September 18, 2018

September is National Suicide Prevention Month and along with continuing to inform people about warning signs, Texas Children’s has recently elevated our prevention tactics with the use of the Columbia Suicide Screening Rating Scale (C-SSRS).

“Texas Children’s Hospital recognizes that our team, our system has an essential role to play in helping young people and their families who may be struggling with mental health problems and suicidal thoughts or actions,” said the Chief of Psychiatry at Texas Children’s Hospital, Dr. Laurel Williams. “Over the past 18 months our Psychiatry, Social Work, Psychology, Nursing and Pediatrician partners have been improving our assessment and care for these young people.”

According to the Columbia Lighthouse Project, C-SSRS supports suicide risk assessment through a series of simple, plain-language questions. The answers help users identify whether someone is at risk for suicide, assess the severity and immediacy of that risk, and gauge the level of support that the person needs.

Texas Children’s is currently using the C-SSRS in all three emergency rooms for all youth over the age of 11 since March 2018, and to date we have screened more than 1,700 adolescents. Individuals who screen positive are given specific treatment plans based on the level of severity, including either further assessments by our psychiatry team or our partners, Mental Health Solutions. Mental Health Solutions is an outside team of social workers who will come to our hospital emergency rooms to assist parents. Their health care teams also locate appropriate locations for inpatient psychiatric care within Houston and surrounding counties for youth needing such specialty services.

“Additionally, the inpatient teams have undergone increased training for nurses and patient sitters in order to better address mental health needs for patients with either suicidal thoughts/actions or aggressive behaviors,” Dr. Williams said. “A safety sweep checklist was developed and is employed for any young person identified as having suicidal thoughts or actions to improve the care environment for them while admitted to our care.”

Suicide is the second leading cause of death in the United States among adolescents between the ages of 15 and 24. This is more than cancer, diabetes, cardiac and neurologic diseases and yet there is still a stigma attached to suicide. Over 450,000 emergency rooms visits annually are secondary to individuals who have self-inflicted injuries.

“This screening process has allowed our team at Texas Children’s Hospital to act on the information received to intervene prior to a suicide attempt,” Williams said. “A treatment plan is also designed to avert harm and improve the patient’s mental health.”

Future plans for C-SSRS include screening other localities within our system such as specialty and general pediatric clinics in conjunction with depression screening.

Suicide is preventable and overall, mental health disorders do have effective treatments. We encourage our entire team to fight against the stigma. For those who might be experiencing suicidal thoughts we encourage everyone to consider the following resources:

  • Emergency or urgent needs – 1-800 273-TALK (8255)
  • Texas Children’s Hospital’s Psychiatry Clinic, For outpatient assessments and treatment – 832-822-3750
  • Texas Children’s Hospital Employee Assistance Program – 832-824-3327

Click here to learn more about suicide prevention. Click here to become more involved in suicide prevention awareness.

January 27, 2015


One in five Americans has a mental illness and many are reluctant to seek help or might not know where to turn for care. On top of that, the symptoms of mental illness can be difficult to detect. Even when friends and family of someone who appears to be developing a mental illness can tell that something is amiss, they might not know how to intervene or direct the person to proper treatment, which means that all too often, those in need of mental health services do not get them until it is too late.

Here at Texas Children’s we are working to build a community that is highly educated about mental illness and extremely compassionate toward those who might be experiencing it. One of the main ways we are going about creating this community is by offering a world-renowned course that helps people identify, understand and respond to signs of mental illness and substance use disorders. Called Mental Health First Aid, the 8-hour course teaches people how to help someone who is developing a mental health problem or experiencing a mental health crisis.

The course introduces participants to risk factors and warning signs of mental health concerns, builds understanding of their impact, and overviews common treatments. It uses role-playing and simulations to demonstrate how to assess a mental health crisis, select interventions and provide initial help. It also helps connect people to professional, peer and social supports as well as self-help resources.

Jill Fragoso, director of employee health and wellness, took the Mental Health First Aid course a year ago, and said it was invaluable to her professionally and personally.

“It provided me with a toolkit and an action plan that I can use if I ever find myself in a situation where I am dealing with a person with a mental disorder,” said Fragoso, who is also a registered nurse. “It also helped educate me on what is and what isn’t a mental disorder so that I can better determine how to help someone.”

Terese Walsh, senior organizational development consultant, said the course cleared up some misconceptions she had about what to say and do to support someone with a mental illness.

“I encourage everyone to take it,” she said of the course. “It was well done and provided me with valuable information.”

Mental Health First Aid was created in 2001 by Betty Kitchener, a nurse specializing in health education, and Anthony Jorm, a mental health literacy professor. Kitchener and Jorm run Mental Health First Aid™ Australia, a national non-profit health promotion charity focused on training and research. The United States is just one of the many countries that have adapted the program.

Texas Children’s Employee Assistance Program started offering the program to its employees free of charge in 2014. So far, feedback to the program “has been fantastic,” said Brent LoCaste-Wilken, program manager of the Employee Assistance Program. “Our goal is to get as many people trained as possible,” he added.

This year there will be three opportunities to take the course, the first being from 7:30 a.m. to 4:30 p.m. Tuesday, February 17, in the Pavilion for Women fourth-floor conference center. The second course will be broken up into two four-hour sessions. The first session of the second course will be from 8 a.m. to noon Wednesday, May 13. Both sessions will be held in the Pavilion for Women fourth-floor conference center. The last course will be from 7:30 a.m. to 4:30 p.m. Tuesday, August 4, in the Pavilion for Women fourth-floor conference center.

To sign up for one of the Mental Health First Aid courses, go to the Learning Academy on Connect or contact the Employee Assistance Program at Ext. 4-3327 or

March 18, 2014


We see it all the time on the news. Heartbreaking stories of tragedy when a suspect with a history of mental illness turns an ordinary day into a devastating scene. People are often left wondering what more could have been done to prevent the incident. It’s a widespread issue that’s now being tackled nationally.

Mental Health First Aid is a program that trains community members to spot and assist people who are having mental health issues or facing a mental health crisis. Texas Children’s is offering a free course for anyone interested in taking action!

“We decided to offer the class here because there were an increasing number of encounters with patients or patient families with mental illnesses,” said Brent LoCaste-Wilken, Employee Assistance Program Manager. “It was disrupting patient care or interaction with the staff.”

LoCaste-Wilken said mental health is not just a problem at Texas Children’s but the crises families often face in this setting can accentuate mental health issues. He said the class is not just for clinical staff but it can be useful for everyone.

Course participants will learn to identify mental disorders and rather than be afraid, actually help the person through the crisis and get the appropriate help. Dr. Brett Perkison, medical director of Employee Health and Wellness, said he found the course to be critical in helping recognize signs of mental distress.

“We all encounter friends and colleagues who are in a state of mind where they need help,” said Perkison. “This class helps one recognize those symptoms early. It is also useful to help take the stigma out of mental health and treat it appropriately.”

“It removes the stigma than can prevent people from giving help,” said LoCaste-Wilken.

Similar to a first aid course, the class will help identify dangers and train you in steps that can be done to help in a situation.

“It goes beyond patient care,” said LoCaste-Wilken. “It could help employees in situations with co-workers or even outside of work with friends, neighbors or anyone in the community.”

Each participant who completes the course and passes the competency is certified as a Mental Health First Aider by the National Council for Behavioral Health.

Class information:
Mental Health First Aid – click to register on Connect

1 day course (8 hours)
Friday, April 4 – 7:30 a.m. to 4:30 p.m. – Pavilion Conference Center fourth floor, Room B (F.0475.50)

2 day course (4 hours each day)
Monday, May 5 – 8 a.m. to noon – Pavilion Conference Center fourth floor, Room B (F.0475.50)
Monday, May 12 – 8 a.m. to noon – Pavilion Conference Center fourth floor, Room B (F.0475.50)