Course overview Each year, according to the American Foundation of Suicide Prevention (ASFP), 45,000 people die from self-directed injurious behavior that results in suicide (ASFP, 2016). This translates roughly into an average of 117 deaths by suicide per day. The foundation estimates the numbers to be higher due to the stigma surrounding suicide that leads to underreporting, and the fact that data-collection methods critical to suicide prevention lack uniformity. The rates of both suicides and suicide attempts are increasing among all age groups and are especially alarming for certain segments of the population. Even more importantly, in recent years it has been identified that suicide rates and emergency department visits for suicidal behavior among adults, adolescents and youth are rising across the US (Kuehn, 2020). Mental health professionals are trained to work with patients and their families in various settings across the healthcare continuum.
Patients may face a variety of chronic or acute mental and physical illness, including co-occurring mental disorders that are commonly diagnosed in individuals with suicidal ideation and a history of attempts. Social workers, counselors, and therapists can assist clients in addressing the psychosocial aspects of health care to meet their physical, mental, and behavioral challenges and achieve healthy outcomes. This course will cover the etiology and risk factors for suicidal behavior, outline important assessment, intervention and prevention programs, and inform effective mental health treatment to help individuals develop and maintain a healthy perspective on life. The course will review research and literature concerning the scope of the problem, identification of high-risk groups, evidence-based prevention, and programs for delivering care and mental health treatment.
INTRODUCTION
Suicide is an issue that affects all Americans; it is a significant public-health problem that is the 10th-leading cause of death in the United States, claiming more than 38,000 lives annually – almost double the number of homicides – and nearly one million lives annually across the globe. In youth aged 10 to 25 years, suicide is the third-leading cause of death, accounting for 14.2 deaths per 100,000 in 2018, an increase of 35% relative to 1999 (Centers for Disease Control and Prevention [CDC], 2020). For a smaller subset of this population, namely adolescents and young adults aged 14 to 25 years, the number of fatalities from suicide exceed the total number of deaths from the top seven non-injury-based medical conditions combined (Miron, Yu, Wilf- Miron, & Kohane, 2019; Olfson, Wall, Wang, Crystal, Bridge, et al., 2018). It is a leading cause of death on college campuses (Cramer et al., 2020). An untold number of other nonfatal attempts and self-harming behaviors escape surveillance, but all have impact on families, peers, and communities. Even when suicide attempts are survived, these nonfatal attempts increase risk for suicide even further. An estimated 6.7% of nonfatal suicide attempters go on to die by suicide in the years following their attempt (Parra-Uribe, et al., 2017), and this is likely a conservative estimate. Therefore, preventing suicide and suicidal behaviors, wherever possible, is a public-health imperative (David-Ferdon, Crosby, Caine, Hindman, Reed, & Iskander, 2016). Finally, evidence is growing of a substantial trend of increasing suicide rates in the United States since the year 2000 (Hedegaar & Curtin, 2018), with rates among adults and youth approximately 30% higher in 2018 than they were in 2000 (Miron et al., 2019). Even more concerning, the Coronavirus (COVID19) pandemic of 2020 has increased public health concern for continued increases in suicidal behavior (Reger, Stanley, & Joiner, 2020). Given the prevalence and increasing trends of suicidal behavior in the United States, it is more important than ever for clinicians, medical staff, educators, community service providers, and even families to be well-versed on the topic of suicide and the best ways to assess and treat those at risk for suicidal behavior. Indeed, most clinicians will treat suicidal individuals in some capacity during their careers, and even more will interact with suicidal individuals unknowingly, due to still- insufficient knowledge about key risk factors and assessment strategies (Franklin et al., 2016). This is problematic because many Americans assume that mental health professionals have substantial training in this clinical domain; this assumption likely influences help-seeking behaviors and/or beliefs about the wellbeing of those seeking help. Confusion and ambiguities surround the terms used to describe suicidal phenomena. The term “suicidality” describes a broad range of thoughts and behaviors. In clinical practice, this term often serves as a catch-all term for anything that may place a
When mental health professionals serve clients with suicidal ideation or behavior, they will often collaborate with members of a multidisciplinary team of professionals from education, mental health, social, and medical services in a variety of inpatient, outpatient and long-term care residential facilities. For clinicians, social workers, educators, and medical professionals to be effective in providing services to clients facing these issues, they must develop competencies of knowledge in the above areas of mental and physical/behavioral health. In addition, they must be competent in clinical skills to deliver the highest quality of care for the welfare of their client. This course will provide information and research on these areas of knowledge to enhance social- work competency in assisting clients with life-threatening suicidal ideation and behavior. The purpose of this course is to assist clinicians in understanding factors that contribute to suicidal behavior, conducting comprehensive suicide risk assessments, and engaging patients in brief, empirically-supported interventions to reduce risk of death. This course meets an increasing demand of many mental health professionals seeking information about working with suicidal clients and conducting empirically-supported suicide risk assessments. This intermediate-level course is designed for social workers, mental health counselors, marriage and family therapists, educators, community-based program administrators, providers, and psychologists. The course will cover major risk factors, demographics and warning signs for suicidal behavior, as well as provide guidance on clinical risk assessment and options for intervention. The course will also take a developmental perspective, covering specific details relevant to suicidal behavior for youth and adolescents, as well as adults across the age spectrum. Although the information presented here is useful to many mental health providers, no continuing education course can provide all of the information that may be required in working with each individual who comes for help. It is therefore important that mental health providers consult knowledgeable colleagues, review the most recent articles and books on the topic of suicide, read and understand the risk-management practices of their agency, and maintain awareness of applicable local and state laws concerning the management and referral of suicidal persons. References and resources for those interested in pursuing further education on this topic are provided at the end of the course. Before proceeding further into the course, it is important for all readers to have well-established definitions regarding suicidal thoughts and behaviors.
RELEVANT DEFINITIONS
person at increased risk for suicide. However, it is precisely this generalization with the term suicidality that makes collaboration among providers challenging. Further, a historical lack of specificity in definitions has clouded research on suicide and led
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Book Code: PYCA1423
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