Active intervention for suicide prevention at a Caribbean Medical School

A retrospective 17-year analysis at Ross University School of Medicine, Dominica, of clinical cases of the counseling service, revealed that there were no recorded cases of suicides. Eighty-two students over the period 2000 to 2017 who were high risk for suicide received active intervention, including being placed on a high-risk list, until considered safe. The counseling service identified 52% of the high-risk cases. 18% were referred as emergencies by the physicians of the health clinic, and 18% self-reported. Major depression was evident in 47% of the students, followed by persistent depressive disorder 20% and substance use disorder 15%. Clinical protective factors included placing all students on a high-risk list, developing a safety plan by a multiteam approach and medically evacuating students who needed inpatient care in the United States. Family notification was done in 74% of the cases. 36% of the high-risk cases were supported by medical leave of absences for recovery and to return to complete their studies. The availability of counseling, psychiatric and medical care in a university setting appears to be of significant value for the prevention of suicides among medical students.