APA 2019 Main Stage: Panel on Suicide Prevention

APA 2019 Main Stage: Panel on Suicide Prevention


I’m Heather Auburn Kelly and I’m a
clinical and community psychologist on the advocacy staff at APA and I’m our
point person for APA suicide prevention advocacy work on Capitol Hill and I’m
thrilled today to welcome you to a session where we’ll really be trying to
bring the pieces together of what we know what we don’t know what we hope for
in terms of suicide work and so I want to start and ask you to welcome two of
our fabulous research scientists in this area for a conversation about what we do
know about the research and where we hope it’s going please welcome dr. Jean Pierson many of
you in this room probably know Jane she is the chair of the research consortium
at NIH is National Institute of Mental Health and dr. Mitch Prince Dean and
Mitch is also well known to many of us at this convention and in this room
Mitch is the distinguished professor in the department of psychology and
neuroscience at the University of North Carolina at Chapel Hill so I’m going to
turn first to you Jane because you really sit atop the federal funding
portfolio with the 30,000 foot view of this work and I want to ask you first to
talk with us about what has become the consensus knowledge from the science in
this area and what are you most excited about that you’re funding right now so I
think consensus wise we do have treatments that help people who have
attempted suicide we know we can reduce their risk for Riya tempting 30 to 50
percent I mean it’s remarkable if we had some
kind of pharmaceutical agent that did that we would be amazed so we we have
that we can do it we were trying to figure out how to roll that out and how
to get practitioners like you comfortable using it and moving ahead
these are broader kind of you know CBT DBT like efforts that are very effective
but we also know that each patient is unique and probably got on this
trajectory in very specific ways so it would benefit all of us if we could make
that more efficient so we’re also trying to look at more
developmental research some of the work that mitch is working on trying to
figure out how somebody got to that state
we’d like to also prevent people as we just heard how important it is to not
act on your thoughts so even though we have these great treatments for
preventing Aria temps we would ideally like to help people who might have
thoughts of suicide not act on them at all so that’s what we’re heading Mitch
you’re also really well-known in this field for your work in particular on
Adolescent Health and peer influence biomarkers of stressors in adolescent
girl populations in particular can you talk with us about what you’re doing now
you happen to have some funding from NIH I believe so
what are you working on that you could share with us that you’re most excited
about we’re working on a number of different things right now but probably
the thing that’s been surprising me the most has been the work that we’re doing
in middle schools and high schools with Universal screening we are going in and
asking just about every kid grade wide to tell us whether they’ve thought about
suicide and also whether they’re engaging in non-suicidal self-injury
here’s what’s surprising me and scaring me recently we’re finding that about two
kids out of every classroom hasn’t merely just thought about suicide but
they are thinking many times a week about how and when they can attempt
suicide this is a remarkably high percentage of kids who may be at
imminent risk and it’s been concerning this is a rural district and we have of
course been working to find referrals one of the things that’s been
disheartening is that there are not many mental health providers available and
those who are available sometimes don’t feel adequately trained or able to take
clients who were reporting suicidality for me when thinking about kids this is
a major public health issue so the former adolescent researcher and me has
to ask I’m thrilled to hear that you’re doing a school-based research how on
earth did you come in school system to let you do this I’m
delighted but can you share with everyone what the magic was I have to
say that we’re very fortunate and that we have a number of school districts in
North Carolina who understand and appreciate research and science and they
know that in order to do the best job in thinking holistically about kids and
their education they need to be thinking about mental health as well you’re not
going to be able to do a whole lot in the school towards educational outcomes
unless you are putting mental health at the front and center of how you’re
thinking about kids development so they have thankfully been very interested in
having psychologists come and work directly with them not just on suicide
but on a wide array of topics to understand the latest psychological
science are you also finding I was at a conference out in Denver are you finding
it since you’re in the schools that they are coming to you with questions about
postvention also they are there are unfortunately a number of schools who
have suffered a suicide loss within the district or within the community and the
rates of contagion are of course remarkably high so there has been a lot
of interest in understanding how within the media within the school district and
within the communities there are ways to help what’s often really interesting I
find is that when you see kids who are suffering of course that’s just the tip
of the iceberg of what the community is experiencing and it’s many of the
parents and the community leaders themselves who might also be thinking
about suicide and need help as well can I say something there abouts a
postvention piece because I think it’s such a challenge you want to be
empathetic sympathetic but for a kid who’s trying to manage their own
emotions to begin with they’re just flooded with this feeling
and if this is the part of the contagion picture that I think we’re all kind of
struggling with and trying to understand and I totally agree with you that I
schools are in the mental health business whether they like it or not so
how can we help them how can we you know connect to crisis services in the
community but of course we’d like to move up upstream and I even have kids in
crisis how can we help kids understand mental health issues New York state
requires K through 12 mental health curricula
how is that working what do you teach kindergartners about mental health so
there’s a lot of room for psychologists to do a lot of work here and we need it
soon that is the perfect segue Jane I believe my home state of Virginia has
also just mandated that same school-based social emotional and mental
health learning so I would love to see people in this room be tackling that and
be building in evaluation from day one Jane you started us thinking
forward-looking so that’s my next question for you is and if I were you
and I were a researcher in the room anytime I’ve got a federal funder on
stage I would be listening very very carefully to what she is saying what if
I gave you and I’m and you know I’m one of 18 lobbyists part of what we do for
you on behalf of APA is we go to Capitol Hill and lobby Congress to make sure the
Congress gives NIH enough money to fund all of you to do this really incredible
and important work we take scientists like Mitch you have results of that
funded research back up to Capitol Hill for to serve as witness in a
congressional hearing or if they haven’t figured out that they should be
addressing a topic we bring Capitol Hill briefings to cut to Congress and say
here’s what you need to know so there are so many ways that all of you can be
involved with APA in furthering this work but so what if I were a really
really good lobbyist and I got you a gajillion dollars for fiscal years
twenty through 25 Jane what five years from now would you hope that all of this
work and what we were about to do from your vantage point well where would you
hope it would be on this issue well if we think of the crisis right now
especially with kids the school obviously is really important as a
setting where we could reach a lot of kids so if you think about how you want
to address anything emerging I wouldn’t call suicide necessarily an epidemic
it’s been slowly creeping up but it’s certainly a huge issue tenth leading
cause of death if we think about other boundary settings where we could be
doing better where we already have people coming we know about 80 percent
of people who die by suicide have been to health care in the last year it might
not be behavioral health it might be primary care who might be pediatricians
offices so if we could work with our colleagues in health care
and be a part of their team and think about how are we gonna help with the
screening that’s happening there’s more phq-9 s the the personal health
questionnaire asking about suicide there’s an suicide item on that how
could we help our colleagues how can we catch people if Kevin had been to the
doctor and had been screened you know what would have happened what could be
announced right a new trajectory so you know it might not have to be perfect but
if we could start catching more people in those systems that would be one dream
of how that would all fit together and there’s a range of research so we could
be doing screening more efficiently we could do it a lot of different ways we
could be providing the intervention a lot of different ways it could be a
person telehealth some kind of app telephonic whatever it is we should be
looking at the outcomes to see how well we’re doing and we should also have like
these Centers of Excellence where health care systems that figure this out like
you know if you’ve got cancer you want to go to the best treatment place right
where do you go for suicide we don’t have those set up we don’t have those
networks we need that infrastructure and then I’ll go to the complete other end
we’d love to have schools that could implement prevention programs where you
could build resilience and kids in the first place because it’s not really
efficient to wait till somebody’s attempted or even have a thought of
suicide let’s build resilience much sooner I think we it’s certainly more
cost-effective so that’s a lot to work on but that’s where we have to go thank
you and Mitch what if again I were so successful that Jane got a gajillion
dollars and she decided to fund you with half a kajillion of it could design any
research program and research into intervention and prevention segues that
your heart desires where would you take where are you taking your work in the
next five to ten years do you think there’s so much that I would want to do
but maybe one of the most important things that I think we need to invest
more in is we need more people doing research on suicide in particular we
need to really think about how we can expand our understanding of suicide
so traditionally underrepresented populations
I think this is critical if you look at clinical psychology counseling school
psychology programs and psychiatry programs including some of the ones that
are the largest within our country they’ll find remarkably few people are
studying suicide we need more investigators and if there
are any students or early career professionals who are listening I would
say that this is a terrific topic that obviously has the potential to make
great great impact particularly if you are someone that is interested in
studying this within african-american populations Latino populations Native
American populations and also the LGB and T communities where there has been
remarkably little research done but we see increasing rates across all diverse
groups and suicidal thoughts and behaviors and to me this is an
incredibly high priority because we need to understand more about why suicide
occurs and what approaches that we can take to address everyone’s need so I
would put in a plug for more scientists who are interested in the topic thank
you and it reminds me again to share with all of you what Mitch raised is
exactly how APA again on your behalf thinks about this at the organizational
level and from our home headquarters in DC is that we go up to the hill and we
lobby not just Congress but we Lobby the agencies themselves on behalf of you
know suicide touches every one of those populations and psychologists can
address every one of those populations there is something every one of you in
this room can do from whatever your particular expertise and stand point is
so I have colleagues on on our suicide prevention advocacy team who are engaged
in lobbying on the older Americans Act who are
working on LGBT issues in this area who are responding to a request from the
Congressional Black Caucus for us to provide recommendations within the next
three weeks about what they can be doing from within Congress to address the
rapidly rising slope of that rate within african-american youth so that is a
clarion call and we want to second that and not only for more researchers but
for translators for those of you who translate that work back into your
clinical work or here’s my plug for becoming policy wonks people who choose
to enter and it can be just coming with us to the hill to share your expertise
or it can be day to day working in the policy world translating the science and
the clinical expertise into better law better policy that our programming so we
have a few minutes left and I want to do that trick of moderators who haven’t
thought about the next question which is to say what what have I not asked you
that we should be talking about Jane I’m a mindful that you are in really you’re
at NIH sure at a huge federal agency there are lots I handle our military
veterans work so I’m working on military and veteran suicide prevention which the
Secretary of the VA has named as his top number one top clinical priority I know
that you’re working with people with colleagues at VA and other places can
you talk a little bit about the interagency at the federal level term
collaboration on this right and let me just also mention around the call for
more researchers when when I reported asked me like why is the funding you
know it’s growing but it’s not really moving I explained this we don’t turn
away suicide research we need more researchers to come in so we get it that
you know if we put more money out there more if you respond so we’re still
working on that but still if it’s been a steady climb but we need to move that
faster and I think if we have more interest in that area it’s going to
happen so let me just say that we also do work with our federal partners
because of we have to leverage what funds we have and we have to leverage
our efforts and make sure we’re not you know working at odds in terms of you
know policies we’re putting forward and through the National Action Alliance on
suicide prevention we have this opportunity to work across lots of
federal and private partners which is great and there’s a lot of opportunities
there think about what has the VA learned in
their system it’s the largest healthcare system in the u.s. what have they
learned in suicide prevention that we can move to the civilian world what are
some things we can do the civilian world that the VA can’t
perhaps so easily right now and you know we all want to learn from each other and
I think there’s so many opportunities there between providers talking about
what they need to learn how they need to take care of themselves these this these
are challenging clients what’s the best way to support yourself doing this what
are policies you could have as your own private practitioner to do this in a
safe way there’s a lot of opportunities there’s the patient-centered oriented
Research Institute that’s beginning to do suicide prevention that I’ve just
become aware of now so you know we all kind of sit in our institutions or
agencies and we you know do our mission relevant stuff but it’s really important
to talk across and I think we have an opportunity with an APA to think about
psychologists who work across all those agencies so that’s another opportunity
as an association where we could get a slice of what’s going on across many
agencies and that makes me turn to you Mitch and say what do you see as a
collaborative effort that’s working could be working better among a lot of
you researchers who are in this area do you have built-in ways obviously
sometimes through sort of PI meetings at agencies but in the larger world are you
all talking to each other are you involved I know you’ve done some
consulting with TV like you’ve expanded your impact in ways that are exciting
can you speak a little bit to how to collaborate with others as scientists I
think there are ways that scientists can collaborate with one another but you
know I think that we as psychologists you know suicides a global health crisis
the answer is going to come from psychology I truly believe that and I
read and I believe that because we are so unique as a discipline we include the
basic scientists the applied scientists the people who are in the trenches on
the ground doing day to day delivery of services and policymakers we as a
discipline have it all and I think what we need to do is we need to figure out
how we be talking to one another in our
different roles with our different hats as psychology we have the science we
have the best practice we have the ability to make a tremendous impact but
it is that communication it’s empowering every psychologist to speak about the
science and what they know to anyone and everyone who listen from as short as a
tweet to a blog to a book to a work with a reporter it’s calling every
policymaker and never letting them forget that to children out of every
classroom wanting to die is horrible and it is deserving as much attention as the
flu or any other physical illness that we have widespread public screening and
interventions for but not for mental health it’s worth having those
scientists talk to the practitioners to get a reciprocal information exchange so
the science can get better and practitioners can learn about the
approaches that are the most likely to succeed we can do it all in psychology I
think we can really make a difference but I’m excited about the direction of
us all working together to make sure that that happens I did not plan this we
are ending on that note but isn’t that a perfect note on which to end so please
thank our thank you

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