HJAR May/Jun 2021

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2021 39 José R. Romero, MD Secretary Arkansas Department of Health When looking at whether a person is at risk of attempting suicide, the Substance Abuse and Mental Health Services Administration recommends using a five- step evaluation and triage plan. This Suicide Assessment Five-step Evaluation and Triage (SAFE-T) approach involves: 1. Identifying Risk Factors: suicidal be- havior such as past attempts, current/ past psychiatric disorders, key symp- toms such as hopelessness or anxiety and panic, family history, stressors, change in treatment and access to firearms. 2. Identifying Protective Factors: inter- nal or external factors, such as religious beliefs or responsibility to children or beloved pets, that may counteract acute risk. 3. Conducting Suicide Inquiry: suicidal thoughts, plans, behavior and intent. 4. Determining Risk Level/Intervention: determine risk and choose appropriate intervention to address and reduce risk. 5. Documenting: assessment of risk, ra- tionale, intervention and follow-up. When a patient visits a healthcare setting, their doctor and any staff they come in contact with should look for verbal and nonverbal clues that may show there is a problem and relay any concerns. The Zero Suicide approach, a project under the Education Development Center, focuses on the belief that suicide deaths for people who saw a healthcare provider are preventable. But communication is key. The Arkansas Department of Health’s (ADH) Suicide Prevention Program offers educational programs and trainings, including a class for doctors and therapists onAssessing and Managing Suicide Risk (AMSR), for anyone wanting to learn more. It is important to remember that help is available 24/7 through a variety of resources. Since 2017, ADH staff have maintained the Arkansas Lifeline Call Center by answering calls Arkansans make to the National Suicide Prevention Lifeline at 800-273- TALK (8255). This is the first call center for the national lifeline to be operated by a state health department. Previously, Arkansas was one of two states without an in-state call center, which meant that calls Arkansans made were answered out of the state. This call center has received over 30,900 calls — averaging about 1,200 calls per month — from the time it opened through late January of this year. About half of the calls received are from family and friends who are concerned about a loved one, while 1,077 of the callers have identified themselves as either a veteran or active-duty military. Nomatter who calls, call center staff provide free support, information and links to local resources such as the community mental health centers that operate in all 75 counties of the state as part of theArkansas Department of Human Services. If suicide is being considered, staff help deescalate the situation. Staff also follow up with each caller within 24 hours to check on the person and see if he or she has connected with local resources. Follow-ups are also conducted at three-month, six-month and nine-month intervals to ensure the caller has received the help they needed. Sometimes the help needed is simply having someone to talk to. The call center received its first call related to COVID-19 on March 3, 2020. It has since received 735 COVID-19 related calls. Many of these callers were not considering suicide, but they needed someone to talk with about their concerns or to learn where to go for help. The top concerns regarding COVID-19 have been job loss, financial strain and homelessness; inability to see a counselor, therapist or doctor; fear and anxiety; and isolation and quarantine. As an additional resource, the state has also created the Promoting Positive Emotions (PPE) program to provide emotional and behavioral health services to Arkansans directly impacted by COVID-19 at no cost to them. Through the PPE program, 14 behavioral health agency partners offer free and confidential crisis counseling services via in-person, video or phone sessions in all 75 counties in Arkansas. Additional resources may be found online at staypositivearkansas.com. Another tool is AR-Connect, which provides care to Arkansans dealing with mental health issues ranging from substance abuse disorders to mental illnesses to crisis situations due to COVID-19. Overseen by the University of Arkansas for Medical Sciences’ Psychiatric Research Institute, the AR-Connect call center is available 24/7 to anyone regardless of their ability to pay by calling 501-526-3563 or toll-free at 800-482-9921. The caller is evaluated by a nurse triage team and, if needed, contacted by another medical professional within 24 business hours. The goal is to help people needing immediate care and connect them with treatment options and resources available in their local area. More information is available by emailing arconnect@uams.edu. For more information, visit https://www. healthy.arkansas.gov/programs-services/ topics/suicide-prevention or call 501-683- 0707. More resources are also available online at suicidepreventionlifeline.org . Arkansas Lifeline Call Center If you are or a loved one is in crisis, please call 1-800-273-8255. Anyone who is deaf or hard of hearing may call 1-800-799-4TTY (4889), while the Spanish language line is 1-888-628-9454. The Veterans Crisis Line is 1-800-273-8255. You can also text HOME to 741741 for free, 24/7 crisis support in the United States. n