Preventing Suicide with Compassion: Keck Medicine’s System-Wide Approach

Psychiatrist Dr. Steven Siegel discusses how the Keck Medicine community addresses suicide prevention.

In recognition of Suicide Prevention Awareness Month, Keck Medicine of USC is featuring a blog series highlighting Keck Medicine’s approach to suicide prevention.

Suicide remains a pressing public health crisis, with nearly 50,000 deaths in the U.S. in 2023. Emily Gilbert Fialkowski, MSW, program manager for the Office of Mental Health for Keck Medicine of USC, spoke with Keck Medicine psychiatrist Steven Siegel, MD, PhD, about why suicide prevention is a shared responsibility and how Keck Medicine is responding with a system-wide framework rooted in compassion, early risk detection and evidence-based care. Dr. Siegel is the vice president of Behavioral Health at the University of Southern California, Chief Mental Health Officer for Keck Medicine of USC and chair of the Department of Psychiatry and The Behavioral Sciences at the Keck School of Medicine of USC.

People often think of suicide as only a mental health issue, but you’ve said it involves more than just mental health. Can you share why?

Dr. Siegel: Suicide rarely has a single cause. Yes, mental illness plays a role, but it isn’t the whole story. People are complex, and triggering factors such as chronic pain, overwhelming stress, grief, harassment, financial hardship and more can all play a role.

These challenges often stem from broader systemic issues, not only personal ones. That’s why suicide prevention requires more than psychiatrists and therapists. It demands a public health approach rooted in compassion, understanding and community-wide action.

How is suicide prevention addressed at Keck Medicine hospitals?

Dr. Siegel: At Keck Medicine hospitals, all admitted patients, if medically able, are screened for suicide risk by their nurse. If risk is identified, then a clinical social worker or psychiatrist conducts an assessment and collaborates with the patient on a safety plan.

What happens if a patient is at one of Keck Medicine’s medical clinics, not a hospital, and suddenly needs help?

Dr. Siegel: That’s where our Mental Health Crisis Specialists are key. These licensed clinical social workers are embedded within the Keck Medicine health system and have backgrounds spanning emergency response, inpatient psychiatry and psychotherapy. When a mental health crisis occurs, the specialist assesses the situation and gets the person connected to the right next step of care.

Some people are surprised to hear that older adults face the highest suicide rates. Can you discuss this?

Dr. Siegel: It’s true that suicide among adolescent and young adults gets a great deal of public attention, understandably so. But we also need to recognize that older adults, especially men, experience the highest suicide rates. The numbers are striking: men over 85 have the highest suicide rate of any age group, nearly four times the national average.

This population faces challenges that become more common later in life, such as chronic disease, loss of independence, social isolation and perhaps loss of a longtime partner and other family and friends. This can deeply affect a person’s outlook and overall quality of life.

As part of Keck Medicine’s focus on suicide prevention, USC Verdugo Hills Hospital, which is part of Keck Medicine, has a special focus on older adult mental health. Can you share more about what this program offers?

Dr. Siegel: The Stepping Stones Inpatient Program at USC Verdugo Hills Hospital provides a geriatric psychiatry unit. It is one of the few dedicated programs of its kind in Los Angeles County and is designed to fill a critical gap by providing specialized inpatient mental health care for this age group.

For less acute needs, USC Verdugo Hills Hospital also offers a Community Resource Center for Aging, which provides free support to help seniors connect to organizations that help with many aspects of aging, including mental health resources.

In addition, each September, USC Verdugo Hills Hospital hosts a Suicide Awareness and Prevention Conference in collaboration with the American Foundation for Suicide Prevention. Now in its 10^th year, the conference brings clinicians, researchers and community members together with the aim of reducing stigma around suicide prevention and building skills and awareness for prevention.

On a hopeful note: what makes you optimistic about progress in suicide prevention?

Dr. Siegel: I’m encouraged by the evidence that our programs are working and by hearing individual patient stories about lives improved and lives saved. I’m also grateful for the people I get to work with across all our mental health settings within Keck Medicine. Our leaders, staff, nurses, social workers and trainees bring skill and compassion to this mission. It is an honor to work alongside them here at Keck Medicine.

Resources

If you or someone you know is struggling with suicidal thoughts:

• Call or text 988 or start an online chat at 988lifeline.org for 24/7 support.
• If you are in immediate danger, call 911 or go to the nearest emergency department.

Online resources

• 988 Suicide & Crisis Lifeline
• Suicide Prevention Resource Center
• Find Support: Substance Abuse and Mental Health Services Administration

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