Serving Those Who Served

have a gaming feature with a chat component that breaks the ice for conversations with other teens who share what they’re going through.

A third group will use both approaches. Sheftall says she hopes nontraditional methods for a tech-savvy generation will open new doors.

“We know rates of suicide among adolescents and even younger [children] have been increasing drastically over the last decade. That’s why I keep doing the work I do,” she says.

Center faculty also research suicide risk in midlife, focusing on addiction struggles, sleep problems, and language and cultural isolation. Wilfred Pigeon, PhD, a professor of Psychiatry and former executive director of the VISN2 Center of Excellence for Suicide Prevention at the Canandaigua VA Medical Center, looks at suicide risk and prevention through the lens of sleep disturbance.

Kenneth Conner, PsyD, MPH, professor of Emergency Medicine, led a team studying a brief intervention for use with individuals with alcohol or drug use problems who have been hospitalized following a suicide attempt. He is also developing projects to prevent unintentional drug overdose. (See story below.)

The Veterans Administration calls veteran suicide prevention its highest clinical priority. In 2020, the suicide rate for veterans was 57 percent higher than for non-veteran U.S. adults, adjusting for population, age, and gender differences. Nearly 6,200 veterans took their own lives that year.

Since 2007, when Eric Caine, MD, helped shape the VISN2 Center of Excellence for Suicide Prevention at the Canandaigua VA Medical Center, CSPS investigators have been deeply involved in studying the issue. Today their work is a national resource.

Most of the VA faculty have URMC appointments; the junior investigator training programs of both centers work closely together. Several former executive directors of the VISN2 Center have roots at URMC, including current Executive Director Stephanie Gamble, a former postdoc fellow, and Professor Wilfred Pigeon, PhD.

Again, the work is ambitious in scope. Studies and interventions seek to reduce suicide risk through a veterans’ crisis line, pain management, violence prevention, and help with depression, sleep disorders, PTSD, and injuries.

Greater social connection is a crucial factor in healthy aging, and many studies show disconnection is a public health concern. As a mortality risk, it’s as big as obesity, physical inactivity, alcohol misuse, and smoking.

Van Orden studies interventions that will foster connection among older adults. She and Conwell have tested community-based social services designed to encourage more social connection in later life, including a peer companionship program called The Senior Connection and volunteering with AmeriCorps Seniors. The team has also developed a brief psychotherapy intervention that Silva is adapting for Spanish speakers at risk for suicide.

A key benefit of how the Medical Center functions is the interplay between research and clinical work.

“URMC is a world leader in the collection of patient-reported outcomes, including depression, as part of routine clinical care,” Van Orden says. It’s a matter of capitalizing on URMC’s “infrastructure and expertise—as both a laboratory for studying suicide prevention efforts as well as a means to optimize the quality of care for patients in UR Medicine.”

Diverse in Many Ways

The Center’s reach into diverse populations includes Black and Hispanic youth and adults and the Deaf community.

Deaf and Hard of Hearing people are at greater risk of suicide than the general population. They have higher rates of severe mental health issues and, at the same time, are more likely to mistrust the health care system and so are less likely to receive treatment.

Aileen Aldalur, PhD senior instructor of Psychiatry, is working on ways to more easily connect Deaf and Hard of Hearing people to mental health services. The CBT intervention she is adapting uses videophone or Zoom technologies that are more accessible.

Sheftall is particularly interested in a concerning rise in suicide rates among Black teens and children. Her research has shown that five- to twelve-year-olds who are Black are twice as likely to take their own lives than are their white counterparts. And in 2020, suicide was tied for the No. 1 cause of death among Black girls ages 12 to 14.

“I think this information is something people are not aware of,” she says. “It’s just not out there.”

And it’s difficult for society to solve a problem that isn’t even known. So Sheftall’s research has been raising awareness. She has made