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Science Policy Around the Web – May 18, 2018

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By: Patrick Wright, Ph.D

Suicide Prevention

Gaps Remain in U.S. State Policies on Suicide Prevention Training

Suicide is the 10th leading cause of death in the United States, with 45,000 people dying by suicide in 2016 according to the Centers for Disease Control and Prevention. Despite this, there is not a universal requirement or standard of suicide prevention training across states, especially among healthcare professionals, according to a recent study in the American Journal of Public Health (AJPH) that aimed to assess the effectiveness of national guidelines by the U.S. Surgeon General and National Action Alliance for Suicide Prevention released in 2012. Given the proximity and dynamic at the healthcare professional-patient interface, clinicians and mental health experts are in a unique, critical position to explicitly tackle suicide in at-risk individuals. As of October 2017, all 50 states had a suicide prevention plan, but only 10 states—California, Indiana, Kentucky, Nevada, New Hampshire, Pennsylvania, Tennessee, Utah, Washington, and West Virginia—require healthcare professionals to complete suicide prevention training and intervene with appropriate intervention. Policies in seven states only encourage training, but do not require it. Even the duration and frequency of training varies extensively.

Jane Pearson, chair of the National Health Suicide Research Consortium, stated “When there’s someone in crisis you have to gather information very quickly and if you’re not asking the exact right questions you can miss someone’s intentions. The most pressing goal is to increase the person’s will to live so it’s greater than their will to die and buy time to get past the crisis, so they have a chance to work on problem solving.” Earlier work has shown that a majority of people who attempt suicide have seen a healthcare professional in the weeks and months prior to their suicide attempt, emphasizing the significance of potential opportunity in these healthcare professional-patient interactions.

The 2012 National Strategy for Suicide Prevention created by the Office of the U.S. Surgeon General and the National Action Alliance for Suicide Prevention outlined four strategic directions, including creating “supportive environments that will promote the general health of the population and reduce the risk for suicidal behaviors and related problems”, developing and implementing clinical and community-based preventive programs, providing treatment and care for high-risk patients, and surveying and evaluating suicide and its prevention nationwide.

Washington was the first state to mandate suicide assessment, treatment, and management training for healthcare providers, through the Matt Adler Suicide Assessment, Treatment, and Management Act of 2012 (House Bill 2366), with the state defining suicide assessment, treatment, and management training as one “of at least six hours in length that is listed on the Best Practices Registry of the American Foundation for Suicide Prevention and the Suicide Prevention Resource Center including, but not limited to: Applied suicide intervention skills training; assessment and management of suicide risk; recognizing and responding to suicide risk; or question, persuade, respond, and treat.”

The AJPH study poses that ensuring that suicide prevention training is disseminated universally among health care professionals is not limited only to legislation; accrediting bodies (e.g. American Psychological Association) share this burden in guaranteeing that graduates are prepared to identify and aid patients who may be at risk for suicide. The study concludes, “Better equipping health care professionals to assess and provide care to patients at risk for suicide may contribute to a meaningful decline in the rate of suicide across the nation, and it is the responsibility of policymakers, health care professionals, and citizens to advocate change.”

(Cheryl Platzman Weinstock, Reuters)

Animal Welfare

Animal Tests Surge Under New U.S. Chemical Safety Law

The Frank R. Lautenberg Chemical Safety for the 21st Century Act of 2016 (H.R. 2576) amended the 1976 Toxic Substances Control Act (TSCA) (S. 3149), the primary chemicals management law in the United States, to require the Environmental Protection Agency (EPA) to “minimize, to the extent practicable, the use of vertebrate animals in testing chemicals” and states “Any person who voluntarily develops information under TSCA must first attempt to develop the information by an alternative or nonanimal test method or testing strategy before conducting new animal testing.” It required the EPA to explicitly develop a strategic plan to promote the development and implementation of alternative test methods that do not require the use of animals. However, despite the goals of the Lautenberg Chemical Safety Act, there has reportedly been a recent increase in the number of animal tests and requested or required by the EPA.

In March 2018, the EPA released a draft of its strategic plan for public comment of their proposed long-term strategy for increasing the use of animal research alternatives, including computer modeling, biochemistry, and cell culture approaches. In response, People for the Ethical Treatment of Animals (PETA) and the Physicians Committee for Responsible Medicine (PCRM) quantified the number of EPA, TSCA-related animal tests and animals used over the last three years. They found that the number of animal tests requested or required by the EPA increased substantially last year, with the total number of tests and animals involved in testing jumping more than an order magnitude, from approximately 6500 across 37 rests required or requested to over 75000 animals across 331 tests. They issued a response letter, stating “The dramatic increase we have documented indicates that EPA is failing to balance its responsibilities to determine whether chemicals present unreasonable risks with its Congressional mandate to reduce and replace the use of vertebrate animals in chemical testing.”

Unfortunately, the underlying cause for this trend is not known. It is possible that the Lautenberg Chemical Safety Act’s stricter requirements on a larger range of chemicals compared to the original TSCA may be driving additional testing and subsequent data collection in order to comply. Moreover, Kristie Sullivan, PCRM’s vice president of research policy, said that EPA staff may need more training and funding of animal research-alternatives and “to stay abreast of new developments in toxicology, so that they can quickly incorporate new methods and kinds of data into their decision-making process.”

In contrast, implementation may be slow due to the EPA’s need to adequately pursue alternatives while adapting to the new law. Daniel Rosenberg, an attorney with the Natural Resources Defense Council, emphasized the importance of taking whatever time is necessary to validate alternative testing strategies: “We need to ensure that the alternative testing methods that are implemented are able to actually identify toxicity, exposure and potential adverse effects of chemicals.”

The comment period on EPA’s draft strategy for reducing animal tests closed earlier this month, with the agency required to release its final plan by the end of June 2018.

(Vanessa Zainzinger, Science)

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Written by sciencepolicyforall

May 22, 2018 at 7:31 pm

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