National Healing After Suicide Event Is Coming to Orlando

Here is the information for this year’s Healing After Suicide Conference, an annual event that is co-sponsored by the American Association of Suicidology and the American Foundation for Suicide Prevention/Suicide Prevention Action Network (SPAN USA).

This year’s conference — on Sat., April 24, in Orlando, Fla. — will feature keynote speaker Donna Schuurman, executive director of the Dougy Center for Grieving Children & Families in Portland, Ore. The luncheon speaker is Thomas Joiner, Bright-Burton Professor of Psychology at Florida State University and a survivor of his father’s suicide.

This year’s theme is “Families, Community Systems, and Suicide: Focusing on Survivor Grief, Healing, and Action.” Designed for survivors of suicide loss, support group facilitators, mental health professionals, and interested others, the purpose of the conference is to:

• Provide assistance to facilitators of survivor support groups.
• Provide survivors with educational tools and resources to help with their individual journey of healing and transform their experience into action.
• Assist mental health professionals and other caregivers in understanding the needs of survivors.

The Healing After Suicide Conference features a number of concurrent workshops in the afternoon, including

• “The 5 Tasks of Grief”
• “Survivors Working in Suicide Prevention: A Dialogue”
• “After a Suicide: Helping the Children Heal”
• “Suicide Loss and the Military” (Panel)
• “Men’s Grief” (Panel)
• “Survivors in Action: Finding Your Role in Suicide Prevention and Advocacy”

The all-day conference closes with a healing ceremony, which will be led by Iris Bolton, author of the classic My Son, My Son.

SPNAC readers may download the registration brochure. Registration is also available online.

The Healing After Suicide Conference is held in conjunction with the American Association of Sucidology’s 43rd Annual Conference, Apr. 21-24 in Orlando.

[The abridged URL for this post is  http://www.tinyurl.com/HASconference .]

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Primary Care Depression Screening Would Save Lives

By Franklin Cook, SPNAC Editor

In a Huffington Post item today, titled “Let’s Not Get Too Depressed about Depression,” Dr. Lloyd Sederer, a psychiatrist and public health advocate, argues for a mandate that would do as much to prevent suicide as any other single action might accomplish:

One hundred percent of primary care practices .. should be screening for depression and using standardized treatment guidelines.

Dr. Sederer has a fairly straightforward plan to accomplish the nationwide screening he recommends.

Mental health has been losing in the competition for fair time and proper management without a numerical measure of a disease. How about starting with its poster child disease — depression — to remedy that?

The good news is that there is a simple, nine-item questionnaire called the PHQ-9 that someone can fill out in the waiting room, before seeing the doctor or nurse, that provides a highly reliable number that tells the doctor the likelihood (almost 90 percent sensitive) that you have a depression.

Of course, screening every visitor to a doctor’s office and then further assessing and effectively treating those who have depressive illness is a vast undertaking that would not be simple nor easy nor without cost. [Editor's note: Please see Dr. DeQuincy Lezine's comprehensive and insightful comment on this point.]

But we know that about 33,000 people a year die by suicide in the United States and that about half of them have a mood disorder (which implicates some type of depression in 16,000 suicides annually). So if depression is mental health’s “poster child disease” and it plays a role in 16,000 deaths every year, might not universal screening for depression in primary care be, as Dr. Sederer argues, a good starting place for prevention?

There are several models already available to move such an initiative forward. Here are two examples:

(1) The Three Component Model developed by the Macarthur Initiative on Depression and Primary Care is “a systematic approach” involving the “primary care clinician and practice, care management, and collaborating mental health specialist.”

The three components include elements shown to improve depression outcomes in recent randomized controlled trials. Telephone support for the depressed patient from a care manager is one central element as is periodic quantitative feedback about the patient’s response to treatment from the care manager to the clinician. The feedback is provided through depression severity scores based on PHQ-9. Another element is closer relationships between the primary care clinician and mental health specialists …

(2) The Suicide Prevention Toolkit for Rural Primary Care is an Internet-based resource containing “information and tools to implement state-of-the-art suicide prevention practices and overcome the significant hurdles this life-saving work faces in primary care practices.”

The Toolkit offers the support necessary to establish the primary care provider as one member of a team, fully equipped to reduce suicide risk among their patients. For instance, the tools will help you engage your patients and those around them in managing their own suicide risk. You’ll find tools for developing partnerships with mental health providers — regardless of how far away they may be — and a guide to developing telemental health services, a promising solution for many rural areas. There are also posters for display in your office, schools, and churches, and wallet cards listing warning signs for suicide and the number of the national crisis line.

[The abridged URL for this post is http://tinyurl.com/DepressionScreening .]

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Alaska Army Post Battles Stigma to Prevent Suicide

By Franklin Cook, SPNAC Editor

In a post last year titled “Culture of Stigma Is a Key Cause of Military, Veteran Suicides,” I wrote that the most important question for suicide prevention advocates is “What is military (and civilian) leadership doing … to decisively lessen the stigma against help-seeking that is killing so many of those whose sacrifices make our freedom possible?”

Today, in “Combat Deaths — At Home after the War,” Anchorage Daily News reporter Richard Mauer takes a look at two current developments at Fort Richardson, Alaska, designed to counter the military’s “culture of stigma.”

First, shortly after assuming command of the U.S. Army in Alaska last fall, Maj. Gen. William Troy learned of a battalion-level decision not to give full honors to a soldier at Ford Richardson who had died by suicide, and Troy made it a policy throughout his command to treat suicide fatalities in the same way other deaths are treated.

“When you do a memorial service in a different way [for a suicide victim], I think that you’re adding to the stigmatization of a soldier who has a behavioral health problem. You don’t mean to, but what you’re doing is, you’re making it look like it’s his fault,” Troy said. “We should be memorializing his service to the nation, his service in combat. He’s a volunteer, a member of a free nation who came and joined our ranks to defend this country, and that’s what we should be memorializing, not passing judgment on the manner of his death.”

Second, soldiers soon to return to Fort Richardson will be the first brigade-size unit (3,000-5,000 soldiers) to test the Army’s Virtual Behavioral Health Pilot Program.

[The program] will screen every … soldier from the commander, Col. Michael Howard, and his sergeant major down to each private. First they’ll describe their experiences in a questionnaire, including any traumatic brain injury they might have suffered, then enter a booth for a private video conference with a mental health professional. The on-line professional can make an immediate referral, including appointment, with a local counselor or therapist, Troy said.

A U.S. Army news release says the objectives of the Virtual Behavioral Health Pilot Program are …

… to provide uniform contact, via face-to-face or the VBHP, with all redeploying Soldiers, in order to identify care requirements early, and help promote a cultural change of Soldiers’ views of behavioral health.

The support of Army leadership in suicide prevention initiatives is evidenced in a Jan. 8 memo issued by Gen. Peter Chiarelli, the Army’s Vice Chief of Staff — who was responding to the report of eight suicide fatalaties in the first eight days of the new year — by asking the Army’s NCOs and other frontline supervisors …

… to troop the line, walk through the motor-pool, stop by the barracks, eat a meal in the dining facility, and visit the guard post at midnight. Look each and every Soldier in the eye. Convey the message that each one is valued by our Army, their families and friends, and our Nation. Remind Soldiers that their Army remains committed to help, support, and assist them to meet hardships head-on, no matter the struggle, stressor, or challenge.

Here are a few SPNAC posts in the past year related to suicide in the military:

• “Culture of Stigma Is a Key Cause of Military, Veteran Suicides” — March 24, 2009 — http://tinyurl.com/StigmaMilitary
• “Military, Veteran Stories Focus on Personal Impact of Suicide” — Apr. 5, 2009 — http://tinyurl.com/PersonalImpact
• “TAPS Reaches Out To Military Families Grieving after Suicide” — May 25, 2009 — http://tinyurl.com/TAPS-reaches
• “Army Commanders’ Caregiving Plays Role in Suicide” — Jul. 13, 2009 — http://tinyurl.com/CommandersCaregiving
• “Suicides in Guard Unit Emblematic of Army’s Dilemma” — Aug. 1, 2009 — http://tinyurl.com/ArmyDilemma

[The abridged URL for this post is http://tinyurl.com/AlaskaPost .]

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