Integrated services and suicide prevention training: a case study of one community mental health agency

Abstract

Purpose/objectives: The objective of this article is to highlight the benefits of a suicide integration training embedded in an integrated services delivery system. Specifically, the article examines the relationship between the tenets of the training and the low incidence of suicidality experienced at a large mental health agency in Western Massachusetts.

Primary practice settings: Through its new integrated service system, both behavioral health and primary care services are delivered at the Center for Human Development (CHD).

Findings/conclusions: On the basis of the experiences of CHD, effective suicide prevention training is essential for maintaining an almost nonexistent suicide rate. The training was developed by Nina Slovik, LICSW, and employed at CHD. It incorporates elements of different practice modalities such as motivational interviewing, the construct of hope, and authenticity. The idea of the "authentic relationship" is emphasized by Slovik. Authenticity is characterized by no pretense that a clinician has something to teach. It is better expressed by the question, genuinely delivered: "So how are you doing?" While clinicians may not always be able to accurately assess a person's suicide risk, looking at the larger context, collaborating as a partner rather than as an expert, and helping find meaning and purpose will improve the chances to recognize risk and provide a positive intervention. Another important difference found at CHD is its use of care managers, a hybridization of medical and mental health case managers, to provide wraparound services and closely monitor the psychological and medical health of CHD's clients through the new integrated services program.

Implications for case management practice: • Care management in an integrated service program utilizes a hybrid form of medical and mental health case management. • Contact with primary care providers is common prior to suicide events. • Facets of successful suicide prevention training include motivational interviewing and the construct of hope. • Establishing a genuine and authentic relationship with clients may save lives.