Coffee With the counselors: Suicide and Mental Health Care

1. Coffee With the counselors: Suicide and Mental Health Care Presented November 30th, 2018 Ryan M. Hill, Ph.D. Assistant Professor Section of psychology, department of pediatrics Baylor College of Medicine and Texas children’s hospital

2. Suicide: How Common Is iT? • About 1 in 6 high school students have seriously considered suicide in the past year • About 1 in 12 made a suicide attempt in the past years • 2nd leading cause of death among 10-34 year olds

3. Suicide: Risk Factors and Warning Signs • Risk factors = anything associated with risk • Bullying (victim or bully), depression, anxiety, behavior problems, traumatic experiences, history of abuse, stressful events, being LGBTQ+, chronic health problems, substance use/abuse... • Warning signs = Things that indicate possible risk right now • Ideation, plans, preparations, writing a suicide note or giving away prized possessions • Mood changes, withdrawal, “major” stressors

4. What Do I do? • First, be sure to ASK about suicide • Suicide is not a bad word! • Seek out help – I don’t expect you to be a therapist • But we will need your support! • Always, always, always take it seriously • When your therapist asks you to do something, please do it.

5. What does care look like? • Often we begin with a “risk assessment” to determine what level of care is needed • Safety plans & Monitoring • Therapy • Medication • Hospitalization

6. Navigating the mental health care system

7. Types of care providers • Psychiatrists – MD, usually specialize in medication-based treatment • Psychologists – PhD or PsyD, use “talking” therapy • There are lots of types of therapy • As a general rule, an “evidence based” therapy is one that has been studied, tested, and we know it works (but not necessarily for everyone) • Licensed professional counselors (LPC), licensed psychological associates (LPA), licensed clinical social workers (LCSW) • Licensed master of social work (LMSW)

8. The Process • Call to make an appointment • Usually asked provide a brief summary of why you are seeking services • First visit • Typically starts with an assessment, ranging from 1-2 hours • May be followed by “testing” – this is just a longer, more detailed assessment • The provider will then outline a treatment plan and you can begin treatment • Treatment schedules depend on the type of services you are receiving

9. What does therapy look like? • Inpatient therapy – typically 7-10 days on an inpatient unit • Usually used for high risk situations, children who are suicidal, etc. • Just intended to stabilize – they don’t “get you better” in a week • Outpatient therapy – typically 1 hour per week, for several months • May be individual, group, or family • Intensive outpatient – typically 2-3 hours per day, several days a week, for several weeks • Typically followed by outpatient therapy

10. Be a savvy consumer • You should feel free to ask questions of the provider! • The first one may not be the best fit – it’s ok to shop around a bit. • Recommendation: Give it 3-6 sessions. If you or your child are not comfortable you may need to find a new provider. (Improvements may be small at first, but there should also be change.) • Therapy takes effort – from you and the provider. If you and your child don’t try to make changes, then nothing will change. • You should know what is going on in the therapy room. • You have legal rights to your child’s therapy notes/test results. • We are not the police/ICE.

11. What to bring • Most providers will tell you what to bring with you • Being extra prepared is always helpful • Bring an ID (e.g., a driver’s license) • Bring any proof of guardianship (if divorced or separated, if child is adopted, etc.) • Previous testing/records • Any prescription medications • Any relevant medical/mental health history (type, dates, outcome) • Have any insurance paperwork available

12. Additional notes • Often there are wait lists – please be patient, but don’t be afraid to look around • Once you find a therapist you like, stick with it! (And don’t miss sessions!) • Often providers collaborate – your psychologist may suggest a psychiatrist of vice versa • Sometimes, the best thing you can do for your child, is get care for yourself

13. General comments/questions?

14. Great resources for more information for youth/parents: • Suicide Prevention Resource Center www.sprc.org • American Foundation for Suicide Prevention www.afsp.org • National Suicide Prevention Lifeline www.suicidepreventionlifeline.org • The Trevor Project (for LGBTQ+ Youth) www.thetrevorproject.org • To Write Love on Her Arms https://twloha.com/find-help/local-resources/ • Live Through This www.livethrougthis.org • Great resources for professionals: • American Association of Suicidologywww.suicidologyorg • Suicide Prevention Resource Center www.sprc.org (for Safety Plan template) • American Foundation for Suicide Prevention www.afsp.org Tools for Risk Management: Resources