The deaths this week of Kate Spade and Anthony Bourdain have sparked a much-needed public discussion about mental health and suicide can be prevented.
The deaths this week of Kate Spade and Anthony Bourdain have sparked a much-needed public discussion about mental health and how suicide can be prevented.
Suicide rates have risen in nearly every state since 1999, and nearly 45,000 Americans age 10 or older committed suicide in 2016, according to recent CDC data. Alarmingly, the CDC also revealed that 54% of those who died by suicide in 2015 did not have a known mental health condition.
With the recent deaths of Spade and Bourdain, health care professionals are also concerned about suicide contagion, a phenomenon in which high-profile suicides influence patients to attempt or committ suicide themselves.
Fortunately, pharmacists can play a key role in preventing suicide.
Pharmacists Preventing Suicide founder and president C. Patrick Tharp, PhD, previously told Pharmacy Times that pharmacists are ideally situated to assist those in need because of their frequent interactions with patients and access to medical records.
However, pharmacists are often unprepared to properly respond to signs of suicide risk, as very few pharmacy schools incorporate suicide prevention courses into their curricula.
“I encourage all pharmacists to learn about suicide prevention and to implement it on a daily basis,” Tharp said. “With proper education and preparation, pharmacists can prevent suicide and save lives.”
In recognition of World Suicide Prevention Day and National Suicide Prevention Week, here are 5 ways pharmacists can help patients who are contemplating suicide.
1. Identify at-risk patients. Because pharmacists regularly dispense mental health medications such as antidepressants, they are in a unique position to identify patients who may be struggling with suicidal thoughts.
Jeannette Y. Wick, RPh, MBA, FASCP, previously wrote that adolescents are among those at particularly high risk, with more than 9% experiencing at least 1 major depressive episode annually and 6.3% reporting severe impairment as a result of their depression.
Another study published in Translational Psychiatry suggested that the suicide rate among youths with major depressive disorder has recently increased because clinicians are hesitant to prescribe selective serotonin reuptake inhibitors, which cause a temporary decrease in serotonin before taking effect.
“All clinicians need to use sound clinical judgment when working with depressed adolescents, and always err on the side of safety,” Wick wrote.
Certain weight-loss drugs, such as naltrexone/bupropion, carry a black box warning for suicide ideation, so patients taking these medications should be monitored, as well.
2. Monitor medication use and mental health. Tharp advised pharmacists to pay close attention to at-risk patients, especially those who regularly take mental health prescriptions. If pharmacists observe any changes in how a medication is prescribed or taken, then they should learn the reasons behind them.
Pharmacists who have any reason to be concerned about a patient’s mental health should speak to the patient directly during a one-on-one consultation. If the patient expresses any feelings of hopelessness or makes any other worrisome comments, the pharmacist should ask if the patient has ever inflicted self-harm or considered doing so.
Patients who have a trusting relationship with their pharmacists will openly discuss their behavior and mood, often disclosing any concerning thoughts or issues that they have experienced, Tharp said.
3. Collaborate with the health care team. Patients who have divulged thoughts of self-harm or suicide should be strongly encouraged to immediately discuss these thoughts with their primary care or mental health provider, Tharp said.
Pharmacists should then personally contact the patient’s other health care providers to discuss their concerns, regularly following up with them as they would for any other critically ill patient to ensure that the patient gets necessary treatment.
4. Refer to suicide prevention resources. There are a number of tools and resources available for both patients experiencing suicidal thoughts and those concerned that a patient, friend, or loved one may be suicidal.
The Substance Abuse and Mental Health Services Administration recently launched its Suicide Safe mobile application specifically for health care providers, such as pharmacists. The app provides users with suicide information and resources, allowing them to evaluate suicide risk, review case studies, and identify treatment options.
Over the past several years, Facebook has made improvements to its suicide prevention program, allowing users to report threats of self-harm or suicide before forwarding the flagged content to the National Suicide Prevention Lifeline (NSPL). As part of the updated features, Facebook users who post concerning content will be sent a notification encouraging them to reach out to a hotline or friend and providing them with additional advice and resources.
Finally, the NSPL offers a 24-hour suicide hotline at 1-800-273-8255, which connects patients to a trained counselor at a local crisis center.
5. Be encouraging and empathetic. Empathy and compassion are essential when treating patients who are contemplating suicide.
Pharmacists should listen carefully and attentively if and when patients open up about any suicidal thoughts, assuring them that their thoughts will pass and their situation will improve.
Tharp acknowledged that helping a suicidal patient can be an emotionally difficult experience for many health care providers, but he encouraged pharmacists to remain motivated by their drive to improve outcomes for their patients.
“It’s distracting if you try to think of the big numbers, but if you think about how you can help someone you know or love, then that will keep you moving every day,” Tharp said. “If we save one, that will be enough.”
Editor's Note: Although pharmacists play a crucial role in helping patients with mental health issues, they may suffer from these conditions themselves. Those who struggle with thoughts of self-harm or suicide should seek immediate help by speaking to another health care professional or calling the National Suicide Prevention Lifeline at 1-800-273-8255.
Suicide rates rising across the US. CDC website. cdc.gov/media/releases/2018/p0607-suicide-prevention.html. Published June 7, 2018. Accessed June 8, 2018.
Click here to read about World Suicide Prevention Day and how it is addressing rising suicide rates.