The Next Frontier

As I reflect on our efforts to prevent suicide, I can see how much is being done to advance the field.  At the same time, I often think about what we are not doing that might make a notable difference, such as:

• having more timely data so we can monitor the effects of our work,
• engaging communities or populations not yet served,
• advancing research not being undertaken, and
• disseminating known promising practices.  

I think about the lives lost, attempts made, pain endured, costs incurred and how we can reduce it all.  I wonder if we could aggressively advance interventions that address modifiable or preventable risk factors. I am intrigued by the concepts of connectedness and social support as “preventers” of suicidal ideation and suicidal behavior.  I am excited about what the next promising frontier in our field will be.

It seems to me that some areas offering the greatest hope might be those ensuring that at-risk individuals are identified, assessed, treated and “connected.”  I believe we are making advances on the screening, identification, assessment and treatment fronts. We know that many who experience suicidal ideation or behavior are lonely and isolated.  We know that many are experiencing mental health challenges that we have the knowledge and practice to assess, diagnose and treat.  That is certainly a major part of the equation and represents progress. 

However, in isolation, it does not complete the task.  It appears clear to me that diagnosing and prescribing treatment for the problem is part of the solution.  Applying tested interventions to reduce risk and increase protective factors, ensuring that follow-up happens and treatment is understood and implementing a collaborative care approach is the rest of the solution.  One without the other is simply insufficient.

Where I see our greatest need is connecting individuals at risk to support systems that will follow them closely.  Some refer to this concept as continuity of care.  When an older adult screens positive for depression, studies show the best effect is reached when they benefit from a collaborative care model ensuring they comply with treatment recommendations and are followed until patient-centered outcomes are achieved. 

When an individual presents at an emergency department for a suicide attempt, studies show that it is essential to ensure they receive follow-up care in a community setting.  For some, it has been found that a simple intervention such as sending a post card over a few months to check on the patient’s welfare makes a difference.  For others, ongoing treatment in the community is vital.  

These “connections” are, in my view, some of the most promising practices of the next frontier.  We should be researching them, putting them into practice, funding them and making sure they become the standard of practice. I’m sure there are many other ideas to consider. What are your thoughts on the most promising steps to chart the next frontier?  Take a moment to share your thoughts via comment.