Suicide awareness and prevention is a task that more pharmacists are including with their patient care services.

A program that Washington State University (WSU) College of Pharmacy and Pharmaceutical Studies has implemented trains student pharmacists to recognize patients in need of suicide intervention to help save lives.

In a session at the 2019 American Association of Colleges of Pharmacies (AACP) Annual Meeting in Chicago, Illinois, Christina Buchman, PharmD, BCACP, and Megan Willson, PharmD, BCPS, both with WSU’s College of Pharmacy and Pharmaceutical Studies, discussed the impact of suicide and the needs of suicide awareness training for student pharmacists. They noted that mental illness and suicide are nondiscriminatory and affect all individuals, including student pharmacists.

Suicide is the second-leading cause of death in individuals ages 15 to 34, and it claims the life of 1 person every 12 minutes, according to the presenters.

In 2016, Washington became the first state to require pharmacists to complete suicide awareness and prevention training to address the public health issue.

The WSU program, taught in the first semester of the pharmacy curricula, assesses students’ knowledge at the beginning of the course and again near the end to evaluate progress, Wilson said.

In between, students are shown videos demonstrating signs that a person needs help and how best to approach the situation.

In classrooms, live interactions and role-playing exercises reinforced the material.

Students also practiced saying the word "suicide," Willson said.

“Sometimes, just saying that word, ‘suicide,’ can be a difficult thing,” she said.

“And having them watch each other’s facial expressions--some people tend to get a nervous giggle, and when you start talking to a patient and then you get the nervous giggle, they may not think that you’re completely serious, and so we practice that and doing it without a smile," Willson said. "But still being empathetic with your audience.”
 
During the practice and role-playing portions of the course, Willson noted the “intensity” of the live exercises.

WSU counseling staff members were on hand and ready to walk students to a health care facility, as needed, she said.

One key component of WSU’s program is the 5 stages of the LEARN system.

“The LEARN acronym is really handy and it’s easy to remember,” Buchman.

The stages are:
 
  • Look for warning signs. These can be feelings or behaviors that raise “red flags.”
  • Empathize and listen. “Empathy is all about listening, no judgment,” Buchman said.
  • Ask about suicide. This should be a direct question using the word "suicide." 
  • Remove the danger. If a patient expresses thoughts of suicide, ask if he or she has a plan and go about removing steps in that plan. Take the individual into a private space to call a hotline. Speak with a patient’s loved one about dangers in the home.
  • Next steps. Connect a patient to a resource to care for them. This would be a health care professional with training in suicide prevention.

“’A’ is the one that everybody fears the most, the ask,” Buchman said.

“It falls in the middle, because there are things to do after you ask," she said. "You can’t ask and be done.”

Regardless of the answer, all 5 steps should be completed, Buchman said.

There is a reason why you asked, she said.

A pharmacist asking a patient if he or she is considering suicide should remove dangers and take the next steps, regardless.

Comparing pre- and post-assessments conducted by WSU instructors, student pharmacists did gain confidence in recognizing suicide warning signs in patients, as well as in co-workers, family members, and friends.

“Everyone gained knowledge in all general areas, so their scores went up,” Willson said.

However, the presenters said assessments also indicated that there is still more work to be done in preparing student pharmacists to be aware of suicidal individuals and take actions to prevent suicides.

The presenters indicated that suicide awareness and prevention could become second nature to students, who would continue providing this life-saving service throughout their careers.


Reference

Buchman C, Willson M. "The suicide epidemic: it's time for pharmacy to take action." Presented at: 2019 American Association of Colleges of Pharmacy (AACP) Annual Meeting; July 13-17, 2019: Chicago, IL.