CHPSO, HQI Launch Series of Webinars on Suicide Prevention

Quality Quarterly Article

National and global organizations such as the Centers for Disease Control and Prevention and the World Health Organization acknowledge that suicide is a significant public health issue that has escalated in recent years. The COVID-19 pandemic has increased concerns around suicide due to a variety of issues ranging from social isolation to financial hardship. In order to raise awareness and help promote suicide prevention, the CHPSO and HQI hosted the first in a series of webinars on the topic. Given the heavy burden health care providers shouldered, even before the pandemic, combined with the added stressors of caring for patients in these unprecedent times, we chose to start the series on Sept. 10 — World Suicide Prevention Day.,  The webinar focused on some of our most vulnerable front-line workers – our nurses – as studies have shown the nurses have a greater risk for suicide then age and gender matched populations. 

Nurse Suicide and Evidenced Based Practice Strategies: Preserving Mental Health Through Crisis was delivered by Dr. Judy Davidson, DNP, RN, MCCM, FAAN. Dr. Davidson is a nurse scientist with the University of California San Diego Health and a research scientist in the Department of Psychiatry, School of Medicine at the University of California, San Diego (UCSD). Her research focuses on clinician suicide and prevention strategies as well as determining best practices for workplace wellness. She and her team have implemented the first nurse suicide screening program, which detecting nurses at risk and referring them successfully into treatment, and has been in place since ] This line of research at UCSD was prompted by the tragic deaths by suicide of three of their nurses in a single year.  

During the 60-minute webinar, Dr. Davidson discussed the incidence of mental health issues in nursing, and described an evidence-based approached to the preservation of mental health at the individual, organizational, and national levels. She described how implementing these programs can facilitate the culture shift required to overcome the stigma the often prevents nursing from seeking support and treatment for mental health issues. Most importantly, she shared evidence-based strategies that attendees can use to develop an effective, sustainable nurse suicide prevention program in their own organizations. 

Some of the highlights of the approaches that organizations may want to use in their programs include those that focus on increasing resiliency such a mindfulness and mantram mediation practices, cognitive therapy type skill building, and intentional acts of kindness. Dr. Davidson emphasized that implementing programs that incorporate these types of approaches will help build resiliency so that a person experiences post-traumatic growth instead of post-traumatic stress. “We can end up being stronger in the future in the face of adversity if we practice these skills,” she said. 

Another concept explored during the webinar was that of loneliness. 

“Loneliness is one of the biggest risks for depression and suicide and under crisis loneliness can be a killer. Each one of us can help combat this by making sure that coworkers feel connected, feel that they are not alone,” said Dr. Davidson.  

One of the simplest, yet still incredibly powerful, techniques that Dr. Davison shared during this webinar was her own practice of not ending her workweek without having directly “praised, consoled, or encouraged” at least three individuals within her organization. Imagine if we all did this? Just the simple act of making a quick phone call or sending a card, an email, or a text to recognize something good or acknowledge that someone has had a hard day is nearly effortless and yet so powerful when practiced by an entire organization. Many organizations, including her own at UCSD, have successfully implemented such programs, using them as culture shift platforms to move from a culture of  ‘ “buck up and take it” to one focused on supporting one another through difficult and challenging times.  

Dr Davidson also shared an outline of the UCSD Healer Education Assessment and Referral (HEAR) Program, which employs an anonymous, encrypted self-care survey —  administered by third-party —  to identify staff at risk. Those staff are then offered the opportunity to talk to a therapist via an encrypted program, over the phone, or in person in a private location. On-going maintenance therapy, for those needing it, is offered through a referral with a warm hand off between the HEAR therapist and the clinician taking over so that staff do not fall thought the cracks of the health care system. 

If you missed this webinar, we encourage you to take advantage of the on-demand recording. Please click here if you would like a copy of the slides with embedded videos. We encourage you to review the slides as we were unable to play the embedded videos during the webinar because of technical difficulties. 

If you are interested in our upcoming webinars in this series, you may visit our upcoming events page. We will be hosting the following webinars on this topic in the coming months, including: 

Adolescent and Pediatric Suicide: Oct. 22 from 10 to 11 a.m. (PST) 

Maternal Suicide Prevention: Nov. 17 from 11 a.m. to noon (PST) 

Suicide in Rural Populations: December (TBD) 

We have also included a list of suggested references and resources for those interested in exploring this topic further. Click here for a link to an on-demand recording of our Care for the Caregiver webinar, originally recorded April 21 in response the COVID-19 pandemic. Produced by HQI, in partnership with BETA Healthcare Group, this online course offers first aid for the head and heart — not only for clinical workers, but for anyone working in health care.  

References and Resources 

Bormann, J. E., Thorp, S. R., Smith, E., Glickman, M., Beck, D., Plumb, D., … & Herz, L. R. (2018). Individual treatment of posttraumatic stress disorder using mantram repetition: a randomized clinical trial. American Journal of Psychiatry, 175(10), 979-988. Available here.  

Davidson, J. E., Proudfoot, J., Lee, K., Terterian, G., & Zisook, S. (2020). A longitudinal analysis of nurse suicide in the United States (2005–2016) with recommendations for action. Worldviews on Evidence‐Based Nursing, 17(1), 6-15. Available here

Davidson, J. E., Graham, P., Montross-Thomas, L., Norcross, W., & Zerbi, G. (2017). Code lavender: cultivating intentional acts of kindness in response to stressful work situations. Explore, 13(3), 181-185. Available here

Melnyk, B. M., Kelly, S. A., Stephens, J., Dhakal, K., McGovern, C., Tucker, S., … & Bird, S. B. (2020). Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review. American Journal of Health Promotion, 0890117120920451. Abstract available here

Sampson, M., Melnyk, B. M., & Hoying, J. (2019). Intervention Effects of the MINDBODYSTRONG Cognitive Behavioral Skills Building Program on Newly Licensed Registered Nurses’ Mental Health, Healthy Lifestyle Behaviors, and Job Satisfaction. JONA: The Journal of Nursing Administration, 49(10), 487-495. Available here