Pediatricians do not always receive adequate training in suicide prevention

(Reuters Health) – Although experts supervising new pediatricians and trainee physicians agree that suicide prevention in children and adolescents is important, most of them also claim that current training does not include the following: is not adequate, according to a new US study.

Training is not always mandatory, for example, and it's not standardized, write the study's authors in the Journal of Adolescent Health.

"Pediatric care providers play a crucial role in detecting the risk of suicide and in appropriately guiding people in need," said Rebecca Bernert, lead author of the study, director of the laboratory's suicide prevention research at the Stanford University School of Medicine in California.

Suicide is the second leading cause of death among youth who attempt suicide at a disproportionate rate compared to other age groups, Bernert added. The Joint Commission and the American Academy of Pediatrics recommend routine screening, but the quality of training is poorly understood.

"Despite significant advances in suicide risk badessment, training practices appear to lack uniformity in various medical fields, including first-line providers able to significantly influence the risk of suicide. screening for suicidal behavior, "Bernert told Reuters Health via email.

Bernert and his colleagues sent a survey to the directors of the 204 pediatric residency programs in the United States and to 494 chief pediatric residents in May 2017 through the Program Directors Association mailing list. of pediatrics. The investigation focused on the importance of suicide prevention training and training in each program. The research team received responses from 95 program directors and 210 chief residents.

Overall, 82% of respondents said that suicide prevention training as part of a residency program was "very" or "extremely" important. At the same time, only about 18% of program directors and 10% of chief residents reported that their programs were adequately prepared for the needs. The average training lasted about three hours and the main priorities were to question the adolescents about the risks, to identify the risk factors and to locate the resources of the community.

"Putting time and space between thought and suicide attempt saves lives," Bernert said. "We can not prevent death if we do not know that a person is at risk."

About half of the survey respondents stated that their program provided formal training to residents and that most of them reported that their training was mandatory and that it was most often done during rotation. trainees in medicine. The majority of programs taught physicians to use a standardized screening instrument, but they used a combination of guidelines and policies.

In addition, respondents identified barriers to training such as limited time, lack of training resources, and the need for additional faculty to guide training. In meetings with patients, they explained that the main barriers to consistent suicide risk badessment were lack of time at appointments, lack of community resources, and lack of clarity about best practices.

"The suicide rate has increased at the national level in almost all demographic groups, especially among young people, and it's a good public health crisis," said Michael Schoenbaum of the United States. National Institute of Mental Health in Bethesda, Maryland.

Paediatricians worried about what should be done after screening, especially in rural areas where they could be the only doctor or have few mental health professionals to refer patients, added Schoenbaum, who did not participate in the survey.

New initiatives should strengthen these relationships in the community so that doctors know where to go and how to quickly help a patient make an appointment, he said.

"Few communities have such a resource, and we should be committed to helping patients be seen in less than 24 hours in these circumstances," Schoenbaum said via e-mail. "It should not be a burden for pediatricians alone, so let's find a way to organize ourselves to do it."

Note: You can get help by calling the National Life Line for Suicide Prevention at (800) 873-TALK or texting to the crisis text line (text HOME at 741741 in the United States). United). Both lines offer free and confidential support 24 hours a day.

SOURCE: https://bit.ly/2XeHAxS Journal of Adolescent Health, online May 22, 2019.