Where suicide prevention becomes law

Dr. Hayley Gorton, a research and community pharmacist, and a Winston Churchill Memorial Trust (WCMT) Fellow 2018, recently visited Forefront Suicide Prevention. Below, check out her blog post about her visit.

I write this from somewhere above the Rocky Mountains. Perspective or what! I wanted to try and get my thoughts down whilst I’m technically still on my WCMT trip. This week I’ve been in Seattle, Washington to learn about their new requirements for pharmacists to be trained on suicide prevention. I was hosted by Dr Jenny Arnold of Washington State Pharmacy association (WSPA) which is akin to our Royal Pharmaceutical Society, so I immediately felt at home. Dr Arnold put together a great program for me to learn about the new law, how the training was developed, speak to trainers and “jobbing pharmacists” about what they think about this new training and requirement.

The 2016 iteration of the “Matt Adler Suicide Assessment, Treatment and Management Act of 2012” named all the healthcare professionals required to have 3 or 6 hours of training on this topic. Pharmacists are required to undertake a 3 hour training program. Dr Jen Stuber, director of Forefront Suicide Prevention was instrumental in mandating this training.

The WSPA partnered with Forefront to produce a bespoke training package for suicide prevention for pharmacists. By their reregistration date in 2018 (interestingly enough, this is on each individual pharmacists’ birthday), pharmacists must have completed an accredited 3 hour online or face-to-face training program. I was kindly provided with access to the online training program so I could understand what training was provided. This was mainly centred around understanding and applying the LEARN™ acronym, which helps recognition of and action with someone who may be in crisis.

Another key focus of the training is the “Safer homes, suicide prevention” campaign, initiated by Forefront. This campaign couples the removal of firearms with sensible medication storage, in order to make the home safer from accident or suicide. From the medication standpoint, the aim is to remove unnecessary medication and keep required medication to small quantities and out of easy access, for example locked in coded safes. I’ve already talked about the availability of over-the-counter medication in the USA in my previous blogs but, needless to say, when I showed the Forefront team a blister pack of medication I had in my bag, they were bowled over! Talking of which, I still can’t get over the fact that they have a new law regarding safe medication disposal. In the UK the essential part of the pharmacy contract requires us to safely dispose of unwanted medication. Now, I assume that the general public are familiar with this, given that the doop bins get full pretty quickly, but I probably ought not to be so sweeping in my assumption and perhaps we have something to learn here from an educational standpoint. Nonetheless, I was absolutely shocked that until now, there were very limited options for the public in Washington to safely dispose of medication. Even more frightening is that this law extends only to Washington state and in many states, there are still no publicly available safe ways to dispose of medication.

Throughout the week I spent time with pharmacists working in different sectors to understand both their experiences in dealing with patients experiencing suicidal thoughts, and also the training. Some gave me examples of where they’d had to intervene, prior to the training, and how that made them feel. There were some mixed responses to the mandatory training: many thought 3 hours was a long time, but most agreed that it was good awareness-raising. For me, it would be interesting to see when pharmacists completed the training in relation to their registration deadline. Might this reflect the importance vs. urgency? For the face-to-face training, they use a “train-the-trainer” type model, whereby they trained a pool of pharmacists who went out and delivered training sessions. I was privileged to sit in on a debrief with this group and listen to what went well and challenges of the session. Again, I had a good reminder that not everyone in the audience might have the same beliefs as me. Something I must bear in mind with this ongoing work.

It was a joy to share our qualitative research on the potential role of community pharmacy teams in suicide awareness & prevention with Dr Stuber and the Forefront team; and Dr Arnold, Dr Rochon & Theresa at WSPA.  I’m now going home to try and make sense of all this fantastic learning and decide what to do next.

To see more blog posts from Dr. Gorton, please visit her website.