Detractors fear setting a precedent; supporters say
benefits outweigh the cost

By Christopher Lopaze, WNPA Olympia News Service

Warning signs for suicide • Talking about wanting to kill themselves, or saying they wish they were dead • Looking for a way to kill themselves, or talking about a specific suicide plan • Feeling hopeless or having no reason to live • Losing interests in things or inability to experience pleasure • Becoming socially isolated or withdrawn from family, friends and others • Acting irritable or agitated Source: American Foundation for Suicide Prevention<>/i>

Warning signs for suicide

• Talking about wanting to kill themselves, or saying they wish they were dead

• Looking for a way to kill themselves, or talking about a specific suicide plan

• Feeling hopeless or having no reason to live

• Losing interests in things or inability to experience pleasure

• Becoming socially isolated or withdrawn from family, friends and others

• Acting irritable or agitated

Source: American Foundation for Suicide Prevention

OLYMPIA — Suicide is a leading cause of death in Washington, especially for veterans, and now lawmakers are considering an expansion for mandatory suicide-prevention training.

Jennifer Stuber’s husband, Matt Alder, died by suicide in 2011, leading to the Matt Alder Suicide Assessment, Treatment, and Management Training Act of 2012, which first mandated training for certain health-care professions.

After her husband’s death, Stuber, an assistant professor at the University of Washington School of Social Work, started Forefront, a suicide prevention advocacy group based at the university.

In testimony at the House Health Care and Wellness Committee last week, she said the idea that doctors and nurses don’t want to spend six hours every six years is “truly a personal insult. It says to me, my husband’s life isn’t worth a small amount of their time.”

The expansion includes chiropractors, physical therapists, licensed practical nurses, and physicians, and would now affect a total of 148,380 licensed practitioners, according to the Department of Health.

According to the American Foundation for Suicide Prevention, 45 percent of those who died by suicide sought help from primary-care providers within the month before their death.

“This bill is about saving lives,” said Rep. Tina Orwall, D-Des Moines, the main sponsor of House Bill 2315. “And I think it will.”

Proponents of the bill said the mandate is necessary because voluntary training has not worked, while opponents said health-care professionals should have the ability to choose their educational opportunities.

Mary Langley with the Association of Advanced Practice Psychiatric Nurses said she was concerned the bill would establish precedent for the state setting training requirements. She said practitioners should be able to choose their continuing education based on their learning needs.

Doris Visaya, a member of the Home Care Association of Washington, said they support suicide-prevention education and training, but not the mandate. She said the cost of providing this additional training wouldn’t be the best use of resources because training is already available.

“Increased regulations adds increased costs,” she said.

High suicide rate

The Washington State Department of Health listed death by suicide as the eighth-leading cause of death in the state in 2011, which is higher than the national rate. The Suicide Prevention Resource Center said 60 to 90 percent of those who died by suicide had a diagnosable medical disorder or a substance-abuse problem.

When you go to a health-care professional with a problem, “you expect and hope they can fix it, and their training and their education prepared them,” said Paul Quinnet, a clinical psychologist and founder of Washington state-based QPR Institute, which offers training to the public and professionals. QPR stands for the question, persuade, and refer method developed by Quinnet as an intervention tool for mental-health emergencies.

Quinnet supports the mandate. He said it’s important for health-care professionals to be able to choose their continuing education, but most have elected not to take this type of training.

John Osborn, a physician at the Spokane Veteran Affairs Medical Center, said he never received formal training in suicide prevention in his 27 years providing care for veterans or during medical school. He said the requirement would not be “unduly burdensome.”

“House Bill 2315 is an important step for Washington state given what is at stake,” Osborn said.

Veterans are a high-risk population, and male veterans have a two times higher rate of death by suicide than the general population. More than 60,000 troops from Washington state are deployed on active duty, and 607,000 veterans live in Washington.

The bill also requires the state Secretary of Health to develop a statewide suicide-prevention plan, and for DSHS and the Health Care Authority to develop a plan for an adult psychiatric pilot program, including the design and cost of the program that would support primary-care providers in assessment and treatment of mental- and behavioral-health disorders.

Orwall said the bill has a strong chance to pass through committee and the House, but could hit an impasse in the Senate because of the mandate.

The National Suicide Prevention Lifeline phone number is 1-800-273-TALK (8255).