According to the Centers for Disease Control and Prevention, suicide is now the second leading cause of death among youth ages 10 to 241, with the fastest-growing rates among youth ages 10 to 142. Additionally, there is significant racial disparity, with suicide rates among Black youth ages 13 and younger twice that for White youth3. According to 2019 Youth Risk Behavior Surveillance System (YRBSS) data, nearly 20% of students (grades 9 to 12) reported seriously considering suicide in the prior year, 4.  

Youth at risk for suicide are often seen by health care providers in the weeks and months prior to their deaths, indicating that there are opportunities to intervene5. For example, approximately 80% of youth who died by suicide had visited a health care provider in the year before their death, and 40% had had a general primary care visit6. In addition to primary care, emergency departments and inpatient facilities are critical settings for suicide prevention, as the rates of emergency department visits and inpatient hospitalizations for suicidal ideation and suicide attempts doubled between 2007 and 20157, 8.  

Medical settings can therefore play an important role in reducing youth suicide. Pediatric primary care, emergency departments, and other medical inpatient units can be critical settings to identify and care for youth at risk of suicide. Physicians and other staff are well suited to conduct routine screening and risk assessments and adopt robust clinical care pathways that can better care for and protect youth. Since many systems do not universally screen for suicide risk and individuals are unlikely to disclose suicide risk when not asked directly, youth who are at risk may be undetected despite receiving care, and that care is unlikely to include suicide-specific interventions, 9.  

Zero Suicide provides a systems-level framework for improving suicide care across settings. Zero Suicide can be leveraged to embed standardized risk identification and development of clear clinical care pathways, as well as suicide-specific treatment and critical follow-up practices. In this webinar, presenters will discuss effective suicide prevention practices applicable to medical settings, the role of clinical care pathways and workflows that provide guidance and support for health system staff, and ways to leverage the Collaborative Care Model to connect primary and mental health care for adolescents at risk for suicide. 

Format

Recorded webinar, non-interactive, self-paced distance learning activity.

This presentation was recorded on June 30, 2021.

Learning Objectives

• Share the basis for medical settings and providers as an important component of youth suicide prevention efforts. 
• Discuss the use of universal screening and clinical pathways in medical settings.  
• Describe how the Collaborative Care Model can be highly applicable for delivering effective care to adolescents at risk for suicide.  

Target Audience

Psychiatrists, residents/fellows, non-psychiatrist physicians (e.g., neurologists, primary care physicians, pediatricians), medical students, and other mental health professionals 

Instructional Level

Introductory, Intermediate

Estimate Time to Complete

Estimated Duration: 1.5 hour  
Program Start Date: July 16, 2021   
Program End Date: July 16, 2024 

How to Earn Credit

After evaluating the program, participants will be provided with an opportunity to claim an hour and a half of participation and print an official CME certificate (physicians) or certificate of participation (other disciplines) showing the event date and hours earned.

Continuing Education Credit

Physicians

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The APA designates this live event for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

All financial relationships relevant to this activity have been mitigated. 

Instructor

• Virna Little, PsyD, LCSW-R, SAP is chief operating officer and co-founder of Concert Health, a national organization providing behavioral health services to primary care providers, and co-founder of Zero Overdose, a nonprofit addressing the national crisis of unintentional overdoses. Previously, Dr. Little worked for 22 years as a senior vice president for a large Federally Qualified Health Center (FQHC) network in New York overseeing over 300 behavioral health and community staff and worked for New York City Health and Hospitals as a citywide family violence coordinator. She has a doctoral degree in psychology, a master’s in social work, and a master’s in business administration and healthcare, and she is a Certified Care Manager (CCM) and a recognized Substance Abuse Professional (SAP). Dr. Little is a nationally and internationally known speaker for her work in integrating primary care and behavioral health, developing sustainable integrated delivery systems, and suicide prevention. Reports no financial relationships with commercial interests.

• Lisa M. Horowitz, PhD, MPH is a pediatric psychologist and staff scientist at the National Institute of Mental Health (NIMH) Intramural Research Program at the National Institutes of Health (NIH). She serves as a senior attending with a specialty in pediatric psychology on the Psychiatry Consultation Liaison Service in the Hatfield Clinical Research Center at NIH. Dr. Horowitz received her doctorate in clinical psychology from George Washington University, completed a Pediatric Health Service Research Fellowship at Harvard Medical School, and obtained a master’s in public health at the Harvard School of Public Health. The major focus of Dr. Horowitz’s research has been in the area of suicide prevention with an emphasis on detection of suicide risk in medical settings. She is lead principal investigator on five NIMH suicide prevention protocols that involve validating and implementing the Ask Suicide-Screening Questions (ASQ) in the emergency department, inpatient medical/surgical, and outpatient primary care settings. Dr. Horowitz is collaborating with hospitals, outpatient pediatric clinics, and school settings around the country, assisting with implementation of suicide risk screening and management of patients who screen positive using the ASQ Toolkit and Youth Suicide Risk Screening Clinical Pathways. Reports no financial relationships with commercial interests.

Planners

• John Torous, MD, American Psychiatric Association. Reports no financial relationships with commercial interests. 

Accessibility for Participants with Disabilities

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Technical Requirements

This internet-based CME activity is best experienced using any of the following:   

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari   
• Internet Explorer 11+   

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.   

Optimal System Configuration:   

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)   
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)   
• Internet Connection: 1 Mbps or higher   

Minimum Requirements:   

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content   

• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content   

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