Addressing suicidality is an urgent concern, particularly as cases of depression and other mental health disorders have spiked across all age groups during the COVID-19 pandemic.
Each year in the United States, roughly 46,000 Americans take their own lives, according to the CDC. Of those, about half had a healthcare visit in the month prior to their death. In other words, many of those having thoughts of suicide either seek help or find themselves in the position to receive help.
Unfortunately, the mental health care system does not always accurately assess their risk—and ultimately lets them down.
When it comes to treating suicidality, traditional mental health care remains logistics-based, with a one-size-fits-all approach. Patients are hospitalized and treated until they’re deemed “safe” enough to be discharged. This is only a short-term solution when, in fact, they need long-term support.
“One of the downfalls from clinicians is that as soon as we start to hear that someone is suicidal—they’re having ideation or talking about a plan—we want to just refer them to the hospital and then have them return to treatment when they are no longer suicidal,” says Amber Parris Claudon, LICSW and Lightfully’s Vice President of Clinical Training. “This is a very tragic mistake, because the truth is a lot of our clients will struggle with suicidal thinking at a more chronic level, and we are missing opportunities to provide effective treatment.”
“Successfully treating suicidality requires a unique care model that provides patients access to the resources they need at lower levels of care,” says Nicole Siegfried, Lightfully’s Chief Clinical Officer. That’s where the company’s groundbreaking treatment model comes in.
Lightfully practitioners use process-based therapy (PBT) to reveal the root processes of each patient’s suicidality, says Siegfried, and then draw from dozens of evidence-based therapies to address those processes in an intentional, data-driven treatment approach.
“The difference with this treatment is that we’re not just decreasing behaviors or alleviating symptoms,” Siegfried says. “We’re changing those underlying core processes so that when other things come up, patients will have a new way of interacting with themselves, others, and the world around them.”
But why is Lightfully’s treatment model so well-positioned to address suicidality? It boils down to these four cornerstones:
- The Equip Training program for clinicians
- The personalized care that PBT provides
- Open communication between clinicians and other practitioners
- A feedback-driven culture
Let’s look at each in more detail.
Cornerstone #1: Equip Training Program
To deliver intentional care that changes patients’ lives in a meaningful way, it’s essential that clinicians are competent—especially when treating suicidality, where cases are complex and vary by patient.
The Equip training model enables clinicians to accurately assess and appropriately respond to patients with suicidal symptoms.
“Most clinicians receive less than two hours of training in suicide assessment and intervention in their graduate programs,” Siegfried says. “It’s our responsibility as a treatment center to equip our clinicians with the tools necessary to care for clients who are struggling with suicidality.”
All staff at Lightfully receive onboarding and ongoing training in suicide assessment, intervention, and postvention. Additionally, clinicians are trained to not only assess and respond to suicidality but to also truly understand the suicidal mind and the psychological processes that drive suicidality so that clients can find relief and build hope.
Understanding the complexity of human suffering is essential to Lightfully’s treatment model, and all practices are rooted in the belief that developing care for patients is an ongoing process that embraces this complexity while helping patients reconnect with their lives.
This means practitioners learn and receive feedback even after they start treating patients—a training method that’s unique to Lightfully and ensures clinicians are constantly honing their treatment methods and providing patients with consistent, high-quality care.
“There’s something really vulnerable about this practice because we’re demonstrating and showing what we’re actually doing behind closed doors,” Claudon says. “But the outcome we’re producing is so clinically rich. It’s really unmatched in other treatment facilities.”
Cornerstone #2: Personalized Care
At Lightfully, clinicians are trained to recognize how each patient’s experience with suicidality is different; that means a patient’s treatment should also be tailored to address the difficulties they’re struggling with.
“Most treatment centers focus on disorders associated with suicidality, like depression or bipolar disorder, with the hope that as symptoms improve, suicidality will remit,” Claudon says. “At Lightfully, we treat suicidality directly as its own process, separate from a diagnosis, which provides clients with new ways of interacting with their thoughts and emotions to promote hope and healing from the inside out.”
Lightfully’s clinicians create a personalized treatment plan using PBT-based interventions, Siegfried says.
“We target those processes that are unique to each individual that may be driving their suicidality,” Siegfried explains. “That provides a treatment roadmap for our clients.
“One of the issues with clients with suicidality is that their thinking is so constricted that they can only see one option,” she continues. “By helping them broaden their attentional processes and separate from their thoughts, they are able to shift their focus and see a broader horizon of possibilities other than just dying by suicide.”
Clinicians are also continually adjusting care to better fit patients’ needs by utilizing assessments from patients. “Using a process we call ‘data-driven clinical decision-making,’ clinicians integrate assessment results to guide them in mapping treatment.”
Ultimately, patients’ treatment plans should leave them well-equipped for their future beyond Lightfully.
“I think a client has reached a point of success or a positive outcome when they have realigned with values that are true to them,” Claudon says, “and they’re able to function in their life in a way that brings fulfillment and congruence.”
Cornerstone #3: Open Communication
Treating suicidality successfully is a group effort that requires collaboration between practitioners inside and outside of Lightfully. Clinicians and referents are all part of a patient’s network of support, so it’s vital that they work together to help patients in the long run.
Lightfully maintains two constant points of contact with referents through clinicians and case managers. Each patient is assigned a case manager, who makes sure referents are updated every week on the details of their patients’ treatment plan and their progress.
Maintaining this open line of communication is especially important because it ensures patients have an easier time transitioning to outpatient care after their stay at Lightfully.
“We have to remember that we are just one point along a client’s journey to healing,” Claudon says. “We have to communicate with the teams who are navigating the next part of the journey after clients leave us. Otherwise, the time spent with us is a detour from the path to wellbeing.”
Cornerstone #4: Feedback-Driven Culture
In addition to Lightfully’s commitment to quality and excellence, we are also committed to learning from what isn’t working—a concept called “wabi sabi,” or the Japanese belief in finding beauty in every imperfection.
Learning from mistakes is an integral component of our success, as it creates a feedback loop of continuous improvement.
Many treatment centers focus on suicide prevention and intervention, but they leave out the equally important postvention. If a client we treat later attempts suicide, we look at all the things we could have done differently. That process involves both the client and his or her clinicians.
Many centers are afraid of this component because it can be difficult to look at what we did or didn’t do as a center in leading up to a client’s suicide attempt. Research shows that neglecting postvention increases risk for another suicide attempt by the same client or by other clients in the center.
At Lightfully, a culture of accountability without blame is embedded in our operations. This approach fosters curiosity and compassion in our teams and our clients, which ultimately promotes safety and decreases risk for suicide.