The importance of collaboration on depression and suicide prevention

The importance of collaboration on depression and suicide prevention

Kate Spade

Anthony Bourdain

A child

A father

A mother

A friend

A brother

A sister

A client…

Who among us has not had our lives impacted by an encounter with death by suicide. When serving those traveling with a mood disorder, explorations of suicidal thoughts and fantasies come with the territory. When the news is full of information about this type of death, our antennas go up and make sure we look out for those we care for.

Most of us learn to explore this area with ease, if not confidence. None of us want to lose someone to suicide. We soldiers enter the conversation with some clear goals:

• Is there a plan?

• How serious and immediate is this plan?

• Do they have access to the resources to execute this plan?

• And so forth.

We AND our customers have access to information, but not always sufficient and equal access to resources. Recent celebrity deaths can and are impacting clients traveling through the darker environment of grief and/or mood disorders.

In the 1980s I worked at the Western Institute of Neuropsychiatry (WIN) in the Mood Disorders Unit. We had the luxury of spending hours working individually with each patient. This was in addition to groups, medication stabilization, etc. Our team included a psychiatrist, a psychologist, a few social workers, and nurses with additional providers. We met regularly, shared information and collaborated on care.

Most brick-and-mortar facilities today do not offer such luxuries. However, hospitalization to protect clients from immediate danger is the standard of care as it should be. But what about the customers who pose no clear and present threat and are still at risk?

One thing I learned from my early and very satisfying experiences at WIN is the importance of a care team. A care team allows practitioners to “place the hospital around the patient,” as a brilliant colleague would say.

That means:

• Increasing the number of visits to two, three, four or more times per week

• with permission from the client, including including family or friends in the care plan as needed

• Communicate at regular times between visits

• Assisting the client in developing a somewhat structured daily schedule - this is extremely valuable for those suffering from brain fog and heaviness that can accompany mood disorders

• Helping them apply the small, simple practices they have learned. During this time, loving meditations through apps can be useful for clients. If you haven't already practiced mindfulness, it's not the best time to learn mindfulness.

• Collaborate with the client's care team. For me, that generally means my client and the prescriber.

This final point, working with the prescribing practitioner, is, in my opinion, often neglected by practitioners in private practice. As my mentor, Dick Olney said, “Don’t wait until you’re in the middle of a fire to practice a fire drill.”

When someone is shut down by the severity of depression AND contemplates suicide, there is a firestorm. We are able to provide better care when we have a good working relationship with our customers' prescribers. If you have clients who are taking medications and you are not in contact with the person prescribing them medication, I hope you get a clearance if you don't already have one. Reach out to your mutual customer to consult and collaborate. By developing this type of collaboration, you can help your client access valuable resources when they may not be able to.

And take care of yourself. Seriously. Reach out to your friends, take some time to be in the forest and put your feet on the grass. If you have lost someone to death by suicide, you probably have tension. How does news of death by suicide impact you and your practice?

Inspired by Melanie McGhee, L.C.S.W.