In spite of the growth of national and local suicide prevention efforts, there has been a steady increase in suicides in the United States since 2000. This is true for our veterans too.
This leads to an obvious conclusion: We need to rethink our efforts to help people who are suicidal.
In March, Mad in America Continuing Education will launch an 11-seminar course titled: Innovative Approaches to Working With People Who Are Suicidal. The eleven presentations will focus on the following:
- What are the social factors, such as unemployment and gun ownership, that are known to affect suicide rates? Do antidepressants reduce—or increase—the risk of suicide?
- Research that provides insight into how to address the increased risk of suicide associated with the presence of a gun in the home.
- How doctors can assess whether drug treatment may be provoking suicidal thoughts and behaviors.
- A public health effort in Oregon that, by carefully analyzing risk factors for suicide, has reduced suicide rates by 40%.
- Innovative programs, including several developed by people with lived experience, that are proving to be effective in lowering the risk of suicide.
- How to protect mental health providers from liability when working with people who are suicidal.
- The efforts of an indigenous, youth-led organization in Canada, We Matter, that is working to reduce suicide among Native American youth.
The presenters are nationally known for their research and programmatic efforts to develop more effective ways to help people who are suicidal. The course will both provide new insights into understanding the factors driving the increase in suicide, and tell of “therapeutic” approaches that “demedicalize” suicide and instead offer new ways to help people in crisis.
We have developed this course with the thought that it will be of interest to professionals and lay people alike. We have titled this course “working with” people who are suicidal to emphasize that innovative approaches do not focus on “treating” the suicidal person, but rather on developing collaborative relationships. Four of the eleven webinars will tell of successful peer approaches to grappling with suicide.
We are reaching out to national professional associations, as well as state and local mental health programs, as we want to present this course to those outside our usual MIA readership. If you belong to such an organization, or want to promote this course to one, please share this blog; or the link to the Continuing Education page. We have also prepared a one-page course description that you can send to others.
We will apply for 1 continuing education credit for each webinar. The fee for the 11-seminar course is $150; however, the early bird rate, which will be available until February 15, is $75. We will also provide reduced “group rates” for organizations. Anyone interested in group rates should contact me at: [email protected].
We hope you will help us make this course known to a larger audience. Here is the lineup and schedule:
Thursday, March 5, 1:30-3 PM Eastern, 10:30-Noon Pacific
Robert Whitaker, Author and Founder, Mad in America
Title: Suicide in the Age of Prozac: A Review of the “Evidence”
Description: This presentation will provide a review of suicide rates for the last sixty years, and investigate the factors that may be driving the steady increase in suicide rates since 2000. It will explore the societal factors—such as unemployment and gun ownership—that are known to influence such rates. Next it will examine the rise of suicide prevention programs since Prozac arrived on the market in 1988, and the commercial and guild interests behind those efforts, which have emphasized the prescribing of antidepressants—and access to psychiatric care—as helpful to reducing the risk of suicide. Does this medical-model approach work? The presentation will review the research on the effectiveness of such efforts, and the research on the suicide risk associated with use of antidepressants.
Thursday, April 2, 1:30-3 PM Eastern, 10:30-Noon Pacific
Paula Joan Caplan, PhD, Du Bois Institute, Hutchins Center for African and African American Research, Harvard University
Title: Issues in Dealing with Suicidal People… and What Experience with Military Veterans Teaches about Nonpathologizing Approaches for All
Description: Massive experience calls into serious question the traditional mental health system’s approach to suicide, while other approaches have been helpful. The speaker will challenge the automatic labeling of people as “mentally ill” because they report having suicidal thoughts or have attempted or committed suicide. She will discuss an alarming way the DSM-IV and DSM-5 encourage the pathologizing of suicidal thoughts. Then she will describe primary reasons people have thoughts of suicide and what can be understood once one takes a more humane, nonpathologizing approach, using examples from a stage play, an Oscar-winning documentary about a “suicide hotline,” research and clinical work about the effects of various kinds of trauma, and a project primarily involving simple, wholehearted, nonjudgmental listening. Using examples from her work with military Veterans and with nonveterans, she will discuss the wide range of other approaches that are helpful to people who feel suicidal.
Thursday, April 16, 1:30-3 PM Eastern, 10:30-Noon Pacific
Matthew Miller, MD, MPH, ScD Professor of Health Sciences and Epidemiology, Northeastern University
Title: Guns and Suicide: Preventing Deaths by Suicide without Necessarily Affecting Underlying Suicidal Ideation or Behavior
Description: Dr. Miller will present an overview of the epidemiological evidence linking the availability of household firearms to suicide mortality, discuss the rationale for why reducing access to firearms can save more lives than perhaps any other suicide prevention strategy, and delve into some of his suicide-related work among military veterans, adolescents seen in emergency departments with acute mental health crises, and the current state of (mis)understandings among the general public and among practicing clinicians about the promise of means restriction (i.e., reducing access to firearms) as a way to save lives.
Wednesday, May 6, 1:30-3 PM Eastern, 10:30-Noon Pacific
David Healy, MD (McMaster University)
Title: How to Tell if a Drug is Causing Suicide and What to Do Next
Description: Clinical practice is judicial in nature. This means that establishing what is going on depends on engaging with a person and working out how best to explain the problem they have. The “scientific” literature is not much help in this respect. The challenge is to get to an objective position shared by the affected person, a mental health professional and ideally others. This workshop will take participants through this process and outline strategies for working through objections that may arise with the persons and clinicians involved.
Thursday, June 4, 1:30-3 PM Eastern, 10:30-Noon Pacific
Kimberly Repp, PhD, MPH (Washington County OR Public Health Department)
Title: If You Want to Save Lives, Start with the Dead: An Innovative Approach to Reducing Suicide
Description: For the third year in a row, U.S. life expectancy has lowered due to loss of life from suicides. Often, suicide prevention activities are implemented without the data necessary to tailor and target interventions, leading to an ineffective use of very limited resources. To change the direction of this trend, Washington County, Oregon created a nationally awarded suicide surveillance system. This suicide surveillance system facilitates the collection of risk factors and circumstances surrounding every suicide in the county within 48 hours of the death. The risk factors collected parallel those in the National Violent Death Reporting System, such as previous attempts, depressed mood, crisis, legal problems, etc., but without the multi-year data delay and with data reported by the actual forensic death investigator who completed the investigation. In conjunction with our suicide fatality review team, this surveillance system has produced demonstrably effective interventions with imminently suicidal people at hotels, animal shelters, and those being evicted, among others. The true value of a surveillance system is measured by whether it leads to prevention or control of adverse events, and Washington County’s population suicide rate has dropped an unprecedented 40%. This course will demonstrate how fast, meaningful and accurate data are shifting the paradigm on how suicide prevention is done.
**Thursday, July 2, 1:30-3 PM Eastern, 10:30-Noon Pacific
Tunchai Redvers, Director of “We Matter” Northern Ontario, Canada
Title: Working with Indigenous People Who Are Dealing with Suicide
Description: We Matter is an Indigenous youth-led and nationally registered non-profit organization committed to Indigenous youth support, hope and life promotion. Our founding project is the We Matter Campaign — a national multi-media campaign in which Indigenous role models and allies from across Canada submit short video, written and artistic messages sharing their own experiences of overcoming hardships, and communicating with Indigenous youth that no matter how hopeless life can feel, there is always a way forward.
**Finalizing date and time
Thursday, August 6, 1:30-3 PM Eastern, 10:30-Noon Pacific
Susan Stefan, JD, Author, Rational Suicide, Irrational Laws: Examining Current Approaches to Suicide in Policy and Law (Oxford University Press 2016)
Title: To Dream the Impossible Dream: How to Actually Help Suicidal Patients Without Having Nightmares about Liability
Description: In this talk, I invite you to question some assumptions you may have about people who are suicidal, challenge entrenched mythology about which provider actions risk or create liability for the suicide of a patient, and provide specific and concrete suggestions about how mental health professionals can best support people struggling with suicide while also protecting against vulnerability to liability. These suggestions are win-win — they enable you to provide better care while reducing your liability exposure.
Thursday, September 3, 1:30-3 PM Eastern, 10:30-Noon Pacific
Sera Davidow, Director, Western Massachusetts Recovery Learning Community
Title: Alternatives to Suicide Groups: Peer Support Strategies When Life is On the Line
Description: This webinar features Sera Davidow, Director of the Western Massachusetts Recovery Learning Community, where the Alternatives to Suicide approach was first developed. Although now a fully formed approach usable by providers, family members, and supporters of all kinds, Alternatives to Suicide originated as a peer-to-peer support group informed by the experiences of many who had ‘been there’ themselves. The groups have now been running for over a decade, and spread to several states in the US, as well as parts of Canada and Australia. This webinar will explore some of the myths about suicide that led up to the need for and development of Alternatives to Suicide, as well as providing an overview of some of the fundamental pieces of what the groups are actually about. Some of the paradoxes of suicide will also be explored including the hard reality that in order to have influence in someone’s life, so often we need to first learn to let go of the idea that we can or should try to control them.
Thursday, October 1, 1:30-3 PM Eastern, 10:30-Noon Pacific
James Greenblatt, MD, Chief Medical Officer, Walden Behavioral Care, Waltham, MA
Title: Suicide Redefined: The Biology of Prevention
Description: Suicide is a public health issue of critical importance, one which merits our best, most focused efforts towards treatment and prevention. This webinar will introduce a biologic framework for suicide prevention, one in which the concept of suicidality as the result of underlying nutritional, genetic, and psychosocial risk factors is explored. Scientific research supporting significant associations between malnutrition, essential fatty acid deficiencies, lithium deficiency, low cholesterol, and suicidality will be reviewed. Studies illustrating the benefits of targeted nutritional augmentation to mitigate risk factors will be presented; evidence-based interventions will be described; and a prevention model centered upon objective biologic measurement and a concept of biochemical individuality will be elucidated.
Thursday, November 5, 1:30-3 PM Eastern, 10:30-Noon Pacific
Chris Hansen, Director, Intentional Peer Support
Title: Intentional Peer Support and Conversations about Suicide
Description: Intentional Peer Support focuses on validating and understanding the feelings and experiences behind thoughts of suicide. Traditional assessment-based practices focus on risk and liability (stopping suicide from happening). This presentation will be about having a conversation where both of us are present and able to benefit, acknowledging the context of what’s happened — past and present — and providing opportunities to explore meaning and possibilities.
Thursday, December 5, 1:30-3 PM Eastern, 10:30-Noon Pacific
Leah Harris, MA, Founder, Shifa Consulting
Title: The Way Forward: Pathways to Hope, Recovery, and Wellness with Insights From Lived Experience
Description: People who’ve been suicidal have been working on many fronts to influence the policy and practice of suicide prevention, care, and response. Leah Harris will share some key principles and insights as a co-contributor to The Way Forward, a 2014 report authored by the Suicide Attempt Survivors Task Force of the National Action Alliance for Suicide Prevention. The guiding principles and recommendations in The Way Forward remain relevant, including peer support as a central part of a non-pathologizing, community-based, collective response.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.