It’s a shocking statistic: Suicide is now the second-leading cause of death among those between the ages of 10 and 24 in the United States. Suicide claims more lives of young people than any medical illness —only accidents kill more.
Given its massive toll – which has only increased since 1999 – UCLA faculty member Joan Asarnow calls suicide the “cancer of mental disorders.” A UCLA professor of psychiatry and an expert in suicide prevention, Asarnow is now co-managing two large projects aimed at reducing the number of suicides.
One of them, funded by the National Institute of Mental Health, is a clinical trial of advanced suicide prevention techniques. The other, supported by the Substance Abuse and Mental Health Services Administration, is developing a national anti-suicide center to train hospital and other health care providers in the treatment and prevention of suicide, substance abuse and self-harm for adolescents who have experienced trauma.
“Far too many kids are dying of suicide now, and we know that effective interventions can reduce suicide attempts, suffering and lifetime medical costs,” said Asarnow, who directs the Youth Stress and Mood Program at the UCLA Semel Institute for Neuroscience and Human Behavior.
For the National Institute of Mental Health project, Asarnow and Greg Clarke of the Kaiser Permanente Center for Health Research will study about 300 people ages 12 to 24 who enter the Kaiser Permanente Northwest health care system after a suicide attempt or another event that puts them at risk of suicide. Half of them are being treated according to guidelines established by Zero Suicide, a campaign of the National Action Alliance for Suicide Prevention; the others will be treated according to the same guidelines but with an added “stepped-care” strategy that provides more intensive care for subjects considered to be at higher risk.
As part of the stepped-care strategy, care managers will deliver cognitive-behavioral therapy training to primary care and emergency clinicians, with the goal of improving their ability to evaluate and treat patients. The program will provide in-person treatment for people with greater risk for suicide, while those with slightly lower risk can access online cognitive-behavioral videos and round-the-clock coaching support; and it will monitor patient outcomes, providing real-time feedback that will help clinicians make better decisions about their care.
Asarnow said the researchers hope the stepped-care strategy will reduce the number of suicide attempts and incidents of self-harm, and help lessen the severity of people’s symptoms of depression better than current practices do. People enrolled in the study will receive care for 12 months.
“We’re trying to roll out something to save some lives,” Asarnow said. “We want something that will work for patients, be cost effective, and ‘stick,’ so that we’ll be able to change care in this country.”
For the Substance Abuse and Mental Health Services Administration project, Asarnow and a co-investigator will establish the Center for Trauma-Informed Adolescent Suicide, Self-Harm, and Substance Abuse Treatment and Prevention. With hubs at UCLA and Duke University Medical Center, the project will train health care providers across the country in suicide prevention and related practices. Asarnow estimates that the providers trained through the program will be able to treat about 20,000 people during the grant period.
“The goal is to bring better care to adolescents who are struggling with the effects of trauma by bringing the latest care strategies, based on research, into emergency services and other settings,’’ Asarnow said.
If you know someone at risk for suicide, call the National Suicide Prevention Lifeline at 800-273-TALK.
