Jennifer Lockman, Ph.D.Care for patients who have attempted suicide or had suicidal ideations should not stop at ensuring they are physically safe (i.e., “suicide prevention”). It should also prioritize assurance that patients are leaving the care setting with receiving treatment, fostering clinical and personal recovery, and creating a valued life that can be lived.
This is the mindset that clinicians and researchers in the UAB Department of Psychiatry and Behavioral Neurobiology are working to establish not only here at UAB but also in health systems worldwide.
Jennifer Lockman, Ph.D., assistant professor in the Department of Psychiatry and Behavioral Neurobiology and the leader of the Suicide Prevention and Recovery in Healthcare initiative at UAB, said that more healthcare providers at all levels of care at UAB are being trained on best practices to establish a recovery culture in suicide care.
“With every suicidal person we encounter, we focus from day one on, ‘How do we get you better? How do we help you get your life back, or help you build a life that you can live and want to live, as you define that?’”
Changing the narrative
According to Lockman, care should not be about simply preventing death when it comes to suicide. It should be about helping people live with less suffering.
“This is a new approach to delivering people the very best care that we know today, ensuring every person has a pathway to life, living, and recovery, which is already best practice in every other area of medicine,” Lockman said. “When patients seek treatment for cancer or a heart condition, physicians don’t assess the condition and then only treat the condition if it is a life-threating emergency. No – patients expect more. They expect treatment, and they expect to get better. The standard of care in all areas of medicine is diagnostic assessment, then treat to target toward restoring health, life, and wellbeing. Suicide care, with an expectation for rapid treatment toward recovery, should be the same.”
“We decided we wanted to change the narrative,” Lockman continued. “We have a suicide recovery and healthcare approach we are using to implement the core best practices that have been identified through research, that are required by the Joint Commission, and that are heralded by Zero Suicide organizations. However, Zero Suicide has multiple limitations in implementation and does not reduce suicides to zero in most organizations. So, we are going to strive for “zero” suicide while having an unwavering, holistic focus on recovery. Thus, our model builds on Zero Suicide Initiatives, but also goes beyond it."
That focus, Lockman said, involves training healthcare providers in ways to establish a “recovery culture” –one that promotes not only stabilization, but motivation. Over the past year, Lockman said her group has held several training events for care providers like nurses, social workers, and psychologists across UAB to focus on a “rapid recovery” approach to suicidal patients, which aims to help them identify a realistic path to recovery within the very first clinical encounter. Then, patients receive appropriate treatments, including psychological treatments that focus on suicide symptoms directly, to ensure health, life, and personal wellbeing are restored.
“And I think what we're finding is that, first of all, we can do this,” Lockman said. “We can treat people and really restore and motivate their desire for living, even when it may not be present at first.”
This method involves not only clinical recovery, defined by reducing suicidal ideation and behaviors, but also personal recovery involving post-traumatic growth, relational growth, engagement, and self-empowerment.
Lockman emphasized that while recovery is the goal, some patients may not necessarily be ready for recovery; however, these patients are not denied care.
“If you're ready to come in any capacity, we will work with you to build capacity for being able to stay safe, physically, from suicide while also focusing on what matters to you, and what you are able to explore, related to recovery, life, and living.”
Sharing the rapid recovery model
The rapid recovery model is being piloted at UAB, but Lockman said the eventual goal is for it to be shared across healthcare systems worldwide. Her team in the THRIVE Suicide Recovery Clinic is currently working to publish data to share the positive outcomes of this model.
“It does provide a possible avenue for expanding access to treatment and helping people get better faster than what is done anywhere else in the world right now that I'm aware of,” Lockman said.
As UAB takes the lead over changing this narrative from “Zero Suicide” to “Suicide Recovery in Healthcare Systems,” Lockman said the evidence of its success is evident in the data and the patients themselves.
“We have people who have the most beautiful stories of rediscovering themselves and their families and reorienting to life in new ways,” Lockman said. “And more often, it's a transformation, not just minor adjustments. To me, that makes suicide recovery one of the most exciting places to work in healthcare: to see people rapidly transform, to go from a place of desperately wanting to die because they don't know if they can live with so much pain, to really reducing the pain and developing a different way of living and orientation to living that works for them, which is beautiful.”