How communities respond to a mental health concern or crisis may directly contribute to consumer perception, potential stigma, and willingness to engage in help-seeking behavior. This week’s Rocky Mountain MIRECC Short Takes podcast highlights a local program invested in proactively reaching out to individuals who may experience mental health challenges, and build healthy relationships that better serve community members both in crisis and for the long haul. Please join Scott Snow (Director of the Crisis Services Division, Denver Police Department) and Chris Richardson (Program Manager of the Mental Health Center of Denver) as they talk about Denver’s Crisis Intervention and Response Unit (CIRU). Here is some of what they discuss:
This week join Adam Hoffberg as he chats with Dr. Elizabeth Conti a clinical psychologist and Postdoctoral Research Fellow with the VA Center for Innovation. Dr. Conti, along with four of her colleagues from the VA’s South Central MIRECC published the manual Collaborative Safety Planning for Older Adults. Dr. Conti gives a wonderful overview of what a safety plan is and leads our audience through creating one. Then she answers why safety planning with older adults’ presents challenges that clinician’s need to address in their practice. Throughout the conversation Elizabeth describes a collaborative approach that harkens to the work of Dr. David Jobes. This is a podcast where clinicians will gain a deeper appreciation of the safety plan and be able to use the skills learned in their everyday practice.
This week Adam discusses Fluid Vulnerability Theory with Craig Bryan, PsyD, with the National Center for Veterans Studies at the University of Utah. Dr. Bryan ducked into an empty room at the hospital where he was delivering a talk to chat with Adam. Craig served four years in the Air Force and deployed to Iraq in 2009 as Director of the Traumatic Brain Injury Clinic at the Air Force Theater Hospital in Balad. Later he worked with Dr. David Rudd has Dr. Rudd developed Fluid Vulnerability Theory (FVT). FVT states that “suicide risk is an inherently dynamically changing construct…that risk will fluctuate over time.” And it is through understanding the processes that underlie the “ideation to acting framework” where work and change come about. Listening to these two really discuss FVT is like having a full conference presentation delivered right to you. It is fascinating.
Suicide is known as a rare event, yet the large number of those impacted by suicide (through exposure, and closer connections including bereavement) makes suicide loss relatable to every human. Preliminary research on suicide bereavement in Veterans and Military Families shows that military family members who have lost someone to suicide are at greater risk for depression, anxiety, and suicidal thoughts of their own. Melanie Hom, M.A., a clinical graduate student at Thomas Joiners’ Laboratory for the Study and Prevention of Suicide-Related Conditions continues this line of research, which she discusses with Adam in this week’s Short Takes podcast. Using common data elements aggregated across 15 studies funded by the Military Suicide Research Consortium, this study finds that the majority (over 50%) of service members and Veterans know someone who has died by suicide. Melanie shares findings about those affected by suicide loss, as well as important clinical implications and needed next steps for future research.
Adam and Dr. Joel Scholten recorded this conversation in the lobby of the Chicago Hilton during the ACRM conference and just as Cubs fans were preparing for their appreciation parade after the team's historic World Series win. Joel talks about the importance of the rehabilitation team at the VA and the vital role they play in suicide prevention.
Could improved sleep potentially help prevent individuals from developing suicidal thoughts or behaviors sometime in the future? Rocky Mountain MIRECC Psychologist Sarra Nazem talks with Adam about her clinical work and research into evidence-based insomnia treatments as it relates to decreasing suicide risk. This topic is particularly relevant for providers working with Veterans and military, who experience sleep disturbances at increasingly high levels in the past decade. The good news: though insomnia is highly prevalent among Vets and military, it is also highly treatable. EB interventions such as SHUTi (Sleep Health Using the Internet) capitalize on a combination of high effectiveness and wide accessibility. Join Sarra and Adam as they discuss improving sleep as a way to increase hopefulness, and improve outcomes for other co-morbid conditions.
Richard Egan shares his professional journey, which spans 26 years’ service with the Air Force (starting with munitions, “bombs and bullets”) to Suicide Prevention Training and Outreach Facilitator, Nevada Department of Health and Human Services, Office of Suicide Prevention. Nevada represents the only State to reduce (by a small amount) suicide rates from 1999 – 2014, while the rest of the nation increased upwards of 24%. How did they achieve this result? Mr. Egan describes a comprehensive life cycle approach, starting with social-emotional learning in elementary school, to supporting older residents, many of whom have left family/friends behind in other states. This podcast also highlights Nevada’s access to lethal means’ programs, proactively reaching and training community members that may come in contact with at-risk individuals.
Adam Interviews John R. Blosnich, PhD, MPH, from the VHA Center for Health Equity Research and Promotion. Dr. Blosnich's program of health equity research in VA focuses on LGBT Veterans, with specific attention to suicidal risk and examining ways that information about patients' social determinants of health can be part of adaptive health care systems.
Adam talks this week with Dr. Julie Kinn from The National Center for Telehealth & Technology (T2), a Department of Defense organization that evaluates new technologies for tele-mental health. T2 has put out lots of mobile apps focusing on the mental needs of Veterans, caregivers, service members and clinicians. The apps have been remarkably popular and useful. Adam explores the process of creating evidence-based apps that are fun, easy to use and beneficial.
Adam interviews a new addition to the Rocky Mountain MIRECC for Suicide Prevention team, Dr. Meredith Mealer. Meredith as done important work studying the high prevalence of PTSD in ICU nurses. Her work has found that ICU nurses suffer from PTSD at a rate comparable to soldiers returning from Iraq and Afghanistan. Dr. Meale's research has also provided steps that nurses and ALL helping professionals can take that have proven to bolster resilience. The work is important for all in the helping field.
In this week's episode Adam discusses moral injury with Georgia Gerard a social worker at Rocky Mountain MIRECC for Suicide Prevention. Moral injury is distinct but can also overlap with PTSD. It is important to tease out the differences and then help the individual back to a a place of acceptance.
Adam Hoffberg visits with Dr. Kate Comtois during a break in the Denver VA's Mental Health Summit. Kate discusses the simple idea of caring contacts as a way to prevent suicide and remain connected with our patients. Give it a try.
Dr. Nazanin Bahraini discusses how research in suicide prevention is made accessible through the art of dissemination and implementation.
Adam Hoffberg interviews Dr. Sean Barnes about his paper “Moving Beyond Self-Report: Implicit Associations about Death/Life Prospectively Predict Suicidal Behavior among Veterans”. The paper explores suicide risk assessment, the limitations of self-report, and why advancing our understanding of objective ways to measure suicide risk is so important. Specifically it examines the predictive validity of the death/suicide Implicit Association Test (d/sIAT) as an objective measure of future risk.
Joe Huggins interviews Dr. Lisa Betthauser about the concept of combat rush. Combat rush was first coined by Dr. Jim Grigsby from his work in the early 1990s with Viet Nam Veterans. Dr. Betthauser explores the role of risky behaviors in returning Veterans, the role of safety planning and possible positive psychological outlets.
Adam interviews Dr. Bridget Matarazzo about using measures to test Dr. Joiner's Interpersonal Theory of suicide. This episode is of particular interest for any clinician who works with Veterans. Dr. Matarazzo explores to recognize perceived burdensomeness and thwarted belongingness in the presence of acquired capability through psychometric tools. And how these tools have been validated for a Veteran population.
In this episode Adam interviews Perry Renshaw, MD PhD MBA, the Medical Director of Rocky Mountain MIRECC who is based in our Salt Lake City, UT office. Dr. Renshaw is the senior author on “Acute Air Pollution Exposure and Risk of Suicide Completion”, one of the American Journal of Epidemiology (AJE) and the Society for Epidemiologic Research’s 2015 Articles of the Year. Listen as they explore what role the environment plays in suicide and the clinical implications.
Adam Hoffberg interviews Dr. Noelle Smith. Dr. Smith is a clinical psychologist at the Tampa VA and affiliated with the VA National Center for Posttraumatic Stress Disorder. She specializes in working with Veterans with PTSD and is the lead author on a recent publication in the Journal of Affective Disorders. The article will appear in the June 2016 print edition and is titled “Nature and determinants of suicidal ideation among U.S. Veterans: Results from the national health and resilience in Veterans study.” Listen to Smith discuss the article and is importance to the field of suicide prevention.
Adam Hoffberg interviews Dr. Ellyn Matthews about her recent study looking at the sleep-wake disturbance in Veterans and it's relationship to suicide. The study was published as "A Qualitative Study of Sleep-Wake Disturbance Among Veterans With Post-Acute Moderate to Severe Traumatic Brain Injury."
Adam Hoffberg interviews Dr. Peter Gutierrez about an editorial by Dr Declan Murray in the British Journal of Psychiatry Open (DOI: 10.1192/bjpo.bp.115.002071) in which Dr Murray discusses abandoning suicide risk assessment.
Adam Hoffberg interviews Dr. Lindsey Monteith from the Rocky Mountain MIRECC for Suicide Prevention about two articles she recently published:"A Closer Examination of Sexual Trauma During Deployment: Not All Sexual Traumas Are Associated with Suicidal Ideation" and "Sexual Trauma and Combat During Deployment: Associations With Suicidal Ideation Among OEF/OIF/OND Veterans".
Rocky Mountain MIRECC for Suicide Prevention presents: Research has highlighted many specific risk factors and warning signs for future suicidal behaviors. This article introduces the concept of "drivers". Think of warning signs and risk factors as a map; drivers are the specific route your patient is traveling.
Adam Hoffberg interviews Dr. Peter Gutierrez on the concepts of risk factors, warning signs and drivers.