Q&A: Erica Floyd-Thomas on suicide prevention and behavioral health in Florida

Erica Floyd-Thomas is the assistant secretary for substance abuse and mental health at the Florida Department of Children and Families. Thomas’ work encompasses everything from supporting community-based behavioral health services, to operating state mental hospitals, to overseeing mobile response teams for crisis stabilization. In Thomas’ words: 

“If you can think about it in the behavioral health space, we are responsible for it.”

 

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One of the department’s key developments during the pandemic was the implementation of the First Responder Suicide Deterrence Task Force within the Office of Suicide Prevention. This task force was assigned to meet throughout the year to address the needs of first responders who, according to Thomas, help Floridians in crisis but are often the last ones to seek mental health support themselves. The task force is currently finalizing its report and recommendations that will then be sent to the state legislature to consider in the upcoming session.

In this Q&A, Thomas shares an update on the task force, and elaborates on the holistic framework she believes is vital to creating effective behavioral health systems for Floridians. 

Nicole Pasia: The task force has representatives from several different organizations, including the Florida Professional Firefighters’ Association, Florida Sheriffs Association, retired first responders, and various behavioral health agencies. Why was it important to incorporate these various perspectives into the task force?

Erica Floyd-Thomas: “To have all of those entities sitting at the table talking about a subject as sensitive and difficult as [suicide] is amazing, specifically from their perspective as people who either are currently working or retired.  What can [behavioral health systems] do to support you better, to be able to cope with the day in, day out, on-the-job stress that you’ve received? …It’s a true collaboration where you’re able to cut up work with a variety of different individuals. It’s nice to have health care professionals and behavioral health professionals in addition to those who are actually serving those spaces, folks that are retired, to be able to kind of talk about what makes sense [for suicide prevention].

NP: The task force identified four focus areas: awareness, prevention, intervention, and follow up. Can you speak on how working with these specific areas in mind can benefit the task forces’ recommendations?

EFT: “Every once in a while you’ll see across your social media feed where somebody brings up awareness about something that is happening in terms of prevention, but this really is more like linking to prevention programs, just to help our Floridians be able to build specific life skills, build strategies. What sort of critical thinking, some coping mechanisms, stress management, where can you do it, number one, and then if you don’t know how to do it, where do you go to be able to, to have that. 

Are you most likely to go to your employee assistance program? Are you going to reach out to your health care provider? … I definitely would like to talk to somebody, but do I want that to be part of something that’s associated with my job? What does that feel like and then you think, some people may have the thought that if I reach out to my health care provider, now, is that a diagnosis that’s now in my health record? So, [the task force is] creating some opportunities there for [treatment] not to feel like this taboo or something that is stigmatized. 

We’re also doing work around intervention, thinking about just incorporating evidence-based practices to be able to think about how you recover from a serious event, what that looks like, and then who’s doing that work with you. Is it a trained professional, but even better if it’s a trained professional who has that same lived experience…another area that that we were looking at with the task force is just the follow up care, follow up in support is key.

It’s really trying to offer that support and figuring out what’s a good model, what are standard procedures or operating procedures that we can apply throughout every entity to just be thinking about the support that’s needed before somebody asks for help.”

NP: What steps is the task force taking to determine the best recommendations for first responder suicide prevention?

EFT: “[The task force is] looking at national, evidence-based [recommendations], how other states are managing it, doing some legwork, pulling out things like what our national consortium is doing, certain things about prevention of suicide in police officers and other helping professions. [We’re] looking at what’s being supported, looking at [the Substance Abuse and Mental Health Services Administration (SAMSA)], to see what’s out there on that front. Also looking at the [Department of Health and Human Services (HHS)] to see if there’s any guidance or directions there. But more importantly, [it’s] really having those conversations about the one-on-one to figure that out.”

NP: Can you give an update on the annual report the task force was assigned to create?

EFT: “The Task Force definitely will be completing a report. It’s being drafted now. Once that report is completed, it will have recommendations about what we should do as a state to move forward with being able to address the four areas of awareness prevention, intervention, and follow up and support so it will focus on those areas. It will look at things systemically that need to be done — ‘Is that really talking about a standardized training module? Is that making sure that if you have an employee assistance program, that there’s a person who actually has been trained on how to engage with first responders?’ Setting those things up — again, looking at federal resources, looking at other states, looking at the evidence-based practices so the report will speak to the work that the task force has done, and it will make recommendations back to our legislative body.” 

NP: What ongoing projects aside from the task force are you most excited about?

EFT: “I’m actually excited about the work that we’re doing under Secretary [Shevaun] Harris, looking at prevention and integration. When you think about prevention and you think about integration, they seem like really simple concepts, but [they’re] very complicated when you think about behavioral health services. For suicide prevention, we can wrap our heads around what prevention looks like. But what does it mean to prevent in the space of behavioral health? We’ve been really diving into that, not wanting to live in a world of crisis, but how do we go upstream to make sure that we are impacting and affecting lives and offering the key services that allow folks to live healthy, resilient lives within their community?

From an integration front, [we’re] allowing individuals who have been in a short-term residential treatment facility, or a state mental hospital, or if you’ve been Baker Acted, what are we doing to make sure that we are integrating care? Maybe it’s housing, employment, or habilitative services. Perhaps they really don’t have any natural supports, and they need to have some place to go everyday that gives them purpose, like vocational rehab. So I’m really excited to be working on this vision, focusing our efforts to begin to dive deep into this work, and this task force cannot be more aligned with the work that we’ve been asked to do by Secretary Harris.”

This interview was edited for clarity and length.