Numerous Sessions to Address One of Psychiatry’s Most Difficult Topics

The disturbing news from the Centers for Disease Control and Prevention last June that suicide rates have increased by more than 30 percent in half of the states since 1999 has been a wakeup call to all of us in the mental health field. The news resulted in a plethora of submissions on suicide for APA’s 2019 Annual Meeting, and the Scientific Program Committee has put together a schedule of diverse and thought-provoking sessions. What follows is a sampling:

• “CBT for Suicidal Behavior”: The presenters—Donna Sudak, M.D., Judith Beck, Ph.D., and Jesse Wright, M.D.—are all giants in the field, so this session promises to be a first-rate, not-to-be missed session.

• “Catching the Ticking Time Bomb: Novel Means of Assessing Imminent Suicide Risk”: This session is composed of an international group of investigators from the Icahn School of Medicine at Mount Sinai (Lisa Cohen, Ph.D., Raffaella Calati, Ph.D., Sarah Bloch-Elkouby, Ph.D.), Florida State University (Thomas Joiner, Ph.D.) and Norwegian University of Science and Technology (Karina Høyen, Ph.D., M.Sc.). They will address narrative models and instrument markers of imminence in vulnerable patients, including those who do not self-report suicidal ideation.

• “The Argument for Suicide-Specific Diagnoses in DSM”: Thought leaders Maria A. Oquendo, M.D., Ph.D., Joiner, and Igor Galynker, M.D., Ph.D., will discuss suicidal behavior disorder, acute suicidal affective disturbance, and suicide crisis syndrome. They will be followed by Skip Simpson, an attorney specializing in mental health malpractice, especially cases involving a death by suicide. He will add the legal perspective on the necessity and consequences of having suicide-specific diagnoses in the DSM.

• “A Suicide-Specific Diagnosis?”: For attendees who can’t attend the above (or who want more), Hal Wortzel, M.D., has put together a panel that includes Joiner and Simpson and adds Morton Silverman, M.D., a noted psychiatrist, suicidologist, and former editor-in-chief of Suicide and Life-Threatening Behavior. This session is intended to be a conversation to explore the pros and cons of creating this new diagnosis.

• “ ‘13 Reasons Why:’ An Inside Look for Psychiatrists, by Psychiatrists”: This three-hour media presentation will feature panelists who were involved in “13 Reasons Why.” Rona Hu, M.D., of Stanford University and Christine Moutier, M.D., chief medical officer of the American Foundation for Suicide Prevention, will provide behind-the-scenes insights on how the show was created, discussions and decisions that went into the production, and the role of a psychiatrist in consulting for an entity with mental health issues at its core. After excerpts are shown, the executive producer, Joy Gorman Wettels, and the lead writer, Brian Yorkey, will join the discussion.

• “Imminent Suicide Risk Assessment in High-Risk Individuals Denying Suicidal Ideation or Intent”: This is a half-day course directed by Galynker and faculty from the Icahn School of Medicine at Mount Sinai. They will train attendees in a novel framework for the assessment of short-term suicide risk: the Modular Assessment of Risk for Imminent Suicide (MARIS) and the Narrative-Crisis Model of Suicidal Behavior (NCM). Given that more than half of suicide decedents are never diagnosed with a mental health disorder and only a quarter disclose suicide intent prior to ending their lives, the great need for this type of clinical training can’t be overstated.

• “Ethical and Legal Issues in the Management of High-Risk Patients in College”: This session will be of special interest to attendees who treat college-age students. Ludmila B. De Faria, M.D., of Florida State University has assembled a panel of experts from across the country to discuss both individual and systemic issues in the diagnosis and treatment of this at-risk population.

• “Responding to the Impact of Suicide on Clinicians”: Eric Plakun, M.D., and Jane Tillman, Ph.D., of the Austin Riggs Center will again offer their rich, highly rated, and long-standing Annual Meeting session. After brief didactic (including their own research findings) presentations, they will cofacilitate a discussion with those who attend. Losing a patient to suicide is one of the most stressful events in the professional life of a psychiatrist, and a major byproduct of workshops like this is the comforting thought that you are not alone.

What I’ve highlighted here are only a few of the many sessions on suicide that will meet the educational needs of psychiatrists coming to APA’s 2019 Annual Meeting. You won’t be disappointed. ■