Oct 28, 2020
Christine Moutier, MD, joins Lorenzo Norris, MD, to discuss how
clinicians can scale up interventions to reduce suicide rates amid
Moutier is chief medical officer of the American Foundation for
Suicide Prevention. She reported no disclosures.
Norris also reported no disclosures.
- Death by suicide is a health outcome, which means that there is
always a place to intervene, whether clinically, socially, or
- Risks for suicide during the pandemic are known to increase;
however, it is not a foregone conclusion that suicide deaths will
rise during or afterward.
- Mental health diagnoses are a risk factor for suicide, and
there will be interplay with stressors such as unemployment,
financial stress, grief, and socioeconomic disparities.
- The basics of suicide prevention include screening for suicidal
ideation at behavioral health appointments. If a change in risk is
identified, clinicians should use a patient-centered intervention,
such as a safety plan.
- The U.S. suicide rate has risen by 35% from 1999 to 2018, and
the rates of suicide are particularly increasing in middle-aged
populations as well as among youths of color.
- Evidence-based efforts are underway to mitigate suicide deaths
through national suicide prevention plans. Yet, everyone has a role
to play in suicide prevention, since part of prevention includes
reducing stigma related to conversations about mental health and
asking about crises and suicidal thoughts.
- In behavioral health settings, routine screening should be
implemented for suicidal ideation and deterioration in any aspect
of mental health. Asking about suicidal ideation is the bare
minimum, and not all patients will admit to suicidal ideation when
asked. Other risk factors for suicide include acute stressors such
as decompensation and losses of relationships and employment.
- Most individuals with suicidal thoughts do not need to be
psychiatrically hospitalized. Suicidal thoughts, as symptoms of a
mental illness, can be treated with interventions other than
hospitalization. The goal is to maintain safety and respond
- In-office interventions include creating a safety plan or
adding to an existing plan.
- As a silver lining, the pandemic has normalized conversations
about mental health and reduced stigma around mental health
experiences. Dr. Moutier discusses how, as the pandemic set in, the
AFSP experienced a notable increase in requests for education about
mental health and suicide prevention.
Moutier C. JAMA Psychiatry. 2020 Oct 16.
Chung DT et al. https://bit.ly/31RYxm9.
American Foundation for Suicide Prevention: https://bit.ly/2HK3S8j
Policy priorities: https://bit.ly/37IvO78
Safety plan worksheet:
Centers for Disease Control and Prevention suicide risk factors:
Show notes by Jacqueline Posada, MD, who is associate producer
of the Psychcast and consultation-liaison psychiatry fellow with
the Inova Fairfax Hospital/George Washington University program in
Falls Church, Va. Dr. Posada has no conflicts of
For more MDedge Podcasts, go to
Email the show: firstname.lastname@example.org