NCAD Spotlight: Treatment Programs Can Make Suicide Prevention Part of Their Core Mission

Many of the patients who enter substance use treatment pose a high risk for suicide, but few specialty programs define suicide prevention as part of their core mission. The senior project associate for the Zero Suicide Institute believes addiction treatment programs can incorporate a focus on suicide relatively easily, and inexpensively.

“Evidence-based and -informed screenings and interventions are easy to apply,” says Jennifer Myers, MA, who will present a session titled “Comprehensive Suicide Care in Substance Use Disorder Settings” at next month's National Conference on Addiction Disorders (NCAD) in Baltimore. “Some of the best tools are free,” Myers tells Addiction Professional.

Zero Suicide is a framework of best practices for health and behavioral health systems to provide more effective care. Myers, whose institute is housed at the Education Development Center, explains that the Zero Suicide approach does not focus on the heroic efforts of individuals in health organizations, but on establishing an overall system that is able to identify suicide risk effectively.

Zero Suicide is built around these key elements for organizations:

• Lead system-wide culture change committed to reducing suicides;

• Train a competent, confident and caring workforce;

• Identify individuals with suicide risk via comprehensive screening and assessment;

• Engage all individuals at risk of suicide using a suicide care management plan;

• Treat suicidal thoughts and behaviors using evidence-based treatments;

• Transition individuals through care with warm handoffs and supportive contacts; and

• Improve policies and procedures through continuous quality improvement.

Implementation barriers

Past overdoses or previous thoughts of suicide are among the factors that might predict future risk of suicide in individuals with a substance use disorder, but many addiction treatment providers do not define suicide as its own discrete problem to be addressed.

For some addiction-focused agencies, suicide prevention might be seen as “too mental health,” Myers says, and these facilities thus will refer a patient somewhere else instead of managing the issue themselves. Also, the array of training that various substance use professionals receive for their alphabet soup of practice credentials leads to much variability in how confident addiction-focused professionals are about addressing patients' suicide risk, she suggests.

Myers cites how the Henry Ford Health System, at the urging of one of its nurses, incorporated a zero suicide mindset into its “perfect depression care” framework. This means that any patient with a behavioral health diagnosis, including a substance use disorder, receives a safety planning intervention and counseling in reduction of lethal means, she says.

She hopes one of the main takeaways for attendees of her Aug. 17 NCAD workshop session will be “that we can do system transformation to really meet the whole person walking through the door.” Once agencies conclude that they can make suicide prevention a priority, they can assess their workforce's readiness to identify and address suicide risk, and proceed accordingly with the necessary training.

The Zero Suicide Institute is introducing full- and half-day trainings on Assessing and Managing Suicide Risk in Substance Use Treatment Settings, Myers says.

Join clinicians and executives at NCAD East, Aug. 15-18 in Baltimore, and work to improve and refine patient care as well as develop sustainable and successful treatment organizations. Visit https://east.theaddictionconference.com for more information.