughters, partners and friends, spoke of the unending pain of losing loved ones to suicide and urged directors to approve the plan.
"The time of healing can only begin when the steady drip-drip-drip of bodies into the raging waters has stopped," said Dana Barks of Napa, whose son, Donovan, jumped to his death in 2008.
According to the Bridge Rail Foundation, which has worked for a barrier, at least 1,600 people have jumped to their deaths from the Golden Gate Bridge, including 46 last year. Many of their family members have joined the campaign for some kind of suicide barrier on the bridge. Some barrier supporters have become familiar faces as they've returned to speak to the bridge board time and again over the years.
After reading a series of Chronicle stories about bridge suicides in the 1970s, Roger Grimes started campaigning for a barrier, walking regularly on the bridge with a sign reading, "Please care: support a suicide barrier," as well as attending numerous meetings.

'It had to happen'

While he was often discouraged by the lack of support, he said after the vote, "I knew someday it would happen. It was so wrong. It had to happen."
Although the funding is lined up and the net is mostly designed, it will take about three years before it is built and installed, said Denis Mulligan, bridge district general manager.

Injured but alive

The net design was chosen out of five potential suicide barriers - the rest were all 10- to 12-foot fences or walls - in 2008. Two nets, made of thick steel cables, will be stretched the 1.7-mile length of the bridge two stories beneath its public sidewalks. The presence of the net, bridge officials hope, will deter anyone from jumping.
But if they do, Mulligan said, they'll probably be injured but alive. The net, suspended from posts, will have a slightly upward slope, and will collapse a bit if someone lands in it, making it difficult for the jumper to climb out. The bridge district will deploy a retrieval device to pluck jumpers from the net.
Nobody voiced any objections to the plan at Friday's meeting, but in the past critics have complained that a barrier would mar the scenic bridge's appearance and that it would simply drive suicidal people elsewhere.

Deter jumpers

Dr. Mel Blaustein, the medical director of psychiatry at St. Francis Hospital, said research shows that people deterred by barriers from jumping to their deaths do not go to other, nearby sites.
"We have scientific evidence of that," he said.
Suicide barriers on other bridges have proved to be successful in deterring jumpers, according to a study released by barrier backers. At the Ellington Street Bridge in Washington, D.C., suicides dropped from 25 in seven years to one in the five years after a barrier was erected. A span in Switzerland with a net saw suicides drop from 2.5 per year to none.
In approving the spending plan, the directors committed to spend $20 million in bridge tolls to the plan, something they had previously opposed. The rest of the money will come from $49 million in federal funds steered toward the barrier by Caltrans and theMetropolitan Transportation Commission, and $7 million in state mental health funds.

'Right thing to do'

Mulligan, in a report to the board, said building the barrier "simply is the right thing to do at this time."
Just before the vote, Director Janet Reilly, who helped campaign for barrier funds, voiced her agreement.
"It's not every day you have an opportunity to save a life, and hardly ever that you have an opportunity to save many lives," she said. "Today is that day."
Michael Cabanatuan is a San Francisco Chronicle staff writer. E-mail:mcabanatuan@sfchronicle.com Twitter: @ctuan

Program to save teens from suicide by texting

By: Victoria Colliver

Updated 1:41 pm, Friday, September 27, 2013
Jacqueline Monetta, 17, whose best friend committed suicide, attends a state Senate meeting on suicide strategies. Photo: Liz Hafalia, The Chronicle
 
(09-27) 13:39 PDT SAN FRANCISCO -- When Dan Strauss' 17-year-old son Alex sought help in the hours before he took his life, he didn't try to talk to someone or call a suicide hotline. He reached out in the way he always communicated: via text, to his therapist in the middle of the night.
"After it was too late, the counselor said she got a text from him," Strauss said. "Students are reaching out by texting. That's how they communicate. Why don't we just recognize this?"
A growing number of suicide prevention groups around the country, including one in San Francisco, are starting to catch on.
Last month, San Francisco Suicide Prevention began a pilot text-based suicide intervention program with one San Francisco high school and plans to expand it to other schools in the city early next year.
The program, called MyLife, gives students a text number they can use to connect with a trained crisis counselor. Similar to telephone hotlines, the counselor can provide emotional support and alert emergency services if necessary. The program is funded by 2004's Proposition 63, also known as the Mental Health Services Act.
"Our intention is to provide more avenues for kids to reach out and contact us," saidMichelle Thomas, director of outreach and education for San Francisco Suicide Prevention. Thomas, who spoke about the program before a California Senate mental health committee hearing earlier this week in San Francisco, declined to identify the school or publicize the text number because the project is still in its early stages.
"Eventually this (texting program) would be for everybody, but we wanted to start with youth based on the research," she said.

S.F.'s suicide rates

San Francisco high school students' suicide rates are comparable to their counterparts in the rest of the country and fluctuate from year to year. San Francisco has about 100 suicides among all ages each year, and about one to three of those deaths involve people under age 20, according to San Francisco Suicide Prevention officials.
A 2011 Centers for Disease Control and Prevention study found that about 26 percent of San Francisco students reported feeling sad or hopeless almost every day for two or more weeks, while 13 percent said they had "seriously considered" attempting suicide in the prior year and 9 percent reported at least one attempt in that time period.
Focus groups conducted by San Francisco Suicide Prevention found that all students interviewed favored adding a text-based service to the current types of help already available. A quarter of the students said they would prefer text over all forms of communication in a crisis while 25 percent indicated they would want to speak to someone face-to-face, 25 percent would use a hotline and another 25 percent preferred chat.

Hotline 'antiquated'

"It was really glaring how antiquated the notion of a traditional hotline was," saidJonathan Mark Herzenberg, a school-based clinical psychologist who participated in the San Francisco Suicide Prevention task force studying the text option.
Herzenberg, associate head of student life at Drew School in San Francisco, said texting generally surpasses all modes of communication for teens. "They don't break up in a relationship over phone or face to face," he said. "They don't ask each other out over the phone or face-to-face. It's over text."

In other states

Text-based hotlines started in other parts of the country, including Nevada and Minnesota, have already shown some success. Minnesota's TXT4Life hotline last year handled more than 3,800 text sessions from 1,985 young people seeking help.
In the wake of his son's death, Strauss of Chico started the Alex Project, a nonprofit that promotes texting access to lifesaving crisis center services.
Strauss' goal is for a statewide and ultimately nationwide 24-hour crisis texting service. But even then, he said, the work will continue. "There will be something after texting," he said. "The crisis centers, because they struggle with funding, will always be one generation behind. But what's at stake is lives."
Jacqueline Monetta, a 17-year-old senior at St. Ignatius College Preparatory in San Francisco, described the best friend she lost to suicide in 2010 as the "queen of texters."
She'll never know if her friend would have turned to a text-based service for help, but Monetta said that wasn't even an option for her.
"It's surprising that there hasn't been a texting program. I rarely talk to any student that called a hotline," said Monetta of Kentfield, who is working on a documentary film that focuses on teen suicide and texting as a way to help.
"Sometimes it's sad to think our culture has gone to never talking on the phone, but that really is our way of communicating - it's texting," she said. "And if it's going to help somebody by texting, that's more important."

Texting to prevent suicides

Suicide is the third-leading cause of death among people aged 15 to 24, claiming 4,140 lives each year, according to federal statistics. A number of suicide prevention services are starting to offer 24-hour text crisis counseling. More information and help can be found here:
San Francisco Suicide Prevention: www.sfsuicide.org 24-Hour Crisis Line: (415) 781-0500.
National Suicide Prevention Lifeline: www.suicidepreventionlifeline.org 24-Hour Hotline: (800) 273-8255.
Source: http://www.sfgate.com/health/article/Program-to-save-teens-from-suicide-by-texting-4847422.php

Program to save teens from suicide by texting

By: Victoria Colliver

Updated 1:41 pm, Friday, September 27, 2013

Jacqueline Monetta, 17, whose best friend committed suicide, attends a state Senate meeting on suicide strategies. Photo: Liz Hafalia, The Chronicle


(09-27) 13:39 PDT SAN FRANCISCO -- When Dan Strauss' 17-year-old son Alex sought help in the hours before he took his life, he didn't try to talk to someone or call a suicide hotline. He reached out in the way he always communicated: via text, to his therapist in the middle of the night.
"After it was too late, the counselor said she got a text from him," Strauss said. "Students are reaching out by texting. That's how they communicate. Why don't we just recognize this?"
A growing number of suicide prevention groups around the country, including one in San Francisco, are starting to catch on.
Last month, San Francisco Suicide Prevention began a pilot text-based suicide intervention program with one San Francisco high school and plans to expand it to other schools in the city early next year.
The program, called MyLife, gives students a text number they can use to connect with a trained crisis counselor. Similar to telephone hotlines, the counselor can provide emotional support and alert emergency services if necessary. The program is funded by 2004's Proposition 63, also known as the Mental Health Services Act.
"Our intention is to provide more avenues for kids to reach out and contact us," saidMichelle Thomas, director of outreach and education for San Francisco Suicide Prevention. Thomas, who spoke about the program before a California Senate mental health committee hearing earlier this week in San Francisco, declined to identify the school or publicize the text number because the project is still in its early stages.
"Eventually this (texting program) would be for everybody, but we wanted to start with youth based on the research," she said.

S.F.'s suicide rates

San Francisco high school students' suicide rates are comparable to their counterparts in the rest of the country and fluctuate from year to year. San Francisco has about 100 suicides among all ages each year, and about one to three of those deaths involve people under age 20, according to San Francisco Suicide Prevention officials.
A 2011 Centers for Disease Control and Prevention study found that about 26 percent of San Francisco students reported feeling sad or hopeless almost every day for two or more weeks, while 13 percent said they had "seriously considered" attempting suicide in the prior year and 9 percent reported at least one attempt in that time period.
Focus groups conducted by San Francisco Suicide Prevention found that all students interviewed favored adding a text-based service to the current types of help already available. A quarter of the students said they would prefer text over all forms of communication in a crisis while 25 percent indicated they would want to speak to someone face-to-face, 25 percent would use a hotline and another 25 percent preferred chat.

Hotline 'antiquated'

"It was really glaring how antiquated the notion of a traditional hotline was," saidJonathan Mark Herzenberg, a school-based clinical psychologist who participated in the San Francisco Suicide Prevention task force studying the text option.
Herzenberg, associate head of student life at Drew School in San Francisco, said texting generally surpasses all modes of communication for teens. "They don't break up in a relationship over phone or face to face," he said. "They don't ask each other out over the phone or face-to-face. It's over text."

In other states

Text-based hotlines started in other parts of the country, including Nevada and Minnesota, have already shown some success. Minnesota's TXT4Life hotline last year handled more than 3,800 text sessions from 1,985 young people seeking help.
In the wake of his son's death, Strauss of Chico started the Alex Project, a nonprofit that promotes texting access to lifesaving crisis center services.
Strauss' goal is for a statewide and ultimately nationwide 24-hour crisis texting service. But even then, he said, the work will continue. "There will be something after texting," he said. "The crisis centers, because they struggle with funding, will always be one generation behind. But what's at stake is lives."
Jacqueline Monetta, a 17-year-old senior at St. Ignatius College Preparatory in San Francisco, described the best friend she lost to suicide in 2010 as the "queen of texters."
She'll never know if her friend would have turned to a text-based service for help, but Monetta said that wasn't even an option for her.
"It's surprising that there hasn't been a texting program. I rarely talk to any student that called a hotline," said Monetta of Kentfield, who is working on a documentary film that focuses on teen suicide and texting as a way to help.
"Sometimes it's sad to think our culture has gone to never talking on the phone, but that really is our way of communicating - it's texting," she said. "And if it's going to help somebody by texting, that's more important."

Texting to prevent suicides

Suicide is the third-leading cause of death among people aged 15 to 24, claiming 4,140 lives each year, according to federal statistics. A number of suicide prevention services are starting to offer 24-hour text crisis counseling. More information and help can be found here:
San Francisco Suicide Prevention: www.sfsuicide.org 24-Hour Crisis Line: (415) 781-0500.
National Suicide Prevention Lifeline: www.suicidepreventionlifeline.org 24-Hour Hotline: (800) 273-8255.
Source: http://www.sfgate.com/health/article/Program-to-save-teens-from-suicide-by-texting-4847422.php

Program to save teens from suicide by texting

By: Victoria Colliver

Updated 1:41 pm, Friday, September 27, 2013

Jacqueline Monetta, 17, whose best friend committed suicide, attends a state Senate meeting on suicide strategies. Photo: Liz Hafalia, The Chronicle


(09-27) 13:39 PDT SAN FRANCISCO -- When Dan Strauss' 17-year-old son Alex sought help in the hours before he took his life, he didn't try to talk to someone or call a suicide hotline. He reached out in the way he always communicated: via text, to his therapist in the middle of the night.
"After it was too late, the counselor said she got a text from him," Strauss said. "Students are reaching out by texting. That's how they communicate. Why don't we just recognize this?"
A growing number of suicide prevention groups around the country, including one in San Francisco, are starting to catch on.
Last month, San Francisco Suicide Prevention began a pilot text-based suicide intervention program with one San Francisco high school and plans to expand it to other schools in the city early next year.
The program, called MyLife, gives students a text number they can use to connect with a trained crisis counselor. Similar to telephone hotlines, the counselor can provide emotional support and alert emergency services if necessary. The program is funded by 2004's Proposition 63, also known as the Mental Health Services Act.
"Our intention is to provide more avenues for kids to reach out and contact us," saidMichelle Thomas, director of outreach and education for San Francisco Suicide Prevention. Thomas, who spoke about the program before a California Senate mental health committee hearing earlier this week in San Francisco, declined to identify the school or publicize the text number because the project is still in its early stages.
"Eventually this (texting program) would be for everybody, but we wanted to start with youth based on the research," she said.

S.F.'s suicide rates

San Francisco high school students' suicide rates are comparable to their counterparts in the rest of the country and fluctuate from year to year. San Francisco has about 100 suicides among all ages each year, and about one to three of those deaths involve people under age 20, according to San Francisco Suicide Prevention officials.
A 2011 Centers for Disease Control and Prevention study found that about 26 percent of San Francisco students reported feeling sad or hopeless almost every day for two or more weeks, while 13 percent said they had "seriously considered" attempting suicide in the prior year and 9 percent reported at least one attempt in that time period.
Focus groups conducted by San Francisco Suicide Prevention found that all students interviewed favored adding a text-based service to the current types of help already available. A quarter of the students said they would prefer text over all forms of communication in a crisis while 25 percent indicated they would want to speak to someone face-to-face, 25 percent would use a hotline and another 25 percent preferred chat.

Hotline 'antiquated'

"It was really glaring how antiquated the notion of a traditional hotline was," saidJonathan Mark Herzenberg, a school-based clinical psychologist who participated in the San Francisco Suicide Prevention task force studying the text option.
Herzenberg, associate head of student life at Drew School in San Francisco, said texting generally surpasses all modes of communication for teens. "They don't break up in a relationship over phone or face to face," he said. "They don't ask each other out over the phone or face-to-face. It's over text."

In other states

Text-based hotlines started in other parts of the country, including Nevada and Minnesota, have already shown some success. Minnesota's TXT4Life hotline last year handled more than 3,800 text sessions from 1,985 young people seeking help.
In the wake of his son's death, Strauss of Chico started the Alex Project, a nonprofit that promotes texting access to lifesaving crisis center services.
Strauss' goal is for a statewide and ultimately nationwide 24-hour crisis texting service. But even then, he said, the work will continue. "There will be something after texting," he said. "The crisis centers, because they struggle with funding, will always be one generation behind. But what's at stake is lives."
Jacqueline Monetta, a 17-year-old senior at St. Ignatius College Preparatory in San Francisco, described the best friend she lost to suicide in 2010 as the "queen of texters."
She'll never know if her friend would have turned to a text-based service for help, but Monetta said that wasn't even an option for her.
"It's surprising that there hasn't been a texting program. I rarely talk to any student that called a hotline," said Monetta of Kentfield, who is working on a documentary film that focuses on teen suicide and texting as a way to help.
"Sometimes it's sad to think our culture has gone to never talking on the phone, but that really is our way of communicating - it's texting," she said. "And if it's going to help somebody by texting, that's more important."

Texting to prevent suicides

Suicide is the third-leading cause of death among people aged 15 to 24, claiming 4,140 lives each year, according to federal statistics. A number of suicide prevention services are starting to offer 24-hour text crisis counseling. More information and help can be found here:
San Francisco Suicide Prevention: www.sfsuicide.org 24-Hour Crisis Line: (415) 781-0500.
National Suicide Prevention Lifeline: www.suicidepreventionlifeline.org 24-Hour Hotline: (800) 273-8255.
Source: http://www.sfgate.com/health/article/Program-to-save-teens-from-suicide-by-texting-4847422.php

Now what should I do? Primary care physicians’ responses to older adults expressing thoughts of suicide

Now what should I do? Primary care physicians’ responses to older adults expressing thoughts of suicide.
Vannoy, S., Tai-Seale, M., Duberstein, P., Eaton, L., & Cook, M. (2011). Journal of General Internal Medicine, 26(9),1005-1011.

Primary care visits are an important opportunity for detecting and responding to suicide risk among older adults. However, a research project revealed that primary care physicians who recognize suicide risk among older adult patients are often unable to effectively address this risk. The authors of an article reporting on this research suggested that physicians’ failure to develop meaningful treatment plans for older adults at risk for suicide “may reflect a lack of coherent framework for managing suicide risk, insufficient clinical skills, and availability of mental health specialty support….”

The research identified three patterns of conversations about suicide between physicians and patients. The first is the “argumentative pattern” in which physicians attempt to convince the patient that suicide is unnecessary. The authors found that this approach “results in mutual fatigue and discouragement.” A second response was the “superficial pattern” in which the physician addresses suicide risk and emotional difficulties “in a seemingly aimless manner with no clear therapeutic goal.” The third response, which the authors labeled the “insufficient pattern,” is “characterized by the physicians initially addressing the issue of suicide and comorbid mood disorder, and offering some potential courses of action, only to drop the subject precipitously with no clear sense of closure or treatment plan.”

None of these approaches contributed to developing a meaningful strategy to reduce the risk of suicide. The authors suggest that physician education and practice support may help promote the ability of primary care physicians to effectively respond to suicide risk among their older adult patients. This response could include monitoring the patient, structured follow-up, and referral to mental health specialists.

The authors caution that the small sample size used in this study limited their ability to provide definitive information on this issue and probably prevented the identification of all patterns of conversation about suicide between primary care physicians and older adult patients. The research involved the analysis of videotapes from 385 primary care office visits by patients over the age of 65. Mental health issues were discussed in 84 of these visits and suicide was discussed in six visits. These six visits represented 3 of the 35 physicians involved in the study. Mental health issues were discussed in 22 percent of primary care visits. Conversations about suicide took place in less than 2 percent of all visits.

Resource Note: The Suicide Prevention Toolkit for Rural Primary Care contains information and tools to integrate suicide prevention practices in primary care settings. The toolkit was developed by SPRC in collaboration with the Western Interstate Commission for Higher Education and can be found on the SPRC website at http://www.sprc.org/pctoolkit/index.asp
Link to Abstract

Adolescents With Suicidal Ideation: Health Care Use and Functioning


FRIDAY, Sept. 16 (HealthDay News) -- Although the U.S. Centers for Disease Control and Prevention reports that suicide is the third leading cause of death for people aged 15 to 24 years, a new study shows few suicidal teens are getting the mental health treatment they need.
The researchers found only 13 percent of teenagers with suicidal thoughts visited a mental health professional through their health care network, and only 16 percent received treatment during the year, even though they were eligible for mental health visits without a referral and with relatively low co-payments.
Even when researchers combined various types of mental health services, such as antidepressants and care received outside their health network, only 26 percent of teens contemplating suicide received help in the previous year.
"Teen suicide is a very real issue today in the United States. Until now, we've known very little about how much or how little suicidal teens use health care services. We found it particularly striking to observe such low rates of health care service use among most teens in our study," the study's lead author, Carolyn A. McCarty, of Seattle Children's Research Institute and research associate professor of pediatrics at the University of Washington School of Medicine, said in a Seattle Children's Hospital news release.
In the study, researchers analyzed the use of health care services among 198 teens ranging in age from 13 to 18 years. Half of the teenagers had had suicidal thoughts; the other half did not.
Although identifying teens with suicidal thoughts is critical, the researchers revealed mental health services were underused among all of the teens studied. Although 86 percent of the teens with suicidal thoughts had seen a health care provider, only 13 percent had seen a mental health specialist. Moreover, just 7 percent received antidepressants, the study found.
Meanwhile, only 10 percent of those without suicidal thoughts had received any mental health visits within the Group Health Cooperative system in the prior year.
Although the myth that suicidal thoughts are a normal part of growing up still persists, the findings suggest suicidal tendencies are often accompanied by trouble in school or with relationships, making mental health care even more important.
"We know that asking teens about [suicidal thoughts] does not worsen their problems," said McCarty. "It's absolutely crucial for a teen who is having thoughts of self-harm or significant depression to be able to tell a helpful, trustworthy adult."
The researchers added that primary care physicians should be screening teenagers for depression and suicidal thoughts. "Effective screening tools are available, as are effective treatments for depression," McCarty noted.
The study was published in the September issue of Academic Pediatrics.
More information
The American Academy of Child & Adolescent Psychiatry provides more information on teen suicide.
Copyright © 2011 HealthDay. All rights reserved.

http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2011/09/16/few-suicidal-teens-get-the-help-they-need

http://www.academicpedsjnl.net/article/S1876-2859(11)00018-0/abstract

Now what should I do? Primary care physicians’ responses to older adults expressing thoughts of suicide

Now what should I do? Primary care physicians’ responses to older adults expressing thoughts of suicide.
Vannoy, S., Tai-Seale, M., Duberstein, P., Eaton, L., & Cook, M. (2011). Journal of General Internal Medicine, 26(9),1005-1011.

Primary care visits are an important opportunity for detecting and responding to suicide risk among older adults. However, a research project revealed that primary care physicians who recognize suicide risk among older adult patients are often unable to effectively address this risk. The authors of an article reporting on this research suggested that physicians’ failure to develop meaningful treatment plans for older adults at risk for suicide “may reflect a lack of coherent framework for managing suicide risk, insufficient clinical skills, and availability of mental health specialty support….”

The research identified three patterns of conversations about suicide between physicians and patients. The first is the “argumentative pattern” in which physicians attempt to convince the patient that suicide is unnecessary. The authors found that this approach “results in mutual fatigue and discouragement.” A second response was the “superficial pattern” in which the physician addresses suicide risk and emotional difficulties “in a seemingly aimless manner with no clear therapeutic goal.” The third response, which the authors labeled the “insufficient pattern,” is “characterized by the physicians initially addressing the issue of suicide and comorbid mood disorder, and offering some potential courses of action, only to drop the subject precipitously with no clear sense of closure or treatment plan.”

None of these approaches contributed to developing a meaningful strategy to reduce the risk of suicide. The authors suggest that physician education and practice support may help promote the ability of primary care physicians to effectively respond to suicide risk among their older adult patients. This response could include monitoring the patient, structured follow-up, and referral to mental health specialists.

The authors caution that the small sample size used in this study limited their ability to provide definitive information on this issue and probably prevented the identification of all patterns of conversation about suicide between primary care physicians and older adult patients. The research involved the analysis of videotapes from 385 primary care office visits by patients over the age of 65. Mental health issues were discussed in 84 of these visits and suicide was discussed in six visits. These six visits represented 3 of the 35 physicians involved in the study. Mental health issues were discussed in 22 percent of primary care visits. Conversations about suicide took place in less than 2 percent of all visits.

Resource Note: The Suicide Prevention Toolkit for Rural Primary Care contains information and tools to integrate suicide prevention practices in primary care settings. The toolkit was developed by SPRC in collaboration with the Western Interstate Commission for Higher Education and can be found on the SPRC website at http://www.sprc.org/pctoolkit/index.asp
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