Security Plan May Help Suicide Survivors Prevent Next Attempt: Gunshots

Many people who try to end suicide find themselves in an emergency room for immediate treatment. But few of these suicides receive the follow-up care they need at a time when they are particularly likely to start committing suicide again.

A study shows that a simple intervention of emergency services staff can reduce the risk of suicide. future suicide attempts. The intervention involves creating a safety plan for each patient and tracking phone calls after the exit.

"This halved the chances of suicidal behavior," says Barbara Stanley, a psychologist at Columbia University and lead author of the study. "It's a phenomenal difference."

The study, which published Wednesday in JAMA Psychiatry, included 1,200 patients in five veterans hospitals across the country. The findings provide a way for hospitals and clinics to help reduce the growing number of suicide deaths across the country.

"When someone goes to the emergency room for a suicide attempt, they are at risk of 39, another suicide attempt for the next three months, "says Stanley. "It's like a time bomb."

This is the first large-scale study on the safety planning intervention that Stanley and his group developed in 2008 and which has been adopted in hospitals and clinics nationwide. It can be provided by a doctor, a nurse or even a social worker and requires very little training.

"The interesting thing about the safety planning intervention is that it's a relatively brief intervention and can be used in many different settings," says Brian Ahmedani, director of health Behavioral to Henry Ford Health Systems in Detroit, Michigan, who was not involved in the new study

Many health systems are starting to think about ways to prevent suicide, he says. This is because, as his own work has shown, nearly 83% of people who die by suicide are having a medical checkup in the year before they die. Yet only 50 percent of these people have been diagnosed with mental illness.

The intervention studied by Stanley and his group begins at an emergency or in a clinic, before the patient suicidal is not released. First, a health professional discusses with the patient and tries to understand the warning signs of a suicide attempt.

"If they had suicidal thoughts, they know what their warning signs are," says Stanley. For example, she says, someone could say, "I find that I stay in my room, do not answer the phone, do not respond to texts, do not respond to emails. This could be a warning sign. "Someone else might have repeated thoughts that they are not worthy."

The next step is for the patient – with the help of the clinician – to propose a set of coping strategies that can help to cope with moments of intense suicidal ideation.For most people, this intense state lasts only a few minutes to a few hours, she says.

The coping strategy could be as simple as playing video games, watching TV or talking to a loved one.

If people who are contemplating suicide can get distracted with something they like to do, they can bypbad that narrow window during which suicidal thoughts can dominate them. "For suicidal people , the pbadage of time is their friend, "she says.

The ten also to convince patients to withdraw or distance themselves from their means of suicide. For example, if they own a firearm, they should lock it up or give it to someone who can keep it away from them. "If you strive to use whatever means you would use, time pbades and you give suicidal thoughts a chance to calm down."

Safety planning includes follow-up phone calls with the patient – the first call is made within 72 hours of the exit of the emergency. The provider asks the patient how he uses his safety plan and helps to revise it if necessary. They also ensure that the patient sees a mental health provider for long-term care. They continue to call until the patient has had a second appointment with a therapist or counselor.

This follow-up is essential, says Julie Goldstein Grumet, psychologist at the Zero Suicide Institute of the Educational Development Center, an organization with purpose non-profit based in Washington DC

"People often fall and do not follow their credentials," she says. "To evaluate the effectiveness of the intervention, the Stanley team examined five VA emergency departments across the country who used it and compared the results of the intervention. these transitions. "

results with four VA emergency rooms that simply unload patients after stabilizing them.

Of the approximately 1,200 people who benefited from the intervention, half of the people had made suicide attempts (or were very close) like those in the control group. In other words, the intervention had almost halved the risk of suicide six months after discharge. Two-thirds of those in the treatment group had used their safety plans and were twice as likely to receive follow-up mental health treatment compared to the control group.

"The study is incredibly important …," says Goldstein Grumet

Rick, a Missouri father, says that a safety plan may have saved his daughter's life from 12 years old. (NPR leaves her family name to protect her daughter's privacy)

In September 2017, she nearly killed herself When he learned this the next day from her school principal Rick l & # 39; took to the ER at Jefferson Mercy Hospital. "The whole process was overwhelming, because you have your 12-year-old who wants to end his life," says Rick. And she had nothing to share with us. "

The hospital was not part of the new study, but also used a security plan. "

" The crisis counselor did an extraordinary job in establishing a safety plan with the Equel my daughter felt comfortable, "he says.

He says his daughter did not want a suicide. to tell her about her struggles, but she agreed to communicate with them in other ways. During times when she felt that she wanted to resume her life, she agreed to watch TV with her mother or to call or send a text message to her father.

Strait says that she usually sends a specific emoji when she is having a bad day. And he responds by distracting her with something completely different.

He says that she also agreed to use a helpline in case of a crisis if things degenerated.

"It was something that she could follow," he says. "It gave him confidence and it gave me confidence."

He says the plan helped his daughter overcome her suicidal phase and even open her slowly to her parents

plan, "says Ahmedani. "The patient is the author of his security plan, but he is guided by a provider."

As part of the 2012 National Suicide Prevention Strategy, many health care providers have adopted the prevention approaches described in the Zero Suicide Initiative, which includes safety planning based on previous evidence.

As security planning began to be used across the country, it should be adopted universally, says Goldstein Gromit.

"This is a brief intervention that hospital workers, primary care staff, outpatient behavioral health, can all be trained to use," she says. [ad_2]
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