As a pediatrician screening for suicide, It’s not about the ones you find positive for suicide, it’s about the ones you may miss. Today’s guest Dr. Horowitz is a Staff Scientist and Pediatric Psychologist at the Nation Institute of Mental Health Intermural Research Program at NIMH and for years she has been helping health care professionals not let kids slip through the cracks. She excels in Suicide Risk Detection and is head PI in several ‘Suicide Prevention Protocols’ using the ASQ Toolkit. She assists hospitals, schools, and pediatric centers in implementing Suicide Screening of patients. Let’s dive in a learn how we as busy professionals can incorporate this suicide screening in our practices. [00:01 - 10:01] Opening Segment Introducing today's guest, Dr. Lisa Horowitz Expertise and work Dr. Horowitz gives us a bit of background on his story How Dr. Horowitz got into her field of work Late 90’s, mental health patients flooding hospitals Saw the need for a suicide screening tool Used as a Fellowship Project Push back from nurses Moved to DC to get a job at NIH Dr. Horowitz story developing screening for the hospital Creation of ASQ
[10:02 - 15:56 How To Implement Screening Even if You’re Not an MH Expert Dr. Horowitz talks about how doctors who aren’t mental health experts can ask screening questions Pilot study results 60%-80% response rate Asking parents to step out Nurses asking the kids without parents in the room Creating a Script to model Most parents responsive Are there risks to the screening? Studies show that you can’t plant the idea of suicide if it’s not there Asking the questions help, they don’t hurt
[15:57 - 22:07] Getting Comfortable with the Whole Script for the Busy Practitioner Dr. Horowitz talks about giving the whole script A fear for busy doctors Don’t change the questions Getting comfortable with the language Getting over the worry of screening positive Positive screenings are very rare When you have one, you can save a life It’s not one size fits all, not everyone has to go to the emergency room
[22:08 - 41:38] Translating From Emergency Room to Primary Care Dr. Horowitz talks about how this can translate into Primary Care Suicide is the second leading form of death Training that pediatricians receive is very little towards what actually kill kids The problem of don’t ask don’t tell The facts of fighting suicide We haven’t made a dent in rates in over 50 years Dr. Horowitz story of Pediatrician using the screening Worried about the ones you miss, not the ones you don’t A lot of people go to health care before their death The difficulties of these screenings Are they safe? What to do if you get a positive What is included in the ASQ toolkit Screening vs. assessment BSSA for Pediatricians Very rare if you need to get them to an emergency room The value of having MH experts in your practice My own experience in risk assessment Clinical pathway Using the guide is not as hard as you think Other ways to learn and work with families at risk
[41:39 - 55:07] Closing Segment Alternative measures to preventing risk Ex: safe storage of guns Distraction and disruption Making it harder can buy time Available resources Screening is an intervention You may be the one to foster positivity Where to start Links below Final Takeaways Ask the questions You can offer hope Be prepared for the positive You can do this and need to
Tweetable Quotes: "I had a parent tell me she was so glad that someone was asking these questions because she didn’t know how to do it.” - Dr. Lisa Horowitz “Fostering resilience is a big part...