Jane Timmons-Mitchell

Comparing the mental health needs of female and male incarcerated juvenile delinquents

The present study was undertaken to survey the prevalence of mental disorder in juvenile justice facilities and to compare the mental health needs for females and males. Girls displayed significantly more mental health needs than boys. The estimated prevalence of mental disorder for boys was 27%, compared with 84% for girls. The difference is highly significant and is discussed in terms of service system issues in juvenile justice that affect males and females differently.

Gatekeeper Training to Prevent Suicide in the Emergency Department and in Primary Care

Applied to suicide prevention, a gatekeeper is an individual who can recognize when a person is manifesting signs of psychological distress including depression and suicidal ideation, approach and talk with that person about concerns, and if necessary, make an effective referral to mental health support services. This chapter introduces the reader to new and innovative game-based simulation technology through which primary care professionals and emergency department personnel learn to effectively manage what can be difficult gatekeeper conversations with their patients. The simulations place users in an online environment where they practice role-plays with emotionally responsive virtual patients who have memory and personality and will react like real patients at risk for suicide. It is by practicing these role-plays, and receiving feedback from a virtual coach, that users gain the knowledge, skill, and self-efficacy to successfully apply evidence-based communication strategies such as motivational interviewing to become effective gatekeepers. The chapter overviews the advantages of utilizing virtual humans in role-plays, the learning model embedded into the Kognito conversation platform that drives the simulations, and the results of two outcome studies that examine efficacy.

Psychosis and Suicide

Among the 21 million people in the world with schizophrenia, the risk of suicide is high. Some studies indicate that about ¼ of schizophrenics will attempt suicide, while others place the estimate higher. There is agreement that the time between diagnosis and engagement with evidence-based treatment for first-episode psychosis is a time of high risk for suicide. Early identification and intervention can be helpful, and protective factors can be strengthened. The chapter discusses screening and assessment instruments specific to psychosis and suicide. Connecting with treatment providers early after the discovery of psychosis is key, as is working with a psychiatrist to find the most helpful medication regimen. Evidence-based treatments are reviewed. It is recommended that patients with psychosis should be carefully monitored for suicide risk.