I’ve returned from a fascinating series of trips to two New York State psychiatric facilities (St. Lawrence Psychiatric and Pilgrim Psychiatric), as part of a project I’m working on with the Office of Mental Health.  I learned a great deal from talking about suicide risk with over 500 clinicians from a variety of disciplines and settings–psychologists, RNs, case managers, social workers, psychiatrists, mobile crisis clinicians, family therapists and others.   It would be hard to find a group of professionals with more experience working with individuals at-risk, and the questions, comments, and concerns the participants contributed matched that level of experience.

I have made some notes about issues that were raised by clinicians, and plan to blog my thoughts about these in coming months as I get pockets of time to reflect on my travels.   As I have stated before, I think it’s important for educational initiatives to map closely onto the real-life concerns of clinicians, rather than simply reflecting content that experts deem important.   Here are a few concerns and questions that I hope to think more about when I have time:/

• When it comes to hospitalizing isn’t it always best to “err on the side of caution?”
• Why are we focusing on suicide so much when the people we work with have so many other problems?
• Why are we focusing on suicide when it’s so rare and most people who die by suicide weren’t in treatment when they die?
• How do we handle individuals at risk who are only marginally involved in treatment-they miss more appointments than they make, but still come enough that they remain on our caseloads?
• Does doing a better job with risk for suicide always mean more work and writing?
• Is there anyone for whom it is not indicated to ask about suicidal thoughts?
• How often should we do a risk assessment?
• What kinds of lawsuits have and have not been successful against clinicians in cases of completed suicide?
• Even if we do everything right, can suicide really be prevented?

Along the lines of that last question, several clinicians shared moving stories about ways in which suicide has touched their lives, personally and professionally.   It is always so sad to hear about these deaths, and so encouraging to hear that some of the ideas I brought for discussion felt relevant to these experiences.

A big thanks to the professionals at OMH, St. Lawrence, and Pilgrim who supported and hosted me during these trips.   And to the clinicians at both facilities who made these trainings so stimulating and enjoyable.

The small island of Nantucket, MA has seen 3 teen suicides in a short period of time, according to the New York Times.  Very sad.   Statistically, three suicides in a high school of 400 represents a meaningful cluster, and a possible contagion effect.   Whether it is or it isn’t contagion in Nantucket (it is impossible to know for sure and the article suggests some disagreement in this case), the key thing for clinicians to know is that vulnerability to contagion has been documented in adolescents.  Clinicians working with adolescents at risk at the time of a public or peer suicide should consider reassessing their clients’ risk for suicide when news of a peer death becomes public.

N.Y. Times has done it again.  A nice article taking a step back from the current flurry of news and discovery about the relationship between anti-depressants and suicide.

A friend pointed me to an article (found via a post at Think Christian) titled, “The Web Is The Worst Place to Grieve.” The article, published in a conservative-libertarian magazine, describes several examples of real and feigned suicides that have been blogged on the web.   Blogging had made possible public suicide notes.  The article is a good reminder of the dark side of Web 2.0 whose opportunities and possibilities I’ve explored here in the past (see posts in Blogging category).

We’re seeing more public awareness of the nuances in the research about suicide and antidepressants, which I’ve posted about before.  This NEW YORK TIMES article is an example.

Caution, Not Panic, Seen After Drug Warnings

The New York Times does a good job raising public awareness about suicide prevention.   Today, they’ve published an article bout suicide in older adults.   Read the full article here.

This is a bit far afield from suicide, but I think worth mentioning here because it illustrates how maps and visualization can present a different, more contextually-sensitive view of a phenomenon, as compared to that which lists and other linear formats can achieve.

I recently became aware of a project called Newsmap, which takes a traditional news feed (Google News) and maps it so that you can see the news landscape in a different way.   The program purports to “to divide information into quickly recognizable bands which, when presented together, reveal underlying patterns in news reporting across cultures and within news segments in constant change around the globe.”   In the quick scans I’ve done, I’ve been impressed with how much information can be presented this way, and with how much more context one apprehends from this visual view.

Mindjet included a vignette about my work with mindmaps in a new customer vignette section of their website.   There are many other vignettes on the site that are interesting and worth reading for anyone interested in using mindmaps for thinking, planning, and presenting.

Just a quick plug for an informational session (.pdf flyer) on October 26th for students considering applying to the Family Therapy Training Program at the University of Rochester Medical Center.   We offer and M.S. degree in Marriage and Family Therapy and a post-degree certificate to degreed professional wishing to re-specialize in family therapy.

Roger Cohen has written a moving Op-Ed piece in which he describes the way in which a recent suicide in the Phoenix airport transported him back to his own mother’s decades long battle with suicidal thoughts and attempts.