The Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), located at the Denver and Salt Lake City Veterans Affairs medical centers, offers clinicians and communities educational resources to help navigate the rare but critical instances when a person with suicidal ideation or behavior arrives at the emergency department for care. A small working group in MIRECC’s education core, led by Douglas Gray, MD, a child and adolescent psychiatrist, created the “How to Talk to a Child About a Suicide Attempt in Your Family” booklet and video. The group aims to arm emergency medical personnel with professionally developed resources to support suicidal patients and their families.

This educational resource was developed to support parents or caregivers who have recently experienced a suicide attempt by a family member and for professionals who provide crisis and immediate follow-up care for suicidal individuals. While the first priority in a mental health emergency is to stabilize and ensure patient safety, suicidal individuals and their family members also have critical needs for immediate follow-up care.

When faced with this situation, providers must manage multiple challenges such as limited staff time and resources while balancing these realities with the need to address patient and family needs and concerns. A large-scale survey conducted via the National Alliance on Mental Illness highlighted specific areas where family needs could be best met by emergency departments, including communicating better about discharge planning and providing written materials and information on other support resources.¹ A Suicide Prevention Resource Center publication also focused on patient follow-up needs subsequent to a suicide attempt and discharge from ED.² Among the recommendations for better continuity of care were positive family involvement and caring emergency physician–patient interactions.

The “How to Talk to a Child” booklet and video supply emergency physicians with a readily available resource that helps meet the most common needs expressed by family members.

The booklet and video are available in Spanish and English and may be downloaded or ordered at no cost. The booklet features a full-color visual presentation that focuses on tools for speaking with three developmental groups (preschool, school age, and teenager), with tips for responding to concerns and challenges unique to each group.

The Booklet:

• Offers tips for parents/caregivers on introducing concepts related to depression, hopelessness, self-directed violence, and suicidality
• Builds understanding of why it is important to speak to children about difficult and traumatic topics, what to share, how much to share, and when
• Addresses mental illness and potentially co-occurring conditions such as substance use
• Promotes elements of resiliency and building resilient coping skills in children and families
• Familiarizes parents/caregivers with developmental concepts that increase their capacity to recognize behaviors that may follow traumatic events, with suggestions for how to support each developmental stage following such an event
• Provides information on recognizing signs of emotional or mental distress that may necessitate intervention by a mental health professional

The video offers the benefits above, plus:

• Visual demonstration of principles in motion, with professional actors as well as graphic presentations of key approaches and takeaway concepts
• Illustration of how a suicide-related conversation might unfold, showing how open-ended inquiries and responsiveness to children’s individual concerns guide the course of the interaction

For more information about the Rocky Mountain MIRECC mission and to learn more about other educational resources available to clinicians, visit www.mirecc.va.gov/visn19.

Melissa McHarg is a program specialist at Rocky Mountain MIRECC.

References

1. Cerel J, Currier GW, Conwell Y. Consumer and family experiences in the emergency department following a suicide attempt. J Psychiatr Pract. 2006;12:341-347.
2. Knesper DJ, American Association of Suicidology, Suicide Prevention Resource Center. Continuity of Care for Suicide Prevention and Research. Newton, MA: Education Development Center, Inc. 2010.