|Posted by Martha Graf on October 24, 2012 at 12:45 AM||comments (0)|
Yesterday was an historic day in the suicide prevention community. With the release of the revised National Strategy for Suicide Prevention (NSSP), we are embarking on a new path that will lead to more advances in our field and more lives saved. It will take time for us to digest this new NSSP and incorporate it into our everyday work. That process begins today.
You can find the revised NSSP, as well as supporting documents with background and sector-specific materials, at www.actionallianceforsuicideprevention.org/NSSP.
This document is the result of more than two years of work and input from some of the top experts in the suicide prevention field. As its main themes, the NSSP says that suicide prevention efforts should:
· Foster positive public dialogue; counter shame, stigma, and silence; and build public support for suicide prevention.
· Address the needs of vulnerable groups, be tailored to the cultural and situational contexts in which they are offered, and seek to eliminate disparities.
· Be coordinated and integrated with existing efforts addressing health and behavioral health, and ensure continuity of care.
· Promote changes in systems, policies, and environments that will support and facilitate the prevention of suicide and related problems.
· Bring together public health and behavioral health.
· Address both risk and protection.
· Reflect the latest science, as well as evidence-based and best practices/programs.
It includes four new strategic directions comprised of 13 goals and 60 objectives that align with the Surgeon General’s National Prevention Strategy, released in June:
· Healthy and empowered individuals, families, and communities
· Community and clinical preventive services
· Treatment and support services
· Surveillance, research, and evaluation
Some of the other new elements of the revised NSSP include:
· Action steps that different sectors can take now to advance each of the strategic directions.
· A new focus on and resources for populations with an increased risk of death by suicide.
· Goals dedicated to the care and support of people impacted by suicide attempts and or death.
· Discussion of the role new and social media platforms can play in suicide prevention.
I hope you will read the revised NSSP and think about what these changes mean to your work and to our entire field. I look forward to many thoughtful and insightful discussions about this work and thank you again for your commitment to the field.
Jerry Reed, Ph.D., MSW
Suicide Prevention Resource Center
|Posted by Martha Graf on October 24, 2012 at 12:35 AM||comments (0)|
Please take a few minutes to listen to Sally Spencer-Thomas on NPR discussing Man Therapy.
|Posted by Martha Graf on October 24, 2012 at 12:25 AM||comments (0)|
By Cynthia Mccormick
October 09, 2012
If there are any people who need easy access to outpatient mental health treatment, it's those who have recently attempted or threatened suicide and are being released from a hospital or psychiatric program.
But these patients face a fractured mental health system where gaps in services and spotty hospital discharge planning only aggravate the risk that they will make another attempt, mental health advocates say. And they say too often patients are released from treatment with only a phone number for a counselor or an appointment that is weeks away.
Police work to thwart suicides - Part 1 of 2
MONDAY: How police are trained to react to a potential threat
TODAY: Filling the gap in care after the hospital
Now, local and national mental health advocates are taking steps to make sure people who have recently contemplated suicide get the follow-up care they need.
The Cape Psych Center, which is part of Cape Cod Healthcare and located across the parking lot from Cape Cod Hospital in Hyannis, is scheduled to launch a pilot project later this month to monitor young adult patients for 90 days after release.
A mental health worker will check in frequently with patients ages 18 to 28 — a group considered at high risk — to make sure they have timely outpatient appointments with a psychiatrist and therapist, said Richard Curcuru, executive director of behavioral health services at Cape Cod Healthcare.
The person in this newly created part-time position will help the patients navigate barriers to treatment, ranging from problems with transportation to lack of money for medication, Curcuru said. The pilot project is scheduled to start by mid-month and is being funded by a $15,000 Cape Cod Healthcare community benefits grant, he said.
At this critical point in their lives, the team is "really just trying to keep our arms around them," he said.
PERIOD OF HIGH RISK
Studies show that the months immediately after discharge from a psychiatric unit or emergency department is a period of high suicide risk for released patients, said Richard McKeon, chief of the suicide prevention branch of the U.S. Substance Abuse and Mental Health Services Administration, or SAMHSA.
Last year, the federal agency commissioned a report with the Suicide Prevention Resource Center in Waltham calling for better continuity of care for discharged patients.
Delayed follow-up can be dangerous, even fatal, said Dr. David J. Knesper, a psychiatrist at the University of Michigan who was the lead author of the report.
As many as one in 10 people who commit suicide had been seen in an emergency department within two months of dying, he reported.
If patients have to wait weeks to get an appointment, "what does that say?" Knesper asked in a phone interview. "That message says, 'Buddy, you are on your own.' They also have to experience that someone cares to want to see them."
As it is, he said, at least half of discharged patients don't show up for their first outpatient appointment, which could be weeks after their discharge.
"All patients should leave the emergency department with a follow-up appointment," said Lisa Capoccia, assistant manager of provider initiatives at the Suicide Prevention Resource Center in Waltham.
And that appointment should be timely.
Patients shouldn't have to wait any longer than two to seven days after being released from the hospital or emergency room to see a mental health provider, Capoccia said.
That can be easier said than done.
The United States has a shortage of psychiatrists. And often there is a disconnect between the electronic records systems of hospitals and those of therapists who tend to be in private practice. Records may not be shared or may arrive after the patient gets to the therapist's office, Knesper said.
But a smoother continuity of care is possible, federal officials say.
At least five of 18 crisis hotline centers involved in a SAMHSA-funded study at Columbia University have established relationships with emergency departments and inpatient treatment centers to provide better follow-up care, said Manisha Vaze, follow-up coordinator with the National Suicide Prevention Lifeline.
She said many crisis centers in the Lifeline network are now checking back with callers within 24 to 48 hours to make sure they are OK or have been able to schedule an outpatient appointment.
In what Knesper cites as a model program, the U.S. Department of Veterans Affairs requires patients identified as being at high risk to have weekly follow-up visits for 30 days after hospitalization.
The VA also helps vets develop a safety plan and obtains the names of people the department can contact if the veterans do not come to an appointment, department spokesman Mark Ballesteros said.
"It's an absolutely critical time," said Mary Munsell of Hyannis, a woman with mental illness who recently started a peer-based social support group in Hyannis. "A lot of people, they just end up going right back" in the hospital, she said.
SEVEN DAYS AFTER
If the Cape Psych Center's intensive aftercare pilot project results in fewer suicide re-attempts and re-hospitalizations, Curcuru plans to make the new position full time.
The center's goal is to make sure patients have an appointment with a psychiatrist within seven days of being discharged and an appointment with a therapist within 14 days, Curcuru said.
Patients who do not have their own therapist can see someone at Cape Cod Behavioral Health Services, Curcuru said.
Anyone having trouble getting in to see a psychiatrist will be directed to return to the Cape Psych Center for an outpatient appointment with a staff psychiatrist, he said.
Such hand-holding is good health care, Knesper said.
Patients who have contemplated suicide typically feel overwhelmed by the challenges of daily life, so expecting them to navigate the tortuous mental health system on their own is senseless, he said.
Other areas that need shoring up are emergency-department standards for assessing suicide risk and research into fast-acting drugs to relieve suicidal distress, Capoccia said.
Locally, mental health care providers need more expertise in dealing with substance abuse in mentally ill individuals, said Tim Lineaweaver, co-chairman of Cape and Islands Suicide Prevention Coalition.
He said the coalition is trying to get the word out that people in crisis can get help from a state Department of Mental Health 24-hour crisis hotline.
Hotline operators can direct people to services or send a crisis team to the patient's home or to meet the patient in a hospital, Lineaweaver said.
|Posted by Martha Graf on October 23, 2012 at 11:10 AM||comments (0)|
Let us rise up and be thankful, for if we didn't learn a lot today, at least we learned a little, and if we didn't learn a little, at least we didn't get sick, and if we got sick, at least we didn't die; so let us all be thankful.