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Suicide Prevention: introducing new treatments

edited November 2014 in Research blog
Today, I’d like to write about the surprising difficulties of bringing new approaches and techniques to the field of professional psychology, and I’ll use our technique for treating suicidal feelings and actions as an example.  

In the last few months there have been an increasing interest in the problem of suicide. For instance, on Feb. 5 of this year, the director of the NIMH (National Institute of Mental Health) in the US, Dr. Tom Insel, wrote this blog: “A new Research Agenda for Suicide Prevention” 

Coincidentally, in January 2014 we posted on our website a layman’s version of what causes suicidal feelings and actions, and how to treat the problem. It turns out that it is caused by a tragic interplay between PTSD and placental death at birth, a link that is still unknown to the medical and psychology professions. We discovered this and had a treatment for it in the early 2000s; and we published our findings in 2004 in The Basic Whole-Hearted Healing Manual. We also teach our students about this problem and its treatment in our therapist training classes.

So, why haven’t you heard about our technique? Why isn’t everyone using it?

From our viewpoint as technique developers, there were several reasons. First, to maximize safety the process should be used while the client is under continuous supervision for two or three weeks to be sure the therapist got all of the problem, since unlike normal therapy, mistakes can lead to a client death. Clearly, this is impractical in a therapist’s office setting. Second, the problem of legal liability: to address this, we tell our students that if they are not qualified and legally licensed to work with this client group, they need to refer them to people who are - even though they could probably do a far better job with these new technique. And unfortunately, these issues also apply to our clinics - it saddens me to say this, but we won’t work with this client group at all, due to the safety and liability issues. 

But what about organizations that routinely work with this client group? Here is where things start to get really strange. Back around 2000, I had contacted every professional group I could find who worked with suicide, to offer our new treatment technique for free. After all, these were the folks who were writing papers, talking about it in conferences, had the money, and supposedly had the motivation to follow up. To my surprise, no one was interested! (Note that our credentials were professionally appropriate, as we had several PhD’s in social work and psychology and two MD’s.) After some weeks, I had to give up to go back to my regular paying work.

Flash forward to 2014. The professional psychology world has changed a lot, especially just in the last few years. Trauma healing is becoming an accepted and important part of therapy. Even some acceptance of prenatal trauma is starting to appear. I had again started to mull over the idea of publishing a short book on the topic of suicide treatment using our approach. Then synchronicity struck - as with so much in life, what happens is all about people. It turned out that one of our new trainees had a passion about the subject, and was excited to work with me on a book on this topic. As we started to do the chapter outline, we realized that to make the book more useful it needed to have information for first responders, such as phone crisis line workers, and a chapter written in an appropriate way for First Nations. For this, we needed help from people who knew about the subject - so I started to call around. 

Contacting the NIMH didn’t work - no response, I still have no idea why. Then to a world-wide organization that teaches how to recognize and treat suicide - they had no interest in our new approach. Then to the Mental Health Commission of Canada, since its stated goal is to improve the mental health system. I got this response from a board member: “I think an element that would be good to include [in your book] would be a discussion of evidence-based approaches to suicide…” From a professor with a large research group on suicide: “Unfortunately, I don’t think I can help you with this…” 

I was getting the same reaction I got 12 years ago. But why? After all, these important, well funded people were supposed to be pushing for new treatments to this terrible problem. A few days later, I saw this article from Stanford University (where I went to school): “Missing Voices: How Can We Get More ‘Doers’ to the Social Innovation Table?” Basically, the Stanford Business School has noticed that the people talking about accelerating and advancing social innovation, investing, doing conferences, and so on were not the people who were actually doing the work and knew what was needed - with the kind of results that could be expected.

So my next calls were to front line organizations in BC - and what a difference! I quickly spoke to two administrators who ran organizations actually doing crisis lines and other suicide interventions; they were very interested and supportive, as they were already, constantly looking for better tools and techniques. They were also terribly busy (underfunded and overcommitted) but made time on the spot to pursue what I was saying. Their personal mandate was clear - to actually help people now. 

There is no telling on how this will all play out, as it really depends on finding altruistic people with an internal commitment to making a difference, regardless of time, money, liability or other issues. But at least to get the ball rolling, we’ll be publishing our improved technique in Peak States Therapy for Suicide Prevention, hopefully by this fall. 

From the desk of the research director,
Dr. Grant McFetridge
April 3, 2014
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