Lehigh Valley medical facilities working toward Zero Suicides with the help of improved patient screening process
Gail Stern, MSN, Administrator of the Department of Behavioral Health for Lehigh Valley Health Network, has been a psychiatric nurse for 40 years. She has treated a number of patients for mental health issues during her career, and become an expert on the topic of suicide. She has also seen an increase in suicide and depression despite her efforts.
“There’s been an overall increase in death by suicide in the past decade, and the primary mode of suicide has changed from hanging to firearms,” Stern said. More women are also electing to use a firearm over poisoning, which had long been the method that they chose.
According to the 2016 Lehigh County Coroner’s Office Annual Report, there were 87 deaths by suicide, 39 of which were by firearm, making that manner of suicide the predominant method, followed by hanging and drug overdose.
“Suicide isn’t just about mental illness,” explained Stern. “You can’t just treat the mental illness to prevent suicide. It’s not that simple. One in five people experience depression in their lives, but only one in 100 people develop serious mental illness. There are many underlying factors that have to be addressed.”
Know the risk factors
There are several factors that can contribute to a person’s contemplation of suicide, including past traumas, preexisting mental illness, and even genetics. Key risk factors include:
- Having a close friend or family member that has died by suicide
- Childhood traumas
- Alcohol and drug use
- Past suicide attempts
- Major life changes like ending a long-term relationship or losing a job
- Various life experiences such as imprisonment, being the victim of a crime, witnessing war atrocities, etc.
“Also, people who don’t have built-in protective factors can be at a higher risk for dying by suicide,” Stern explained. “Connection to family and friends, religious or spiritual outlets, a good job that they like, and good coping skills for life’s stresses are some examples. The more connected we are to each other, the more resilient we are.”
With that in mind, it’s a good idea for individuals who have suffered from serious mental illness to have a safety plan in place with a close friend or family members in case the individual’s personality changes.
Proactive healthcare community screens for signs of depression
“There’s a greater level of awareness, locally and nationally, for suicide today than there was in the past, and the health care industry is taking a more proactive approach with its own role in early diagnosis and prevention,” says Stern. “Many medical facilities and health networks are participating in programs like the Zero Suicide initiative to assess all patients that come into their practices for depression and suicide risk.”
At LVHN, primary care physicians and internists, whose practices see the largest number of patients each year, are now using a screening process that includes two questions about depression. If a patient indicates that they have felt depressed or had suicidal thoughts or tendencies, the physician then follows up with a detailed series of nine questions known as the PHQ-9 for further evaluation. Upon completion of the form, the physician can better gauge the severity of depression, the patient’s intention for self-harm, and then refer him or her for psychiatric treatment.
Arming the community with training and information
Local healthcare organizations are also spending more time and resources to train members of the community in how to recognize signs of depression and how to help a suicidal person.
“We understand how important it is to share what we know about these health conditions with groups and individuals so they can help the people in their lives,” explained Stern. “Presentations are now being given to church groups and members of the clergy, community organizations, parents at schools, residents at senior centers, and to social clubs and organizations.”
“Teachers are now required by the state to have such training in order to maintain their certifications,” she continued. “And many first responders will often have a social worker on staff who can help them during their calls when dealing with residents.”
Speak up and speak out
Stern also stressed the importance of peer counseling and having others who have suffered from depression talk to those currently dealing with it and talking about their story. “The more that people who have been through this situation can share their experience with others, the more people they can help. Knowing that others have been where they are helps people with depression feel less isolated and alone.”
While these ongoing efforts will take time to take hold in the community, the goal of preventing, and eventually eliminating, suicide in the Lehigh Valley is worth striving for by working together to achieve it.