Abstract
Suicide is the second-leading cause of death among youth ages 10 to 24 in the US, and youth who receive OT services may be at risk. Yet, little is known about OT provider capabilities to identify and reduce suicide risk in pediatric clients. In this study, we surveyed pediatric OT providers about their knowledge, comfort, and training needs related to youth suicide. This information is necessary to inform steps to enhance the impact OT can make on the reduction of youth suicide.
Primary Author and Speaker: Anne Kirby
Contributing Authors: Alexandra Terrill, Jarrett Henderson
Suicide is the second leading cause of death among youth 10-24 in the US (CDC, 2014). Based on existing research evidence, youth with mental health conditions and those with intellectual and developmental disabilities may be particularly at risk (NIMH, 2016). Thus, suicide screening and prevention is highly relevant for populations often treated by pediatric occupational therapy (OT) practitioners. A recent article by Kashiwa et al. (2017) called for OT practitioners to take more responsibility for suicide prevention, particularly among military veterans. We argue that this need expands to pediatric OT practitioners as well, given the growth of youth suicide as a national concern. In this study, we aimed to examine pediatric OT practitioner knowledge, comfort, and training needs related to youth suicide.
This is a descriptive, online survey research study. Recruitment is ongoing; at the time of abstract submission, n=116 respondents have completed the survey. Participants are required to be OT practitioners (therapist or assistant) who spend ≥50% of their time in a setting with children or youth (≤21 years of age). We are recruiting through social media, electronic flyers to state OT organizations, and hardcopy flyers to 1,000 pediatrics AOTA members.
An OT and psychology interdisciplinary team developed a survey instrument specific to this study. After consenting to participate and confirming eligibility, participants answered five types of questions: Awareness (assessing awareness of youth suicide statistics and risk factors), Comfort/Competence (exploring beliefs, experiences, and education related to youth suicide), Clinical Scenarios (examining reactions to hypothetical pediatric clinical situations), Demographic (collecting descriptive information), and Open-Ended (exploring participant perspectives on training needs and OT roles). Current analysis includes descriptive statistics; inferential statistics (i.e., regression) will be conducted with the full sample to determine if demographic characteristics (e.g., years of experience) differentially predict youth suicide knowledge, comfort, or training. To date, participants are primarily females (87%) at the therapist level (95%) with a range of years of experience. Participants currently represent more than 30 states. The majority work primarily in schools (57%) and/or outpatient clinics (40%).
Fewer than 5% of participants correctly answered all four youth suicide statistics questions. When assessing their own knowledge about youth suicide, only 20% said they ‘agree’ or ‘strongly agree’ that their knowledge is adequate; 23% said they ‘agree’ or ‘strongly agree’ that they could recognize suicidal intentions in their clients. Only 28 participants reported that they had received suicide-focused education or training, compared with 67 who reported that they had not (the remainder were unsure). Across the different clinical scenarios, most respondents selected appropriate actions. To open-ended questions, participant responses indicated needs for education about youth suicide, training on screening techniques, clear workplace protocols, and research guidance to help increase their knowledge, comfort, and competence.
Preliminary study results point to a need for greater education and training for pediatric OT practitioners around the topic of youth suicide. Despite the finding that many practitioners identified appropriate clinical actions in the scenarios, most felt their knowledge was inadequate and were uncertain if they could identify suicidality in their clients. Impact: Our results suggest that with more educational opportunities, workplace protocols, and clarity in disciplinary roles, OT practitioners have the potential to make an impact on the growing problem of youth suicide.
Centers for Disease Control and Prevention (CDC) (2014). Data & statistics fatal injury report. Retrieved from http://www.cdc.gov/injury/wisqars/fatal_injury_reports.html
National Institute of Mental Health (NIMH) (2016). NIMH answers questions about suicide. Retrieved from https://www.nimh.nih.gov/health/publications/nimh-answers-questions-about-suicide/nimh-answers-questions-about-suicide_153553.pdf
Kashiwa, A., Sweetman, M. M., & Helgeson, L. (2017). Centennial Topics—Occupational therapy and veteran suicide: A call to action. American Journal of Occupational Therapy, 71, 7105100010. doi:10.5014/ajot.2017.023358