This quick guide for clinicians may be used to develop a safety plan—a prioritized written list of coping strategies and sources of support to be used by patients who have been deemed to be at high risk for suicide.
A multi-source collection of readings, tools, videos, and webinars to help you understand and implement Zero Suicide.
This manual describes a brief clinical intervention, safety planning, that can serve as a valuable adjunct to risk assessment and may be used with individuals who have made a suicide attempt, have suicide ideation, have psychiatric disorders that increase suicide risk, or who are otherwise determined to be at high risk for suicide. It is intended to be used by VA mental health clinicians, but it is also relevant for clinicians who treat non-veterans.
Safety Plan is a free mobile safety planning app developed by the New York State Office of Mental Health, along with the New York State Psychiatric Institute, the Research Foundation for Mental Hygiene and the New York State Suicide Prevention Initiative. Safety Plan helps individuals identify suicide warning signs, create coping strategies, identify positive contacts and social settings to distract from the crisis, identify family members and friends available to help, find professional help and resources, and make their environment safe from lethal means that may be used in a suicide attempt.
MY3 is a free mobile safety planning app developed in partnership between the California Mental Health Services Authority and the Link2Health Solutions. With My3, users define their network and their plan to stay safe.
These recommendations were developed in an effort to enhance the provision of care in inpatient and residential facilities and, in particular, to promote, when possible, the incorporation of families as meaningful members of the treatment team.
This letter can be used and adapted to announce the commitment to improve the care provided to patients who are struggling with suicide and the adoption of the Zero Suicide approach. It should be sent from the chief executive officer, or someone else in a position of leadership, to all staff members.
The Way Forward report, authored by the Suicide Attempt Survivors Task Force of the National Action Alliance for Suicide Prevention, provides recommendations based on evidence-based practices which incorporate personal lived experience of recovery and resilience.
May, E. L. (2013). The Power of zero: Steps toward high reliability healthcare. Healthcare Executive, 28(2), 16.
The Suicide Care in Systems Framework report, authored by the Clinical Care and Intervention Task Force of the National Action Alliance for Suicide Prevention, laid the groundwork for Zero Suicide. It outlines three critical factors common to initiatives that have reduced suicide attempts, deaths, and the costs associated with unnecessary hospital and emergency department care.
This free, online training from the New York State Office of Mental Health and Columbia University provides an overview of the instrument and teaches how and when to administer it in real world settings. Behavioral healthcare practitioners in New York State working in non-profit settings can receive a certificate of completion by completing the training through the Center for Practice Innovations (CPI) Learning Community. Practitioners outside of New York State are not eligible to receive a certificate of completion.
Three versions of the Columbia Suicide Severity Rating Scale are available for use in clinical practice. The Lifetime/Recent version allows practitioners to gather lifetime history of suicidality as well as any recent suicidal ideation and/or behavior. The Since Last Visit version of the scale assesses suicidality since the patient’s last visit. The Screener version of the C-SSRS is a truncated form of the full version.
The PHQ-9 is used to diagnose and monitor the severity of depression. Question 9 screens for the presence and duration of suicide ideation.
These comprehensive guidelines outline a framework for structured assessment of adults suspected to be at risk of suicide and the immediate and long-term management and treatment that should follow if an individual is found to be at risk. A summary version is available at this link: http://www.healthquality.va.gov/guidelines/MH/srb/VASuicideAssessmentSummaryPRINT.pdf
Fowler , J. C. (2012). Suicide risk assessment in clinical practice: Pragmatic guidelines for imperfect assessments. Psychotherapy, 49(1), 81–90.
Simon , G. E., Rutter, C. M., Peterson, D., Oliver, M., Whiteside, U., Operskalski, B., & Ludman, E. J. (2013). Does response on the PHQ-9 Depression Questionnaire predict subsequent suicide attempt or suicide death? Psychiatric Services, 64(12), 1195–1202.
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