Leading through the Law

In 2009, over 36,000 people died by suicide in the United States. Yet far from suffering in silence, nearly half those who died by suicide were seen by a mental health professional in the months leading up to their death. With such a high rate of people seeking help, behavioral scientists—and victims’ families—are wondering why the path to effective care proved so elusive.

The state of Washington is addressing this issue head-on. Spurred by a single tragedy, state legislators recently adopted a bill that requires mental health professionals to receive periodic professional training in suicide prevention. This law is the first of its kind in the nation, and EDC is helping other states learn what it takes to accomplish the same goal.

An avoidable tragedy

Matt Adler was a 40-year-old attorney, husband, and father of two, and had been receiving treatment for depression and an anxiety disorder when he died by suicide in February 2011.

His widow, Jen Stuber, was devastated. Adler had been open about his struggles and had been seeking help from mental health professionals. She was haunted by the question, could this have been prevented? As she went looking for answers, one theme kept surfacing: the professionals who had been treating him—while competent and caring—were unprepared to treat the needs of a suicidal client.

“I asked experts across the state whether this is the type of care that people who are suicidal should expect,” she said. Sadly, the answer she kept hearing was “yes.”

This tragedy was the catalyst behind the Matt Adler Suicide Assessment, Treatment, and Management Training Act, which was signed into Washington law on March 29, 2012. The law requires a broad swath of health professionals, including chemical dependency professionals, family therapists, mental health counselors, and social workers, to take a minimum of six hours of training in assessing and managing suicidal patients every six years.

Educating leaders

Laurie Davidson, who works with EDC’s Suicide Prevention Resource Center (SPRC), speaks of a gap between the care that suicidal patients need and the training that their health providers have received. “If you ask people with masters in social work, masters in counseling, doctorates in psychology, how much training they got in assessing and managing suicidal patients, they’ll tell you almost none,” she says.

Davidson, a mental health counselor by training, recently moderated a webinar titled “Health Professional Training in Suicide Prevention: Legislative Innovation in Washington State.” The online meeting was co-sponsored by the American Foundation for Suicide Prevention and featured Stuber and others who had been instrumental in pushing for the new law, including Washington State Representative Tina Orwall.

The goal? To help state leaders and mental health practitioners learn what it took to turn tragedy into a law that may help others avoid the same pain. Sixty policymakers, advocates, and mental health providers from 25 states were in attendance.

During the webinar, Orwall spoke about the importance of ongoing training for people in the mental health fields. “There’s the assumption by the public that health care professionals have been trained in this—and they haven’t been,” she said.

Making a case for training

Getting the law passed was no simple matter. During the legislative process, different groups objected to it on the grounds that it would be expensive to implement and that it would open the floodgates for more mandatory trainings for mental health professionals. Backers of the bill used data about the prevalence of suicide in Washington State—where the rate of suicide is 13.8 per 100,000 people, compared to 12 per 100,000 nationally—to help make their case. The bill eventually passed overwhelmingly in the state legislature.

“Faced with a client who is actively suicidal, even the most competent clinicians can question their own judgment and practice,” adds Davidson. While she does not expect the new law to solve one of the biggest public health crises of our time, she is confident that training clinicians to recognize and respond to suicide warning signs is a step in the right direction.

“When mental health professionals have the proper training,” she says, “suicide can be prevented.”