A Review of Suicide Prevention Training Within Hematology-Oncology Fellowship Programs

• Published in: Psycho-oncology (Chichester, England) Vol. 23; p. 119
• Main Authors: Ralston, Laurel, Schuermeyer, Isabel
• Format: Journal Article
• Language: English
• Published: Chichester Wiley Subscription Services, Inc 01-02-2014
• Subjects: Cancer; Data collection; Hematology; Oncology; Prevention; Risk factors; Suicides & suicide attempts
• ISSN: 1057-9249; 1099-1611

The purpose of this study was to better understand how hematology-oncology fellowship programs increase their trainees' awareness of suicide risk management. Cancer patients are twice as likely to commit suicide as compared with the general population. In response to growing evidence that distress negatively affects cancer patient outcomes, The Commission on Cancer has mandated that providers evaluate for patient distress as a standard of care. We believe that effective distress management should also include suicide screening in patients with suicidal ideation or known suicide risk factors. In this study, we review if and how training oncology training programs are integrating risk assessment screening into their curriculum. Program directors at each of the 136 ACGME accredited hematology and oncology fellowship programs were emailed a survey link along with a brief disclosure of our research purpose. Responses were voluntary and anonymous. Survey topics addressed depression screening, suicide risk assessment and lethal means counseling. Information about the evolution and implementation of these clinical skills was also collected. We are still collecting data for this project. From what we currently know, we hypothesize that the majority of programs have not yet implemented a formalized tool or process for training fellows about screening and management of suicide risk factors. The recent requirement that all cancer patients be screened for distress may potentially lead to a natural evolution of improved suicide screening by oncology staff. Our data suggests that most oncology fellowships do not formally include this within their training curriculum. One possible solution is to amend current ACGME accreditation guidelines to include suicide prevention management as a component within the current competency of "managing pain, anxiety and depression in patients with cancer." The increased incidence of suicide in the cancer population necessitates an adequate suicide risk assessment as a component of emotional distress screening.