Happenings
Warning signs
At long last the new public health message on Warning Signs of Suicide which was worked on last year with a task force of clinical-researcher experts using only warning signs that were in fact supported by research has been released. We see this as a dynamic work – it will change as new research is presented regarding acute risk factors for suicide; but, in the interim, we believe this represents the best current statement of what we should be telling the public regarding what to look for and what to do if you find it.
The recommendation is for all of us to use the same public health message, so as to minimize confusion and maximize a consistent public health statement.
Key Messages
Are you or someone you love at risk of suicide?
Get the facts and take appropriate action .
Get help immediately by contacting a mental health professional or calling 1-800-SUICIDE (784-2433) for a referral should you witness, hear, or see anyone exhibiting any one or more of the following:
- Someone threatening to hurt or kill him/herself, or talking of wanting to hurt or kill him/herself.
- Someone looking for ways to kill him/herself by seeking access to firearms, available pills, or other means.
- Someone talking or writing about death, dying or suicide, when these actions are out of the ordinary for the person.
Seek help as soon as possible by contacting a mental health professional or calling 1-800-SUICIDE (784-2433) for a referral should you witness, hear, or see someone you know exhibiting any one or more of the following:
- Hopelessness
- Rage, uncontrolled anger, seeking revenge
- Acting reckless or engaging in risky activities, seemingly without thinking
- Feeling trapped – like there’s no way out
- Increasing alcohol or drug use
- Withdrawing from friends, family and society
- Anxiety, agitation, unable to sleep or sleeping all the time
- Dramatic mood changes
- No reason for living; no sense of purpose in life
Treatment of Complicated Grief
A Randomized Controlled Trial
Katherine Shear, MD; Ellen Frank, PhD; Patricia R. Houck, MSH; Charles F. Reynolds III, MD
JAMA. 2005;293:2601-2608
Complicated grief is a disorder that has negative effects on one’s health. Grief is associated with a wide range of emotions including anger, guilt, despair, and sadness in response to the death of a loved one. These feelings diminish over time with support, however if these feelings fail to abate over time or are severe, this may be considered complicated grief. Other aspects of complicated grief include the inability to accept a loved one’s death as well as a preoccupation of thoughts of a passed loved one.
Treatments for this disorder have been a disappointment in their efficacy and therefore a comparison of complicated grief treatment with standard psychotherapy, or interpersonal psychotherapy, has been done. A randomized clinical trial was administered, stratified by the manner of death of a loved one and where the treatment site was located. Clinical trials took place in a university-based psychiatric research clinic and a low income satellite clinic located in an African American community during April 2001 and April 2004. A total of 83 women and 12 men aged 18 to 85 years were recruited through professional referral, self-referral, and media announcements who met the criteria for complicated grief . Participants of the trial were randomly selected to either receive interpersonal psychotherapy or complicated grief treatment.
The result of these treatments illustrates that the response rate was greater for complicated grief treatment (51%) than for interpersonal psychotherapy (28%). Due to these results it’s clear that the usage of complicated grief treatment, as opposed to interpersonal psychotherapy, procures a greater response rate for persons suffering from complicated grief and thus is an improvement over the use of interpersonal psychotherapy with complicated grief.
For more information on this article, visit :
http://jama.ama-assn.org/cgi/content/abstract/293/21/2601
Suicide screening programs not associated with increased risk
Evaluating Iatrogenic Risk of Youth Suicide Screening Programs: A Randomized Controlled Trial Madelyn S. Gould, PhD, MPH; Frank A. Marrocco, PhD; Marjorie Kleinman, MS; John Graham Thomas, BS; Katherine Mostkoff, CSW; Jean Cote, CSW; Mark Davies, MPH
JAMA. 2005;293:1635-1643.
Universal screening for mental health problems and suicide risk is at the forefront of the national agenda for youth suicide prevention, yet no study has directly addressed the potential harm of suicide screening. Because of this, a study was conducted to examine whether asking about suicidal ideation or behavior during a screening program creates distress or increases suicidal ideation among high school students or among high-risk students reporting depressive symptoms, substance use problems, or suicide attempts.
A randomized controlled study was administered within the context of a two day screening strategy. Participants in this study included 2342 students in 6 high schools in New York State during 2002-2004. Classes were randomized to an experimental group, which received the first survey with suicide questions, or to a control group, which did not receive suicide questions. The distress of the students was measured at the end of the first survey and at the beginning of the second survey, two days after the first.
The results from the randomized controlled study showed that there was no evidence of iatrogenic effects, or inadvertently imposed effects, of suicide screening. The distress levels from the experimental and control groups did not differ. Students exposed to suicide questions were no more likely to report suicidal ideation after the survey than unexposed students. High-risk students (defined as those with depression symptoms, substance use problems, or any previous suicide attempt) in the experimental group were neither more suicidal nor distressed than high-risk youth in the control group; on the contrary, depressed students and previous suicide attempters in the experimental group appeared less distressed.
From this study it would be safe to conclude that students are not at risk of iatrogenic effects due to suicide screening programs. Suicide screening programs in a high school environment are a safe component to youth suicide prevention efforts.
To read more about the study, visit:
