Current Trends in Suicide Prevention, Intervention, and Postvention

Silvia Giliotti, LCSW

New York State Office of Mental HealthDownstate Suicide Prevention Coordinator(212) 330-6361

Ackerman Institute for the Family

Silvia.Giliotti@omh.ny.gov

Using Best Practices to Prevent Suicide and Promote Healing After a Suicide

The purpose of the Best Practices Registry (BPR) is to identify, review, and disseminate information about best practices that address specific objectives of the National Strategy for Suicide Prevention

BPR is a collaborative project of the Suicide Prevention Resource Center (SPRC) and the American Foundation for Suicide Prevention (AFSP)

It is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). 

POINTS OF INTERVENTION

Population Prevention & Public Health MeasuresPopulation Prevention & Public Health Measures Mass ScreeningMass Screening

Individualized Risk AssessmentIndividualized Risk Assessment

Triage: Triage:

Hospitalization vs. Outpatient treatmentHospitalization vs. Outpatient treatment

Brief InterventionsBrief Interventions

Individual and/or Family TherapyIndividual and/or Family Therapy

(Postvention)(Postvention)

INDIVIDUALIZED RISK ASSESSMENT: C-SSRS

Posner, K., Brown, G.K., Stanley, B., Brent, D.A., Yershova, K.V., Oquendo, M.A., Currier, G.W., Melvin, G., Greenhill, L., Shen, S., & Mann, J.J:

The Columbia- Suicide Severity Rating Scale (C-SSRS): Initial Validity and Internal Consistency Findings from Three Multi-Site Studies with Adolescents and Adults. American Journal of Psychiatry (November 2011)

http://cssrs.columbia.edu/about_cssrs.html

BRIEF INTERVENTIONS:SAFETY PLANNING Prioritized written list ofPrioritized written list of coping strategies andcoping strategies and

resourcesresources for use during a suicidal crisis.for use during a suicidal crisis. Helps provide a sense of control.Helps provide a sense of control. Uses a brief, easy-to-read format that uses the Uses a brief, easy-to-read format that uses the

patient’s own words.patient’s own words. Can serve to motivate people to engage in treatment.Can serve to motivate people to engage in treatment. Should be the first intervention with a suicidal patientShould be the first intervention with a suicidal patient Helps to immediately enhance patients’ sense of Helps to immediately enhance patients’ sense of

control over suicidal urges and thoughts and conveys a control over suicidal urges and thoughts and conveys a feeling that they can “survive” suicidal feelingsfeeling that they can “survive” suicidal feelings

It is no substitute for treatmentIt is no substitute for treatment Not to be used if there is imminent dangerNot to be used if there is imminent danger It is NOT a No-Suicide ContractIt is NOT a No-Suicide Contract

SAFETY PLANNING: An example

SAFETY PLANNING

Safety Planning App Now Available for Download

New York State Office of Mental Health (OMH), along with the New York State Psychiatric Institute, the Research Foundation for Mental Hygiene and the New York State Suicide Prevention Initiative, created the free "Safety Plan" app for iOS devices (iPod, iPod Touch and iPad)

Alternate versions of this application for Android-compatible devices will be available in the coming months.

BRIEF INTERVENTIONS:Applied Suicide Intervention Skills Training (ASIST)

ASIST is a two-day non clinical, experiential, practice-oriented workshop developed by http://www.livingworks.net/ASIST. ASIST-trained first aid intervention caregivers, will be better able to:

Identify people who have thoughts of suicide Understand how beliefs and attitudes can affect

suicide interventions Seek a shared understanding of the reasons for

thoughts of suicide and the reasons for living Review current risk and develop a plan to increase

safety from suicidal behavior for an agreed amount of time

Follow-up on all safety commitments, accessing further help as needed

BRIEF INTERVENTIONS:Upcoming ASIST workshops

January 14 and 15, 2014 8:30 a.m. to 4:30 p.m. (each day)Police Organization Providing Peer Assistance 26 Broadway, Suite 1640New York, NY 10004-1898

February 10 and 11, 20148:30 a.m. to 4:30 p.m. (each day)Police Organization Providing Peer Assistance26 Broadway, Suite 1640New York, NY 10004-1898

POSTVENTION IS PREVENTION:

CONNECT

Connect is designed to reduce risk and promote healing following a suicide death and is a designated National Best Practice program. The CONNECT Suicide Postvention Training provides specific knowledge and skill development for various professions who might be involved in suicide response.

http://www.theconnectprogram.org

Specifically for Schools Creating Suicide Safety in Schools Workshop

Creating Suicide Safety in Schools is a one-day, interactive workshop designed to engage high school teams in a process to: Evaluate existing suicide prevention and intervention readiness, receive evidence-based and best practice guidance, develop a comprehensive suicide prevention and response plan, and learn about resources to enhance safety and health of your school environment that are subsidized or available at low or no cost. Creating Suicide Safety in Schools workshop is endorsed by the NYS Association of School Psychologists, and is on the Suicide Prevention Resource Center Best Practice Registry

Creating Suicide Safety in Schools Workshop

Specifically for Schools Lifelines: A Comprehensive Suicide

Awareness and Responsiveness Program for Teens, Schools and Parents

Lifelines trilogy is an Evidence Based, whole-school program made up of three unique components: Prevention, Intervention and Postvention. The Lifelines trilogy is based on over 20 years of suicide-in-youth research that indicates an informed community can help to prevent vulnerable teens from ending their lives.

Specifically for Schools

At Risk At-Risk for High School Educators is

a one-hour online, interactive gatekeeper training simulation designed for high school teachers and staff using emotionally responsive student avatars

Specifically for Schools

Sources of Strength (University of Rochester)Sources of Strength is a best practice youth suicide prevention project that utilizes the power of peer social networks to change unhealthy norms and culture and ultimately prevent suicide, bullying and substance abuse. The program is designed to prevent suicide by increasing help seeking behaviors and connections between peers and caring adults with a focus on Hope, Help and Strength. Sources of Strength takes a different approach in youth suicide prevention by moving beyond a singular focus on risk factors through building multiple sources of support around young individuals so that when times get hard they have strengths to rely on

UPCOMING WORKSHOPS IN NYC AND LI

omh.ny.gov/omhweb/suicide_prevention/training

omh.ny.gov/omhweb/suicide_prevention/Garrett_Lee_Smith

preventsuicideLI.org

preventsuicideNY.org