HJAR Mar/Apr 2023
HEALTHCARE JOURNAL OF ARKANSAS I MAR / APR 2023 41 Jennifer Dillaha, MD Director Arkansas Department of Health 3. Conducting suicide inquiry: suicidal thoughts, plans, behavior, and intent. 4. Determining risk level/intervention: determine risk and choose appropriate interventions to address and reduce risk. 5. Documenting: assessment of risk, ra- tionale, intervention, and follow-up. In Arkansas, we have a few resources available through the ADH Suicide Preven- tion Program, which offers educational pro- grams and training for healthcare workers and the public. Healthcare workers who ask or talk with their patients about their thoughts of suicide, but are unsure of the next step, can always assist the patient in calling the ‘988’ Suicide and Crisis Lifeline, where help is available 24/7. Since 2017, ADH staff have maintained theArkansas Lifeline Call Center by answering calls Arkansans make to the National Suicide Prevention Lifeline by calling 988 or 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 received 10,791 calls in 2022. It averages about 965 calls eachmonth. Nearly half of the calls are from family and friends concerned about a loved one. No matter who calls, call center staff provide free support, information, and links to local resources such as the community mental health centers that cover all 75 counties of the state through theArkansas Department of Human Services. There is a directory of the centers on the DHS Division of Aging, Adult, and Behavioral Health Services web- site. If suicide is being considered, staff help de-escalate the situation. Staff also follow up with each caller within 24 hours to check on the person and see if they have connected with local resources. Sometimes the support needed is simply having someone to talk to. Another tool is AR ConnectNow, a com- prehensive behavioral health treatment program that provides care to Arkansans dealing with mental health issues ranging from substance abuse disorders to mental illnesses (such as anxiety and depression) to bipolar disorder and schizophrenia. Over- seen by the University of Arkansas for Medi- cal Sciences’ Psychiatric Research Institute, theAR ConnectNow 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 avail- able in their local area. More information is available by visiting https://uamshealth. com/ar-connectnow/ or emailing arconnect@uams.edu. For more information on Suicide Prevention, visit https://www.healthy. arkansas.gov/programs-services/topics/ suicide-prevention or call 501-683-0707. More resources are available online at 988lifeline.org . AQuick Guide for Clinicians is also available at https://www.sprc.org/ sites/default/files/SafetyPlanningGuide%20 Quick%20Guide%20for%20Clinicians.pdf. ARKANSAS LIFELINE CALL CENTER The Arkansas Lifeline Call Center: 988 or 800-273-TALK (8255). Other options include: • Deaf or hard of hearing: 800-799-4TTY (4889) • For Spanish: 888-628-9454 • Veterans Crisis Line: 800-273-8255 • Text Message: Text HOME to 741741 n or having no purpose, talking about feeling trapped or in unbearable pain, and talking about being a burden to others. Other signs include worsening use of alcohol or drugs, acting anxious, agitated, or reckless, show- ing rage or talking about seeking revenge, and displaying extreme mood swings. As a result of stigma often associated with mental health problems, some people may find it difficult to talk to others about their mental health concerns or thoughts of sui- cide. For people who are able to reach out to a healthcare provider for help, the Zero Sui- cide approach developed through the Edu- cation Development Center may be helpful. It focuses on the belief that suicide deaths for people who recently saw a healthcare provider can be prevented, but communi- cation is key. Zero Suicide is an evidence- based framework for health and behavioral healthcare systems that takes a system-wide approach to improve outcomes and close gaps. More information about Zero Suicide can be found at zerosuicide.org . When a patient visits a healthcare setting, healthcare workers should be on the look- out for verbal and nonverbal clues that may show a patient is at risk for suicide. TheADH recommends using the SuicideAssessment Five-step Evaluation and Triage (SAFE-T) approach when considering whether a person is at risk of attempting suicide. The steps are: 1. Identifying risk factors: suicidal be- havior such as past attempts, current or past psychiatric disorders, key symp- toms like hopelessness or anxiety and panic, family history, stressors, changes in treatment, and access to firearms. 2. Identifying protective factors: internal or external factors such as religious beliefs or responsibility to children or beloved pets that may counteract acute risk.
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