Overcoming Fear Together

By Barb Gay, MA, Executive Director, Area Substance Abuse Council, Inc., Cedar Rapids, Iowa; Member, Suicide Attempt Survivor Task Force, National Action Alliance for Suicide Prevention

Although the field of suicide prevention has made enormous strides in recognizing the contributionsof people with lived experience, it has not totally overcome the fear of engaging suicide attempt survivors in their own recovery as well as in efforts to prevent suicide and improve the systems that help people recover. Attempt survivors are still often described as fragile and unstable—as people who need to be protected from themselves. Far too often, this “protection” takes the form of silence.

I experienced this silence after surviving my own suicide attempts. It sent a clear message that I should not talk about my attempt. It left me afraid, lonely, and isolated. Yet my experience also taught me that suicide attempts can be prevented and that people who attempt suicide can and do recover. I used this knowledge in my work. But I did not share my personal experience with suicide for more than 25 years, because I was afraid that that I would lose credibility and that people might see me as weak, unstable, or unprofessional. This fear also kept me from talking about what I had accomplished and how strong I was. It kept me from sharing my knowledge about how to help people see alternatives to suicide as well as how care should be provided after someone attempts suicide.

Silence sends the wrong message—a message that runs counter to what we know about preventing suicide. We know that people should not be afraid to ask for help if they are experiencing a suicidal crisis. We know that both lay people and professionals should not be afraid to directly ask a family member, friend, or client if he or she is having suicidal thoughts. We need to believe in the messages of hope and recovery that we promote. Engaging people with lived experience in our work can help us better understand how to prevent suicide and to help people who have attempted suicide find hope, rekindle a desire to live, and recover.

Attempt survivors have much to contribute across the entire spectrum of prevention and treatment activities. We can help create prevention messages that will resonate with people at risk for suicide. We can help combat the misconception that talking with someone about suicide will cause harm. We can help clinicians learn to talk about the attempt experience in ways that promote recovery rather than risk and help them understand how the clinical and therapeutic environment can be made supportive of recovery. And we can help other attempt survivors reintegrate with their families, their jobs, and their communities.

The field of suicide prevention needs to engage people with lived experience. We should be represented on suicide prevention coalitions, advisory groups, speaker panels, planning groups, and the boards of behavioral health organizations. Our experience is not just one of risk, but of recovery. And what we have learned from these experiences can help others make this journey.

Resources

Engaging Suicide Attempt Survivors: A SPARK Talk by Barb Gay

The Way Forward: Pathways to Hope, Recovery, and Wellness with Insights from Lived Experience – Suicide Attempt Survivors Task Force, National Action Alliance for Suicide Prevention

This post has been cross-posted on the Suicide Prevention Resource Center site.

Guns, media and suicide: What providers need to know

By Dr. Jane Pearson, National Institute of Mental Health & Action Alliance; Cathy Barber, MPA, Harvard School of Public Health; Dr. Dan Reidenberg, Suicide Awareness Voices of Education; and Colleen Carr, National Action Alliance for Suicide Prevention Secretariat

Suicidal behavior is complex. Understanding factors like access to lethal means and the media’s potential influence on suicidal behavior is important when it comes to identifying suicide risk and intervening outside of health care settings.

WHY MEANS MATTER

Gun owners are no more likely to have experienced a mental health problem, thought about suicide or attempted suicide. However, gun owners are at twice the risk of dying by suicide as people who don’t have guns in the home.

• Suicidal crises are often brief. One survey of suicide attempt survivors found that for nearly half of the respondents, while they had been struggling for varying amounts of time, the interval between first thinking about suicide and starting the attempt was ten minutes or less.
• Lethality varies greatly by method. If a person attempting suicide substitutes virtually any method for a gun, they have a better chance of surviving. Approximately 8 percent of individuals who overdose in a suicide attempt die, while approximately 90 percent of people who use a gun in a suicide attempt die. Research is needed to better understand why people choose the methods they do. 
• Long-term survival odds are good. Current estimates are that most people (90 percent) who attempt suicide and survive do not go on to die by suicide later. Understanding who re-attempts, and with what method, is a research gap. 
• By reducing a person’s access to the most lethal suicide methods, particularly firearms, you can reduce their chance of dying and create more opportunities for treatment and recovery. 

What you can do as a behavioral health provider to help your patients: 

• Complete the Suicide Prevention Resource Center’s (SPRC) free online training on Counseling on Access to Lethal Means (developed by Harvard, Dartmouth, and SPRC). 
• Start a conversation that respects and normalizes gun ownership and suggest that the patient store their gun in a way that is inaccessible to them until they feel better. Underscore that both this mental health crisis and the alternate gun storage are temporary.
• Recognize that a suicidal crisis can emerge quickly. Consider introducing safety planning and lethal means counseling to all patients struggling with mental health and substance abuse problems or experiencing difficult and traumatic life stressors, even if they are not currently suicidal.

THE MEDIA’S INFLUENCE

Suicide contagion is real. Research has documented an increase in suicides following unsafe media coverage of suicide, and vulnerable adolescents are particularly at a greater risk of contagion following exposure to suicide in the media.

On the other hand, responsible media coverage of suicide and stories of positive coping and overcoming adverse circumstances have shown to have protective effects against suicide.

Unsafe media coverage of suicide includes: 

• Presenting too simplistic of an explanation for suicide or normalizing suicide as a solution to a problem (e.g., an LGBT teen was bullied, so they killed themselves; a veteran had PTSD, so they killed themselves).
• Repetitive, ongoing or excessive reporting of suicide. 
• Sensational coverage of suicide (e.g., showing photos, or describing the details of the death or methods used). 
• Glorifying suicide or someone who has died by suicide. 
• Focusing on the positive characteristics of the suicide without balance to the challenges or illnesses surrounding it.

What you can do as a behavioral health provider:

• Provide media contacts with the Recommendations for Reporting on Suicide created by suicide prevention and media experts. 
• Provide accurate information to the media and help them better understand the complexity of suicide. 
• Provide media resources for readers to include in coverage (including the National Suicide Prevention Lifeline, 800-273-TALK (8255). 

This post has been cross-posted on the National Council for Behavioral Health site.

Champions, Catalyzers, and Cultivators

By Doryn Chervin, DrPH, Executive Secretary of the National Action Alliance for Suicide Prevention and Vice President and Senior Scientist at Education Development Center, Inc.

The National Action Alliance for Suicide Prevention (Action Alliance) continues to work toward fulfilling a vision of a nation free from the tragedy of suicide. As executive secretary of the Action Alliance, I am incredibly grateful to the members of this public-private partnership for their ongoing dedication and efforts to champion, catalyze, and cultivate suicide prevention as a national priority.

The last 18 months have been exceptionally noteworthy. The vision, perseverance, and accomplishments of our Executive Committee, Task Forces, and Tiger Teams have resulted in steady progress in advancing the objectives of the 2012 National Strategy for Suicide Prevention. I would like to acknowledge some of the many Action Alliance members whose contributions have made a significant and lasting impact in the field of suicide prevention.

In March 2015, under the leadership of Research Prioritization Task Force co-leads Thomas Insel (National Institute of Mental Health [NIMH]) and Phillip Satow (Jed Foundation), the Action Alliance released U.S. National Suicide Prevention Research Efforts: 2008-2013 Portfolio Analyses. This report showed that investments in suicide research are severely lagging relative to research on other leading causes of death. The Portfolio Analyses calls for a large-scale research investment focused on a comprehensive prevention strategy and timely and effective evidence-based interventions. This report was made possible only through the herculean efforts of Jane Pearson from NIMH. She deserves all of our gratitude for her tireless work on this important initiative.

Also deserving of our thanks is each and every person who contributed his or her time and expertise to the development of two important sets of guidelines released by the Action Alliance. Special thanks go to the co-leads of our Clinical Workforce Task Force, Brian Boon (CARF International) and Alexander Ross (Health Resources and Services Administration). In November 2014, this task force released Suicide Prevention and the Clinical Workforce: Guidelines for Training. This resource will help assure that the nation’s clinical workforce is prepared to treat persons at risk for suicide. Under the leadership of Drs. Boon and Ross, the task force spent more than three years creating guidelines which can serve as the foundation for creating suicide prevention training programs in health and human services professions. Gratitude is also due to Lori Rogers (CARF) for her time and contributions to this important work.

I also would like to acknowledge Franklin Cook (Unified Community Solutions), Karen Moyer (Moyer Foundation), and John Jordan (Family Loss Project), the co-leads of the Action Alliance’s Survivors of Suicide Loss Task Force. Their hard work and dedication brought forth the landmark report Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines. This publication, released in April 2015, is a set of comprehensive and strategic guidelines detailing how communities can effectively respond to the devastating impact of suicide loss. These guidelines pave the way for decisive advances in postvention. Responding to Grief also puts forth a call to strengthen and expand care to meet the needs of the bereaved and others who suffer from the effects of suicide loss.

A very special thanks is due the Action Alliance’s Faith Communities Task Force which, in September 2014, launched the Your Life Matters! campaign. Your Life Matters! is an opportunity for any faith community to focus one Sabbath each year on the core characteristics common to most faiths that help prevent suicides.The task force co-leads, Talitha Arnold (Unified Church of Santa Fe), Anne Matthews-Younes (Substance Abuse and Mental Health Services Administration), and David Litts (formerly with SPRC) worked diligently on the campaign’s successful launch and are true stewards, serving those in suicidal despair through their work with faith leaders and faith communities.

Several members of the Action Alliance’s Public Awareness and Education Task Force have contributed significantly to suicide prevention educational programs and resources. Jack Benson (Reingold, Inc.) and Dan Reidenberg (Suicide Awareness Voices of Education), along with partners from the Department of Veterans Affairs, the American Foundation for Suicide Prevention, and SPRC were instrumental in establishing the Poynter/Action Alliance Covering Suicide and Mental Health Reporting Institutes. In one year these educational sessions equipped 90 journalists from 30 states with the tools to produce balanced and safe suicide prevention coverage.

Finally, I wish to recognize and celebrate the accomplishments of Public Awareness and Education Task Force co-lead Brian Dyak (Entertainment Industries Council, Inc.) for the Council’s ongoing development of educational resources: Social Media Guidelines for Mental Health Promotion and Suicide Prevention and Entertainment and Media Depiction Suggestions for Portraying Behavioral Health Conditions: Mental Illness and Substance Abuse Disorders.

Again, to all our hard-working and committed volunteers, thank you!


This post has been cross-posted on the Suicide Prevention Resource Center website.

Treating and Preventing Suicidal Behavior

By Dr. Jane Pearson, National Institute of Mental Health & Action Alliance; Dr. Brian Ahmedani, Henry Ford Health System; and Colleen Carr, National Action Alliance for Suicide Prevention Secretariat

There is no one-size-fits-all approach to treating and preventing suicidal behavior. That is why it’s important to understand a variety of research-based strategies that can help you most effectively serve your patients’ unique needs.

1) Train Providers
Research shows that clinicians are likely to come in contact with individuals at risk for suicide over the course of their training and careers, but too few clinicians (even those trained in behavioral health) are adequately prepared to work with individuals at risk for suicide.

It is critical to assess the training needs of clinicians in your organization. For example, a staged training approach might be best-suited to your organization’s needs where all staff has basic knowledge and skills to identify individuals at risk for suicide, and clinicians most likely to see high-risk patients receive advanced training in suicide assessment and treatment. Research can inform the most effective models for sustaining clinician knowledge include ongoing training sessions like annual training or regular online training.

The National Action Alliance for Suicide Prevention recently released Suicide Prevention and the Clinical Workforce: Guidelines for Training. This tool can help you develop suicide training guidelines specific to the needs of your organization’s clinical staff to improve the delivery of suicide care.

2) Increase access to affordable care
Suicide rates are higher where there is less access to trauma centers and where there are high rates of uninsured individuals. There are a number of ways to improve access to affordable care. Mental health parity benefits legislation is one way to encourage utilization of mental health services for people who need them. Implementation of comprehensive parity legislation has proven to increase access to care, increase diagnosis of mental health conditions and reduce the prevalence of poor mental health and suicide rates. Specifically, strong state mental health parity laws have been associated with decreases in suicide rates in the year after the law is enacted.

3) Improve Continuity of care
A 2010 research review on continuity of care concluded that the lack of continuity of care within and across systems increases suicide risk. Repeated follow-up contacts after hospitalization or emergency care have been found to reduce suicidal behavior.

Consider how your organization can establish systems, policies and practices that improve the likelihood of continuity of care for your patients at risk for suicide as part of your standard care, and how you can track these improvements.

One promising example is from Henry Ford Health System’s Perfect Depression Care initiative. In 2001, Henry Ford implemented follow-up appointments based on risk level, established access to a 24-hour crisis line, offered online and drop-in appointments provided email contact and tracked patient follow-up in an electronic medical record system. The results were impressive with suicide mortality rates dropping from over 100 per 100,000 to less than 20 per 100,000 after full implementation.

4) Increase help-seeking and referrals for at-risk individuals
Reluctance to seek help is often multi-faceted. Embarrassment or shame, the belief that treatment is not needed, treatment would not be effective, treatment is inconvenient and/or difficult to obtain, treatment will be unpleasant, or treatment would be detrimental to a specific career path are all factors that can discourage people in need from pursuing care.

To improve help-seeking, it is important for clinicians and organizations to address this reluctance, whether it is related to self-stigma or other beliefs that get in the way. It is not enough to talk broadly about improving awareness by “reducing stigma.” In fact, experts suggest avoiding the term “stigma” in public messaging as it can reinforce negative attitudes and be counter-productive. Instead, it may be more useful to provide stories of successful treatment—by expert providers, peer support specialists and/or family members—where describing a range of effective treatment options and outcomes could improve the community’s knowledge about behavioral health services.

This post has been cross-posted on the National Council for Behavioral Health site.

What Is in Your Treatment Toolbox? Clinical Interventions to Prevent Suicidal Behavior

By Dr. Jane Pearson, National Institute of Mental Health & Action Alliance; Dr. Joel Sherrill, National Institute of Mental Health; and Colleen Carr, National Action Alliance for Suicide Prevention Secretariat

Community behavioral health providers are expected to know how to treat suicidal patients. As so often is the case, though, the practice demands are ahead of the research. New studies are testing the best ways to treat and prevent suicidal behavior, but how do you treat these behaviors without a full toolbox?

Medication Interventions

Many individuals with suicidal ideation will receive medications to address symptoms and “underlying” psychiatric conditions. However, most medication takes weeks to provide relief from psychiatric symptoms.

Currently, the only medication with a specific FDA indication relevant to suicide is clozapine. Clozapine is indicated for reducing the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder. However, agranulocytosis, a rare side effect of clozapine, results in the need for frequent monitoring of white blood cells, which limits its use in practice.

Although not FDA-indicated, lithium medication has been associated with lowering suicide risk in individuals with bipolar disorder. Research has found that individuals who remained adherent to lithium treatment were at lower risk for suicide, but placebo-controlled studies of lithium are still needed to isolate the medication versus compliance benefits in reducing suicide risk.

Ketamine, originally used as an anesthetic, is a repurposed medication that is showing promise as a fast-acting treatment for severe depression and suicidal ideation. Additional research is needed to determine the safety, feasibility, dose and duration for the use of Ketamine, but it does open up the potential for future fast-acting medication treatments for suicidal ideation that could be used in acute care settings.

In addition to tracking possible untoward side effects, there is also a need to test suicidal events as outcomes in medication research studies focused on treating mental disorders. In the past, many industry-sponsored trials excluded suicidal individuals from efficacy trials.

Psychotherapy Interventions

Several research reviews have found that outpatient psychotherapies (e.g., cognitive behavior therapy; dialectical behavior therapy; problem solving therapy) reduce suicidal thinking and re-attempts among high-risk adult patients. One review notes that psychotherapy recipients had, on average, a 32 percent reduction in the likelihood of a suicide attempt compared with usual care within a year.

Another study from the Danish health care registry followed recipients of psychotherapy and those not receiving psychotherapy for up to 20 years. Those who received psychotherapy were 16 percent less likely to attempt suicide and 25 percent less likely to die by suicide.

Modeling the future

In 2014, the Action Alliance’s Research Prioritization Task Force modeled optimal implementation of evidence-based psychotherapy delivered to the U.S. population of adults seen in emergency care for suicide attempts. The model estimated that more than 109,000 suicide attempts and more than 13,000 suicide deaths could be averted over 5 years by delivering effective psychotherapy to adults seen in emergency care settings for self-harm. This demonstrates enormous potential for successful intervention. In the meantime, we must continue to invest in suicide research.

Unanswered Questions

Research challenges include the need to better understand developmental and contextual factors:

• Youth, adult, older adult;
• Transitional, work and health contexts such as discharge from military and COPD onset;
• Co-occurring psychopathology (e.g., substance use);
• Social context (LGTBQ; domestic violence; recent loss);
• Prior suicidal behavior;
• Treatment history and
• Current setting–including immediate (referred from inpatient or emergency care)–in intervention research.

We need to know how to better match potential interventions to the patient’s needs. New treatment targets (e.g., isolation; anhedonia; insomnia; agitation; psychosis) might also be more efficiently addressed.

While suicide research around effective interventions is rapidly increasing, there remain many questions left to answer. For lives to be saved, effective research must be translated into practice.

As community behavioral health providers on the front line, you are the lifeline for patients at risk for suicide and those recovering from an attempt.

(See Section IX in the Research Agenda for citations for all research mentioned above. )

This post has been cross-posted on the National Council for Behavioral Health site.

What We Know (and What We Don’t) About Predicting Suicide Risk

By Dr. Jane Pearson, National Institute of Mental Health & Action Alliance; Dr. Lisa Colpe, National Institute of Mental Health; and Colleen Carr, National Action Alliance for Suicide Prevention Secretariat

Screening for suicide risk is common to most suicide prevention efforts and clinical practices that aim to identify at-risk individuals. To reduce suicide’s burden, there are a number of research-supported screening and risk detection tools to employ, but there is no doubt that further research is necessary to better understand the various factors that put people at risk of suicide.

The Continuum of Suicide Risk
Ideas about screening reflect our assumptions about a continuum of suicide risk—it is assumed there is a progression of suicide ideation, plans and eventual behavior (i.e., suicide attempts, suicide death). For example, multinational surveys have found that about a third of individuals who think about suicide make a plan and about a third go on to attempt suicide. Meanwhile, another subgroup reports having made an attempt with little or no ideation or planning.

Active versus Passive Ideation
Current approaches to assessing risk are heavily weighted toward identifying active ideation with a plan versus passive ideation (e.g., desire for death). However, some studies have found that passive ideation is just as strongly associated with morbidity as active ideation.

Screening Approaches
Many stakeholders consider screening for suicide risk an essential step in reducing suicides—and there are many opportunities to screen. Holding an annual depression screening day in the workplace or a school screening event following a suicide are two community examples. Screenings can be standalone, web-based for use in public settings or clinical tools (e.g., PHQ-9) integrated into primary care or other intake procedures to detect and monitor depression with suicide ideation. In fact, research looking at a large set of electronic health record data found a six-fold increased risk for suicide attempt (includes 709 attempts and 46 deaths) if someone responded ‘every day’ to the question, “Over the past two weeks, how often have you been bothered by thoughts that you would be better off dead, or hurting yourself in some way?” on PHQ-9.

Screening within Health Systems
Screening practices are ahead of research. The Joint Commission recommends screening in all medical care settings to prevent suicide attempts and deaths. However, health care settings vary with regard to the proportion of patients at risk and the steps necessary to get identified patients to adequate care. In any setting, risk detection alone will not reduce suicide. Assessment, adequate intervention and ongoing monitoring must support screening and detection efforts to have the desired impact of reduced suicidal behavior.

Promising Research
Research links neurocognitive science with risk detection and screening. For example, the Suicide Implicit Association Task (IAT) has shown to improve prediction of who will attempt suicide in the future. It examines reaction times to ‘life’ and ‘death’ words and can be administered on the computer in 5-10 minutes. It is currently being studied in emergency department environments with both youth and adults.

Recent research has also identified specific genetic markers for suicidal behavior, but the studies require replication before having a role in clinical practice.

How Can Risk Detection Contribute to Achieving a 20% Reduction in Suicide?
There are a number of ways to model how our nation could achieve a 20% reduction in suicides. One strategy is to stratify risk and identify those in the high-risk group due to risk factors and those in the low-risk group due to risk and protective factors. If we can identify those in the high-risk group and intervene so we move more individuals into the lower part of the triangle (see graphic), we can begin to reduce suicide’s burden on our nation.

On January 29, the National Council launched a six-part webinar series highlighting the National Action Alliance for Suicide Prevention’s Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives. This series is a collaborative effort between the National Council for Behavioral Health,National Action Alliance for Suicide Prevention and the National Institute of Mental Health. Subsequent webinars will describe how this current understanding influences detecting those at risk, clinical care and services, as well as highlighting a number of the pressing research needs to reduce the burden of suicide. For more information about this webinar series, see Linda Rosenberg’s recent blog post announcing this collaboration.

This post has been cross-posted on the National Council for Behavioral Health site.

The Four Factors that Lead to (and Protect Against) Suicide

By Dr. Jane Pearson, National Institute of Mental Health & Action Alliance; Dr. Elizabeth Ballard, National Institute of Mental Health; and Colleen Carr, National Action Alliance for Suicide Prevention Secretariat

The ultimate answer to “Why do people become suicidal?” is complex, and as depicted in the figure below, research has focused on several long- and short-term risk factors that interact to place an individual at increased suicide risk.

1. Social Determinants

Healthy connectedness with family members, neighborhoods, cultural groups and society can serve as a protective factor against suicide. Conversely, social isolation is associated with increased risk. Social networks can be leveraged to promote protective influences across all ages. Young people’s attachment to their family and schools can serve as a protective factor with “school-connected” teens exhibiting a decreased risk for suicidal behavior over time. Interventions that increase healthy connections have been related to reduced suicide risk in older Japanese adults.

At the same time, certain types of social networks can relate to increased suicide risk, both in person and via media influences. Social networks can contribute to a “contagion” of suicidal behavior, potentially through imitation, idealizing and/or by ‘normalizing’ suicidal behavior. Media reporting of high-profile suicides also carries a concern for increased suicidal behavior.

2. Clinical Factors

Research has identified a host of clinical suicide risk factors. Psychiatric risk factors for suicide include depression, anxiety, post-traumatic stress and addiction; physical symptoms include pain and insomnia. Suicide has been associated with specific cognitive symptoms such as suicidal thoughts, making a plan, hopelessness, feeling like a burden and impulsiveness. However, it is important to note that the vast majority of people with behavioral health and physical illness diagnoses do not kill themselves.

3. Neurocognitive Factors

There is a connection between suicide attempts and deficits in basic cognitive functions (e.g., attention, memory), executive performance (e.g., conceptual processes, reversal learning), impulse control, decision-making and implicit thought processes (e.g., implicit associations, like preference and self-esteem). The neurocognitive findings associated with suicide risk include motor impulsivity, decision-making, response inhibition, flexibility of response generation, self-monitoring/error-processing, sensitivity to others’ anger, impaired response to positive emotional stimuli, harm avoidance and an inability to delay rewards. Recent research demonstrates that teens who attempt suicide may have impaired decision making on tasks such as the Iowa Gambling Test.

None of these factors has been determined to be entirely specific to suicide—whether or not these factors can be used reliably as clinical predictors remains to be seen.

4. Biomarkers that Reflect Biological Processes

Early research provided some evidence that suicidal behavior is heritable. Twin studies report 36-43 percent heritability; non-fatal suicide attempts have heritability estimates of 17-45 percent, even after controlling for any psychiatric disorders. In addition, children are five times more likely to attempt suicide if a parent has a history of suicide attempts, and it may relate to impulsive aggression. Another example of tragic and toxic parent-child outcomes, between 10-40 percent of individuals who experience suicidal thoughts and behavior have a child abuse history.

Immune factors, patterns of brain activity observed with imaging and genetic variants, have all been studied to identify biomarkers that can help predict risk or resilience. Current research trends include serotonergic functioning, glutamatergic functioning and responsiveness to stress in the HPA (hypothalamic–pituitary–adrenal) axis, which may be linked to childhood traumatic experiences.

At this point in time, there is no biomarker with diagnostic clinical utility.

There is a great deal to be hopeful about with regard to improving our understanding of why people consider and try to kill themselves. For more information and detailed citations on the information presented above, see the full Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives.

On January 29, the National Council launched a six-part webinar series highlighting the National Action Alliance for Suicide Prevention’s Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives. This series is a collaborative effort between the National Council for Behavioral Health, National Action Alliance for Suicide Prevention and the National Institute of Mental Health. Subsequent webinars will describe how this current understanding influences detecting those at risk, clinical care and services, as well as highlighting a number of the pressing research needs to reduce the burden of suicide. For more information about this webinar series, see Linda Rosenberg’s recent blog post announcing this collaboration.

This post has been cross-posted on the National Council for Behavioral Health site.