Mind Dive
The Menninger Clinic’s Mind Dive podcast is a twice-monthly exploration of mental health topics from the professional’s perspective, including the dilemmas clinicians face in their practice. Hosts Dr. Bob Boland and Dr. Kerry Horrell dive into the complexities of mental health care including the latest research and other topical developments through lively discourse with distinguished colleagues from near and far.
Mind Dive
Episode 60: Surviving Personal Crisis with Dr. Christine Yu Moutier
This episode of The Menninger Clinic’s Mind Dive Podcast features Christine Moutier, MD, chief medical officer at the American Foundation for Suicide Prevention (AFSP), for a conversation about how clinicians and community members can become better educated on the signs of mental health crisis and aid one another in supporting individuals who suffer from suicidal ideation.
Dr. Moutier shares her insights into the evolving journey of understanding the many factors that surround suicide and mental health crises. Drawing from Thomas Joyner’s interpersonal theory of suicide, she stresses the need for integrating diverse research disciplines to better recognize and support individuals in crisis. In her role at AFSP, Dr. Moutier has made it the organization’s mission to create large scale public health initiatives and raise greater awareness for mental health causes.
Dr. Moutier is the author of Suicide Prevention, a Cambridge University Press clinical handbook. She has also contributed articles and book chapters for publications such as the Journal of the American Medical Association, the Lancet, Academic Medicine, the American Journal of Psychiatry, the Journal of Clinical Psychiatry, Depression and Anxiety, and Academic Psychiatry.
“There’s a lot of assumptions and projecting about weakness or cowardice,” says Dr. Moutier. “What’s actually happening in the brain of somebody who is suicidal is that they’re not able to think about their connections to loved ones, their optimism, or their own healthy coping strategies.”
Follow The Menninger Clinic on Twitter, Facebook, Instagram and LinkedIn to stay up to date on new Mind Dive episodes. To submit a topic for discussion, email podcast@menninger.edu. If you are a new or regular listener, please leave us a review on your favorite listening platform!
Visit The Menninger Clinic website to learn more about The Menninger Clinic’s research and leadership role in mental health.
Welcome to the Mind Dive podcast brought to you by the Menninger Clinic, a national leader in mental health care. We're your hosts, dr Bob Bowen and Dr Keri Harrell.
Dr. Kerry Horrell:Monthly we explore intriguing topics from across the mental health field and dive into hidden realities of patient treatment.
Dr. Bob Boland:We also discuss the latest research and perspectives from the minds of distinguished colleagues near and far.
Dr. Kerry Horrell:So thanks for joining us.
Dr. Bob Boland:Let's dive in. So we're very excited. We've been trying to do this for a bit and I'm glad we finally got our schedules together. We have Dr Christine Yu Mutier today. Dr Mutier, she serves as the Chief Medical Officer for the American Foundation for Suicide Prevention, that's the AFSB. She leads a nationwide movement fueled by science and grassroots efforts. Dr Mutier has served as a practicing psychiatrist, professor of psychiatry, dean of the medical school and medical director of the inpatient psychiatric unit at the VA Medical Center in San Diego, california. Is that where you're a dean? Where were you a dean?
Dr. Christine Yu Moutier:Yeah, in the School of Medicine at UC San Diego.
Dr. Bob Boland:Oh awesome, I didn't know that Are you still in San Diego.
Dr. Christine Yu Moutier:No, no, I moved for the work with AFSP in 2013. Oh wow.
Dr. Bob Boland:All right, well, I got more.
Dr. Kerry Horrell:I know I'm sorry I get so stuck. I love to be here.
Dr. Bob Boland:She has testified before Congress numerous times, presented at the White House and the National Academy of Sciences and co-anchored CNN's Emmy Award-winning Finding Hope Suicide Prevention Town with Anderson Cooper and Dr Sanjay Gupta. Dr Muthia has authored Suicide Prevention, a Cambridge University Press clinical handbooks. She also has contributed articles, book chapters or publications such as JAMA, lancet, academic Medicine, american Journal of Psychiatry, journal of Clinical Psychiatry, depression and Anxiety, and Academic Psychiatry Wow.
Dr. Kerry Horrell:You're like the person to talk to about suicide prevention.
Dr. Bob Boland:And we've been wanting to talk about it. I know this is so exciting.
Dr. Kerry Horrell:Okay, wait, but though to land the plane. Where are you now?
Dr. Christine Yu Moutier:Right now I am at my home in New Jersey so that I can get to our New York office where AFSP is headquartered. You know every now and then, but AFSP is national, so many of our staff are actually remote staffing our chapters out there amongst the 50 states.
Dr. Kerry Horrell:You're in the fall dreamy.
Dr. Bob Boland:Well, welcome and thanks for being a part of it.
Dr. Kerry Horrell:Thank you so much for being here.
Dr. Bob Boland:Yeah, thank you.
Dr. Kerry Horrell:We usually start with sort of our the same question for every guest, because we're interested in this, which is if you can tell us just a little bit about your career so far and how you became interested in really specializing and focusing on suicide prevention.
Dr. Christine Yu Moutier:Yeah, thanks for asking about that, because I actually think it's kind of unusual for anyone, even a psychiatrist, to mainly and solely focus on suicide prevention. And it does have to do with my own personal and professional story, as most of our careers go right. A particularly pivotal mental health crisis experience while I was in medical school and taking the time off to get treatment for a full year was transformative. That was the first time I received therapy and treatment myself and it set me personally off on a completely different course that was healthier, more centered, more grounded, like I got to live because I was alive and a human being, not for all the super rigid, perfectionistic kind of judgmental narrative that I was unconsciously living with up to that point. And so that lived experience part of my story. Then, you know, coming back into the academic medical environment where it I had, honestly it was a little bit odd, but I had a probably a mild version of PTSD from the first couple of years and how sort of on the outside of everything that I felt for those first couple of years, and so the awareness that I had, right from that early part of my career about the disparity, the gap in what a culture that would actually be open and supportive around human needs, mental health needs of its learners and workers, was just kind of very, very, you know, vivid and visceral for me.
Dr. Christine Yu Moutier:And then over the subsequent years of my residency, training and early on in my faculty career at University of California, san Diego, there were a series of suicide deaths. Experience was a medical student I had worked very closely with and then the following year he took his life. And then over a period of about a decade, maybe a little bit more, there were more than a dozen faculty physicians who took their lives. And by then I was into my dean for students and medical education role and I had not really intended to stay in academic medicine. I always thought you go to medical school to serve the people. But by then I had really stayed, in large part because a number of things. I had wonderful mentors, I mean lots of incredible opportunity. I was just passionate about treating people with mental illness, but also I had this sort of secret mission that was around the culture and could I stick around? And you know I didn't view myself as anyone special, but could I have some kind of impact on policies? You know what becomes safe to talk about ourselves and then fast forward.
Dr. Christine Yu Moutier:I started volunteering for the American Foundation for Suicide Prevention.
Dr. Christine Yu Moutier:I became something of a, you know, focused interest and expert in physician suicide and medical student suicide, and so anyway, you know, now, 11 years ago, I became the chief medical officer of AFSP, which is a nationwide look that funds research and uses a public health model, and so it's so interesting in a way that what feels like, you know, a very teeny, tiny kind of lived experience that I had and then a local experience with losses, and then and actually I didn't mention my mentor, sid Zisick and I actually got put in charge of trying to do something about the suicide problem that was happening amongst physicians and then also nursing staff at UCSD, and so that, like being in the trenches with the messiness, the grittiness of trying to do suicide prevention according to any sort of evidence that might be out there. But this was even, you know, 15, 20 years ago. It wasn't as clear what constitutes effective suicide prevention and I am happy to say that there is more science now and more needed. But so it's very much a 360 passion of mine, both clinically, personally, professionally, you know, family, community, like it's all around my life, and I feel very, very lucky and privileged to focus on something so meaningful, even though it is a complex health issue for sharing your own experience along with it.
Dr. Kerry Horrell:That's fantastic. Yeah, I was feeling that. I was like thank you for sharing your story.
Dr. Bob Boland:But I mean I think, as you say, I mean it's like the science has really grown. I mean when I was training, I mean I think everything they told me about suicide was just anecdotes and clinical wisdom and I think there was very, really very little literature outside of just basic kind of like census. You know census type, you know things and things like that. But you know the research really has grown and can you give us a little primer about you know what we've learned and what we know now compared to what we knew, and maybe what we what might surprise us?
Dr. Christine Yu Moutier:Yeah, I think we knew. We always think we know a fair amount and maybe we're always a little bit less sure about what we don't know, but it's easy to look back on what we didn't know then. I'm sure we still don't know a lot now, but I think what we didn't know then, what we did know, was largely informed by clinical experience. However, once you have hypotheses and theories, then experience tends to confirm those pre-existing theories. So there wasn't as much actual data from a clinical, neurobiological, societal community and clinical treatment, for example, perhaps until CBT for suicidal patients CBT for suicidal patients which was when around maybe the early 2000s, 2005 perhaps, when Aaron Beck and Greg Brown were already studying the effects of CBT, and then they got an AFSP grant to customize CBT for suicidal thoughts and suicidal behavior and, lo and behold, got even more effective results by not just focusing on depression and anxiety in the usual CBT manner but focusing more specifically on what drives an individual's suicidal thoughts and urges an individual's suicidal thoughts and urges. So that is one example of, I think, what I would say are now probably six or seven modalities that were developed specifically for clinical use for suicide risk reduction, reducing suicidal thoughts and or behaviors and, ideally, death. So you know, back in the day we didn't, there was not the development of those treatments yet. And then, I think even more than that, we knew something about broader societal issues. But we but until Maddie Gould started the work around suicide contagion, and you know what about certain newspaper articles and journalists? You know broadcast messaging around suicide, and now of course there's a lot more on social media messaging and also entertainment content messaging. We didn't know if, if talking about suicide in certain contexts with certain people was safe or dangerous. Now there are four or five or six studies that have pretty clearly shown that even asking a high-risk population about whether they're having thoughts of suicide in various formats in writing or verbally, in person that that does not increase risk, does not increase intensity of suicidal ideation or risk of acting on those thoughts. So I mean there's a whole host of things.
Dr. Christine Yu Moutier:There's a whole section of the suicide research field that's focused on the genetics that look like they're related in some ways to mood and anxiety disorders and other diagnostic categories and then in some ways look like it runs outside of it that there's a separate, probably set of inherited factors that relate to neurobiologies.
Dr. Christine Yu Moutier:You know the stress diathesis, what happens physiologically in the brain when under a state of stress in terms of cognitive constriction. So there is a lot more that has been worked out, but I would say it's being worked out. A lot of it is very complex and obviously it's not a matter of one study to how that all works. And last thing I'll say is that the clinical lens on suicidal patients is really important and it's also a selection bias from a whole population standpoint as to the types of patterns of behavior that clinicians will tend to see versus those that exist out there that may never show up in a clinical setting, that are still people who are at risk for suicide. So I think you know there's a lot there, but I think, look, here's one big way to sum it up. When AFSP got started in 1987, there was some controversy amongst the founders, including some scientists, about whether we could even have the word prevention in the name of the organization and in fact it was called the American Foundation for Suicide and later it might cause some confusion.
Dr. Bob Boland:Yeah, yeah, definitely was never pro-suicide, but yeah right, like Kevorkian wasn't a member or anything.
Dr. Christine Yu Moutier:No, no, it was never like that. But there literally was not clear consensus on whether preventing suicide was possible, and we can get into that topic as well, because there's some like everything around suicide, there's a lot of nuance and complexity.
Dr. Kerry Horrell:Wow, there's so much of nuance and complexity. Wow, there's so much more on that that I want to ask about, because I think that's such an interesting idea in psychiatry is something to think about that. But I do want to ask something that I think is I'm hearing a lot about I've heard you speak about before too which is being really thoughtful about our language around suicide and sort of changing some of the ways that we've kind of historically talked about suicide, like I think probably one of the biggest ones is talking about committing suicide versus dying by suicide, and I wonder if you can speak to why that feels especially important and just even understanding, like the core concept of suicide.
Dr. Christine Yu Moutier:Yeah, I think the term commit suicide came out of a time when we say things like commit certain acts, usually acts that have a morally laden, you know reprehensible kind of tone murder, sin, adultery, et cetera, et cetera. And suicide was lumped in with all of these, you know, extremely violent or negative, sinful sorts of that category. Because I think there was, I think the way that society understood suicide was more from a philosophical or spiritual or religious lens, because it was not a health or scientific lens to you know, to really understand this phenomenon of human behavior. And now that there is, I would say, enough of a body of science to really say, while complex, like other complex health issues, I put it in the exact same framework as, let's say, heart disease or other you know complex health issues where there's genetics, there's early childhood, there's environment, there's family dynamics, there's individual psychological traits, cognitive traits, all of those things we could say about heart disease that it's highly multifactorial as well. You can't necessarily predict. So anyway, the health framework, I think, really is acceptable and there's consensus around that.
Dr. Christine Yu Moutier:And so then you look at language like commit and we don't say commit about any other health issue, commit cancer, you know, just wouldn't even make sense and it does imply a morality or a blame of the individual, whereas I think, if you understand the health lens on this, people are succumbing to lots of things that don't apply, based on even the clinical lens of what we typically see, let alone for lay people.
Dr. Christine Yu Moutier:There's a lot of just projecting in and making assumptions about, you know, the weak, weak people and cowardly, and it's their way out. That's not what's actually happening in the brain of somebody who is suicidal, that cognitive constriction. They're not thinking about their connections to loved ones, their optimism, their other healthy coping strategies. So that's part of what I think the work of suicide prevention. That makes it a little bit complicated is that for every person out there in society, knowing a little bit about how to prevent heart disease actually requires some knowledge, and with suicide we have to correct so many of the myths of the past and that's kind of a challenge. So I mean starting with just rooting out that phrase commit suicide, which I think is a really important one, and hopefully more and more clinicians will understand why and the importance of it as well, as you know, they're modeling it, for I view us as health professionals, as leaders in communities around these topics.
Dr. Kerry Horrell:Absolutely.
Dr. Bob Boland:Yeah, I mean, you know, as mental health clinicians, I mean one of the things we always wrestle with and this is kind of getting to what you're saying is just knowing who's more likely or who's at higher risk. Kind of figuring out who are the ones that we should be the most worried about is a constant challenge. Yeah.
Dr. Christine Yu Moutier:Yeah, it is. It is I mean yeah Because I think the role of the clinician is that is remains a very challenging space in suicide prevention that I don't think we have all the answers, and nor I'm not sure we ever will in terms of a formulaic way to understand. You know more like, I think, if we could put our anxiety aside for a moment and think about how primary care and cardiologists approach people who have heart attacks or who die of heart disease. They don't really get hung up on which ones should I hone in on? They apply the same preventive approach to everyone who has risk factors for dying of heart disease, and I think that's something we could definitely think about, employing that very systematic approach.
Dr. Bob Boland:That's a great idea.
Dr. Kerry Horrell:I did want to just mention for a second or go back to something you said when I was a trainee when I was, I think I was in my fellowship I got to hear Thomas Joyner speak and I remember one of the things I really walked away with from his interpersonal theory of suicide was, like him andomeness and wanting to relieve the burden of how other people feel, feeling so isolated and disconnected from other people Like these are usually not people who are, who are wanting to do this to hurt other people or to hurt them.
Dr. Kerry Horrell:They're trying to oftentimes find a way to to help the people like the people in my life would be better off, and so I'm. Yeah, I don't know if you have thoughts about that, but I feel like that's been such an important framework shift for me as a clinician was just really thinking about that model and thinking it through. This idea that the folks who died by suicide are oftentimes facing such darkness and such a sense of of feeling alone and like the world would be better off without them. It feels so opposite than selfish.
Dr. Christine Yu Moutier:Yeah, yeah, it's, it's true, and Thomas Joyner's theory is is terrific in from that standpoint to get beyond just what we had all learned probably previously was, you know, clinical depression, hopelessness, you know prior suicidal behavior. We were thinking about males, isolation, divorce, and those are all demographic true facts. But as far as actually understanding what drives people to become suicidal, to have suicidal thoughts, that is. And then there's even a section of the field that's looking at what leads, what differentiates people whose experience remains in this thinking about suicide arena, which is the majority, and those who go on to act. And because there are, at least the theory that drives those researchers is that there's a different, or perhaps overlapping, but unique perhaps, set of risk factors that drives the action.
Dr. Christine Yu Moutier:But yeah, but back to Thomas Joyner's theory. I think the thwarted belongingness, the sense of burdensomeness, those were really important contributions to embed in clinicians' minds. Thomas Joyner, I think you know, is a force amongst the field and it's interesting that his was shaped around a psychological theory. And the way that I look at the suicide research field is that in order to really continue to make progress on understanding what drives suicide risk, we have to actually integrate and combine a whole host of different disciplines and how they study suicidal ideation and suicidal behavior. His happened to become extremely kind of popular amongst other researchers that were being mentored, and so any number of other studies got formulated around that theory, and it's all good, but it requires a broad set of tools to understand suicide.
Dr. Bob Boland:Oh my man, I'd love to talk about that more, but we probably should get to your work on suicide prevention and hearing about what you've done and what you're doing. Can you tell us more about that?
Dr. Christine Yu Moutier:Yes, well, I serve in the role of chief medical officer at an organization that is the largest and leading suicide prevention nonprofit organization in the United States, probably in the world, which we're blessed by the fact that. What I'll say is that our storyline is that we began as a small research funding organization in New York City in the late 80s and then in the 90s and into the early 2000s, there was felt to be by our board of directors and others a readiness to engage in a broader kind of public health strategy that involves public education, awareness raising through our out of the darkness walks, the development of a chapter network where suicide prevention, education and loss and healing programs could be implemented through this kind of you know, the arms and legs into actual communities which, you know. Even just our walks are a very interesting story. They started in about 2004. And at that time even people on our board of directors were not sure that anyone would come out for these suicide prevention walks, called Out of the Darkness Walks. When they started, people did come out and every year, you know, it started out with a handful of them. There are now about 500 walks every year that occur and in the last 10 years, amongst the peer-to-peer event awareness and fundraising events, like for breast cancer and other things, other causes it's been in the top five fastest growing. It's been in the top five fastest growing, which tells you that there was an appetite amongst the public to come out of previously stigmatized kind of in the shadows experience, for was talking about it who even had a place to file it away in your brain as something important to consider about your life or about how you navigate? And so that growth is not to be underestimated in terms of what that gives individuals and communities. And now many people come every year to an Out of the Darkness walk and then through those events they get involved in other things that AFSP is doing.
Dr. Christine Yu Moutier:And so back to the question of how we approach suicide prevention at AFSP. It is not just me. I'm very blessed to be leading the kind of scientific and medical and programmatic effort of AFSP that really includes an entire public health approach that also now includes public policy. We have 55,000 volunteers across all 50 states who have signed on and any time their voice is needed on a particular piece of legislation. And then we have a strong policy team helping congressional team members ongoing draft legislation to make sure that it is aligned with the science on what is evidence-based, and I will say that it's also not just science, it's lived experience and scientific discovery together that guides the most kind of progressive approach to you know as to what to do as far as passing public policy legislation or as far as, if you have the opportunity to get in front of faith leaders, what do they need to know so that they can play their part in the public health model around suicide prevention?
Dr. Christine Yu Moutier:Because I look at suicide prevention as kind of like a. Well, there's upstream, so you can prevent far, far ahead of time by changing certain factors about an environment that a child is in that could be their family environment, let's say, if they're LGBTQ, those affirming accepting behaviors are potently lead to different outcomes than rejecting behaviors in the home. That research was done 15 years reduced rates of suicidal behavior, legal involvement and improved other you know academic and you know other outcomes. So there's way upstream approaches. Then there's you know again, this is kind of the public health model what does everyone need? A basic amount of education, support stigma-free environment to actually talk about what we're experiencing and to process stress and reduce risk factors and optimize protective factors. And then there's who are the groups that have higher risk, either from a clinical lens, from a demographic lens, and affording them more supports and more opportunity. And so gatekeeper training is one approach that I don't like that term, but what the term means is you provide specific education to those who are involved with youth, who are involved with LGBTQ youth, people who you know touch the public in some really important special ways, like first responders, health professionals, you might say public policymakers also have a special role. So all the way up the ladder of the public health model, you get to the clinical tier and you need actual treatments. And you know, I think from a health system standpoint, we are very early in the implementation of what science is telling us can reduce suicide risk. We've just only started to scratch the surface on screening and providing training to the whole team.
Dr. Christine Yu Moutier:Use of safety planning, lethal means, counseling, affording access I mean you know who has access to CBTSP. I mean even, let alone CBT or DBT. So these are all things that AFSP through our partnerships, through our chapter network, through our public policy. But the partnership work is really serious. It's kind of taking off because, for example, workplaces are just sort of waking up to the role of a workplace in that public health framework around suicide prevention. And I'm happy to say that in the construction industry we're just at the start of a really significant partnership with a large company called Bechtel that has funded us to kind of catalyze a movement of suicide prevention within the construction industry for the construction workers at a global level, and we're tasked with reaching 500,000 construction workers with any number of customized resources that we're busy kind of developing after doing an environmental scan. So that's just a little bit. And we continue to fund research. We continue to be the leading private funder of suicide research.
Dr. Kerry Horrell:This is fantastic. I mean like the level of depth and the different system levels, like that's incredible. I wonder if and this is probably a little bit simplified, but I'm thinking about, like clergy people, teachers, workplaces like what are some of the major things Like if you had just a few minutes to talk to people like workplaces like what are some of the major things Like if you had just a few minutes to talk to people? Like here are the major things to be looking out for? Or warning signs like what are some of the major risk factors?
Dr. Christine Yu Moutier:warning signs if you only had a few minutes to tell people like this is the biggest stuff to be looking out for we have a campaign called Real Convo, hashtag Real Convo and a number of things like Talk Away the Dark is our adult campaign and Seize the Awkward is our youth and young adult campaign. That all get at this. And we have some faith leader specific education and teacher specific education that really can take like an hour, you know. So if they really want to do a deep dive and but even that is just kind of, it's kind of a one-on-one experience and then you know, everyone needs to kind of be on their journey of progression. But what I would say is that for the people in your life that you encounter on a regular basis, in whatever hat you're wearing, you know their patterns of behavior and when those patterns begin to deviate, it could mean it doesn't always mean, but it could mean that their mental health is deteriorating Because, believe it or not, human behavior tends to stay in a fairly predictable and kind of narrow range, even though we don't think of ourselves that way with free will and all.
Dr. Christine Yu Moutier:So when people start showing up in different ways late, disheveled, withdrawn, more agitated, losing their temper, drinking more, using more, just behaving in very uncharacteristic ways those all signal mental health change. And when mental health is changing for many people and when other factors are oftentimes present too, because, remember, suicide is not caused by any one thing. Even from a clinical standpoint, there's usually a psychological autopsy shows six to 12 different risk factors that are actively bearing on that individual who ultimately dies by suicide, and so we need to be thinking about are they experiencing, you know, whatever it is, you know, something traumatic in their life, a loss even, you know, for children it could be that, you know, a parent has lost a job, their parents have just are going through a divorce. So if I'm a teacher and I know that my student is showing up in class seeming a little off their normal behavior patterns and their parents are going through something, maybe you know that is a moment where then learning the skill of what to do and the what to do does depend on your context to do and the what to do does depend on your context.
Dr. Christine Yu Moutier:In the school environment we try to tell, we try to help schools have a team approach, but any staff member should know the basics about approaching a child in a caring conversation that ultimately, the goal is to alert the parents when appropriate and get them plugged into the next level of appropriate care, whether that's with the pediatrician's involvement or with the guidance counselor. Now some school districts have school psychologists as well, so all of this can be customized. But it all starts with a basic sense of trust your gut about changes in behavior and don't assume that it's someone else's job and you're not the one to approach them in a nonjudgmental, caring conversation. That those are kind of the basics, and then you can like learn more skills from there so much more sure, super helpful though I mean we're getting near the end, but I wanted to get to ask you it.
Dr. Bob Boland:You know a lot of the listeners here are clinicians, and what advice do you have if they want is one of them to go you?
Dr. Christine Yu Moutier:know, walk away with something after they hear this, and most of your community are mental health clinicians, yeah, okay, well, I mean, the first thing I would say is just a humongous thank you and please take care of yourselves so that you can remain healthy and present in your work with patients, because the way you show up obviously matters so much. I mean all of your training and all of that, of course, but the way you show that you're present and you're listening and you're taking people seriously can make all the difference to a patient who may be having suicidal thoughts and has not told anyone yet. You know, I guess what I would want people to walk away with is that you don't have to be able to predict who's going to attempt or die by suicide in order to be playing a pivotally important role in preventing suicide. Reducing suicide risk might be a more literal way to think about it, and that will just be by certainly doing all the evidence-based, competent things you're already doing to optimize their mental health and manage their you know their diagnosed mental health conditions, psychiatric conditions.
Dr. Christine Yu Moutier:But the one new way to think about is that suicide risk in the modern era now, I would suggest, can be put on the problem list as its own clinical target and so that we can keep track of it and monitor how an individual who is at higher risk for suicidal behavior or suicide death, how are they doing over time? And that, like like we would do that for hypertension or diabetes, we would be following people over a long period of time and that would be the way. If you have a, if you have a role in your health system, as far as you know, using the EHR, a way to build safety planning that's not just a one-off but actually follows up with the patient later to find out how they're using their safety plan. Those are some of the kind of more modern ways of thinking.
Dr. Kerry Horrell:This is a loose idea here, but I was thinking about the quote the enemy of the good is the great, and I feel like around suicidality, there can be this idea of like if we don't get it perfectly right to the science of who's going to die and who's not, and it does feel like we lose this idea that, like the work we do in talking about shame and listening to people and helping them think through their specific, you know, triggers and warnings around suicide, like it matters so much and I just I'm so, I'm so appreciative of the work that you do Again, I was just listening to these different levels that the AFSP is intervening at just feels so remarkably useful and again I'm just very grateful for your work and I'd recommend your website, which is easy to find by Googling.
Dr. Christine Yu Moutier:Yes, yes, afsporg, and I'd say that we're building more and more clinical tools. You can also find clinical education at the Suicide Prevention Resource Center and please, please know that if you have any interest in getting more involved at a community level with suicide prevention, your local AFSP chapter would love to meet you, because mental health clinicians are hard to come by and they serve a very special role on AFSP chapter boards and in the volunteer work of AFSP. So thank you for considering that.
Dr. Kerry Horrell:Again, we've been listening to Dr Christine Yu-Muthieh, representing the American Foundation for Suicide Prevention. Thank you so much again for coming on.
Dr. Christine Yu Moutier:Thank you so much for having me. You two are just amazing the work that you're doing. Thank you so much.
Dr. Kerry Horrell:And you've been listening to the Mind Dive Podcast. I'm your host, Dr Keri Harrell.
Dr. Bob Boland:And I'm Bob Bowen.
Dr. Kerry Horrell:And thanks for diving in. The Mind Dive Podcast is presented by the Menninger Clinic. If you're curious about the professional experiences of mental health clinicians, make sure to subscribe wherever you listen.
Dr. Bob Boland:For more episodes like this, visit wwwmenningerclinicorg.
Dr. Kerry Horrell:To submit a topic for discussion. Send us an email at podcast at menningeredu.