Risk for Suicide among Medicaid Beneficiaries

Demographic, diagnostic, and service expenditure characteristics of Florida Medicaid enrollees who died by suicide were investigated. Among persons receiving Medicaid and Supplemental Security Income (SSI), findings indicate the most powerful predictors of suicide were involuntary psychiatric examination, mental health hospitalization, and high mental health service use. Among Medicaid enrollees not receiving SSI, strongest suicide predictors were mental health hospitalization, high expenditures for physical health medications, and involuntary psychiatric examination. Findings suggest reducing involuntary psychiatric examinations and mental health hospitalizations while improving physical health may reduce suicide in the Medicaid population. Comprehensive hospital discharge planning, adherence monitoring with follow‐up care, training mental health providers in assessing suicide lethality, and providing adequate assessment time are all crucial to achieve these objectives.     

Memory in a Whiteheadian Perspective

Whitehead does not provide us with a systematic account of the various types of experience to which the word “memory” is applied. Nevertheless, he does provide us with a way of understanding the world, and living creatures who inhabit it, that places the discussion in a different context from the usual one: the diverse features of human experience that we call memory are developed forms of basic patterns of relationship that characterize all actual entities. I will first review the relevant features of Whitehead's conceptuality, then contrast the resulting view with its usual formulation, and then speculate about some forms of memory in Whiteheadian categories.     

A Call for Research: The Need to Better Understand the Impact of Support Groups for Suicide Survivors

Support groups for suicide survivors (those individuals bereaved following a suicide) are widely used, but little research evidence is available to determine their efficacy. This paper outlines the pressing public health need to conduct research and determine effective ways to identify and meet the needs of suicide survivors, particularly through survivor support groups. After describing the various approaches to survivor support groups, we explain the need for further research, despite the inherent challenges. Finally, we pose several questions for researchers to consider as they work with survivors to develop a research agenda that sheds more light on the experiences of survivors and the help provided by survivor support groups.     

Predictors of Multiple Suicide Attempts among Suicidal Black Adolescents

Psychopathology, social support, and interpersonal orientation were studied in relation to suicide attempt status in acutely suicidal, psychiatrically hospitalized Black adolescents and a matched sample of White adolescents. In the total sample, multiple attempters were differentiated by lower perceived support. Within the Black youth subsample, social comparison and positive stimulation from others differentiated multiple attempters from single attempters/ideators. Only suicidal ideation predicted multiple attempts among White youth and only higher interpersonal orientation predicted multiple suicide attempts within Black adolescents.     

The Role of Conversation in Developing Accurate Political Perceptions: A Multilevel Social Network Approach

We employed social network data from 25 randomly sampled voluntary associations to understand the factors associated with accurate perceptions of candidate preferences of group members. We analyzed relationships at the dyadic level, but also considered the overall accuracy of perceptions by each ego of all alters (“perceptiveness”) and the overall accuracy of perception by all alters of each ego (“explicitness”) regarding candidate preferences using multilevel modeling techniques. We found low levels of accuracy on average, but high variability and differential patterns of prediction of perceptiveness and explicitness. There was a strong, consistent link between the frequency of communication and accuracy both at the dyadic and aggregate levels which was moderated by the homophily of political preferences within the group.     

Modifying Dialectical Behavior Therapy for Deaf Individuals

Therapies that rely on written materials, information, or procedures involving familiarity with the dominant culture (e.g., colloquialisms, history) often pose barriers to people who use another language, have low English literacy, or are less familiar with the dominant culture. All this applies deaf individuals. One of the most well-validated mental health treatments for reducing suicidality in those diagnosed with borderline personality disorder is Dialectical Behavior Therapy (DBT; Koons et al., 2001; Linehan et al., 1999; Linehan et al., 2006; Linehan et al., 2002; Verheul et al., 2003). Unfortunately, its heavy reliance on written materials, prevalent use of metaphors, and other culture-bound characteristics make DBT inaccessible to the average deaf consumer. We describe the potential benefits that DBT could offer deaf clients, some of which are uniquely related to the life experiences and societal challenges faced by deaf people. Barriers to accessing standard DBT treatment and the materials used are described. Modifications of DBT materials and methods that we have found effective with deaf clients are detailed. It is concluded that DBT materials and methods can be successfully modified for use with this population. Available resources and additional benefits of employing DBT with deaf clients are noted.