Most clinicians-in-training learn to summarize suicide risk in a categorical probability judgment expressed as low, moderate, or high, often with gradations like low-moderate. But what do we really mean when we say a patient is at “low” “moderate” or “high” risk? Risk compared to whom? Compared to when? In what setting? These labels are devoid of context, lack predictive validity, and provide little help when developing plans and responses to prevent suicide. In this Suicide Prevention Resource Center Director's Corner, Anthony Pisani, PhD explains moving away from a prediction model to a prevention model.
A multi-source collection of readings, tools, videos, and webinars to help you understand and implement Zero Suicide.
Centerstone of Tennessee developed this Memorandum of Understanding with emergency departments to enhance follow-up services for clients.
Copyrighted and published by Project HOPE/Health Affairs as: Michael F. Hogan and Julie Goldstein Grumet “Suicide Prevention: An Emerging Priority For Health Care” Health Affairs (Millwood) 2016, Vol. 35, No. 6, 1084-1090. The published article is archived and available online at www.healthaffairs.org.
Stefan, S. (2016). Rational Suicide, Irrational Laws: Examining Current Approaches to Suicide in Policy and Law. Oxford University Press.
Health and behavioral health care (HBH) organizations and providers implementing suicide prevention practices often have concerns about liability and legal issues. Providing quality patient care while minimizing liability risk is a priority across HBH organizations, especially when caring for patients at risk for suicide. Liability risks can be reduced when providers deliver patient-centered care with embedded systems-level communication and documentation practices.
Health and behavioral health care organizations can support providers and manage risk by adopting practices that ensure that suicide risk is properly identified and assessed, timely and effective treatment that allows for patient choice and involvement is provided, patient health information is appropriately communicated between providers, patients and collaterals, and documentation is thorough.
This webinar will explore the legal and liability issues related to implementing systems-level changes designed to improve suicide care practices. Participants will hear from three experts who will discuss common liability concerns including those related to confidentiality and HIPAA, key elements considered in liability cases, and strategies to minimize liability against a provider or health care organization.
By the end of this webinar, participants will be able to (1) Identify misconceptions related to provider liability in litigation involving patient suicide; (2) Describe suicide care practices that are of particular importance in liability cases; and (3) Explain system- or organizational-level improvements to suicide care that can enhance an organization’s abilities to deliver quality care and minimize liability concerns.
This Joint Commission Sentinel Event Alert aims to assist all health care organizations providing both inpatient and outpatient care to better identify and treat individuals with suicide ideation. Clinicians in emergency, primary and behavioral health care settings particularly have a crucial role in detecting suicide ideation and assuring appropriate evaluation. The suggested actions in this alert cover suicide ideation detection, as well as the screening, risk assessment, safety, treatment, discharge, and follow-up care of at-risk individuals. Also included are suggested actions for educating all staff about suicide risk, keeping health care environments safe for individuals at risk for suicide, and documenting their care.
This manual is intended to make motivational interviewing easy to learn and use in practice with Native American clients. This client-centered counseling approach provides strategies to enhance an individual’s capacity to change, use communication skills to decrease resistance, and developing a commitment to change.
This two-page fact sheet features a strengths-based intervention that identifies the needs of youth and the goals that the youth and his or her family will work towards with the assistance of the team and community.
Beckstead, D. J., Lambert, M. J., DuBose, A. P., & Linehan, M. (2015). Dialectical behavior therapy with American Indian/Alaska Native adolescents diagnosed with substance use disorders: Combining an evidence based treatment with cultural, traditional, and spiritual beliefs. Addictive behaviors,51, 84-87.
Bigfoot, D. S., & Schmidt, S. R. (2010). Honoring children, mending the circle: cultural adaptation of trauma‐focused cognitive‐behavioral therapy for American Indian and Alaska Native children. Journal of clinical psychology,66(8), 847-856.
Nebelkopf, E., & King, J. (2003). A holistic system of care for Native Americans in an urban environment. Journal of Psychoactive Drugs, 35(1), 43-52.
The goal of this paper is to highlight key steps emergency department (ED) providers can take to establish continuity of care for patients at risk for suicide, and thereby, to substantially reduce the number of suicide deaths and suicide attempts that occur after discharge. The risk of suicide attempts and death is highest within the first 30 days after a person is discharged from an ED or inpatient psychiatric unit, yet as many as 70 percent of suicide attempt patients of all ages never attend their first outpatient appointment. Therefore, access to clinical interventions and continuity of care after discharge is critical for preventing suicide.
In 2014, six states and their provider partners set out with the Suicide Prevention Resource Center and the National Council for Behavioral Health on the Zero Suicide Breakthrough Series– a project designed to learn how best to support the successful launch and implementation of the Zero Suicide approach under the direction of a state mental health or public health office. State leaders who had already begun the process of launching Zero Suicide initiatives were asked to invite a provider organization to partner with them in the process. Over the course of the nine-month Breakthrough Series period, they were given additional technical assistance and supports to move towards suicide safer care practices. This report details lessons learned throughout the process.
Pisani, A. R., Murrie, D. C., & Silverman, M. M. (2015). Reformulating Suicide Risk Formulation: From Prediction to Prevention. Academic Psychiatry, 1–7.
David Jobes, PhD, ABPP, Professor of Psychology, Associate Director of Clinical Training, The Catholic University of America, discusses a "Stepped Care" model for suicide prevention.
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