Optimizing Patient Care – Suicide Prevention

The World Health Organization identified that a major strategy for suicide prevention is the use of evidence-based individual-level approaches to the assessment and management of patients at risk for suicide. The current chapter will focus on the individual-level interventions that mental health clinicians can use in their community management. Reliable and valid assessment measures help ensure clinicians cover the necessary content involved in assessing suicide risk and can improve the communication of risk from one clinician to another during transitions in care. However, the gold standard assessment remains that done by a trained and experienced clinician. Clinicians should ensure that safety planning is carried out. A crucial part of the safety plan is working with the patient and family to remove access to lethal means of suicide such as guns, poisons and large quantities of medication. The new standards call for providing “caring contacts” to patients with significant risk after hospital discharge or emergency department discharge, follow-up in primary care or mental health settings and when care is interrupted (e.g., missed appointments; transfers of care). Adopting these new systematic approaches to care for patients at risk for suicide appears to hold great promise to keep patients under our care safe and well. The World Health Organization identified that a major strategy for suicide prevention is the use of evidence-based individual-level approaches to the assessment and management of patients at risk for suicide. This chapter focuses on the individual-level interventions that mental health clinicians can use in their community management. It discusses the clinical assessment of suicide risk including a broad discussion of risk and protective factors; however, the reader must remember that these factors will vary from one community to the next. The chapter highlights some specific interventions that should be under taken with patients at risk for suicide and introduces the approach to managing patients with a suicide plan and high intent, with low intent but with serious risk factors and with suicidal thoughts but no plan. It concludes with identifying important factors to imbed in the clinician-patient relationship and pinpointing that documentation and supervision are necessary to safeguard the clinician’s welfare in managing patients at risk for suicide.