Goal 3: Implement Best Practices for Suicide Prevention within the Health Care System


Increase resources for mental health and health care providers in screening, assessment, and treatment of mental health and substance use disorders, as well as suicidal thoughts and behavior.

The majority of individuals who died by suicide were involved with mental health treatment at the time of their death or had been involved in mental health treatment previously. And many of the objectives in this plan are designed to ensure that those in need of treatment have access to it. Therefore, it is critical to ensure that mental health, substance use, and health care providers are equipped with the best practices in identifying and responding to individuals who may be suicidal. Fortunately, there are an increasing number of tools available. These include screening tools, such as the Columbia Suicide Severity Rating Scale (C-SSRS), professional training on treating individuals who are suicidal, such as Assessing and

Managing Suicide Risk (AMSR) and Collaborative Assessment and Management of Suicide (CAMS),and protocols for various settings in responding to individuals who are suicidal. The Zero Suicide movement is directed primarily at these providers and has created an evolving website to support these efforts.

(See Wisconsin Suicide Prevention Strategy, Page 20)

Resources:

 Zero Suicide in Wisconsin

Zero Suicide is a basic commitment to suicide prevention in the healthcare and behavioral healthcare systems. Zero Suicide is based on a systematic approach to quality improvement; it does not rely on the heroic efforts of individual clinicians but rather the conscientious and consistent use of specific tools and strategies throughout organizations.  Just as health systems have been able to initiate systematic practices and policies that alleviate medical errors and falls, the Zero Suicide Model can and has reduced the number of suicides by individuals. For more information, contact Shel Gross at shelgross3@gmail.com

Assessing and Managing Suicide Risk (AMSR): Care competencies for mental health professionals. A one-day workshop for mental health professionals on assessing suicide risk, planning treatment and managing ongoing care for at-risk clients. The Suicide Prevention Resource Center (SPRC) offers continuing education credits to social workers, certified counselors and psychologists. For more information contact Shel Gross at 608-250-4368 or shelgross@tds.net.

Columbia Suicide Severity Rating Scale (C-SSRS)

Collaborative Assessment and Management of Suicide (CAMS): CAMS, the Collaborative Assessment and Management of Suicidality, an evidence-based suicide-specific clinical intervention that has been shown through extensive research to effectively assess, treat and manage suicidal patients in a wide range of clinical settings. This link takes you to a six-hour, online, self-paced training (fee involved).

Improve continuity of care.

According to the Suicide Prevention Resource Center (SPRC):

The risk of suicide attempts and death is highest within the first 30 days after a person is discharged from an emergency department (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.

While there are various evidence-based practices that can be implemented, these are only beginning to be recognized by these entities. And because “continuity” assumes someone on the other end, EDs and hospitals cannot achieve this without partnerships with community behavioral health and health providers, consumers, family members, and other community stakeholders.

Wisconsin’s initial efforts to work with EDs have offered promise. However, it is clear that there are many systemic hurdles to overcome. And, as the data suggests, this is also one of the most critical links in the chain or care that can be targeted for action.

(See Wisconsin Suicide Prevention Strategy, Page 22)

Resources:

Supporting Your Loved One Through a Suicidal Crisis A brochure created by the Prevent Suicide Chippewa Valley coalition about what to do and say when a loved one is discharged from the hospital (or not admitted) around a suicidal crisis. This brochure can be used as a template for other coalitions.

Continuity of Care for Suicide Prevention: The Role of Emergency Departments

Continuity of Care for Suicide Prevention and Research. (2011)

Wisconsin United for Mental Health, Information for Emergency Departments

Safety PlanningNo-suicide contracts are not evidence based; safety planning is. Safety planning is 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. Various resources can be found at this site.