BILL ANALYSIS Ó
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|Hearing Date:June 23, 2014 |Bill No:AB |
| |2198 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Ted W. Lieu, Chair
Bill No: AB 2198Author:Levine
As Amended: April 21, 2014Fiscal: Yes
SUBJECT: Mental health professionals: suicide prevention training.
SUMMARY: Requires a psychologist, marriage and family therapist,
educational psychologist, professional clinical counselor and clinical
social worker, who began graduate study on or after January 1, 2016,
to complete a minimum of 15 hours of coursework on suicide prevention,
before being issued a license. Further requires, commencing January
1, 2016, a person licensed in these professions who began graduate
study prior to January 1, 2016, to take a six-hour continuing
education course on suicide prevention in order to renew a license.
Existing law:
1)Requires the director of the Department of Consumer Affairs (DCA),
by regulation, to develop guidelines to prescribe components for
mandatory CE programs administered by any board within DCA and
requires that those guidelines ensure that mandatory CE is used as a
means to create a more competent licensing population, thereby
enhancing public protection. (Business and Professions Code (BPC) §
166)
2)Establishes the Psychology Licensing Law which provides for the
licensure and regulation of licensed Psychologists. (BPC § 2901 et
seq.)
3)Requires an applicant for licensure as a psychologist to comply with
the following requirements:
a) Not be subject to denial, as specified;
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Page 2
b) Possess an earned doctorate degree, as specified;
c) Have engaged for at least two years in supervised professional
experience under the direction of a licensed psychologist, as
specified;
d) Take and pass an examination, as specified; and,
e) Show by evidence satisfactory to the Board of Psychology (BOP)
that he or she has completed training in the detection and
treatment of alcohol and other chemical dependency, as specified.
(BPC § 2914)
4)Requires BOP to develop guidelines for the basic education and
training of psychologists whose practices include patients with
medical conditions and patients with mental and emotional disorders
who may require psychopharmacological treatment and whose management
may require collaboration with physicians and other licensed
prescribers, as specified. (BPC § 2914.3 (b))
5)Establishes the Licensed Marriage and Family Therapy Act
administered by the Board of Behavioral Sciences (BBS) to regulate
marriage and family therapists (MFT) and interns. (BPC § 4980.04 et
seq.)
6)Establishes the requirements of educational programs for applicants
for licensure as an MFT, as specified. (BPC § 4980.36, 4980.39)
7)Requires each educational institution preparing applicants to
qualify for registration or licensure to notify each of its students
by means of its public documents or otherwise in writing that its
degree program is designed to meet the requirements, as specified,
and certify to the BBS that it has so notified its students. (BPC §
4980.38)
8)Specifies that an applicant for registration or licensure submit to
the BBS a certification by the applicant's educational institution
that the institution's required curriculum for graduation and any
associated coursework completed by the applicant meets specified
requirements.
(BPC § 4980.38)
9)Establishes the Licensed Educational Psychologists Practice Act to
regulate educational psychologists (LEPs). (BPC § 4989.10 et seq.)
10)States the practice of educational psychology is the performance of
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any of the following professional functions pertaining to academic
learning processes or the educational system or both: (BPC 4989.14)
a) Educational evaluation;
b) Diagnosis of psychological disorders related to academic
learning processes;
c) Administration of diagnostic tests related to academic
learning processes including tests of academic ability, learning
patterns, achievement, motivation, and personality factors;
d) Interpretation of diagnostic tests related to academic
learning processes including tests of academic ability, learning
patterns, achievement, motivation, and personality factors;
e) Providing psychological counseling for individuals, groups,
and families;
f) Consultation with other educators and parents on issues of
social development and behavioral and academic difficulties;
g) Conducting psychoeducational assessments for the purposes of
identifying special needs;
h) Developing treatment programs and strategies to address
problems of adjustment; and,
i) Coordinating intervention strategies for management of
individual crises.
11)Requires an LEP seeking to renew his or her license to certify to
BBS, on a prescribed form, completion in the preceding two years of
not less than 36 hours of approved continuing education in, or
relevant to, educational psychology. (BPC § 4989.34)
12)Establishes the Clinical Social Worker Practice Act to license and
regulate licensed clinical social workers (LCSWs). (BPC § 4991 et
seq.)
13)Establishes the licensure requirements for an LCSW and requires
each applicant to furnish satisfactory evidence to BBS that he or
she has complied with specified requirements including adequate
instruction and training in the subjects of alcoholism and other
chemical substance dependency; spousal or partner abuse assessment,
detection, and intervention; human sexuality, as specified; and,
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child abuse assessment and reporting, as specified. (BPC § 4996.2
(e-h))
14)Requires an LCSW to complete continuing education coursework in
aging and long term care, as specified. (BPC § 4996.26)
15)Establishes the Licensed Professional Clinical Counselor Act to
license and regulate professional clinical counselors (PCCs). (BPC
§ 4999.10 et seq.)
16)Establishes the licensure requirements for a PCC and requires each
applicant to furnish satisfactory evidence to BBS that he or she has
complied with specified education and practicum requirements. (BPC
§ 4999.32)
17)Prohibits the BBC from renewing a PCC license unless the applicant
certifies to BBS, on a form prescribed by BBS, that he or she has
completed not less than 36 hours of approved continuing education
in, or relevant to, the field of professional clinical counseling in
the preceding two-years, as specified. (BPC § 4999.76)
This bill:
For Psychologists :
1)Requires an applicant for licensure as a psychologist, who began
graduate study on or after January 1, 2016, to complete as a
condition of licensure, a minimum of 15 contact hours of coursework
in suicide assessment, treatment, and management and prohibits the
BOP from issuing a license to a psychologist applicant until the
applicant has met the specified educational requirements.
2)Requires a licensed psychologist, who began graduate study prior to
January 1, 2016, to complete a six-hour continuing education course
in best practices for suicide assessment, treatment, and management
during his or her first renewal period, as specified, and submit
acceptable evidence to BOP of the person's satisfactory completion
of that course, and prohibits BOP from issuing a license to a
psychologist until the applicant has met the specified educational
requirements.
3)Permits continuing education courses taken in suicide assessment,
treatment and management, to be applied to the 36 hours of approved
continuing education required, as specified.
4)Delays the implementation of the continuing education requirement
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until January 1, 2016.
For Licensed Marriage and Family Therapists :
5)Requires a qualified applicant for licensure as a marriage and
family therapist, who began graduate study on or after January 1,
2016, to complete, as a condition of licensure, a minimum of 15
contact hours of coursework in suicide assessment, treatment, and
management.
6)Requires a MFT, who began graduate study prior to January 1, 2016,
to complete a six-hour continuing education course in best practices
for suicide assessment, treatment, and management during his or her
first renewal period, as specified, and submit acceptable evidence
to BBS of the person's satisfactory completion of that course.
7)Permits continuing education courses taken in suicide assessment,
treatment, and management, to be applied to the 36 hours of approved
continuing education required, as specified.
8)Delays the implementation of the continuing education requirement
until January 1, 2016.
For Licensed Educational Psychologists :
9)Requires an applicant for licensure as an educational psychologist,
who began graduate study on or after January 1, 2016, to complete as
a condition of licensure, a minimum of 15 contact hours of
coursework in suicide assessment, treatment, and management and
prohibits BBS from issuing a license to an educational psychologist
until the applicant has met the specified educational requirements.
10)Requires a LEP, who began graduate study prior to January 1, 2016,
to complete a six-hour continuing education course in best practices
for suicide assessment, treatment, and management during his or her
first renewal period, as specified, and submit acceptable evidence
to BBS of the person's satisfactory completion of that course.
11)Permits continuing education courses taken in suicide assessment,
treatment, and management, to be applied to the 36 hours of approved
continuing education required, as specified.
12)Delays the implementation of the continuing education requirement
until January 1, 2016.
For Licensed Clinical Social Workers :
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13)Requires an applicant for licensure as a clinical social worker,
who began graduate study on or after January 1, 2016, to complete as
a condition of licensure, a minimum of 15 contact hours of
coursework in suicide assessment, treatment, and management and
prohibits BBS
from issuing a license to a social worker until the applicant has met
the specified educational requirements.
14)Requires a LCSW, who began graduate study prior to January 1, 2016,
to complete a six-hour continuing education course in best practices
for suicide assessment, treatment, and management during his or her
first renewal period, as specified, and submit acceptable evidence
to BBS of the person's satisfactory completion of that course.
15)Permits continuing education courses taken in suicide assessment,
treatment, and management, to be applied to the 36 hours of approved
continuing education required, as specified.
16)Delays the implementation of the continuing education requirement
until January 1, 2016.
For Licensed Professional Clinical Counselors :
17)Requires a qualified applicant for licensure as a professional
clinical counselor, who began graduate study on or after January 1,
2016, to complete, as a condition of licensure, a minimum of 15
contact hours of coursework in suicide assessment, treatment, and
management.
18)Requires a PCC, who began graduate study prior to January 1, 2016,
to complete a six-hour continuing education course in best practices
for suicide assessment, treatment, and management during his or her
first renewal period, as specified, and submit acceptable evidence
to BBS of the person's satisfactory completion of that course.
19)Permits continuing education courses taken in suicide assessment,
treatment, and management, to be applied to the 36 hours of approved
continuing education required, as specified.
20)Delays the implementation of the continuing education requirement
until January 1, 2016.
FISCAL EFFECT: This measure has been keyed "fiscal" by Legislative
Counsel. According to the Assembly Committee on Appropriations
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analysis dated May 14, 2014, the bill would cause minor an absorbable
workload and costs to the Board of behavioral Sciences and the Board
of Psychology for verifying that an applicant has completed required
coursework.
COMMENTS:
1.Purpose. This bill is sponsored by the Author . According to the
Author, "Currently there are numerous requirements in California
Business and Professions Code governing graduate and continuing
education requirements. There is however no specific law in
California that requires graduate training or continuing education
in suicide assessment?AB 2198 will lead to lives being saved through
mental health professionals identifying suicidal intentions before
they become life threatening."
2.Background.
Suicide Prevention Strategies. Suicide is a serious public
health problem and is one of the leading causes of death
worldwide. Suicide is a complex phenomenon associated with
multiple biological, psychological, psychiatric and social
factors including age, sex, mental illness, physical illness and
interpersonal violence. This complexity makes it especially
difficult to identify preventative efforts. As such, there is a
paucity of consistent research findings on suicide prevention
strategies.
A 2002 study posits that, "?improving the training and competence
of mental health professions is the most logical ways to prevent
suicide and save lives" (Schmitz et al, 2002). Statements by the
Joint Commission and the Institute of Medicine are cited in this
study to support the need to have mental health practitioners
achieve competence in suicide risk assessment and management.
Several other peer reviewed research studies and publications
shed a different light on preventative efforts. These studies
show that there are two preventative efforts that have been found
to be most effective in reducing suicide: 1) physician training
and 2) limiting the access to means for suicide e.g. medications,
firearms.
The results of a systematic review of 5,020 studies, which examined
strategies to prevent suicide, was published in the Journal of
the American Medical Association in 2005. The review reported
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that physician education in recognizing depression and
restricting access to lethal methods were the most efficacious
prevention interventions (Mann, et al, 2005). The World Health
Organization's 2012 Health Evidence Network report entitled, For
Which Strategies of Suicide Prevention is There Evidence of
Effectiveness, examined suicide prevention strategies utilized in
Europe, the country with the highest suicide rates, and found
that limiting access to means was the most effective strategy.
Similarly, the American Foundation for Suicide Prevention
promotes teaching general practitioners to recognize and treat
depression and limiting access to means as the most successful
preventative efforts. The U.S. Surgeon General's Call to Action
to Prevent Suicide suggests to, "?improve the ability of primary
care providers to recognize and treat depression, substance abuse
and other major mental illnesses associated with suicide risk and
increase the referral to specialty care."
Suicide Interventions. Research on interventions is slightly
more promising, but still lacking. The American Foundation of
Suicide Prevention indicates that following up with patients
after hospitalization and providing psychopharmacology treatment
as effective intervention strategies. Similarly, the World
Health Organization's study, described in the prior section,
endorses medication as an effective intervention.
Centers for Disease Control and Prevention (CDC)
Recommendations for States' Efforts to Address Suicide. A CDC
research brief examined the efforts of various states to identify
the most successful suicide prevention plans. This research
study emerged from the 2001 National Strategy for Suicide
Prevention position which called for "coordination of resources
at all levels of government to address the public health problem
of suicide mortality and morbidity." In response, states across
the nation formulated state-level suicide prevention plans.
However, according to the CDC brief, "To date, little empirical
information has been available to provide guidance to these
states." In response, the CDC conducted their own research study
to describe the "key ingredients" of successful state-based
suicide prevention planning. Their suggestions included the
establishment of a "leadership group" or task force to examine
the issue within the state. They also suggested involving
existing entities such as the public health and mental health
departments and agencies in prevention efforts. They caution,
"State suicide prevention strategies must be developed within the
context of social, economic and political realities?states need
to carefully consider their vision and goals for suicide
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prevention before seeking legislative action."
Academic Standards Addressing Suicide. The licensees that
would be impacted by this bill receive academic and clinical
training that includes the identification and assessment of
psychopathology including the assessment of suicidality and
intervention strategies for dealing with patients in crisis. The
American Psychological Association and the Council on Social Work
Education accredit programs of psychology and social work
respectively, and set standards for the coursework and clinical
training that students receive. These bodies require that
coursework address areas such as, dysfunctional behavior or
psychopathology, theories and methods of assessment and diagnosis
and effective intervention. For MFTs and LPCCs their required
courses are outlined in statute. Both the MFT and LPCC statutes
require that students receive training in, "the patient dangerous
to self or others." The LPCC statute further requires training
in multidisciplinary responses to crises and emergencies, crisis
and trauma counseling, assessment strategies for clients in
crisis and principles of intervention for individuals with mental
or emotional disorders during times of crises.
Current Mandated CE and Education Requirements for Mental
Health Professionals. This bill would mandate 15 contact hours
in suicide assessment, treatment and management, or for those who
graduate prior to January 1, 2016, 6 hours of continuing
education. Currently, for the groups that would be affected by
this bill, there are already various mandated continuing
education and pre-requisite education requirements for licensure.
Importantly, there are very clear reasons why these
pre-requisites are mandated.
At the time that most of the mandated continuing education and
pre-requisite education requirements were implemented, the
licensing boards did not have continuing education requirements
and training programs were not covering specific topics in their
curriculum. For example, the human sexuality requirement was
added in the 1970's, when clinical diagnoses pertaining to
sexuality changed in the Diagnostic and Statistical Manual of
Mental Disorders, and training programs had not implemented
curriculum on human sexuality. Similarly, the alcohol dependence
requirement was added in the 1980's when the cocaine epidemic was
in full force and training programs had not implemented
curriculum on substance abuse. The remaining mandated education
requirements were added because the licensees affected by this
bill are mandated by law to report child abuse, elder abuse and
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to break confidentiality and warn victims if their patient
discloses intent to harm others. The ongoing law and ethics
requirement is consistent with requirements for other health
professionals in order to ensure that health professionals stay
abreast of changes in the law that affect their practice. This
bill would mandate coursework on suicide assessment, treatment
and management, however; instruction in this area is already
included in training program curriculum.
This chart reflects the requirements for the mental health
practitioners that would be affected by this bill. With the
exception of the law and ethics courses, which must be repeated
upon renewal of one's license, all others are one-time
pre-requisites for licensure.
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|Psychologists|Licensed |Licensed |Licensed |Licensed |
| |Clinical |Marriage and |Professional |Educational |
| |Social |Family |Clinical |Psychologists|
| |Workers |Therapists |Counselors | |
|-------------+-------------+-------------+-------------+-------------|
|Human |Human |Human |Human |n/a |
|Sexuality |Sexuality |Sexuality |Sexuality | |
|(10 hours) |(10 hours) |(10 hours) |(10 hours) | |
|-------------+-------------+-------------+-------------+-------------|
|Alcoholism/Ch|Alcoholism/Ch|Alcoholism/Ch|Alcoholism/Ch|Alcoholism/Ch|
|emical |emical |emical |emical |emical |
|Dependence |Dependence |Dependence |Dependence |Dependence |
|(one quarter |(15 hours) |(15 hours) |(15 hours) |(15 hours) |
|or semester | | | | |
|long course) | | | | |
|-------------+-------------+-------------+-------------+-------------|
|Child Abuse |Child Abuse |Child Abuse |Child Abuse |Child Abuse |
|(7 hours) |(7 hours) |(7 hours) |(7 hours) |(7 hours) |
|-------------+-------------+-------------+-------------+-------------|
|Spousal/Partn|Spousal/Partn|Spousal/Partn|Spousal/Partn|n/a |
|er Abuse |er Abuse |er Abuse |er Abuse | |
|(15 hours) |(7 hours) |(7 hours) |(7 hours) | |
|-------------+-------------+-------------+-------------+-------------|
|Aging/Long-Te|Aging/Long-Te|Aging/Long-Te|Aging/Long-Te|n/a |
|rm Care |rm Care |rm Care |rm Care | |
|(10 hours) |(3 hours) |(7 hours) |(7 hours) | |
|-------------+-------------+-------------+-------------+-------------|
| | | | | |
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|-------------+-------------+-------------+-------------+-------------|
|n/a |HIV/Aids |HIV/Aids |HIV/Aids |n/a |
| |(7 hours) |(7 hours) |(7 hours) | |
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1. Arguments in Support. The National Alliance on Mental Illness
(NAMI) Santa Clara County Board of Directors , Community Solutions ,
California Institute for Mental Health and Momentum for Mental
Health similarly write in support of the bill, "?numerous
individuals and professionals in California are being trained to
recognize signs of suicide; however, no similar requirement mandates
that the people being referred, i.e., our mental health
professionals, are competently trained. Patient safety should be
paramount and excellent suicide assessment, treatment and management
of professionals must always be ensured."
NAMI California supports the bill and writes, "By creating
standards for suicide prevention training for specified mental
health professionals, we can ensure that these mental health
professionals providing services to individuals living with mental
illness are in a position to identify and address potential signs
that the patient is at risk of death by suicide."
The California Catholic Conference of Bishops supports AB 2198 and
writes, "?mental health professionals are on the front lines. It
makes good sense and quality public policy to provide them with
effective training and tools for assessing and treating those that
seek their help."
The American Foundation for Suicide Prevention supports the bill
and reports, "An American Association of Suicidology Task Force
Report finds that only 50% of psychologists, 25% of social workers,
6% of marriage and family therapists and 2% of counselors
nationwide are trained in suicide risk assessment and management.
We can and must do better for the state of California and for the
millions of Californians living with mental illness."
The Association of California Healthcare Districts writes in
support of the bill, "Mental health is as important as physical
health. Numerous studies have shown that when people receive
appropriate mental health care, their use of medical services
decline. Untreated mental health illness can lead to suicide
attempts, and it is important that the appropriate mental health
professionals are trained accordingly to prevent patients with
mental illness from committing suicide."
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The Family & Children Services of Silicon Valley supports the bill
and writes, "By creating standards of suicide prevention training
for specified mental health professionals, California will create a
foundation for promoting mental health and for mitigating the
tragic impact of suicide on individuals and families. We welcome
the additional training obligation, so that we can continue to
ensure the very best outcomes for our clients and their families."
The El Camino Hospital supports the bill and writes, "California
law requires a mental health professional to be certified by a
county mental health director to perform an involuntary detention
(Welfare and Institute Code 5151 et al). There is, however, no
requirement that the individual performing the assessment,
treatment and management is certified or qualified in suicide
prevention. By creating standards of suicide prevention training
for specified mental health professionals, California will create a
foundation for promoting mental health and for mitigating the
tragic impact of suicide on individuals and families."
The Didi Hirsch Mental Health Services states their support, "Didi
Hirsch's staff members train mental health providers in Los Angeles
and Orange Counties?A simple act of legislation can make our work
"the norm" across the State. It is a thrilling prospect. So many
lives will be saved when mental health professionals identify
suicidal intentions before they threaten lives."
The Caltrain writes, "Expanding education and training about
suicide assessment to mental health professionals is vital to
lowering suicide rates."
The California Professional Firefighters supports the bill and
write, "As first responders, some of the most difficult calls our
members respond to are those involving suicide victims. Because AB
2198 will help address the growing concern that more and more
Californians of all ages are losing their lives to suicide, we urge
your support for this bill."
2. Support if Amended. The California Mental Health Directors
Association (CMHDA) supports the bill but shares the concern,
"CMHDA supports AB 2198, but believes it will better accomplish its
intent if amended to require all healthcare professionals receive
training in suicide assessment, treatment and management."
3. Arguments in Opposition. The California Psychological Association
opposes the bill and writes, "There currently exist a number of
mandated CEs on psychologists, including law and ethics, domestic
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Page 13
violence, and aging and long-term care- all of these originated on
a piecemeal basis. Moving towards a mandated CE will increase the
burden of professionals in this area, and will not allow them to
take other CE courses in areas that may be more appropriate to
their specialty. The mandated CE creates less room for other
worthy topics such as multiculturalism, advance in cognitive
behavior therapy, current trends in family
courts and child custody proceeding, and new information on
psychopharmacology (to list a few)."
The California Board of Psychology is opposed. In their letter
they write, "The Board is aware that suicide is an extremely
important topic that has touched the lives of many families in our
state. The Board is committed to educating our licensees and the
general public on this issue via various outreach and educational
tools. The Board does not believe, however, that AB 2198 is the
appropriate vehicle for achieving competence in this area.
Specifically, the Board opposes the bill for the following reasons;
The coursework and CE hours mandated in the bill will
not help a licensee achieve competence in the area of suicide
assessment, prevention and training. The Board is concerned
that attending a six hour course may provide a false sense of
subject area mastery to a licensee.
Suicide assessment, prevention and training is currently
integrated into the curriculum of most graduate training
programs. Additionally, suicide assessment is a knowledge
point tested in both the national and state examinations.
The Board is opposed to CE courses being mandated by the
legislature when the Board, is better positioned to determine
what areas of study will further their professional
development."
The Alameda County Psychological Association and the San Joaquin
Valley Psychological Association both oppose the bill and write,
"This bill is problematic and unnecessary. Students are given
continuous and constant attention towards suicidality. Suicidality
is addressed in program orientation training, case conference (3
trimesters), advanced ethics (commitment, Tarasoff and other laws),
Psychological Assessment (3 trimesters or more, many testing
instruments assess for suicidality), and intervention courses?[We]
oppose this piecemeal approach to mandated continuing education.
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Competency in recognizing and preventing suicide is taught in
graduate courses, in real life applications through practicum and
internship, and currently offered as specialty CE courses for
practitioners."
The National Association of Social Workers- California Chapter also
opposes the bill and they write, "We believe that a social work
education prepares graduates with training about suicide
prevention. Professionals who work in areas where they are exposed
to suicidal clients have a variety of CE courses they can choose
from to strengthen their skills. Social work is a very broad field
and not all social workers will pursue their license. We believe
that these courses should be voluntary and professionals should be
trusted to pursue coursework that will be needed on the job."
The California Association for Licensed Professional Clinical
Counselors also opposes this bill. In their letter they state,
"Suicide prevention is an important issue. This is why education
on this topic is included in the curriculum for the 60-unit
master's degree required for LPCC licensure. Existing law
(4999.33) requires students preparing for the LPCC to pass a
three-unit course in Crisis of Trauma. Much of this course is
devoted to suicide assessment, prevention and management. In
addition, suicide prevention is threaded throughout the rest of the
curriculum. Requiring additional continuing education on this
topic would be redundant and would not likely impact the suicide
rate in California."
The California Association of Marriage and Family Therapists oppose
the bill. In their letter they write, "We believe a licensee, who
already has a 36 hour continuing education requirement for license
renewal, will select courses that enhance their practices and
fulfill their individual deficiencies. Content-specific continuing
education coursework tends to lose value when it is mandated by the
State of California. Marriage and family therapists already have
in their educational training, among other things: the diagnosis,
assessment and treatment of mental disorders, including severe
mental disorders; trauma and abuse, health function, and health
promotion; resilience and coping with trauma, tragedy threat and
other stresses."
1. Oppose Unless Amended. The Board of Behavioral Sciences opposes
the bill unless it is amended. In their letter they write, "The
board recommends the bill be amended to form a task force to
include members of this board, its stakeholders, the Board of
Psychology, county mental health officials, and university
educators. This group should discuss the following areas of
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concern to determine the best course of action:
Current coverage of the topic of suicide assessment,
treatment and management in Master's level mental health degree
programs, including identifying courses that typically include
the topic, aspects of the topic that are already being
addressed, and aspects of the topic where improved training is
needed.
Whether college campus mental health care workers and
others who are likely to encounter suicidal individuals are
likely to be licensed mental health care professionals, and if
not, how to address their training needs; and
Lack of resources at the county mental health care level
which may be impeding treatment for those who need it."
The American Association for Marriage and Family Therapy also
opposes the bill unless amended. In their letter they note, "We
believe the bill's requirements are largely redundant with existing
law, and thus are unlikely to have any meaningful impact on the
state's suicide rate?The Centers for Disease Control and Prevention
identifies lack of access to treatment and stigma of seeking help,
among other factors- not inadequate suicide training of mental
health professionals- as key factors increasing the risk of
suicide?If you are interested in ensuring adequate care for
suicidal patients, the severe psychiatric bed shortage represents
low-hanging fruit?Every mental health professional in the state is
currently required to receive training in suicide assessment,
prevention and intervention as part of the qualifying degree?The
training program your bill requires would be redundant and thus
would likely fail to have a demonstrable impact on suicide."
1. Policy Issue for Consideration. It has been well documented that
the suicide rate across the nation is rising. What remains unclear
is the reason for the rising rate and what the most appropriate
method for preventing suicide is. As highlighted in the background
section of the analysis, the best methods to prevent suicide are:
1) physician education and training and
2) restricting access to lethal means.
While the spirit of this legislation is laudable, there is a severe
paucity of evidence demonstrating that requiring mental health
professionals to take additional education courses is a proven
method for preventing suicide. As noted in the background section
of the analysis, mental health professionals already receive
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coursework and training in suicide assessment and treatment
interventions. As such, this requirement may not be a fruitful
strategy for achieving the Author's goal. In fact, research
indicates that efforts to provide education and training on suicide
prevention and assessment should be focused on providers who do not
have mental health training as part of their education and clinical
background.
Another feasible alternative may be to form a task force, as
suggested by the CDC's report. The task force could include groups
such as the licensing boards who regulate practice and promulgate
regulations regarding continuing education, accrediting agencies
that set standards for coursework and the mental health
associations who represent practitioners. The task force could be
charged with identifying the best practices for suicide prevention
that could be implemented in the state and report back to the
Legislature at a specified date.
SUPPORT AND OPPOSITION:
Support:
American Foundation for Suicide Prevention
Association of California Healthcare Districts
California Catholic Conference of Bishops
California Federation of Teachers
California Institute for Mental Health
California Professional Firefighters
California State Sheriffs' Association
Caltrain
Didi Hirsch Mental Health Services
El Camino Hospital
Family & Children Services of Silicon Valley
Momentum for Mental Health
NAMI California
NAMI Santa Clara County Board of Directors
Veterans Caucus for the California Democratic Party
Opposition:
Alameda County Psychological Association
Board of Behavioral Sciences
Board of Psychology
California Association for Licensed Professional Clinical Counselors
California Association of Marriage and Family Therapists
AB 2198
Page 17
California Psychological Association
National Association of Social Workers- California Chapter
San Gabriel Valley Psychological Association
San Joaquin Valley Psychological Association
8 individuals
Consultant:Le Ondra Clark, Ph.D.