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. 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. Although the information presented here is useful to many mental health providers, no continuing education course can provide all 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.
CLARIFICATION OF TERMS
Confusion and ambiguities surround the terms used to describe suicidal phenomena. For example, in the United States, the term non-suicidal self-injury (NSSI) refers to self-harming behaviors (e.g., cutting, burning, or picking at skin) that do not have a fatal outcome and were not done with suicidal intent. Suicide gesture usually means that a client is engaged in sublethal self- harming behavior, but with a motivation that was not intended as life-ending. However, some use the term to denote any suicide attempt that did not have a fatal outcome. Gesture also has the connotation that the suicide attempt was less serious than one in which a method with a higher lethal probability was used. However, suicide gestures should be taken very seriously, and clinicians should focus on lethality and intent of any suicide- related behavior (Frey et al., 2020). The term commit suicide is one that advocacy and other groups challenge because the word commit usually connotes engaging in a crime. (Suicide once was considered a crime.) The favored terms are to complete suicide or die by suicide, and this course holds to that convention (Massachusetts Coalition for Suicide Prevention, 2016). Table 1 lists terms describing suicidal behavior as currently defined (Glenn et al., 2020). These terms were selected to help clarify various issues of concern to mental health providers, Table 1: Nomenclature Describing Suicidal Behavior Suicide
coroners, and researchers. Each of these acts, with the exception of suicide and suicidal thoughts, can be further clarified as being with injuries, without injuries, or with fatal outcome. The intent to kill oneself is a foundational aspect of defining an act as suicide-related. For example, if a person were to die as a consequence of an instrumental suicide-related behavior , as defined in Table 1 (e.g., a knife wound self-inflicted for the purpose of mood regulation rather than death), the death would be classified as accidental rather than suicide because the intent to die is missing. The goal of developing a uniform nomenclature is to increase the ability of mental health providers, researchers, epidemiologists, and policy makers to better communicate with each other and to better research and intervene with at-risk populations. According to the Navy and Marine Public Health Center (n.d.): The knowledge and use of appropriate terminology when dealing with issues related to suicide helps to reduce stigma associated with help seeking. Appropriate use of terminology by the healthcare team and those referring individuals for care promotes and facilitates appropriate and timely care of at-risk individuals and those affected by suicide and demonstrates respect and sensitivity to the experiences of those affected by suicide.
Death from injury, poisoning, or suffocation where there is evidence that the injury was self-inflicted and that the deceased intended to kill him- or herself. An action resulting in nonfatal injury, poisoning, or suffocation where there is evidence that the injury was self- inflicted and that the person intended at some level (more than zero) to kill him- or herself. A potentially self-injurious behavior with a nonfatal outcome for which there is evidence that the person intended at some level (nonzero) to kill him- or herself. A suicide attempt may or may not result in injuries. A potentially self-injurious behavior for which there is evidence that the person intended at some level (nonzero) to kill him- or herself. A suicidal act may result in death (completed suicide), injury, or no injury.
Suicide attempt with injuries
Suicide attempt
Suicidal act
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Book Code: SWUS1524
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