Suicide, Self-Harm, &amp; Traumatic Stress Exposure: A Trauma-Informed Approach to the Evaluation and Management of Suicide Risk

Asarnow, Joan Rosenbaum; Goldston, David B.; Tunno, Angela M.; Inscoe, Adrienne Banny; Pynoos, Robert S.

doi:10.1080/23794925.2020.1796547

Cited by 27 publications

(18 citation statements)

References 23 publications

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“…Notably, results highlight the key role of parents in youth service use and the importance of addressing caregiver distress in maintaining engagement in treatment (Logan & King, 2001). Feedback from caregiver interviews informed the development of a trauma-informed approach to youth suicide prevention that aims to promote collaboration with youth and families; establish physical and psychological safety; recognize signs of traumatic stress exposure; mobilize youth, family, and community strengths; and provide linkage to appropriate follow-up care and ongoing youth monitoring (Asarnow et al, 2020; Tunno et al, in press).…”

Section: Discussionmentioning

confidence: 99%

Trauma-informed care for youth suicide prevention: A qualitative analysis of caregivers’ perspectives.

Inscoe¹,

Donisch²,

Cheek³

et al. 2022

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Research shows elevated rates of trauma exposure and traumatic stress among youth with suicidal thoughts and behaviors, underscoring the need for a trauma-informed approach to suicide prevention and intervention. The purpose of this study was to identify, from the perspective of caregivers, clinical practices that are sensitive to the needs of youth with co-occurring traumatic stress and suicidal thoughts and behaviors, as well as common barriers to receiving care. Method: Qualitative interviews were conducted with 13 caregivers of youth with trauma histories and comorbid suicidal thoughts and/ or behaviors. Interviews were analyzed using a grounded theory approach. Results: Qualitative analysis of interviews revealed themes related to the need for caregiver involvement in treatment, the impact of therapist and relationship characteristics such as authenticity and genuineness, and the importance of provider education about trauma. Common barriers included difficulties navigating the mental health system and cost. Conclusions: Findings provide guidance on how mental health providers can effectively recognize and respond to traumatic stress among youth presenting with suicidal thoughts and behaviors. System-level issues related to accessibility also are discussed. Clinical Impact StatementWhen asked about suicide prevention practices that are sensitive to the needs of youth and families who have experienced trauma, caregivers of youth with co-occurring traumatic stress and suicidal thoughts/behaviors emphasized the importance of (a) caregiver involvement and acknowledging caregiver distress; (b) clinician authenticity, genuineness, and warmth; and (c) clinician knowledge about trauma and the impact of traumatic stress on suicide risk. Caregivers also emphasized the need for more direct support around mental health care navigation.

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Section: Discussionmentioning

confidence: 99%

Trauma-informed care for youth suicide prevention: A qualitative analysis of caregivers’ perspectives.

Inscoe¹,

Donisch²,

Cheek³

et al. 2022

Psychological Trauma: Theory, Research, Practice, and Policy

Self Cite

View full text Add to dashboard Cite

show abstract

“…Designated providers employ client-centered techniques (e.g., motivational interviewing, trauma-informed care, harm reduction strategies) in developing and assessing a client’s recovery plan. Research on the effects of these approaches suggest improvements in treatment outcomes across diverse clinical settings [ 99 – 101 ], including suicide risk [ 102 , 103 ]. Suicidality and traumatic stress co-occur in criminal-legal populations [ 104 , 105 ], which underscores the need for incorporating client-centered principles—such as trauma-informed care—into the evaluation and management of suicide risk.…”

Section: Discussionmentioning

confidence: 99%

Correlates of suicide risk among Black and White adults with behavioral health disorders in criminal-legal systems

2022

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Background Adults with behavioral health disorders in criminal-legal systems are at heightened risk of suicide relative to the general population. Despite documented racial disparities in criminal processing and behavioral health treatment, few studies have examined racial differences in suicide risk in this already high-risk population. This study examined 1) the correlates of suicide risk in this population overall and by race and 2) the moderating role of race in these associations. Methods We investigated correlates of clinician-rated suicide risk at baseline in a statewide sample of 2,827 Black and 14,022 White adults with criminal-legal involvement who engaged in community-based behavioral health treatment. Regression-based approaches were used to model suicide risk and test for evidence of interaction effects. Results Findings showed the strongest correlates of suicide risk were greater behavioral health needs, evidence of self-harm, and a primary mental health diagnosis or co-occurring diagnosis. In race-specific analyses, correlates of suicide risk were mostly similar for both Black and White clients, with a couple exceptions. Interaction terms testing between-group effects on correlates of suicide risk were non-significant. Conclusions Adults with behavioral health disorders in criminal-legal systems experience similar risk factors for suicide as the general population. Similar to prior research, we found that Black adults, in particular, are at lower risk for suicide overall. Contrary to expectations, we found similarities in correlates of suicide risk across race in our sample of felony-level adults with behavioral health disorders in the criminal-legal system. Prior research shows that behavioral health professionals should be cognizant of cultural factors when developing a comprehensive approach to suicide care and treatment. Our findings show correlates of suicide risk are largely stable in Black and White adults involved in criminal-legal systems, suggesting culturally responsive treatment for suicide risk should target shared risk factors.

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“…The TI model orients research practices around the understanding of widespread impact of trauma as well as paths for recovery, tends to signs of trauma among all those involved with the study, and responds by integrating knowledge about trauma into procedures and practices to prevent re-traumatization (SAMHSA, 2014). Most literature on the TI model has focused on its application in service settings (e.g., Marsac et al, 2016), including in services for suicidal patients (Asarnow et al, 2020; Asarnow & Mehlum, 2019). We suggest that by infusing the TI model ethos in their research, investigators can enhance their response to the ethical mandate of beneficence.…”

Section: Discussionmentioning

confidence: 99%

Infusing the trauma-informed approach in youth suicide research: Lessons from the field.

Quijada¹,

Inostroza²,

Vaccari³

et al. 2021

American Journal of Orthopsychiatry

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Adolescent suicide is a serious public health problem in Chile. Given the high prevalence of suicidal behaviors and suicide, youth suicide researchers must approach participants, families, and communities with care. Special attention must be given to suicide-related trauma among survivors of suicidal behaviors and of suicide. In this article, we discuss how investigators can infuse the trauma-informed model in their work. Our discussion is organized around research stages and tasks: study design, recruitment, data collection and analysis, and care for the research team. We illustrate the integration of the trauma-informed (TI) model key elements and principles with examples from our work in youth suicide research. We posit that infusing the TI model in research aligns with the ethical mandate of beneficence. Our goal is to help other researchers reflect on how to design and implement TI informed research that is attuned to participants, staff, and communities. Public Policy Relevance StatementSuicide is the leading cause of death among Chilean adolescents. This manuscript highlights lessons learned from the design and implementation of public funded trauma-informed school-based suicidal behaviors study in Chile. Our findings support the need to implement trauma-informed suicide research in communities affected by high rates of suicidal behaviors and suicide.A dolescent suicide and suicidal behaviors are a serious public health concern in Chile. Suicide is the leading cause of death among youth between the ages of 15 and 24 years (Araya, 2019). Chile's youth suicide prevalence of 10.3 suicides per 100,000 youth is among the highest in the world (UNICEF Office of Research, 2017). The suicide rate for people ages 15-19 years increased from 8.6 to 12.9 for every 100,000 people between 2000 and 2010 (Araya, 2019). The findings of international studies describe a similar pattern. For example, the Organisation for Economic Co-Operation and Development ( 2015) reported that the deaths by suicide among Chilean teens increased from 4.9 to 10.8 between 2000 and 2011. With variations by geographic area and year of data collection, between 15% and 57% of teens surveyed reported suicidal ideation, and between 5% and 25% reported life time prevalence of suicide attempts (

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Suicide, Self-Harm, & Traumatic Stress Exposure: A Trauma-Informed Approach to the Evaluation and Management of Suicide Risk

Cited by 27 publications

References 23 publications

Trauma-informed care for youth suicide prevention: A qualitative analysis of caregivers’ perspectives.

Trauma-informed care for youth suicide prevention: A qualitative analysis of caregivers’ perspectives.

Correlates of suicide risk among Black and White adults with behavioral health disorders in criminal-legal systems

Infusing the trauma-informed approach in youth suicide research: Lessons from the field.

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