Texas Tech University

Conversations About a Challenging Topic

Doug Hensley

April 13, 2023

Texas Tech professors are working to help train primary care providers in suicide prevention.

Few subjects are as taboo as suicide. Just the word can put people on edge, unearth particularly painful memories or shut down a conversation. However, not talking about it maintains stigma and can keep people who are thinking about suicide from seeking and receiving support.

Unfortunately, suicide rates are continuing an upward and tragic trajectory across virtually every demographic, and it is taking an especially terrible toll on young people across the country.

“One of the things we've seen on a national level is that the rates of depression, anxiety and suicide ideation and attempts are increasing,” said John Cooley, an assistant professor in Texas Tech's Department of Psychological Sciences. “Recent data released earlier this year indicated Lubbock leads the state in the rate of suicide attempts by children ages 6 to 17.

“This is something we know our youth are struggling with, but it's also something they might not disclose unless someone asks them about it.”

Primary Care

Cooley and his colleague, assistant professor Sean Mitchell, are collaborating with the Texas Tech University Health Sciences Center's Department of Psychiatry on a project in which primary care providers within the Child Psychology Access Network (CPAN) will be trained in identifying youth who could be at elevated risk for suicidal thoughts or behaviors and how to talk to them about what they are experiencing.

“A lot of this training is about how to have these conversations in an effective way,” Mitchell said. “If a provider is nervous about interacting with a patient who might be thinking about suicide, they could be feeling unsure about what to do next, and a question asked might be, ‘You're not thinking about suicide, are you?' There are more effective ways to provide support and engage in conversations so young people feel less scared as far as what the next steps might look like.”

The training, called SAFETY-A, couldn't arrive at a more auspicious moment for young people in general. According to recent numbers from the National Center for Education Statistics, 76% of public schools last year reported an increase in their staff expressing concerns about students showing symptoms of depression, anxiety and trauma while 70% said they had seen an increase in mental health concerns among their students.

“It can be really scary for a young person to tell someone they are having suicidal thoughts if they don't know how the other person is going to react, especially if they ask a question that implies they don't want to hear you talk about it,” Mitchell said. “That is not a good way for them to feel supported or feel that person is trustworthy. It's a big step as far as how to broach this topic and start that conversation.”

For primary care providers throughout the West Texas region, the training is expected to start this summer. For Mitchell and Cooley, the work begins with surveying providers about their current practices prior to a three-hour training session. Follow-up includes several one-hour consults to address questions and another survey assessing the training's helpfulness and impact.

“We know that many children and adolescents experiencing suicidal ideation will have contact with a primary care provider before they access mental health services,” Cooley said. “Primary care providers are a really good point of prevention to identify youth who may be exhibiting some risk and then hopefully be able to connect them with services.”

In 2020, almost 46,000 people died by suicide in the U.S., equating to one every 11 minutes, according to data from the Centers for Disease Control and Prevention. 

“It is encouraging to see funds put toward these initiatives,” Mitchell said. “When John and I looked through the literature on these topics, these are not things being published on recently or frequently. Generally, when looking at these initiatives and where they are happening, it tends to be larger cities, but we know rural communities are at high risk for suicide, so this is also an opportunity to engage rural providers in these conversations because there is elevated risk and a shortage of providers.”

SAFETY-A operates from a strength-building, collaborative perspective where the provider not only builds rapport with the young person but also with their family or caregiver rather than sending them to the emergency room as a first option. The approach is designed to reduce stigma and stress.

“It is thinking of ways to identify the youth's strengths,” Mitchell said, “and talking through how to bring the family or caregiver into these discussions. The main goal is to try to connect them with the appropriate mental health services or level of care they need.”

Cooley explained the immediate impact of their work is equipping more people with knowledge and awareness around a sensitive topic so young people who might be struggling can work with a trusted resource to understand their options.

“The earlier we can catch these difficulties, mental health risk factors that might increase the risk for suicide ideation or behavior, the earlier we can provide intervention, and the more of an impact we can have,” Cooley said.

(If you are having suicidal thoughts, help is available at RISE or Beyond Okay or contact the Texas Tech Crisis HelpLine at 806-742-5555 or the Suicide & Crisis Lifeline by dialing 988.)