Decreasing the Risk of Suicide Among those with Chronic Invisible Illnesses
Cathy L. Pederson, Ph.D. Professor of Biology, Wittenberg University and Founder, Standing Up to POTS Kathleen Gorman-Ezell, Ph.D., LISW-S Assistant Professor of Social Work, Ohio Dominican University Jeffrey B. Brookings, Ph.D. Emeritus Professor of Psychology, Wittenberg University Chronic Invisible Illnesses • Chronic illnesses: Prolonged, don’t resolve spontaneously, and are rarely cured completely –Debilitating, but not fatal • Invisible: Lack of diagnostic tests –Blood tests normal –Urine tests normal –MRI, CT, ultrasounds normal •Found predominantly in women
https://upload.wikimedia.org/wikipedia/commons/e/ee/Vacutainer_blood_bottles .jpg
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Chronic, Invisible Illness: Postural orthostatic tachycardia syndrome (POTS) • 500,000 to 3 million cases in US • 75% cases in women age 15-50 • ~ 1 million teens have POTS • Dysfunction of autonomic nervous system that affects • Heart rate tachycardia • Blood vessel diameter blood pooling, dizziness, headaches • Pupil diameter light sensitivity http://standinguptopots.org/learning/pots-causes • Food movement gastroparesis • Body temperature hot flashes, Up ® Standing To POTS chills Raising awareness for Postural Orthostatic Tachycardia Syndrome Chronic, Invisible Illness: Myalgic encephalomyelitis and chronic fatigue syndrome • 1 million cases in US – Most often in adult women • Symptoms – Unrefreshing sleep fatigue – Headaches – Loss of memory/concentration – Enlarged lymph nodes – Unexplained muscle/joint pain – Extreme exhaustion more than 24 http://bigeddyfilmfest.com/unrest/ hours after physical or mental Up ® exercise Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Chronic, Invisible Illness: Ehlers-Danlos Syndrome • Genetic condition - 13 types – 1 in 5,000 people have EDS • Disrupts connective tissue – Loose joint articulation subluxations, dislocations – Soft, velvety skin stretchy, bruising, abnormal scarring – Tearing of blood vessels internal bleeding, organ rupture http://nimbusmassage.com/2018/05/01/massage-ehlers-danlos-syndrome/ (particularly vascular type) Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Chronic, Invisible Illness: Fibromyalgia • ~4 million people in US – 75-90% are adult women • Symptoms – Widespread pain > 3 months • Both sides of body • Above and below waist – Fatigue https://prsrehabservices.com/patcenter/articles/dry-needling-fibromyalgia/ – Cognitive difficulties • Trouble concentrating Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Chronic Invisible Illness: Lyme Disease •~ 300,000 diagnosed annually •Symptoms of chronic Lyme –Severe headaches
–Dizziness http://www.michiganradio.org/post/its-tick-season-again-heres-what-you-should-look-out –Problems with short term memory –Neck stiffness –Facial palsy –Rashes –Arthritis –Intermittent pain in tendons, muscles, joints and bones https://www.bayarealyme.org/blog/lyme-disease-bullseye-rash/ Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Information from https://www.cdc.gov/lyme/ Common Symptom of Chronic Illness: Chronic Pain • Prevalent in • Ehlers-Danlos syndrome (EDS) • Fibromyalgia • Lyme disease • Myalgic encephalomyelitis, chronic fatigue syndrome (ME, CFS) • Postural orthostatic tachycardia syndrome (POTS)
https://www.7ad.com.au/martin-agatyn/martins-interviews/83430- • Chronic pain health-matters-july-23-chronic-pain – Interferes with activities of daily living – Increases suicide ideation and attempts1,2 1. Legarreta, M., Bueler, E., DiMuzio, J., McGlade, E., & Yurgelun-Todd, D. (2018). Suicide behavior and chronic pain: An exploration of pain-related catastrophic thinking, disability, and descriptions of Up the pain experience. J Nerv Ment Dis, 206(3), 217-222. ® 2. Racine, M. (2017). Chronic pain and suicide risk: A comprehensive review. Prog Standing To POTS Neuropsychopharmacol Biol Psychiatry, pii: S0278-5846(17)30467-0, 1-12. Raising awareness for Postural Orthostatic Tachycardia Syndrome Common Symptom of Chronic Illness: Chronic Pain • Neuropathic pain – Shooting – Stabbing – Burning https://dfzljdn9uc3pi.cloudfront.net/2013/37/1/fig-1-full.png – Stinging • Headaches • Abdominal pain • Chest pain • Joint pain • Pain is self-reported http://img.medscape.com/thumbnail_library/dt_150916_chronic_pain_headache_migr – No good diagnostic tool aine_800x600.jpg Up ® – Not objectively quantified Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Common Symptom of Chronic Illness: Sleep Disturbance • Decreased sleep efficiency • Insomnia • Nightmares
• Can be related to: – Pain – Sympathetic surges http://www.reilycenter.com/wp-content/uploads/blogs/sleep.jpg – Lack of exercise – Poor sleep hygiene – Increased risk of suicide1 Up 1. Pederson, C. L., & Brook, J. B. (2017). Sleep disturbance linked to suicidal ideation in postural ® orthostatic tachycardia syndrome. Nat Sci Sleep, 9, 109-115. Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Common Symptom of Chronic Illness: Fatigue • Unrelenting exhaustion not relieved by rest – Not the same as being tired • Reduces – Energy – Motivation – Concentration
– Emotional wellbeing http://standinguptopots.org/ • Often the most debilitating symptom of chronic illness Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Common Symptom of Chronic Illness: Depression • Link between chronic medical illness and depression – Heart disease – Cancer – Other well understood illnesses • 50 % of people with chronic pain are depressed1
https://mydiaryofaquarterlifer.wordpress.com/2017/02/24/is-there- • 35% of those with POTS reported such-a-thing-as-part-time-depression/ severe to extreme depression2
1. Nicholas, M. (2011). Depression in people with pain: There is still work to do. Scandinavian Journal of Pain, 2(2), 45-46. 2. Pederson, C. L., & Brookings, J. B. (2018). Suicide risk linked with perceived Up ® burdensomeness in postural tachycardia syndrome. Journal of Health Science & Education, Standing To POTS 2(1), 1-8. Raising awareness for Postural Orthostatic Tachycardia Syndrome Chronic Illness Significantly Impairs Quality of Life
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•Problems with 30
–General health 25 –Sleep 20
15 POTS Mean –Brain fog perDays month 10 Control Mean –Bodily pain 5 •Neuropathic pain 0 •Migraine headaches •Abdominal pain •Muscular and joint pain Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural –Physical and social functions tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81.
Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural Up tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81. ® Schmaling, K. B., & Betterton, K. L. (2016). Neurocognitive complaints and functional status among Standing To POTS patients with chronic fatigue syndrome and fibromyalgia. Qual Life Res, 25(5), 1257-1263. Raising awareness for Postural Orthostatic Tachycardia Syndrome Chronic Illness Significantly Impairs Quality of Life
•Significant minority (30% with POTS) require help with activities of daily living –Eating –Bathing –Brushing teeth/hair –Dressing –Moving around house
https://www.advancedrm.com/measuring-adls-to-assess-needs-and-improve-independence/
Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in Up ® postural tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81. Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Challenges for the Chronically Ill • Lack of quality medical care – Difficult to diagnose – Difficult to treat – Best case: manage symptoms well • Physical barriers – Decreased mobility – Poor memory – Confusion – Poor quality of life • Financial pressures from – Medical bills
– Medication http://standinguptopots.org/learning/pots-symptoms – Inability to work Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Challenges for the Chronically Ill • Stigma – Not really sick, “all in your head” The picture can't be displayed. – Symptoms from psychological rather than physical problems • Grieving the loss of a healthy body • Feelings of isolation and loneliness • Struggling to find a new role in school, work, and relationships
• Loss of hope http://www.nerdgirl.com/wp-content/uploads/2013/03/ 480628_571779489523061_818166877_n.jpg • Perceive themselves as a burden – Feel judged – Withdrawal of love and/or support Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Risk Factors for Suicide • Major physical illness • Sense of isolation • Hopelessness • Job or financial loss • Loss of relationships • Lack of good health care • Stigma with asking for help • Easy access to lethal means • History of trauma or abuse • Previous suicide attempt https://www.thefyi.org/risk-factors-for-suicide-infographic/ • Family history of suicide or knowing
others who died by suicide Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome The Problem: Elevated Suicide Risk • Increased risk of suicide documented for – Myalgic encephalomyelitis, chronic fatigue syndrome • Second leading cause of death1 • 20% of ME, CFS patients die by suicide2 – Postural orthostatic tachycardia syndrome • 48% with POTS were at high risk for suicide • 15% had attempted suicide3 – Fibromyalgia • 33% with fibromyalgia experience suicidal ideation4 – Hypermobile EDS • 4% had attempted suicide5 – Lyme disease • 1,200 deaths by suicide chronic Lyme6
1. Jason, L. A., Corradi, K., Gress, S., Williams, S., & Torres-Harding, S. (2006). Causes of death among patients with chronic fatigue syndrome. Health Care Women Int, 27(7), 615-626. 2. Smith, W. R., Noonan, C., & Buchwald, D. (2006). Mortality in a cohort of chronically fatigued patients. Psychol Med, 36(9), 1301-1306. 3. Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural tachycardia syndrome. Clinical Autonomic Research, 27(2), 75- 81. Up 4. Triñanes, Y., González-Villar, A., Gómez-Perretta, C., & Carrillo-de-la-Peña, M. T. (2015). Suicidality in chronic pain: predictors of suicidal ideation in ® fibromyalgia. Pain Pract, 15(4), 323-332. 5. Cederlöf, M., Larsson, H., Lichtenstein, P., Almqvist, C., Serlachius, E., & Ludvigsson, J. F. (2016). Nationwide population-based cohort study of psychiatric Standing To POTS disorders in individuals with Ehlers-Danlos syndrome or hypermobility syndrome and their siblings. BMC Psychiatry, 16, 207. Raising awareness for Postural Orthostatic Tachycardia Syndrome 6. Bransfield, R. C. (2017). Suicide and Lyme and associated diseases. Neuropsychiatr Dis Treat, 13, 1575-1587. Why Increased Suicide Risk? • Physical illness1 or multiple illnesses2 • Chronic invisible illness3 • Functional disability4 – Require help with activities of daily living, i.e. eating, bathing, moving around • Chronic pain5 –Neuropathic pain
–Migraine headaches or abdominal pain http://images.wisegeek.com/bedridden-woman.jpg • Sleep disturbance6
1. Cheung, G., & Sundram, F. (2017). Understanding the progression from physical illness to suicidal behavior: A case study based on a newly developed conceptual model. Clin Gerontol, 40(2), 124-129. 2. Ahmedani, B. K., Peterson, E. L., Hu, Y., Rossom, R. C., Lynch, F., Lu, C. Y., . . . Simon, G. E. (2017). Major physical health conditions and risk of suicide. Am J Prev Med, 53(3), 308-315. 3. Pederson, C. L. (2018). The importance of screening for suicide risk in chronic invisible illness. Journal of Health Science & Education, 2(4), 1-5. 4. Fässberg, M. M., Cheung, G., Canetto, S. S., Erlangsen, A., Lapierre, S., Lindner, R., . . . Wærn, M. (2016). A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging Ment Health, 20(2), 166-194. 5. Nicholas. 2011. Depression in people with pain: There is still work to do. Scandinavian Journal of Pain 2(2): 45-46. 6. Pederson, C. L., & Brook, J. B. (2017). Sleep disturbance linked to suicidal ideation in postural orthostatic tachycardia syndrome. Nat Sci Sleep, 9, 109-115. Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Is Suicide Linked with Depression in Chronic Illness? •Many with chronic illness have no mental health diagnosis1 •Suicidal ideation response to suffering •Mechanism to permanently relieve distress2 •Life weariness3 •Negative treatment by healthcare 4 practitioners https://www.healthline.com/health/depression/talking-about-depression-at-wor
1. Ahmedani, B. K., Peterson, E. L., Hu, Y., Rossom, R. C., Lynch, F., Lu, C. Y., . . . Simon, G. E. (2017). Major physical health conditions and risk of suicide. Am J Prev Med, 53(3), 308-315. 2. Alderson, S. L., Foy, R., Glidewell, L., McLintock, K., & House, A. (2012). How patients understand depression associated with chronic physical disease--a systematic review. BMC Fam Pract, 13, 41. 3. Newton-John, T. R. O. (2014). Negotiating the maze: Risk factors for suicidal behavior in chronic pain patients. Up Current Pain and Headache Reports, 18(9), 1-7. ® 4. Jason, L. A., Corradi, K., Gress, S., Williams, S., & Torres-Harding, S. (2006). Causes of death among patients with Standing To POTS chronic fatigue syndrome. Health Care Women Int, 27(7), 615-626. Raising awareness for Postural Orthostatic Tachycardia Syndrome Is Suicide Linked with Depression in Chronic Illness? • Must be diagnosed carefully – Most depression screenings include questions about physical symptoms • Chronic illness symptoms artificially increase depression scores – Overlapping symptoms, including changes in • Appetite • Weight • Sleep • Fatigue • Ability to work • Worry about health https://medworksmedia.com/product/zung-self-rating-depression-scale/ • Interest in sex Up ® Standing To POTS Pederson, C., Gorman-Ezell, K., & Mayer, G. (2018). Assessing depression in those who are chronically Raising awareness for Postural Orthostatic Tachycardia Syndrome ill. Counseling Today, 60(9), 38-43. Why Increased Suicide Risk?
The picture can't be displayed. •Interpersonal theory of suicide –Perceived burdensomeness •Feeling like a burden to family and friends •97% of POTS patients limited by illness1 –30% need help with basic personal care https://miamioh.edu/cas/academics/departments/psychology/ –25% can’t work or attend school •Elevated in chronic pain patients2 –Low belongingness •Feeling that you don’t belong in a social group •71% of POTS patients reported low belongingness1 •76% reported high/very high levels of loneliness1 –Physical limitations https://positivitypost.com/isolation-and-loneliness-pose- –Different life experiences dangerous-health-threat/
1. Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural Up tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81. ® 2. Kanzler, K. E., Bryan, C. J., McGeary, D. D., & Morrow, C. E. (2012). Suicidal ideation and Standing To POTS perceived burdensomeness in patients with chronic pain. Pain Practice, 12(8), 602-609. Raising awareness for Postural Orthostatic Tachycardia Syndrome Why Increased Suicide Risk?
•Perceived burdensomeness –May be more important suicide risk factor than •Low belongingness1, 2 •Loneliness1, 3 1 •Depression http://www.klein-kraepelin.com/
1. Pederson, C. L., & Brookings, J. B. (2018). Suicide risk linked with perceived burdensomeness in postural tachycardia syndrome. Journal of Health Science & Education, 2(1), 1-8. 2. Zullo, L., Horton, S., Eaddy, M., King, J., Hughes, J., Diederich, A., . . . Stewart, S. (2017). Adolescent insomnia, suicide risk, and the interpersonal theory of suicide. Psychiatry Res, 257, 242-248. Up 3. Van Orden, K. A., Cukrowicz, K. C., Witte, T. K., & Joiner Jr., T. E. (2012). Thwarted ® belongingness and perceived burdensomeness: Construct validity and psychometric properties Standing To POTS of the Interpersonal Needs Questionnaire. Psychological Assessment, 24(1), 197-215. Raising awareness for Postural Orthostatic Tachycardia Syndrome Honing your Skills in Small Groups
• Thinking about chronic illness The picture can't be displayed. –What questions would you ask to detect chronic illness? • What symptoms would you be most concerned about? –How would you refer them if you
https://docs.google.com/presentation/d/1tWBOpYfo94bP7CkOE5S suspect a chronic illness? WlHa5riWJP0T48Cld-BP_G-U/edit#slide=id.g16891fd0eb_0_1 • What is an appropriate referral? • What barriers must be overcome?
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Accessibility for the Chronically Ill
• Office The picture can't be displayed. • Home based therapy • Community Psychiatric Supportive Therapy • Alternative –Teletherapy –Online therapy https://tex.org/wp-content/uploads/2014/08/Social-Worker-Day-1.jpg –Others?
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Decreasing the Risk of Suicide
• Of those who attempt suicide – 64% visited healthcare practitioner The picture can't be displayed. in previous month – 38% visited the previous week1 • Actively screen chronically ill patients for suicidal thoughts – Online questionnaires https://blog.medmee.org/the-relationship-between-health-care- professionals-and-patients-consumers-varies-from-region-to- – Ask during appointment b04391e6f5e6
1. Ahmedani, B. K., Stewart, C., Simon, G. E., Lynch, F., Lu, C. Y., Waitzfelder, B. E., . . . Up Williams, K. (2015). Racial/Ethnic differences in health care visits made before suicide ® attempt across the United States. Med Care, 53(5), 430-435. Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Decreasing the Risk of Suicide • Practice compassionate care – BELIEVE patients when they talk about their illness • Recent studies show physical anomalies for – Myalgic encephalomyelitis, CFS1 The picture can't be displayed. – Lyme disease2 – POTS3 – LISTEN without judgment – BE GENUINE in your concern https://woundcareadvisor.com/compassionate-care-the- – INSTILL HOPE for the future crucial-difference-for-ostomy-patients_vol2-no5/ – EXPRESS CONFIDENCE in their ability to make good decisions 1. Loebel, M., Grabowski, P., Heidecke, H., Bauer, S., Hanitsch, L. G., Wittke, K., . . . Scheibenbogen, C. (2016). Antibodies to β adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome. Brain Behavior and Immunity, 52, 32-39. 2. Strle, K., Sulka, K. B., Pianta, A., Crowley, J. T., Arvikar, S. L., Anselmo, A., . . . Steere, A. C. (2017). T-Helper 17 cell cytokine responses in Lyme disease correlate with Borrelia burgdorferi antibodies during early infection and with autoantibodies late in the illness in patients with antibiotic-refractory Up Lyme arthritis. Clin Infect Dis, 64(7), 930-938. ® 3. Ruzieh, M., Batizy, L., Dasa, O., Oostra, C., & Grubb, B. (2017). The role of autoantibodies in the Standing To POTS syndromes of orthostatic intolerance: a systematic review. Scand Cardiovasc J, 51(5), 243-247. Raising awareness for Postural Orthostatic Tachycardia Syndrome Decreasing the Risk of Suicide
•Identify suicidal thinking in The picture can't be displayed. early stages to give time for –Medications and other treatment –Counseling –Improving relationship dynamics
•Decreasing feelings of https://listovative.com/top-10-reasons-why-socializing-is-very- burdensomeness important/ •Increasing socialization via text, phone, or home visits
Up ® Pederson, C. L. (2018). The importance of screening for suicide risk in chronic invisible illness. Journal Standing To POTS of Health Science & Education, 2(4), 1-5. Raising awareness for Postural Orthostatic Tachycardia Syndrome Confronting Invisible Illness Therapeutically • Treat the psychological aspects of chronic pain –Person Centered Care –Strong Therapeutic Alliance –Openness to Learn about Illness –Accessible Care – Therapy Approaches •Mindfulness based stress reduction
https://cdn1.msw.usc.edu/content/49ca7068212b42febfbe56285d2c918a •Cognitive behavioral therapy /178478211-400x266.jpg •Acceptance and commitment therapy •Dialectical behavioral therapy
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Confronting Invisible Illness Therapeutically • Decrease the Loneliness, Perceived Burdensomeness, and Hopelessness –Supportive Listening –Understanding Grief –Psycho-Educational Information –Support Groups • Online • Community –Therapy • Group Therapy http://www.firstchoiceforwomen.org/services/options-counseling/ • Family Therapy Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Collaborative Assessment and Management of Suicidality (CAMS) • Problem focused clinical intervention to target and treat suicidal “drivers” • Enhance therapeutic alliance – Suicide-specific assessment – Suicide-specific treatment planning Tracking of ongoing risk – http://ct.counseling.org/wp-content/uploads/2016/05/0001-245393381.jpg – Clinical outcomes and dispositions Up ® Standing To POTS • Uses Suicide Status Form Raising awareness for Postural Orthostatic Tachycardia Syndrome Collaborative Assessment and Management of Suicide (CAMS) • Understand the function of suicidal thoughts • Help determine ways to decrease suicidal thoughts • Be clear that suicide prevention is the goal • Review limitations of https://pbs.twimg.com/media/Bh7qvnNCUAAea9f.jpg confidentiality and potential for hospital admission openly (Jobe, 2009) Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Collaborative Assessment and Management of Suicide Approach • Initial Assessment • Ongoing Assessments –Suicidal Ideation –Suicide Plan
https://studenthealth.ucsf.edu/sites/studenthealth.ucsf.edu/files/migrate/images/counseling- –Suicide Intent services.jpg –Suicide risk decreases when three sessions without Suicidal ideation, Plan, or Intent • Final Assessment
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Applying the CAMS Approach to People with Invisible Illnesses • Does the individual feel that they have any control over their condition or treatment plan? • How does the thought of suicide provide comfort? • Does the individual feel that assessment and treatment planning occur in a collaborative and non-judgmental manner?
Link to CAMS
https://www.conncoll.edu/media/header-images/student-experience/health-safety-and- counseling/counseling-header.jpg
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Limitations of CAMS for Chronic Illness Community •Requires multiple sessions for administration •Clinician must understand physical symptoms of chronic illness(es) •Low belongingness among
chronic illness community https://depauliaonline.com/35318/news/invisible-illnesses-the- challenge-of-caring-for-students-living-with-chronic-illness/ differs from traditional social isolation Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Rationale for the Suicide Screening Tool – Chronic Illness •Elevated rate of suicide for those with chronic illness •No measures exist to assess suicidal ideation in members of the chronic invisible illness communities •Eliminate questions related to https://www.supportisp.org/ physical illness which would falsely elevate risk Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Rationale for the Suicide Screening Tool – Chronic Illness
•Address specific risk factors for this population –Perceived Burdensomeness –Loneliness –Hopelessness •Administration that could be
https://www.researchgate.net/publication/50268793_Suicides_in_Late_ done in one visit across settings Life/figures?lo=1&utm_source=google&utm_medium=organic
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Suicide Screening Tool – Chronic Illness
•Full survey is 14 questions •Currently in press at Measurement and Evaluation in Counseling and Development
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Chronic Invisible Illness Example
Unrest coverage of Jennifer Brea
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Honing your Skills in Small Groups • How would you broach suicide even if person not depressed? • How would you assess risk factors linked to chronic illness? –Perceived burdensomeness? –Sleep disturbance? –Hopelessness? –Chronic pain? http://30got1mo77p8zm7180t9tf2p.wpengine.netdna-cdn.com/wp- –Loneliness? content/uploads/2015/08/social-worker-700x357.jpg • When would you feel the need to refer to a higher level of care? Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Decreasing the Risk of Suicide • Support Caregivers of the Chronically Ill • Caregivers can develop – Compassion fatigue – Burnout – Isolation • Empower caregivers to – Guard their own health
http://www.caregivingcafe.com/blog/wp-content/uploads/2014/03/BLOG-Male- – Find a support group Caregiver.jpg – Learn psycho-educational information about specific condition
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome Call to Action • Consider the possibility of an invisible illness • Assess suicidal ideation • Educate the family/friends • Empower caregivers • Listen and try to understand • Funding and coverage for comprehensive treatments http://medsin.org/public/images/diagram.png • Access to health insurance, Social Security, and Disability
Up ® Standing To POTS Raising awareness for Postural Orthostatic Tachycardia Syndrome