Helping Suicidal People
By Stephen O'Connor, Ph.D., Harborview Injury Prevention & Research Center, Department of Psychiatry & Behavioral Sciences, University of Washington at Harborview Medical Center
I'm honored to write an informational piece for such an important website. Thank you for the opportunity. I'd like to update you on the latest from several lines of exciting research currently underway that specifically target individuals at high risk for suicide.
Working with David Jobes, Kate Comtois, and others at the University of Washington, we recently completed a study measuring the efficacy of the Collaborative Assessment and Management of Suicidality (CAMS) for patients discharged from an acute medical setting at a Level 1 Trauma Center, Harborview Medical Center. CAMS is a therapeutic framework that orients the patient and provider to focus on the underlying “drivers” of suicidality and has been discussed in previous publications (Jobes, 2006; Jobes, Comtois, Brenner, & Gutierrez, in press). The majority of our participants spent time on the inpatient psychiatry unit following a suicidal crisis that involved either an attempt or serious plans and preparation for an attempt, and everyone endorsed active suicidal ideation upon discharge from the hospital. We were able to recruit 38 individuals for the study, 32 of which were randomized to receive either CAMS or care as usual. We followed study participants for 12 months, assessing different aspects of their mental health, as well as the health care services they received. At the 12-month mark, the participants in CAMS reported significant improvements in comparison to the care as usual group in several areas, including suicidality, general level of functioning, and hope and optimism about the future. We are currently collaborating with Lisa Brenner and Pete Gutierrez at the Denver VA MIRECC, as well as colleagues in the Southern Regional Medical Command, to replicate this study with active duty military personnel who are experiencing serious suicidal thoughts and behaviors. We look forward to beginning this study in the near future and appreciate the opportunity to help those who have valiantly served our country.
In addition to helping with CAMS studies, I have begun a line of research examining ways to improve identification, management, and treatment of suicidal patients admitted to a medical/surgical floor in an acute care hospital. Currently, I am conducting a small randomized trial piloting a brief intervention for patients 15-24 years of age admitted to the hospital following a suicide attempt. My interest in this specific setting came out of a clinical rotation I completed during my internship with the Psychiatry Consultation/Liaison service, where we assessed and treated all patients admitted to Harborview following a suicide attempt. I decided to spend my research fellowship looking at ways to improve the service that is delivered and to look more closely at the idea of a teachable moment following a suicide attempt. I'm hoping to apply the results from this study to a more comprehensive investigation of medical/surgical floors in the future, as recent data suggests that a significant number of patients may experience serious suicidal thoughts while in the hospital even if they were admitted following an unintentional injury. Screening and treating suicidal patients in large trauma centers may provide the opportunity to engage at risk populations in a potentially life saving treatment.
I'd be happy to provide more information on any of the research mentioned above. Feel free to email me at email@example.com if you have any questions.
Jobes, D. A., (2006). Managing suicidal risk: A collaborative approach. New York: Guilford Press.
Jobes, D. A., Comtois, K., Brenner, L., & Gutierrez, P. (in press). Clinical trial feasibility studies of the Collaborative Assessment and Management of Suicidality (CAMS). In: R. O’Connor, S. Platt, & J. Gordon (Eds.), International handbook of suicide prevention: Research, policy & practice. Chichester: Wiley Blackwell.