How new ideas and research coming out of Nashville are paving the way for a better tomorrow

In sea of suicide statistics, mental health professionals are refusing to give up. By collaborating on research with the nation's elite in this field, new solutions are turning the tide on suicide in Tennessee.

Last year more Tennesseans died from suicide than from motor vehicle accidents. That's over 1000 of our neighbors. It's a sobering fact that makes it clear that we face a major public health problem. Here in Nashville two initiatives have launched, offering new ideas to a worldwide concern.

The first initiative is about how we think about suicide. This is a new suicide specific diagnosis. Mental Health Cooperative's Crisis Stabilization Unit (CSU), a voluntary short-term inpatient psychiatric unit located in the heart of Nashville, partnered with Dr. Thomas Joiner, a nationally recognized suicide researcher at Florida State University. The 6-month collaborative study revealed a new diagnosis, 'Acute Suicidal Affective Disturbance' or ASAD. ASAD is the first ever suicide specific diagnosis. It outlines the experience of a rapid and dramatic increase in the desire to die by suicide, marked by specific symptoms. As research continues to refine this understanding of suicide, the potential emerges for more sensitive clinician assessment tools and better informed crisis interventions. These study results have been submitted for publication in the Journal of Psychological Assessment.

In a suicidal crisis, current interventions include short-term inpatient care - either at a Crisis Stabilization Unit, Crisis Respite or a psychiatric hospital. These inpatient facilities offer a safe environment, medication management, discharge planning and group counseling, all of which are designed to provide a safe environment and diminish immediate pain. These methods are vital, yet leave room for unexplored treatment options. A second initiative is focusing on a new suicide specific treatment. This research includes using inpatient group counseling to specifically target interpersonal reasons that drive some people to consider suicide. The idea here is to cultivate counter-experiences to suicide reasoning.

The leading theory for why people die by suicide, the Interpersonal Theory of Suicide, is rooted in relationship with others. When someone feels like they do not belong, like they are a burden to others and generally hopeless about things ever getting better, they give serious consideration to suicide. By leading groups that foster opposite experiences, that is, experiences of belonging and giving within the group, can plant seeds of hope. "If I could experience belonging in that group, maybe I could belong somewhere else too." "If I helped people in that group, maybe I can help people elsewhere as well."

Mental Health Cooperative's CSU has developed this approach and has been guiding groups in this manner over the past few years. The team is now entering into research partnerships to study and validate the approach. The goal is to establish a model and share this method globally.

If you or someone you know is thinking about suicide, professionals are available to help 24 hours a day, seven days a week at places like Mental Health Cooperative's CSU and Mobile Crisis Team.

Adam Graham is Supervisor of Diversion Services at the Nashville-based Mental Health Cooperative, which provides behavioral health and primary care services, including diagnosis and treatment, to people living at or below the poverty line throughout the state. For more information, call 888-844-2005 or visit www.mhc-tn.org.