Resources For Families

• American Foundation for Suicide Prevention (AFSP) has local chapters throughout Texas that can deliver education programs to schools, workplaces and communities.
• AFSP Texas Chapters
• The Columbia Lighthouse Project, affiliated with Columbia University, offers a website that discusses use of the Columbia-Suicide Severity Rating Scale (C-SSRS), an evidence-based tool that anyone can use to assess suicide risk and next steps.
• National Alliance on Mental Illness (NAMI Texas). The nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. Local NAMI chapters can deliver education programs to communities.
• Project ChildSafe partners with law enforcement in Texas to provide safety kits for firearms, with cable-style gun locks and installation instructions.
• Patient Safety Plan: Substance Abuse and Mental Health Services Administration webinar to train health-care providers using the Patient Safety Plan toolkit. “The Safety Planning Intervention to Reduce Suicide Risk for People with SMI (serious mental illness)” PPT.
• Safety Plans Work. A safety plan worksheet from the Substance Abuse and Mental Health Services Administration.

Featured

• American Academy of Child and Adolescent Psychiatry. (2021). Suicide in Children and Teens. Facts for Families, No. 10.
• American Academy of Child and Adolescent Psychiatry. (2023). Recommendations for Pediatricians, Family Practitioners, Psychiatrists, and Non-physician Mental Health Practitioners.
• American Academy of Pediatrics. (2023). Suicide: Blueprint for Youth Suicide Prevention.
• American Academy of Pediatrics. (2023). Suicide: Blueprint for Youth Suicide Prevention. Clinical Pathways for Suicide Prevention.
• American Academy of Pediatrics. (2023). Suicide: Blueprint for Youth Suicide Prevention. Youth Suicide Prevention Background.
• American Academy of Pediatrics. (2022). Policy Statement: Firearm-Related Injuries and Deaths in Children and Youth: Injury Prevention and Harm Reduction.
• American Academy of Pediatrics. (2022). Technical Report: Firearm-Related Injuries and Deaths in Children and Youth. Pediatrics 150 (6): e2022060070
• American Academy of Pediatrics and Pediatric Approach to Trauma, Treatment and Resilience (PATTeR). (2021). AAP Infographic: Moving beyond ACE Scores.
• American Academy of Pediatrics. (2020). Suicide and Suicide Attempts in Adolescents. Pediatrics 138(1):e20161420
• American Foundation for Suicide Prevention (AFSP). (2019). Q&A: AFSP discusses the clinician’s role in suicide prevention.
• American Foundation for Suicide Prevention. (2019). Learn the facts.
• American Psychological Association. (2023). A Guide to Sexual Orientation and Gender Diversity Terms.
• Brodsky, B. S., Spruch-Feiner, A., & Stanley, B. (2018). The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care. Frontiers in Psychiatry, 9(33).
• Brown, G., & Stanley, B. (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Risk. Cognitive and Behavioral Practice, 19(2).
• Centers for Disease Control and Prevention. (2023). Disparities in Suicide.
• Centers for Disease Control and Prevention. (2023). Suicide Prevention.
• Centers for Disease Control and Prevention. (2022). Suicide Prevention Resource for Action.
• Centers for Disease Control and Prevention. (2022). 10 Leading Causes of Death Reports, 2020.
• Centers for Disease Control and Prevention. (2019). Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students – 19 States and Large Urban School Districts, 2017. Morbidity and Mortality Weekly Report, 68:67-71.
• Cheung, A. H., Zuckerbrot, R. A., Jensen, P. S. Laraque, D., Stein, R. E. K, & the GLAD-PC Steering Group. (2018). Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management. Pediatrics, 141(3):e20174082.
• Columbia-Suicide Severity Rating Scale (C-SSRS) – Pediatric version to assess the level of risk and type of services that are needed.
• Safe-T With C-SSRS – SAMHSA SAFE-T risk assessment with C-SSRS questions embedded.
• Education Development Center. (2019). Zero Suicide Toolkit.
• Everytown for Gun Safety Support Fund. (2021). The Impact of Gun Violence on Children and Teens.
• Harvard, T. H. Chan School of Public Health. (2023). Means Matter. Clinicians: Recommendations for Clinicians.
• Healio News. (2019). Q&A with Jill Harkavy-Friedman, PhD: AFSP discusses the clinician's role in suicide prevention.
• Horowitz, L. M., Mournet, A. M., Lanzillo, E., He, J. P., Powell, D. S., Ross, A. M., Wharff, E. A., Bridge, J. A., & Pao, M. (2021). Screening pediatric medical patients for suicide risk: Is depression screening enough? Journal of Adolescent Health. 68(6):1183-8.
• Kalmoe, M. C., Chapman, M. D., Gold, J. A., & Giedinghagen, A. M. (2019). Physician Suicide: A Call to Action. Missouri Medicine 116(3): 211–216.
• Khangura, S. D., Kanga, I., Seal, K., & Spry, C. (2018). Suicide-Specific Psychotherapy for the Treatment of Suicidal Crisis: A Review of Clinical Effectiveness [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 May 28.
• Lindsey, M. A., Sheftall, A. H., Xiao, Y., & Joe, S. (2019). Trends of Suicidal Behaviors Among High School Students in the United States: 1991–2017. Pediatrics, 44(5): e20191187.
• Logan, K., Cuff, S., & Council on Sports Medicine and Fitness. (2019). Organized Sports for Children, Preadolescents, and Adolescents. Pediatrics,143(6) e20190997.
• Lu, C. Y., Penfold, R. B., Wallace, J., Lupton, C., Libby, A. M., & Soumerai, S. B. (2020). Increases in Suicide Deaths Among Adolescents and Young Adults Following US Food and Drug Administration Antidepressant Boxed Warnings and Declines in Depression Care. Psychiatric Research & Clinical Practice. Volume 2, Issue 2, pgs. 43-52.
• March, J. S., Silva, S., Petrycki, S., Curry, J., Wells, K., Fairbank, J., Burns, B. Domino, M., McNulty, S., Vitiello, B., & Severe, J. (2007). The Treatment for Adolescents with Depression Study (TASD): long-term effectiveness and safety outcomes. Archives of General Psychiatry. 2007 Oct;64(10):1132-43. Erratum in: Archives of General Psychiatry. 2008 Jan;65(1):101. PMID: 17909125.
• Mayo Clinic. (2023). Self-injury/cutting.
• National Action Alliance for Suicide Prevention: Transforming Health Systems Initiative Work Group. (2018). Recommended Standard Care for People with Suicide Risk: Making Health Care Suicide Safe. Washington, DC: Education Development Center, Inc.
• National Institute of Mental Health. (2021). Frequently Asked Questions About Suicide.
• Pew Research Center. (2019). What the data says about gun deaths in the U.S.
• Plemmons, G., Hall, M., Doupnik, S., Gay, J., Brown, C., Browning, W., . . . Williams, D. (2018). Hospitalization for Suicide Ideation or Attempt: 2008-2015. Pediatrics, 141(6):e20172426.
• Substance Abuse and Mental Health Services Administration. (2020). Treatment for Suicidal Ideation, Self-Harm, and Suicide Attempts Among Youth.
• Substance Abuse and Mental Health Services Administration. (2019). Texas Group Promotes Suicide Prevention Among Hispanics.
• Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884.
• Stone, D. M., Mack, K. A., & Qualters, J. (2023). Notes from the Field: Recent Changes in Suicide Rates, by Race and Ethnicity and Age Group—United States, 2021. Morbidity and Mortality Weekly Report 72:160-162.
• Suicide Prevention Resource Center. (2019). Warning Signs for Suicide.
• Texas Department of State Health Services (2023). Youth Risk Behavior Survey (YRBS), Texas Results.
• Texas Department of State Health Services. (2022). Texas Projections of Supply and Demand for Primary Care Physicians and Psychiatrists, 2021-2032.
• Texas Health and Human Services. (2023). Suicide Care in Texas Toolkit.
• Texas Occupations Code, Sec. 159.005. Physician-Patient Communication: Consent for Release of Confidential Information.
• Texas State Plan for Suicide Prevention 2023—2028.
• Texas State Plan for Suicide Prevention: Guidelines for Suicide Prevention in Texas, 2018.
• Texas Youth Health Survey Data Brief. (2022). Mental Health and Suicide..
• Texas Youth Risk Behavior Study. Texas 2021 Results.
• The Trevor Project. (2020). National Survey on LGBTQ Youth Mental Health 2020.
• United Health Foundation and American Association of Public Health. (2020). America’s Health Rankings, 2022. Suicide in Texas.
• U.S. Department of Health and Human Services. Protecting Youth Mental Health: U.S. Surgeon General’s Advisory. (2021).
• Zuckerbrot, R. A., Cheung, A. H., Jensen, P. S., Stein, R. E. K., Laraque, D., & GLAD-PC Steering Group (2018). Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management. Pediatrics, 141(3):e20174081.

Medical Definitions

The medical definitions in this module were obtained or adapted from the Child Mind Institute, Contagion of Violence: Workshop Summary, Evidence-Based Mental Health, the Missouri Department of Health and Senior Services, the National Center for Biotechnology Information, Psychology Today and WebMD.

Continuing Medical Education

The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. 

The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.50 contact hour(s) of Continuing Nursing Education.

Social Workers

The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 1.50 contact hour(s) of Continuing Social Work Education.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated 1.50 hour(s) for attendance.

General Disclosure

One of the requirements of continuing education is disclosure of the following information to the learner:

1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
   • Create a Texas Health Steps account.
   • Complete on-line registration process.
   • Thoroughly read the content of the module.
   • Complete the on-line examination.
   • Complete the evaluation.
2. Commercial Support.
   The THSTEPS Web-based Continuing Education Series has received no commercial support.
3. Disclosure of Relevant Financial Relationships.
   The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
4. Non-Endorsement Statement.
   Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
5. Off-Label Use.
   Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

Glossary of Terms

Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.

Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.

Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

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