• Clinician’s Corner: Patients Can Use Simple Tool to Identify Intense Emotions before Suicidal Crises

    Through our work with military service members and their family members who have experienced a recent suicidal crisis, we have learned that emotions immediately preceding such crises vary significantly from person to person. During individual psychotherapy sessions, our clinicians ask patients to share their suicide stories to better understand the circumstances that resulted in the suicide-related hospitalization and which circumstances resulted most often in the decision to attempt suicide. While providing this narrative, patients report a wide range of emotions that preceded the suicidal crisis such as intense despair, extreme excitement, agitation, uncontrollable anger, numbness, or indifference, as well as debilitating feelings of inadequacy.

    We believe that an important clinical strategy in working with suicidal patients is to first identify emotions that activate and shape a patient’s trajectory from suicidal thinking to suicidal behaviors. The next step is to understand the intensity of these identified emotions so that we can teach the patient to modulate these emotions more adaptively in the future. By mapping out the patient’s emotions in a stepwise fashion, the clinician is able to help the patient identify key points for early intervention strategies, such as a self-soothing technique, deep breathing exercise, or other healthy coping technique (e.g., calling a friend, engaging in strenuous exercise) to impede further escalation.

  • Primary Care and Emergency Providers Can Help Prevent Suicide
    Military Crisis Line

    An important finding about suicide is spurring a new approach to reducing it: In the month before they take their own lives, many people who die by suicide seek medical or psychological care.

    These patients don’t come to their local clinic or hospital for help with suicidal thoughts, but with other medical or mental health issues. They may have traumatic brain injury, or they could be depressed. They may have chronic health problems. They might have gone to the emergency department following a drug overdose. Those conditions are treated, but the patient is not necessarily assessed for suicidal risk.

    By evaluating all patients at risk of suicide no matter their reason for seeking care, immediately treating those at risk, and providing follow-up care, health care systems can substantially reduce suicides, presenters said at the 2015 summit of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

    “The potential is there for primary and behavioral health providers to reduce suicide,” said Eileen F. Zeller, an official with the Substance Abuse and Mental Health Services Administration (SAMHSA).

  • DCoE Webinar: Psychologist Discusses Methods to Manage Suicidal Patients

    Identifying risks in suicidal patients and knowing how to handle the situation in a clinically appropriate, legally sound manner can help save a life.

    That’s the message a psychologist with the Department of Veterans Affairs will deliver in a webinar hosted by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury 1-2:30 p.m. (ET) Sept. 24.

  • Military Medicine Tackles Suicide with Prevention Tools

    When DCoE, in partnership with the Department of Veterans Affairs (VA) released its Assessment and Management of Suicide Risk Clinical Support Tools last fall, they were hailed in a Rand report as an example of how to expedite providers’ adoption of new research. The tools make it easy for providers to apply the latest clinical guidelines for suicide prevention issued by the Defense Department and VA). Also included in the toolkit is information for families and patients. The following post from explains how the tools were developed and how they can be used to improve care.

    Get this photo from the Air Force website
    U.S. Air Force photo illustration by Tech. Sgt. Nadine Y. Barclay

    When it comes to preventing suicide, the military provides resources for individuals, friends, families and providers who can make a difference and help save lives. The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) and other Department of Defense experts collaborated with the Department of Veterans Affairs (VA) to develop a new set of tools, released last year in support of the 2013 clinical practice guideline for the assessment and management of suicide risk.

    “We worked with the VA/DoD Evidence Based Work Group to develop clinical support tools that cover such areas as warning signs, evidence-based treatments and care transition,” said Public Health Service Cmdr. Angela Williams-Steele, a clinical psychologist and chief of evidence-based practices at DCoE’s Deployment Health Clinical Center.