Welcome to our educational resource on the Suicide Risk Care Pathway in the Military Health System. This page is designed to provide healthcare professionals, particularly those working within the military community, with vital information and guidance on assessing and managing suicide risk among Service members.
As a healthcare provider, your role in recognizing and addressing suicide risk is paramount. Understanding the unique challenges and risk factors faced by Service members is key to delivering effective care. This page will cover various aspects of suicide risk assessment, safety planning, lethal means safety, communication strategies, and the importance of understanding both risk and protective factors.
We will also delve into specific scenarios and best practices, guiding you on how to respond to different levels of risk and how to effectively communicate with patients and their families. Whether you’re a behavioral health specialist or a non-behavioral health provider, this resource aims to equip you with the knowledge and tools necessary to make a difference in the lives of those who may be struggling with thoughts of suicide.
Engaging in this training and integrating the Suicide Risk Care Pathway into your practice can enhance your ability to provide compassionate and effective care to Service members. Your role in suicide prevention is critical; with the right knowledge and skills, you can contribute to saving lives.
Suicide Risk Care Pathway in the Military Health System Post-Test Answers
Potential Military-specific risk factors noted in this training include:
- Limited or no access to lethal means
- Perceived sense of injustice or betrayal by unit or command
- Promotion to command/leadership
- All of the above
Answer: Perceived sense of injustice or betrayal by unit or command.
Safety planning is:
- Used to help patients manage their suicidal thoughts and feelings before they develop into a crisis
- Used to guarantee that a patient will not attempt suicide
- Created for the patient without their input
- Only recommended for patients who have a High Acute risk level
Answer: Used to help patients manage their suicidal thoughts and feelings before they develop into a crisis
Safety planning is a collaborative process between a patient and their healthcare provider. It involves identifying potential triggers, coping strategies, sources of support, and steps to take if the individual feels they are in crisis.
It’s important to note that while a safety plan can be a valuable tool in managing suicide risk, it cannot guarantee that a patient will not attempt suicide. It is a part of a comprehensive approach to treatment and should be used in conjunction with other therapeutic interventions.
___________is defined by: “Thoughts of death, the wish to die, and/or indifference to dying.”
- Passive ideation
- Active ideation
- Suicidal intent
- Preparatory behavior
Answer: Passive ideation
Passive ideation refers to thoughts about death or a desire to die without a specific plan or intent to act. In contrast, active ideation involves not only thoughts of death but also the formulation of a plan and the intent to act on it.
Suicidal intent refers to the determination to act on thoughts of suicide and includes having a specific plan. Preparatory behavior includes actions taken in preparation for attempting suicide, such as acquiring means or setting affairs in order.
An effective provider does the following when discussing lethal means safety:
- Insists on always removing firearm from patient’s home, regardless of risk level
- Invites family and friends who know patients well to make decisions for the patients
- Explains to patients that their input on the issue cannot be trusted
- Meets the patients where they are and gets their input at every step
Answer: Meets the patients where they are and gets their input at every step.
An effective provider “Meets the patients where they are and gets their input at every step” when discussing lethal means safety.
It is essential for healthcare providers to engage in a collaborative approach with patients when discussing lethal means safety. This involves respecting patients’ autonomy and incorporating their perspectives and preferences into the safety planning process. By involving patients in the discussion, providers can better tailor interventions to suit the individual’s unique circumstances and needs.
The other options listed are not considered best practices. Insisting on always removing a firearm from a patient’s home regardless of risk level does not take into account the patient’s input or unique circumstances. Inviting family and friends to make decisions for the patients without involving the patients themselves disregards the importance of patient autonomy.
Telling patients that their input on the issue cannot be trusted is not a collaborative or respectful approach and may damage the therapeutic alliance.
A comprehensive and useful safety plan should:
- Use medical jargon and be in provider’s own words
- Include ways to seek social and professional support, and lethal means safety measures
- Include a signed contract by the patient that they will not harm self
- Be kept locked in safe with guns and medications
Answer: Include ways to seek social and professional support, and lethal means safety measures.
A safety plan should be personalized and practical. It should include strategies for identifying triggers or warning signs, coping strategies, sources of support (both informal, like friends or family, and formal, like mental health professionals), and steps to restrict access to lethal means, such as firearms or medications.
Using medical jargon is not recommended as it may make the plan less accessible and understandable to the patient. It is important that the patient understands the safety plan and feels comfortable using it.
While some clinicians have historically used no-suicide contracts, where a patient agrees not to harm themselves, this practice is generally not considered to be effective or evidence-based. Moreover, it is not a substitute for a comprehensive safety plan.
Clinical indicators that could warrant a C-SSRS screening include: positive depression screen, recent psychiatric hospitalization, and/or recent, serious psychosocial stressors.
- True
- False
Answer: True
Clinical indicators that could warrant a C-SSRS (Columbia-Suicide Severity Rating Scale) screening include a positive depression screen, recent psychiatric hospitalization, and/or recent serious psychosocial stressors.
The C-SSRS is a tool used to assess suicide risk, and it is important to administer this screening when there are indicators that suggest an individual may be at risk for suicidal ideation or behavior.
A positive depression screen, recent psychiatric hospitalization, and recent serious psychosocial stressors are all factors that can increase an individual’s risk for suicide, and therefore warrant further assessment through tools like the C-SSRS. This is aligned with best practices in mental health care for the identification and management of suicide risk.
What is included in a warm-hand-off from one provider to another?
- Direct communication about patient’s suicide risk
- The receiving provider acknowledges and confirms receipt of care
- Either or both providers can involve a representative for this hand-off
- All of the above
Answer: All of the above.
A warm-hand-off is a best practice in healthcare that involves a direct and personal transition of care from one healthcare provider to another. This includes:
- “Direct communication about patient’s suicide risk” – It is essential for the provider handing off the patient to communicate any relevant information about the patient’s suicide risk, including any assessments, safety plans, or other pertinent details.
- “The receiving provider acknowledges and confirms receipt of care” – It is important for the receiving provider to acknowledge that they have received all of the necessary information and are now assuming care for the patient.
- “Either or both providers can involve a representative for this hand-off” – In some cases, it may be appropriate or necessary for a representative (such as a case manager or another member of the healthcare team) to be involved in the hand-off to ensure that all relevant information is communicated and that the transition of care is smooth.
A non-BH provider should refer to a BH provider, BH Consultant in Primary Care, or the nearest emergency department:
- When patient is communicating suicidal intent, verbally, electronically, or in writing
- When suicidal ideation is present and paired with access to lethal means, such as firearms
- When suicidal ideation is present and paired with preparatory behaviors, such as putting affairs in order
- All of the above
Answer: All of the above.
A non-BH (Behavioral Health) provider should refer a patient to a BH provider, BH Consultant in Primary Care, or the nearest emergency department in the following scenarios:
- “When the patient is communicating suicidal intent, verbally, electronically, or in writing” – Expressing suicidal intent is a critical indicator that the individual is at high risk for suicide and needs immediate intervention.
- “When suicidal ideation is present and paired with access to lethal means, such as firearms” – Having access to lethal means significantly increases the risk of a suicide attempt being fatal. This scenario requires immediate attention and intervention.
- “When suicidal ideation is present and paired with preparatory behaviors, such as putting affairs in order” – Engaging in preparatory behaviors is a strong indicator that the individual is seriously contemplating suicide and may be planning to act on these thoughts.
When a patient endorses a method, plan, intent, and/or recent history of suicidal behavior on the C-SSRS:
- The C-SSRS is “positive” and the next steps involve discussion of stigma concerns
- The C-SSRS is “negative” and family support should be focus of action steps
- The C-SSRS is considered “positive” and next steps include direct observation and referral and warm hand-off to BH or ED
- The C-SSR is considered “negative” and can be managed “in-house” with a safety plan
Answer: The C-SSRS is considered “positive” and next steps include direct observation and referral and warm hand-off to BH or ED.
The C-SSRS is a screening tool used to assess the severity of suicidal ideation and behavior. When a patient endorses having a specific method, plan, intent, or recent history of suicidal behavior, it indicates a heightened risk for suicide. In such cases, the C-SSRS is considered “positive” for suicide risk.
The appropriate response to a positive C-SSRS includes ensuring the safety of the patient through direct observation to prevent self-harm, and initiating a referral and warm hand-off to Behavioral Health (BH) services or an Emergency Department (ED) for further evaluation and intervention. This is critical to ensure that the patient receives the necessary care and support to address the risk of suicide.
With respect to guidelines for sensitive and appropriate terminology for suicide risk care, professionals should take care to avoid use of the following term:
- Suicide attempt
- Suicidal gesture
- Active ideation
- Died by suicide
Answer: Suicidal gesture.
With respect to guidelines for sensitive and appropriate terminology for suicide risk care, professionals should take care to avoid the use of the term “Suicidal gesture”.
The term “Suicidal gesture” can be perceived as judgmental and may imply that the behavior was not serious or was done for attention-seeking purposes. This can contribute to stigma and may invalidate the experiences of individuals who are struggling with suicidal thoughts or behaviors.
Instead, it is important for professionals to use language that is non-judgmental, respectful, and accurately reflects the seriousness of the situation. Terms like “suicide attempt,” “active ideation,” and “died by suicide” are considered more appropriate and sensitive in the context of discussing suicide and suicide risk.
Using accurate and compassionate language can foster a more supportive environment for individuals at risk and can be an important aspect of suicide prevention efforts.
Feeling overwhelmed when working with a patient with suicide risk:
- Should signal a need to recuse self from work until competencies can be strengthened
- Should signal a need to suspend all work in suicide risk care
- Is normal and could prompt healthy connections with peers and supervisors for support
- Is normal and unlikely to improve with training and experience
Answer: Is normal and could prompt healthy connections with peers and supervisors for support.
Working with patients who are at risk for suicide can be emotionally challenging and overwhelming for healthcare professionals. It is normal to experience a range of emotions, including anxiety, sadness, or feeling overwhelmed. It is important for professionals to recognize these feelings and seek support as needed.
Connecting with peers and supervisors can be a valuable way to manage these emotions. Through these connections, professionals can gain insights, advice, and emotional support that can help them to more effectively care for patients at risk for suicide.
Suicide protective factors include:
- Healthy problem-solving and coping
- Engagement in effective behavioral health care
- A sense of purpose and meaning in life
- All of the above
Answer: All of the above.
- “Healthy problem-solving and coping” – Individuals who have effective problem-solving skills and coping strategies are often better equipped to manage stress and emotional challenges, which can reduce the risk of suicidal thoughts and behaviors.
- “Engagement in effective behavioral health care” – Engagement in mental health treatment, especially if it’s evidence-based, can be a significant protective factor. It can help individuals manage mental health conditions that might otherwise increase their risk of suicide.
- “A sense of purpose and meaning in life” – Having a sense of purpose and meaning can provide individuals with a reason to live. This can be a powerful protective factor, especially during times of crisis.
When a caller reports current suicidal behaviors on the phone, it is appropriate to place them on hold while connecting to a BH provider.
- True
- False
Answer: False.
When a caller reports current suicidal behaviors on the phone, it is not appropriate to place them on hold. It’s crucial to keep the line of communication open and to remain engaged with the individual. During this time, the person may be in crisis and may need immediate support and reassurance.
In such situations, it’s important to stay on the line, listen, and provide support while simultaneously seeking assistance. If you are not a trained mental health professional, it is best to try to get someone who is trained in crisis intervention involved as quickly as possible. If the person is in immediate danger or experiencing a life-threatening emergency, contacting emergency services while staying on the line with the individual is critical.
Putting the caller on hold could increase feelings of isolation and desperation, and it’s essential to maintain connection and support during such a critical time.
Reducing access to firearms through safe storage practices:
- Does not concern providers and is not their responsibility
- Should only be discussed when patient is being discharged from acute care
- Reduces the likelihood of a suicide attempt by increasing both time and distance between an individual and lethal means
- None of the above
Answer: Reduces the likelihood of a suicide attempt by increasing both time and distance between an individual and lethal means.
Reducing access to firearms through safe storage practices is an evidence-based strategy for suicide prevention. By increasing both the time and distance between an individual who is at risk of suicide and lethal means, it can reduce the likelihood of a suicide attempt. This is because many suicide attempts are impulsive, and even small barriers can prevent an attempt.
Healthcare providers have an important role in discussing safe storage practices and reducing access to lethal means as part of a comprehensive approach to suicide prevention. It is important for providers to address this issue proactively and not just when a patient is being discharged from acute care.
Engaging in conversations about safe storage practices and reducing access to firearms is a responsibility that falls within the scope of healthcare providers, especially those who are working with individuals at risk for suicide. It is part of ensuring the safety and well-being of patients.
Lethal means safety can be reinforced when the provider:
- Raises the issue and partners with the patient to plan for how to reduce risk
- Inquires directly about access to lethal means, including firearms, medications, etc.
- Makes recommendations to reduce risk, including safe storage practices
- All of the above
Answer: All of the above.
- “Raises the issue and partners with the patient to plan for how to reduce risk” – Engaging the patient in a conversation and collaborating with them to develop a plan for reducing access to lethal means is an effective approach. It ensures the patient is actively involved in their own safety planning.
- “Inquires directly about access to lethal means, including firearms, medications, etc.” – Asking direct questions about the patient’s access to lethal means is important in assessing the level of risk and understanding what measures need to be taken to ensure safety.
- “Makes recommendations to reduce risk, including safe storage practices” – Providing recommendations for safe storage practices and other strategies to reduce access to lethal means is a critical component of lethal means safety.
High Acute Risk is characterized by:
- Suicidal ideation with intent to die by suicide and inability to maintain safety independent of external support or help
- Suicidal ideation with or without intent to die and ability to maintain safety independent of external support or help
- No current suicidal intent and no current suicide plan
- Suicidal ideation with no recent preparatory behaviors and collective high confidence in the patient’s ability to maintain safety
Answer: Suicidal ideation with intent to die by suicide and inability to maintain safety independent of external support or help.
High Acute Risk refers to a situation where an individual is experiencing suicidal thoughts and has a specific intent to die by suicide, combined with an inability to ensure their own safety without external intervention or support.
This level of risk necessitates immediate intervention to prevent self-harm. Individuals at high acute risk may require hospitalization or another form of intensive care to ensure their safety. It’s important for healthcare providers to take immediate action to connect individuals experiencing high acute risk to the appropriate level of care.
Behavioral health and psychiatric symptoms such as hopelessness, depressed mood, and insomnia are risk factors for suicide.
- True
- False
Answer: True.
Behavioral health and psychiatric symptoms such as hopelessness, depressed mood, and insomnia are indeed risk factors for suicide.
Hopelessness, in particular, is strongly associated with suicidal thoughts and behaviors. Individuals who feel hopeless may believe that their situation will not improve, which can contribute to feelings of despair and thoughts of suicide.
Depressed mood is also a significant risk factor for suicide, especially in cases of major depressive disorder. Depression can cause individuals to experience intense sadness, feelings of worthlessness, and a lack of interest or pleasure in activities.
Insomnia and other sleep disturbances have also been linked to an increased risk of suicide. Sleep problems can exacerbate mental health issues and contribute to impaired judgment and decision-making.
Lethal means counseling might address all of the following EXCEPT:
- Storing firearms locked and unloaded
- Storing ammunition separately from the firearm
- Using a cable lock, lock box, and gun safe
- Patient signing a private contract for commitment to safety
Answer: Patient signing a private contract for commitment to safety.
Lethal means counseling focuses on strategies to reduce access to methods a person might use to harm themselves, such as firearms or medications.
This includes advising on safe storage practices like storing firearms locked and unloaded, storing ammunition separately from the firearm, and using safety devices such as cable locks, lockboxes, or gun safes.
On the other hand, having a patient sign a private contract for commitment to safety, often referred to as a “no-suicide contract,” is not considered an evidence-based practice and is not part of lethal means counseling.
These contracts are controversial and have not been proven effective in preventing suicide. Lethal means counseling focuses on practical steps to reduce access to lethal means, rather than relying on a contract or agreement.
The following are tips for de-escalating a crisis:
- Be empathetic
- Respect personal space
- Remain calm
- All of the above
Answer: All of the above.
- “Be empathetic” – Showing empathy towards the individual in crisis can help them feel understood and less isolated. This can create a connection that may reduce the intensity of the crisis.
- “Respect personal space” – In a crisis situation, an individual may be highly sensitive to their surroundings. Respecting personal space can prevent the escalation of anxiety and agitation.
- “Remain calm” – Maintaining a calm demeanor can have a soothing effect on the individual in crisis. It can also model a sense of control and help the individual to focus on resolving the situation.
With respect to openness to discussing lethal means safety:
- The majority of firearm owners (or those who live with them) are open to a discussion
- The majority of those who own firearms are NOT open to a discussion
- The majority of those who live with a firearm owner are NOT open to a discussion
- No data are available on openness to firearm discussions
Answer: The majority of firearm owners (or those who live with them) are open to a discussion.
Research has shown that many firearm owners and individuals living in households with firearms are open to discussions about lethal means safety when approached respectfully and non-judgmentally. Healthcare providers can play a significant role in these discussions, especially in the context of suicide prevention.
It is important for healthcare providers to address lethal means safety as part of a comprehensive approach to suicide prevention, and to do so in a manner that respects the values and perspectives of firearm owners and their families. This can include providing information on safe storage practices and discussing the role that limiting access to firearms can play in preventing suicide.
When a patient can be managed in a Primary Care or outpatient mental health treatment setting, with routine reassessment of risk, the risk level is most likely:
- High Acute
- Intermediate Acute
- Low Acute
- None of the above
Answer: Low Acute.
Low Acute Risk typically refers to a situation where an individual may have some suicidal thoughts, but there is no specific plan or intent, and they are able to maintain safety without intensive intervention. Such individuals can often be managed in primary care or outpatient mental health settings, where they can receive ongoing monitoring and treatment to address any underlying mental health issues.
In contrast, individuals at High Acute Risk or Intermediate Acute Risk usually have more immediate and severe suicidal thoughts or behaviors, and often require more intensive interventions such as hospitalization or close monitoring in a specialized mental health setting.
As a non-behavioral health provider, you may do the following when you learn that your patient is experiencing a new suicide risk factor:
- Conduct a suicide risk screening to identify risk and determine next steps
- Conduct a clinical evaluation and comprehensive risk assessment to assign a risk level
- Provide evidence-based behavioral health treatment
- Immediately escort patient to the emergency department
Answer: Conduct a suicide risk screening to identify risk and determine next steps.
It is important for non-behavioral health providers to be vigilant in recognizing signs and risk factors for suicide. Conducting a suicide risk screening is a crucial first step in identifying whether a patient is at risk and determining the appropriate next steps. This might include referring the patient to a behavioral health specialist for a more comprehensive evaluation, or coordinating with other healthcare providers for appropriate intervention.
Conducting a clinical evaluation and comprehensive risk assessment to assign a risk level, providing evidence-based behavioral health treatment, or immediately escorting the patient to the emergency department are actions that might be taken based on the results of the initial screening and depending on the severity of the risk, but it is important to start with a screening to assess the situation.
Non-BH providers are NOT responsible for:
- Communicating results of validated screening to providers
- Facilitating referral to BH for clinical evaluation, if appropriate
- Administering cognitive behavioral therapy for suicide prevention
- Facilitating direct observation and warm-hand off to ED, if appropriate
Answer: Administering cognitive behavioral therapy for suicide prevention.
Non-behavioral health (Non-BH) providers play an important role in the initial identification and referral of patients who may be at risk for suicide. This includes communicating the results of validated screenings to other providers, facilitating referrals to behavioral health (BH) for clinical evaluation when appropriate, and facilitating direct observation and a warm hand-off to the emergency department (ED) if necessary.
However, administering cognitive behavioral therapy (CBT) for suicide prevention is a specialized intervention that should be conducted by trained mental health professionals. CBT is a form of psychotherapy that requires specialized training and expertise, and it is typically provided by psychologists, psychiatrists, or other mental health professionals who have experience in treating suicidal ideation and behavior.
Non-BH providers can play a crucial role in referring patients to the appropriate mental health services where they can receive specialized interventions such as CBT.
Recent biopsychosocial stressors are risk factors for suicide. An example of this includes:
- Legal or disciplinary issues
- Financial problems
- Transition of care
- All of the above
Answer: All of the above.
- “Legal or disciplinary issues” – Facing legal problems or disciplinary actions can create significant stress and may contribute to feelings of hopelessness or despair, which are associated with an increased risk of suicidal thoughts and behaviors.
- “Financial problems” – Financial stress, especially if it is severe or sudden, can have a major impact on a person’s mental health and well-being, and is considered a risk factor for suicide.
- “Transition of care” – Changes in healthcare, such as moving from one healthcare setting to another, or changes in healthcare providers, can be stressful and disruptive, especially for individuals with mental health conditions. This can contribute to a sense of instability and increase the risk of suicide.
Each of these factors can contribute to an individual’s overall stress level and potentially exacerbate underlying mental health issues, increasing the risk for suicidal thoughts and behaviors. It is important for healthcare providers to be aware of these and other stressors and to consider them in the context of a comprehensive assessment of suicide risk.
Indicators of potential suicide risk that require consideration of a warm hand-off and referral to a BH provider include:
- The detection of self-inflicted injuries
- Endorsement of suicidal ideation on a routine depression screen
- Recent suicide attempt
- All of the above
Answer: All of the above.
- “The detection of self-inflicted injuries” – Self-inflicted injuries are a clear sign of emotional distress and self-harm, and can be indicative of a higher risk for suicide. It is crucial to take this seriously and ensure that the individual receives the appropriate mental health support.
- “Endorsement of suicidal ideation on a routine depression screen” – When someone indicates that they are experiencing suicidal thoughts during a routine depression screening, this is a significant warning sign and indicates that they may be at risk for suicide.
- “Recent suicide attempt” – A recent suicide attempt is one of the strongest indicators of suicide risk. Individuals who have recently attempted suicide are at a significantly higher risk of making another attempt.
In each of these cases, it is important to ensure that the individual is connected with the appropriate mental health services. A warm hand-off, which involves direct communication between the referring provider and the receiving behavioral health provider, can help to ensure that the transition is smooth and that the individual receives the care they need.
Why is knowledge of a patient’s protective factors important?
- Protective factors indicate there is no suicide risk
- Protective factors cancel out risk factors during screening
- Strengthening protective factors is an important clinical objective
- None of the above
Answer: Strengthening protective factors is an important clinical objective.
Knowledge of a patient’s protective factors is important because these factors can help reduce the risk of suicidal behavior. Protective factors are characteristics or conditions that may help individuals to cope with stressful situations and mitigate the impact of risk factors. Some examples of protective factors include social support, coping skills, and engagement in meaningful activities.
It is important to note that protective factors do not eliminate the risk of suicide altogether, nor do they cancel out risk factors.
However, they can be a buffer against the effects of risk factors. Strengthening these protective factors can enhance resilience and is often an essential component of suicide prevention strategies.
Encouraging patients to build and maintain social connections, develop coping skills, and engage in activities that provide them with a sense of purpose are examples of how healthcare providers can help strengthen protective factors.
For patients with Low Acute Risk, the following provider action is indicated:
- Patient should be hospitalized until there is no suicide risk present
- Patient care can be managed in Primary Care or Outpatient mental health setting, with routine re-assessments of suicide risk
- Patient should be required to attend intensive outpatient mental health treatment
- Patient should be kept under constant and direct observation.
Answer: Patient care can be managed in Primary Care or Outpatient mental health setting, with routine re-assessments of suicide risk.
Patients categorized as having Low Acute Risk are typically not considered to be in immediate danger, but still require monitoring and support. Managing their care in a Primary Care or Outpatient mental health setting allows for the provision of necessary support and interventions in a less restrictive environment compared to hospitalization.
It is also crucial to have routine re-assessments of suicide risk for these patients to monitor any changes in their condition and to ensure that they receive the appropriate level of care based on their evolving needs.
Reducing access to lethal means includes applying safe storage practices to:
- Medications
- Household poisons
- Knives
- All of the above
Answer: All of the above.
Reducing access to lethal means is a key component of suicide prevention. This involves applying safe storage practices to:
- “Medications” – This includes safely storing prescription medications, especially those that could be used in an overdose, in a locked cabinet or other secure location.
- “Household poisons” – Similar to medications, household chemicals and poisons should be stored in a secure location to prevent access by individuals who might be at risk of self-harm.
- “Knives” – Secure storage of knives and other sharp objects is also important, as these can be used in acts of self-harm.
By reducing access to these and other lethal means through safe storage practices, it is possible to create a safer environment and reduce the risk of impulsive acts of self-harm or suicide. This approach recognizes that moments of crisis can be temporary, and placing barriers between an individual and the means to harm themselves can be life-saving.
Risk factors for Service members include all of the following EXCEPT:
- H and psychiatric symptoms (hopelessness, insomnia)
- Separation from unit, disciplinary actions
- Access to and engagement in outpatient behavioral health care
- Substance or alcohol use, eating disorders, recent discharge from psychiatric facility
Answer: Access to and engagement in outpatient behavioral health care.
“Access to and engagement in outpatient behavioral health care” is the option that is NOT a risk factor for Service members. Instead, it is considered a protective factor.
- “BH and psychiatric symptoms (hopelessness, insomnia)” – Behavioral health and psychiatric symptoms such as hopelessness and insomnia are risk factors for suicide among Service members as they indicate mental distress.
- “Separation from unit, disciplinary actions” – Separation from one’s unit or disciplinary actions can be isolating and distressing experiences for Service members, and they are considered risk factors for suicide.
- “Substance or alcohol use, eating disorders, recent discharge from psychiatric facility” – Substance or alcohol use and eating disorders are indicative of mental health issues and coping challenges, and a recent discharge from a psychiatric facility indicates a recent mental health crisis. These are all considered risk factors for suicide among Service members.
On the other hand, access to and engagement in outpatient behavioral health care is considered a protective factor as it involves receiving support and treatment for mental health issues, which can help in reducing the risk of suicide.
As a best practice, providers should:
- Follow up with patients who miss scheduled appointments and reschedule
- Never contact patients once they have been discharged from acute care
- Not track and monitor engagement of at-risk patients
- Not adjust treatment plans based on level of risk
Answer: Follow up with patients who miss scheduled appointments and reschedule.
Following up with patients who miss scheduled appointments is essential for ensuring continuity of care, especially for those who might be at risk for suicide or experiencing mental health issues.
By reaching out to these patients and rescheduling their appointments, healthcare providers can show that they are invested in the patients’ well-being and can potentially re-engage individuals who might be in need of support or intervention.
This practice is also important for monitoring the patients’ health status and for making necessary adjustments to treatment plans based on any changes in their condition. The other options listed are not best practices and do not reflect a proactive and caring approach to patient care.
