BPR Application Office Hours—Extended by Popular Demand!

SPRC’s new Best Practices Registry (BPR) is seeking applications for programs and interventions that prevent suicide. Working on an application or considering it? Wherever you are in the process, we’re here to help—for one more month!

To help meet popular demand, we’re happy to announce we’ve extended our weekly office hours through June. In each session, SPRC’s BPR team will offer guidance on preparing an application, walk you through examples, and answer your questions.

Check out the available office hours and register today. Come learn more about applying to the nation’s one-stop source for suicide prevention programs and interventions. We look forward to seeing you there!

If you have questions, please contact sprcbpr@ou.edu.

Frailty and Suicide Risk Among Older Adult Veterans

A recent study found frailty was associated with suicide attempt risk among U.S. veterans ages 65 and older.

Study participants were 2,858,876 veterans (mean age 75.4) who received care at U.S. Department of Veterans Affairs (VA) medical centers from October 1, 2011, through September 13, 2013. The sample population was 2.3% female and 97.7% male, 9.0% non-Hispanic Black, 87.8% non-Hispanic White, and 2.6% “other” or unknown ethnicity. Among all participants, 16.6% had diagnosed substance use disorder (SUD) and 6.8% had diagnosed post-traumatic stress disorder (PTSD).

The study integrated databases from VA health care services, Centers for Medicare & Medicaid Services, and other national suicide data. Using suicide attempts through December 31, 2017, as the main outcome measure, researchers analyzed degree of frailty categorized into five levels (nonfrailty; prefrailty; and mild, moderate, and severe frailty).

The researchers found that the risk of suicide attempts was higher in veterans with all levels of frailty compared to those without frailty. Risk of lethal suicide attempts was associated with lower levels of frailty. A total of 8,995 (0.3%) participants had a documented suicide attempt and 5,497 had died by suicide by the end of the study period. The greatest percentage of suicide attempts was found among those with mild or moderate frailty and the smallest percentage among those without frailty. Veterans with prefrailty had the highest cumulative incidence of fatal suicide attempts over time. The risk of any suicide attempt was 48% higher among older veterans with moderate frailty compared to veterans without frailty. The presence of chronic pain, use of durable medical equipment (e.g., motorized wheelchair), lung disease, SUD, PTSD, or other mental health disorder increased the risk of suicide attempts as well as deaths.

The sample for this study was predominantly male (97.7%); women have only recently begun to enter the military in large numbers and are not well represented in the older veteran population. This means caution should be used in generalizing these results to female veterans. The findings may also be less generalizable to people of color, non-veterans, and veterans who do not use VA services. Since frailty was only measured once (at baseline), these results cannot account for the effects of progressive disabilities over time. Nonetheless, this study highlights the importance of assessing and addressing depression and suicidality among frail older adults.

Kuffel, R. L., Morin, R. T., Covinsky, K. E., Boscardin, W. J., Lohman, M. C., Li, Y., Byers, A. L. (2023). Association of frailty with risk of suicide attempt in a national cohort of US veterans aged 65 years or older. JAMA Psychiatry, 80(4): 287-295. doi:10.1001/jamapsychiatry.2022.5144

What Students Are Saying About the CDC Report on Teen Sadness

The New York Times

Teens are reflecting on recent national data that show they are struggling with their mental health. In response to an invitation from The New York Times, high school students shared that they were not surprised by the findings. Some said it was common for teens to talk openly about sadness and depression, and they were glad adults are now listening. According to some students, pandemic-related isolation made them feel hopeless and alone, but some said they have felt better since reconnecting with others in person. Feedback on the links between social media and mental health were mixed, with many teens feeling it leads to disconnection and low self-esteem and some saying it has helped normalize talking about mental health. In response to findings that some groups are struggling more than others, students said they see these disparities in their daily lives and believe they should be addressed. Some teens criticized the research for under-representing certain groups, such as trans and nonbinary people. To address these issues, students called for more open conversations about mental health, opportunities to connect offline, and supportive school environments. According to Madelyn Pelletier from Miami Country Day School, instead of talking about abstract ideals, take real action to support the unique needs of each student. “The solution to the mental health crisis cannot be ‘one-size-fits-all’ . . . I believe individualized concrete solutions and action plans are needed to create tangible change,” Pelletier said.

Spark Extra! Find information on preventing suicide in schools.

Federal Awards Announced for School Mental Health

The U.S. Department of Education (ED) will award more than $95 million in funding across 35 states to increase access to school-based mental health services through the training and placement of mental health providers in districts with high need.

One in Four Black Transgender and Nonbinary Youth Attempted Suicide in Past Year, Survey Finds

CNN

According to a study by The Trevor Project, a quarter of Black transgender and nonbinary youth reported a suicide attempt in the previous year. That was more than twice the rate of suicide attempts reported by Black LGBQ young people who are not transgender or nonbinary. The study also found almost 80% of Black transgender and nonbinary youth had experienced discrimination and 40% had experienced physical threats or harm based on their sexual orientation or gender identity. They were also more likely than their peers to experience anxiety, depression, violence, and homelessness. The authors suggest social support can help Black transgender and nonbinary youth navigate challenges, noting that those who reported strong family social support were half as likely to attempt suicide in the past year. They also call for interventions to reduce suicide risk. “Immediate steps must be taken by educators, youth-serving adults, and mental health professionals to ensure that Black trans and nonbinary young people feel seen, supported, and protected against a world that so often brings them harm,” said Dr. Myeshia Price, Trevor’s director of research science. The study data came from Trevor’s 2021 survey of 34,000 LGBTQ youth ages 13 to 24 across the U.S.

Spark Extra! Watch our brief video on culturally competent care for LGBTQ youth.

Black Adults More Likely to Seek Mental Health Treatment at EDs, Pre-pandemic Data Show

Fierce Health Care

According to a recent report from the National Center for Health Statistics, Black adults were nearly twice as likely as White adults to seek mental health care in an emergency department from 2018 to 2020. Black adults had higher rates of emergency department visits associated with all categories of mental health disorders studied, including mood and anxiety disorders, schizophrenia, and substance use disorders. The report also found Black patients had significantly longer waiting times in emergency departments than White patients, and their visits were less likely to result in a hospital admission or care transfer. “Research has shown that Hispanic and non-Hispanic Black adults are less likely to receive routine treatment for mental health disorders,” the authors note. “In the absence of routine care, patients with mental health disorders often receive care related to a mental health disorder in emergency departments.” This study took place before emergency department overcapacity documented during the pandemic. To address these issues, hospital and provider groups are calling for more investment in behavioral health inpatient services.

Spark Extra! Learn about addressing behavioral health disparities in Black communities.