Screening for Depression and Suicide Risk Assessment
|
|
- Abigayle McCarthy
- 5 years ago
- Views:
Transcription
1 Screening for Depression and Suicide Risk Assessment Karl Rosston, LCSW Suicide Prevention Coordinator (406) Updated: July, 2017
2 Suicide Fact Sheet Center for Disease Control WISQARS website, (January, 2017) Suicide has surpassed car accidents as the No. 1 cause of injury-related death in the United States. There has been a 28% increase in the number of suicides in the United States since 2001 (CDC, 2016) In 2015 there were 44,193 suicides in the U.S. (121 suicides per day; 1 suicide every 12 minutes). This translates to an annual suicide rate of 13.8 per 100,000. Males complete suicide at a rate four times that of females. However, females attempt suicide three times more often than males. Firearms remain the most commonly used suicide method, accounting for nearly 50% of all completed suicides.
3 Suicide and Primary Care Up to 45% of individuals who die by suicide visit their primary care provider within a month of their death, with 20% of those having visited their primary care provider within 24 hours of their death Elders who complete suicide: 73% have contact with primary care physician within a month of their suicide, with nearly half visiting in the preceding week. There is a strong correlation between chronic pain and suicide 20-30% of those who die by suicide have issues of chronic illness or pain. A person with chronic pain is 3 times the risk of suicide
4 Montana Suicides with identified Warning Signs In the 74% of the suicides where warning signs were identified, at least 3 warning signs were present in each suicide. No Identified Warning Signs, 144, 26% Warning Signs Identified, 411, 74%
5 Suicide in Montana Data Source: CDC-WISQARS (1/27/17), Montana Suicide Mortality Review Team (June, 2016) For all age groups, Montana has ranked in the top five for suicide rates in the nation, for the past forty years. According to the most recent numbers released by the National Vital Statistics Report for 2015, Montana has the third highest rate of suicide in the United States (272 suicides for a rate of 26.3). Between January 1, 2014 and July 14, 2017, Montana had 974 suicides for a rate of 28.5
6 Approximately 90% of those who complete suicide suffer from at least one major psychiatric disorder Mood disorders are consistently the most prevalent disorder (49-64%) The 2 nd most frequent diagnosis is a Substance abuse disorder. (however, it is important to note that not all mentally ill people attempt suicide) Montana Suicides with Identified Mental Health Issues Mental Health Issues, 261, 83% Montana Suicides By Type of Mental Health Disorder Anxiety, 21, 7% Other, 15, 5% Psychotic Disorder, 9, 3% PTSD, 22, 8% Bipolar, 24, 8% None Reported, 52, 17% Based on 313 suicides that provided mental health information 55 of the 261 (21%) had multiple mental health issues. Depression, 202, 69%
7 Depression is Treatable Depression is one of the most treatable of all psychiatric disorders in young people 86% treatment rate with a combination of antidepressants and therapy* Only between 40-70% with either by themselves. * Source: The TADS Team. The Treatment for Adolescents with Depression Study (TADS): Long-term Effectiveness and Safety Outcomes. Archives of General Psychiatry. Oct 2007; VOL 64(10).
8 The estimation of suicide risk, at the culmination of the suicide assessment, is the quintessential clinical judgment, since no study has identified one specific risk factor or set of risk factors as specifically predictive of suicide or other suicidal behavior. From The American Psychiatric Association Practice Guidelines for the Assessment and Treatment of Patients with Suicidal Behaviors, page 24.
9 For a tentative diagnosis of depression; Questions 1 or 2 are endorsed in the shaded area. If there are at least 4 checks in the shaded section (including Questions #1 and #2), consider a depressive disorder. if there are at least 5 checks in the shaded section (one of which corresponds to Question #1 or #2), consider Major Depressive Disorder (a dx of MDD indicates 25x the risk of suicide.) Shaded response to question #9 indicates 10x the risk of suicide
10 Interpretation of Total Score Total Score Depression Severity 1-4 Minimal depression 5-9 Mild depression Moderate depression Moderately severe depression Severe depression
11 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up Ideation Severity Subscale Questions 1-5: Five types of ideation of increasing severity Score presence/absence of any suicidal ideation yes/no Questions 1 &2 are screening questions; if the answers to both are no, you do not need to ask questions 3-5 and may skip to the suicidal behavior section. The most severe ideation endorsed (1-5) becomes the score for this section. Bottom section provides history, presenting symptoms, and stressors.
12 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up Intensity of Ideation Subscale (Referring only to the most severe ideation endorsed above for the timeframe of interest): Add the highest numbers endorsed on the 5 intensity items (Frequency, Duration, Controllability, Deterrents, and Reasons for Ideation). The sum ranges from 2 to 25, with the higher number indicating more intense ideation. If no ideation was endorsed on the Severity Subscale, assign a score of 0 or N/A for the Intensity Subscale.
13 INTENSITY OF IDEATION The following features should be rated with respect to the most severe type of ideation (i.e.,1-5 from above, with 1 being the least severe and 5 being the most severe ). Ask about time he/she was feeling the most suicidal. Most Severe Ideation: Type # (1-5) Description of Ideation Frequency How many times have you had these thoughts? (1) Less than once a week (2) Once a week (3) 2-5 times in week (4) Daily or almost daily (5) Many times each day Duration When you have the thoughts, how long do they last? (1) Fleeting - few seconds or minutes (4) 4-8 hours/most of day (2) Less than 1 hour/some of the time (5) More than 8 hours/persistent or continuous (3) 1-4 hours/a lot of time Controllability Could /can you stop thinking about killing yourself or wanting to die if you want to? (1) Easily able to control thoughts (4) Can control thoughts with a lot of difficulty (2) Can control thoughts with little difficulty (5) Unable to control thoughts (3) Can control thoughts with some difficulty (0) Does not attempt to control thoughts Deterrents Are there things - anyone or anything (e.g. family, religion, pain of death) - that stopped you from wanting to die or acting on thoughts of committing suicide? (1) Deterrents definitely stopped you from attempting suicide (4) Deterrents most likely did not stop you (2) Deterrents probably stopped you (5) Deterrents definitely did not stop you (3) Uncertain that deterrents stopped you (0) Does not apply Reasons for Ideation What sort of reasons did you have for thinking about wanting to die or killing yourself? Was it to end the pain or stop the way you were feeling (in other words you couldn t go on living with this pain or how you were feeling) or was it to get attention, revenge or a reaction from others? Or both? (1) Completely to get attention, revenge or a reaction from others. (4) Mostly to end or stop the pain (you couldn t go on (2) Mostly to get attention, revenge or a reaction from others. living with the pain or how you were feeling). (3) Equally to get attention, revenge or a reaction from others (5) Completely to end or stop the pain (you couldn t go on and to end/stop the pain. living with the pain or how you were feeling). (0) Does not apply Most Severe 13
14 INTENSITY OF IDEATION The following features should be rated with respect to the most severe type of ideation (i.e.,1-5 from above, with 1 being the least severe and 5 being the most severe ). Ask about time he/she was feeling the most suicidal. Most Severe Ideation: Type # (1-5) Description of Ideation Frequency How many times have you had these thoughts? (1) Less than once a week (2) Once a week (3) 2-5 times in week (4) Daily or almost daily (5) Many times each day Duration When you have the thoughts, how long do they last? (1) Fleeting - few seconds or minutes (4) 4-8 hours/most of day (2) Less than 1 hour/some of the time (5) More than 8 hours/persistent or continuous (3) 1-4 hours/a lot of time Controllability Could /can you stop thinking about killing yourself or wanting to die if you want to? (1) Easily able to control thoughts (4) Can control thoughts with a lot of difficulty (2) Can control thoughts with little difficulty (5) Unable to control thoughts (3) Can control thoughts with some difficulty (0) Does not attempt to control thoughts Deterrents Are there things - anyone or anything (e.g. family, religion, pain of death) - that stopped you from wanting to die or acting on thoughts of committing suicide? (1) Deterrents definitely stopped you from attempting suicide (4) Deterrents most likely did not stop you (2) Deterrents probably stopped you (5) Deterrents definitely did not stop you (3) Uncertain that deterrents stopped you (0) Does not apply Reasons for Ideation What sort of reasons did you have for thinking about wanting to die or killing yourself? Was it to end the pain or stop the way you were feeling (in other words you couldn t go on living with this pain or how you were feeling) or was it to get attention, revenge or a reaction from others? Or both? (1) Completely to get attention, revenge or a reaction from others. (4) Mostly to end or stop the pain (you couldn t go on (2) Mostly to get attention, revenge or a reaction from others. living with the pain or how you were feeling). (3) Equally to get attention, revenge or a reaction from others (5) Completely to end or stop the pain (you couldn t go on and to end/stop the pain. living with the pain or how you were feeling). (0) Does not apply Most Severe 14
15 INTENSITY OF IDEATION The following features should be rated with respect to the most severe type of ideation (i.e.,1-5 from above, with 1 being the least severe and 5 being the most severe ). Ask about time he/she was feeling the most suicidal. Most Severe Ideation: Type # (1-5) Description of Ideation Frequency How many times have you had these thoughts? (1) Less than once a week (2) Once a week (3) 2-5 times in week (4) Daily or almost daily (5) Many times each day Duration When you have the thoughts, how long do they last? (1) Fleeting - few seconds or minutes (4) 4-8 hours/most of day (2) Less than 1 hour/some of the time (5) More than 8 hours/persistent or continuous (3) 1-4 hours/a lot of time Controllability Could /can you stop thinking about killing yourself or wanting to die if you want to? (1) Easily able to control thoughts (4) Can control thoughts with a lot of difficulty (2) Can control thoughts with little difficulty (5) Unable to control thoughts (3) Can control thoughts with some difficulty (0) Does not attempt to control thoughts Deterrents Are there things - anyone or anything (e.g. family, religion, pain of death) - that stopped you from wanting to die or acting on thoughts of committing suicide? (1) Deterrents definitely stopped you from attempting suicide (4) Deterrents most likely did not stop you (2) Deterrents probably stopped you (5) Deterrents definitely did not stop you (3) Uncertain that deterrents stopped you (0) Does not apply Reasons for Ideation What sort of reasons did you have for thinking about wanting to die or killing yourself? Was it to end the pain or stop the way you were feeling (in other words you couldn t go on living with this pain or how you were feeling) or was it to get attention, revenge or a reaction from others? Or both? (1) Completely to get attention, revenge or a reaction from others. (4) Mostly to end or stop the pain (you couldn t go on (2) Mostly to get attention, revenge or a reaction from others. living with the pain or how you were feeling). (3) Equally to get attention, revenge or a reaction from others (5) Completely to end or stop the pain (you couldn t go on and to end/stop the pain. living with the pain or how you were feeling). (0) Does not apply Most Severe 15
16 INTENSITY OF IDEATION The following features should be rated with respect to the most severe type of ideation (i.e.,1-5 from above, with 1 being the least severe and 5 being the most severe ). Ask about time he/she was feeling the most suicidal. Most Severe Ideation: Type # (1-5) Description of Ideation Frequency How many times have you had these thoughts? (1) Less than once a week (2) Once a week (3) 2-5 times in week (4) Daily or almost daily (5) Many times each day Duration When you have the thoughts, how long do they last? (1) Fleeting - few seconds or minutes (4) 4-8 hours/most of day (2) Less than 1 hour/some of the time (5) More than 8 hours/persistent or continuous (3) 1-4 hours/a lot of time Controllability Could /can you stop thinking about killing yourself or wanting to die if you want to? (1) Easily able to control thoughts (4) Can control thoughts with a lot of difficulty (2) Can control thoughts with little difficulty (5) Unable to control thoughts (3) Can control thoughts with some difficulty (0) Does not attempt to control thoughts Deterrents Are there things - anyone or anything (e.g. family, religion, pain of death) - that stopped you from wanting to die or acting on thoughts of committing suicide? (1) Deterrents definitely stopped you from attempting suicide (4) Deterrents most likely did not stop you (2) Deterrents probably stopped you (5) Deterrents definitely did not stop you (3) Uncertain that deterrents stopped you (0) Does not apply Reasons for Ideation What sort of reasons did you have for thinking about wanting to die or killing yourself? Was it to end the pain or stop the way you were feeling (in other words you couldn t go on living with this pain or how you were feeling) or was it to get attention, revenge or a reaction from others? Or both? (1) Completely to get attention, revenge or a reaction from others. (4) Mostly to end or stop the pain (you couldn t go on (2) Mostly to get attention, revenge or a reaction from others. living with the pain or how you were feeling). (3) Equally to get attention, revenge or a reaction from others (5) Completely to end or stop the pain (you couldn t go on and to end/stop the pain. living with the pain or how you were feeling). (0) Does not apply Most Severe 16
17 INTENSITY OF IDEATION The following features should be rated with respect to the most severe type of ideation (i.e.,1-5 from above, with 1 being the least severe and 5 being the most severe ). Ask about time he/she was feeling the most suicidal. Most Severe Ideation: Type # (1-5) Description of Ideation Frequency How many times have you had these thoughts? (1) Less than once a week (2) Once a week (3) 2-5 times in week (4) Daily or almost daily (5) Many times each day Duration When you have the thoughts, how long do they last? (1) Fleeting - few seconds or minutes (4) 4-8 hours/most of day (2) Less than 1 hour/some of the time (5) More than 8 hours/persistent or continuous (3) 1-4 hours/a lot of time Controllability Could /can you stop thinking about killing yourself or wanting to die if you want to? (1) Easily able to control thoughts (4) Can control thoughts with a lot of difficulty (2) Can control thoughts with little difficulty (5) Unable to control thoughts (3) Can control thoughts with some difficulty (0) Does not attempt to control thoughts Deterrents Are there things - anyone or anything (e.g. family, religion, pain of death) - that stopped you from wanting to die or acting on thoughts of committing suicide? (1) Deterrents definitely stopped you from attempting suicide (4) Deterrents most likely did not stop you (2) Deterrents probably stopped you (5) Deterrents definitely did not stop you (3) Uncertain that deterrents stopped you (0) Does not apply Reasons for Ideation What sort of reasons did you have for thinking about wanting to die or killing yourself? Was it to end the pain or stop the way you were feeling (in other words you couldn t go on living with this pain or how you were feeling) or was it to get attention, revenge or a reaction from others? Or both? (1) Completely to get attention, revenge or a reaction from others. (4) Mostly to end or stop the pain (you couldn t go on (2) Mostly to get attention, revenge or a reaction from others. living with the pain or how you were feeling). (3) Equally to get attention, revenge or a reaction from others (5) Completely to end or stop the pain (you couldn t go on and to end/stop the pain. living with the pain or how you were feeling). (0) Does not apply Most Severe 17
18 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up There are no cut off score for intensity. That said, we do have the following data that looked at ranges of scores and risk ratios for suicide behavior and found a 34X increase for the range with lower odds ratios as the score range drops. These scores are best used to help inform clinical judgment when there is uncertainty about disposition and to assess change over time. Moderate (6-10) Mod. Severe (11-15) Severe (16-20) Very Severe (21-25) 11x 13x 19x 34x
19 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up Suicidal Behavior Subscale: 4 types of suicidal behaviors are scored yes/no and identify categorical occurrence and density of actual, interrupted, aborted attempts and preparatory behaviors and distinguish suicidal and non-suicidal self injurious behavior. Presence of an attempt is a number one risk factor for dying by suicide Number of suicidal behaviors the total number of each type of suicidal behavior that occurred during the given time period shows the density of suicidal behavior (more behaviors represents higher degree of risk for example, multiple attempters are more at risk than single attempters).
20 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up High Risk Suicidal ideation with intent or intent with plan in past month (C-SSRS Suicidal Ideation #4 or #5) Or Suicidal behavior within past 3 months (C-SSRS Suicidal Behavior)
21 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up High Risk Triage Refer to Psychologist or Psychiatrist to evaluate for hospitalization Place on Facility High Risk List
22 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up High Risk Possible Interventions Assessment of patient s medical stability Observation Status Elopement precautions Body/belongings search Pharmacological treatment Family/significant-other engagement Psychotherapy (CBT, DBT) Psychoeducation (coping skills, stress management, symptom management, etc.) Safety Plan Telephone Follow-up upon discharge
23 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up High Risk Possible Interventions Safety needs to consider in the physical environment: Assess the physical environment, focusing on limiting access to methods. The most common methods of suicide in hospitals are hanging, suffocation and jumping. If risk assessment is conducted in outpatient setting: Place individual in a room that is away from exits but close to staff where patient is observed at all times Beware of elopement risk if patient is against admission AND/OR wanting to be alone to follow through with plans of suicide
24 SAFE-T Protocol with C-SSRS, Safety Planning and Telephone Follow-up General Guidelines for; Treatment plan for reducing risk level Suicide risk following discharge from inpatient setting Community Prevention Practices Guidelines for when to document suicide risk assessment
25 Depression is Treatable Suicide is Preventable If you are in crisis and want help, call the Montana Suicide Prevention Lifeline, 24/7, at TALK ( ) or text MT to
Suicide in Montana Colleges and Universities. Karl Rosston, LCSW Suicide Prevention Coordinator (406)
Suicide in Montana Colleges and Universities Karl Rosston, LCSW Suicide Prevention Coordinator (406) 444-3349 krosston@mt.gov Updated: January, 2016 Suicide Fact Sheet Center for Disease Control WISQARS
More informationWith additional support from Florida International University and The Children s Trust.
The Society for Clinical Child and Adolescent Psychology (SCCAP): Initiative for Dissemination of Evidence-based Treatments for Childhood and Adolescent Mental Health Problems With additional support from
More information5/11/2017. Objectives. Epidemiology of suicidality in youth. Suicide in Children & Adolescents: Risks, Screening & Prevention
Suicide in Children & Adolescents: Risks, Screening & Prevention Stephen Lassen, PhD Associate Professor of Pediatrics Objectives Recognize risk factors for suicidal behavior in children and adolescents
More informationColumbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE)
Columbia-Suicide Severity Rating Scale Baseline ( ) Questionnaire Supplement to the Study Data Tabulation Model Implementation Guide for Human Clinical Trials Prepared by CDISC and Analgesic Clinical Trial
More informationCRPS and Suicide Prevention
1 CRPS and Suicide Prevention Jill Harkavy Friedman, PhD June 23, 2012 RSDSA Board Meeting 2 What we know about suicidal ideation and behavior Majority of people have thought about suicide at some point
More informationDURING A SUICIDAL CRISIS
DURING A SUICIDAL CRISIS 1 UTAH RANKS 5 TH IN THE NATION 1 6 7 5 3 9 10 4 8 2 Data Source: WONDER 2016 Suicide Fatality Rates ages 10+ 2 Crude Rate of Suicides per 100,000 UTAH AND U.S. SUICIDE TREND Rate
More informationSuicide Prevention: From a Pharmacist s Perspective. Daina L. Wells, Pharm.D., BCPS, BCPP VA PBM Academic Detailing Service
Suicide Prevention: From a Pharmacist s Perspective Daina L. Wells, Pharm.D., BCPS, BCPP VA PBM Academic Detailing Service CPE Information and Disclosures Daina L. Wells declare(s) no conflicts of interest,
More informationPost-Traumatic Stress Disorder
Post-Traumatic Stress Disorder Teena Jain 2017 Post-Traumatic Stress Disorder What is post-traumatic stress disorder, or PTSD? PTSD is a disorder that some people develop after experiencing a shocking,
More informationScreening for Depression and Suicide
Screening for Depression and Suicide Christa Smith, PsyD Western Interstate Commission for Higher Education Boulder, Colorado 10/2/2008 Background My background A word about language Today stopics Why
More informationBrief Interventions for Managing Suicide Risk PRESENTATION. Andrea Hood, Utah Zero Suicide Project Coordinator
Brief Interventions for Managing Suicide Risk PRESENTATION Andrea Hood, Utah Zero Suicide Project Coordinator Zero Suicide Quality Improvement Framework PRESENTATION Zerosuicide.sprc.org Treatments That
More informationSuicidal Risk Management Protocol
Suicidal Risk Management Protocol Instructions: I. If one of the following two events occurs, then proceed in protocol: 1) Subject mentions any suicidal ideation at any point OR 2) Subject answers question
More informationColumbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE)
Columbia-Suicide Severity Rating Scale Baseline ( ) Questionnaire Supplement to the Study Data Tabulation Model Implementation Guide for Human Clinical Trials Prepared by CDISC and Analgesic Clinical Trial
More informationSuicide Spectrum Assessment and Interventions. Welcome to RoseEd Academy. Disclaimer
RoseEd Module 7 Suicide Spectrum Assessment and Interventions Suicide Spectrum Assessment and Interventions J. Scott Nelson MA NCC LPC CRADC Staff Education Coordinator Welcome to RoseEd Academy Disclaimer
More informationColumbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE)
Columbia-Suicide Severity Rating Scale Baseline ( ) Questionnaire Supplement to the Study Data Tabulation Model Implementation Guide for Human Clinical Trials Prepared by CDISC and Analgesic Clinical Trial
More informationSuicide Prevention and Intervention
Suicide Prevention and Intervention Kim Myers, MSW May 2, 2017 Division of Substance Abuse and Mental Health Overview Suicide in Utah Suicide Risk & Protective Factors Suicide Warning Signs C-SSRS Safety
More informationSuicide Risk Factors
Suicide Prevention Suicide Risk Factors Mental Health disorders, in particular: o Depression or bipolar (manic-depressive) disorder o Alcohol or substance abuse or dependence o Schizophrenia o Post Traumatic
More information4/28/2016. Youth Suicide in Maine; Prevalence, Risk Assessment and Management. Introduction
Youth Suicide in Maine; Prevalence, Risk Assessment and Management MCCAP Conference, 2016 Maine Suicide Prevention Program Education, Resources and Support It s Up to All of Us Greg A Marley, LCSW Clinical
More informationHow do I do a proper suicide assessment and document it in my note? September 27, 2018
Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences How do I do a proper suicide assessment and document it in my note? September 27, 2018 Christopher R. DeCou, PhD
More informationZERO SUICIDE WORKFORCE SURVEY
ZERO SUICIDE WORKFORCE SURVEY The Zero Suicide Workforce Survey is a tool to assess staff knowledge, practices, and confidence. This survey is part of our organizational mission to adopt a system-wide
More informationUPMC SAFE-T Training Adapted for Pediatric Primary Care. Sheri L. Goldstrohm, Ph.D.
UPMC SAFE-T Training Adapted for Pediatric Primary Care Sheri L. Goldstrohm, Ph.D. Prevalence of Suicide in the U.S. 10th most frequent cause of death for all ages 2nd leading cause of death for individuals
More informationECZTRA 3. Efficacy Assessment & C-SSRS Manual
ECZTRA 3 Efficacy Assessment & C-SSRS Manual LP0162 1339 Efficacy Assement & C SSRS Manual, v 1.0, 25 Jan 2018 Efficacy Assessments General instruction Investigator assessments should be performed after
More informationPatient Health Questionnaire-2
Resources Developmental, Behavioral, and Psychosocial Screening and Assessment Patient Health Questionnaire-2 Over the past 2 weeks, how often have you been bothered by any of the following problems? Little
More informationMental Health Series for Perinatal Prescribers. Severe postpartum syndromes
Mental Health Series for Perinatal Prescribers Severe postpartum syndromes 2 Maternal Filicides Acutely psychotic - 24% Depression Altruistic - 56% to relieve suffering associated with suicide 80% due
More informationIntegrated Primary Care Approach to Suicidal Youth and Adults
Integrated Primary Care Approach to Suicidal Youth and Adults Bill Elder, PhD Professor of Family and Community Medicine University of Kentucky College of Medicine Source: Dr. Thomas Insel, PowerPoint
More informationSample Report for Zero Suicide Workforce Survey
Sample Report for Zero Suicide Workforce Survey Zero Suicide Workforce Survey Zero Suicide Workforce Survey Results This reports presents results from the Zero Suicide Workforce Survey that was implemented
More informationPatient Management Tools
Patient Management Tools Many concrete and easy-to-use tools are available to assist you and your staff in preventing suicide. This section includes pocket-sized tools to facilitate assessment and intervention
More informationYouth Suicide Assessment and Intervention in Primary Care. Tina Walde, DNP, PMHNP OHSU School of Nursing
Youth Suicide Assessment and Intervention in Primary Care Tina Walde, DNP, PMHNP OHSU School of Nursing Objectives Role of the NP History Terms Epidemiology Groups with increased risk Warning signs The
More informationSuicide Prevention Month Community Edition Presented by Aimee Johnson, LCSW & Karon Wolfe, LISW-S
Suicide Prevention Month 2017 Community Edition Presented by Aimee Johnson, LCSW & Karon Wolfe, LISW-S 1 Overview Objectives Veterans and VA Facts about suicide Myths/realities about suicide The steps
More informationDepression Assessment and Management. John Kern MD Clinical Professor University of Washington
Depression Assessment and Management John Kern MD Clinical Professor University of Washington Handouts Antidepressant Treatment Flowchart Managing antidepressant nonresponse handouts 2 Diagnosis PHQ-9
More informationHELPING TEENS COPE WITH GRIEF AND LOSS RESPONDING TO SUICIDE
HELPING TEENS COPE WITH GRIEF AND LOSS RESPONDING TO SUICIDE HOW TEENS COPE WITH LOSS & GRIEVE Grief is personal There is no right or wrong way to grieve Influenced by developmental level, cultural traditions,
More informationSuicide A National Problem, What Every Physician Needs to Know!
Suicide A National Problem, What Every Physician Needs to Know! Asim A. Shah M.D. Professor & Executive Vice Chair Menninger Department of Psychiatry, Professor, Department of Community and Family Medicine,
More informationSuicidal Behaviors among Youth: Overview of Risk and Promising Intervention Strategies
Suicidal Behaviors among Youth: Overview of Risk and Promising Intervention Strategies David B. Goldston, Ph.D. Department of Psychiatry & Behavioral Sciences Duke University School of Medicine Goals of
More informationPhone Screen. Beginning the Psychoeducational Process: The Intake. The Psychoeducational Process and Elements throughout Care
Brian McKain, RN, MSN Christina Hanna, MS 1. Identify and explain the components used to assess and diagnose depression 2. How to share the wealth with both patients and their parents 3. Understand that
More informationSuicide Awareness & Prevention The Silent Epidemic Kristin A. Drake Cell:
Suicide Awareness & Prevention The Silent Epidemic Kristin A. Drake Cell: 915 525 8937 What is Suicidality? ~According to Dr. Osvaldo Gaytan, Child and Adolescent Psychiatrist for El Paso Behavioral, Suicidality
More informationAcute Mental Health Emergencies- from the office to the ED
Acute Mental Health Emergencies- from the office to the ED Jacqueline Grupp-Phelan, MD MPH Division of Emergency Medicine Cincinnati Children s Hospital Medical Center Learning Objectives Be familiar with
More informationLOUDOUN COUNTY PUBLIC SCHOOLS Department of Pupil Services. Suicide Prevention Guidelines
LOUDOUN COUNTY PUBLIC SCHOOLS Department of Pupil Services Suicide Prevention Guidelines 2016-2017 PREFACE As part of a comprehensive approach to suicide prevention, Loudoun County Public Schools (LCPS)
More informationSuicide Risk Management
Suicide Risk Management jump to ALGORITHM This CPM presents a model of care based on scientific evidence available at the time of publication. It is not a prescription for every physician or every patient,
More informationVA Edition 1 S.A.V.E.
VA Edition 1 S.A.V.E. December 2017 A little housekeeping before we start: Suicide is an intense topic for some people. If you need to take a break, or step out, please do so, with one condition Let me
More informationOrientation for New Child and Adolescent Psychiatry Residents: Module Two - Assessment
Orientation for New Child and Adolescent Psychiatry Residents: Module Two - Assessment Objectives: To describe important aspects of emergency evaluations of children and adolescents. Steps to Completion
More informationDepression Disease Navigation
Depression Disease Navigation The depression disease navigation program is designed to reach out to members who have been diagnosed with major depression disorder. This is accomplished by promoting treatment
More informationSuicidality and Older Adults
Suicidality and Older Adults Leo Sher, M.D. Associate Professor of Psychiatry Icahn School of Medicine at Mount Sinai Director, Inpatient Psychiatry James J. Peters Veterans Administration Medical Center
More informationWe all have our share of good days and bad. After all, life is filled with. many ups and downs. Some days may be so bad that we have trouble doing
A Publication of the Amputee Coalition of America About Depression First Step - Volume 4, 2005 Easy Read Original article by Bill Dupes Translated into plain language by Helen Osborne of Health Literacy
More informationCBT+ Measures Cheat Sheet
CBT+ Measures Cheat Sheet Child and Adolescent Trauma Screen (CATS). The CATS has 2 sections: (1) Trauma Screen and (2) DSM5 sx. There are also impairment items. There is a self-report version for ages
More informationTeen Suicide 2013 Kmcfarlane 10/3/13
1 2 3 4 5 6 7 Teen Suicide Kevin McFarlane BSN,RN,CEN,EMT University of New Mexico Hospital Suicide The spectrum of suicide Suicide Defined Suicide: Intentionally causing one s own death. Sometimes difficult
More informationSuicide Safer Care for Primary Care Providers. Warren Jay Pires, LCSW
Suicide Safer Care for Primary Care Providers Virna Little, PsyD, LCSW r, SAP, CCM Warren Jay Pires, LCSW Discussion for Workshop Primary Care Providers Role in Suicide Safe Care Identifying Patients at
More informationUNDERSTANDING BIPOLAR DISORDER Caregiver: Get the Facts
UNDERSTANDING BIPOLAR DISORDER Caregiver: Get the Facts What does it mean when a health care professional says bipolar disorder? Hearing a health care professional say your youth or young adult has bipolar
More informationSuicide & Violence Prevention
Suicide & Violence Prevention Donna Cooke, Ed.D. Dr. Jillian Friedin Alex Koenig, NCSP Gilda MacDonald, LCSW Christine O Leary, LCSW Kimberly Brothers, MA NYS PREVENTION AGENDA Priority Area: Promote Mental
More informationUnitedHealthcare Community (UHCCP) Louisiana Clinical Program Guidelines Record Supplemental Tool
December-18 UnitedHealthcare Community (UHCCP) Louisiana Clinical Program Guidelines Record Supplemental Tool Facility Name: Primary Dx: Member Gender: Member Age: Reviewer Name: Date of Facility Review:
More informationOperation S.A.V.E Campus Edition
Operation S.A.V.E Campus Edition 1 Suicide Prevention Introduction Objectives: By participating in this training you will learn: The scope and importance of suicide prevention The negative impact of myths
More informationFIREARMS AND SUICIDE PREVENTION
FIREARMS AND SUICIDE PREVENTION WHAT LEADS TO SUICIDE? There s no single cause. Suicide most often occurs when several stressors and health issues converge to create an experience of hopelessness and despair.
More informationAppendix C: Algorithms. Algorithm C-1: Enhanced Screening Algorithm
Appendix C: Algorithms Algorithm C-1: Enhanced Screening Algorithm PCC Depression Screening Neg Annual Screening Pos CPRS Alert to Team Enhanced Screening Via Telephone Unable To Contact Telephone Introduction
More informationSuicide Facts. Each year 44,965 Americans die by suicide, roughly 123 per day.
1 Suicide Facts Each year 44,965 Americans die by suicide, roughly 123 per day. For every completion, there were 25 attempts. In 2016-494,169 were hospitalized for self harm. Men are almost 4 times as
More informationWHAT IS IMMINENT RISK? UNDERSTANDING THE FUNDAMENTALS OF SUICIDE RISK ASSESSMENT AND MANAGEMENT
Stacy Rivers, MSW, LICSW WHAT IS IMMINENT RISK? UNDERSTANDING THE FUNDAMENTALS OF SUICIDE RISK ASSESSMENT AND MANAGEMENT Journal of Dawn Renee Befano, 10/29/1995 I want to die. Today I feel even more vulnerable
More informationSuicide Prevention in the United States: Challenges, Opportunities, and Innovations. Richard McKeon Ph.D.Chief, Suicide Prevention Branch SAMHSA
Illinois Suicide Prevention Summit Suicide Prevention in the United States: Challenges, Opportunities, and Innovations Richard McKeon Ph.D.Chief, Suicide Prevention Branch SAMHSA 1 Disclaimer The views,
More informationSuicide Risk Assessment
Suicide Risk Assessment Interviewing Basics Prepared by: Dr. Aviva Rostas Psychiatry Resident, University of Toronto Epidemiology Suicide is common. According to Statistics Canada, in 2009 there were 3,890
More informationSuicide Prevention: How to Keep Someone Safe & Alive. January 2017
Suicide Prevention: How to Keep Someone Safe & Alive January 2017 Goals & Objectives Define Mental Illness, Age of Onset Discuss Statistics of Suicide, Nonfatal Suicidal Thoughts & Behaviors, Racial &
More informationSUICIDE PREVENTION IN THE SCHOOL COMMUNITY
SUICIDE PREVENTION IN THE SCHOOL COMMUNITY Frank Zenere, Ed.S. School Psychologist School Crisis Management Specialist Miami-Dade County Public Schools WHY SCHOOLS SHOULD ADDRESS SUICIDE Maintaining a
More informationSuicide Prevention & The Art of Asking: Bridging Clinical Assessment and Community Conversations to Promote Awareness and Prevention
Suicide Prevention & The Art of Asking: Bridging Clinical Assessment and Community Conversations to Promote Awareness and Prevention Introductions Daniel Schwarz, Ph.D. Daniel Schwarz, Ph.D. Anna Trout,
More informationChild and Adolescent Psychiatry Trends. ADAMHS Board - 28 Oct 2014
Child and Adolescent Psychiatry Trends ADAMHS Board - 28 Oct 2014 Current Need for Child and Adolescent Psychiatrists There are currently approximately 7400 Child and Adolescent Psychiatrists in Practice
More informationSupplementary Material
Supplementary Material Supplementary Table 1. Symptoms assessed, number of items assessed, scoring, and cut-off points for the psychiatric rating scales: Montgomery Åsberg Depression Rating Scale, Hamilton
More informationSchools and Adolescent Suicide: What We Know and Don't Know. October 16, James Mazza, Ph.D.
October 16, 2015 James Mazza, Ph.D. University of Washington Professor in School Psychology Areas of Focus for Schools Prevention Intervention Re-entry Postvention 20 U.S. Youth Suicide Rates 15 10 5 0
More informationDepression Management
Depression Management Ulka Agarwal, M.D. Adjunct Psychiatrist Pine Rest Christian Mental Health Disclosures The presenter and all planners of this education activity do not have a financial/arrangement
More informationDr Carmelo Aquilina Senior Staff Specialist & Service Director Sydney West Area Health Service Clinical Senior Lecturer, University of Sydney
Dr Carmelo Aquilina Senior Staff Specialist & Service Director Sydney West Area Health Service Clinical Senior Lecturer, University of Sydney A suicide Outline Part 1: understanding suicide Part 2: What
More informationSection 3. Objectives. Vocabulary clinical depression cutting suicide cluster suicides
Section 3 I Objectives ~ Explain why it is important to identify and treat clinical depression. ~ Explain why individuals might deliberately injure themselves. ~ Describe one major risk factor for suicide.
More informationMCPAP Clinical Conversations:
MCPAP Clinical Conversations: After the screen: A Practical Approach to Mental Health Assessment in the Pediatric Primary Care Setting Barry Sarvet, MD Professor and Chair of Psychiatry, UMMS-Baystate
More informationSuicide.. Bad Boy Turned Good
Suicide.. Bad Boy Turned Good Ross B Over the last number of years we have had a few of the youth who joined our programme talk about suicide. So why with all the services we have in place is suicide still
More informationSuicide in Missouri: Where We Stand
Suicide in Missouri: Where We Stand Liz Sale, PhD Missouri Institute of Mental Health University of Missouri-St. Louis August 2017 Outline Prevalence of suicide World, U.S., Missouri comparisons Trends
More informationHope Begins with You. Jeff Morris, Presenter
Hope Begins with You. Jeff Morris, Presenter What do you want to learn? How to help someone who is depressed. How to help family members of a depressed person. How to identify students who are high-risk.
More informationUNDERSTANDING DEPRESSION Young Adult: Get the Facts
UNDERSTANDING DEPRESSION Young Adult: Get the Facts What does it mean when a heath care professional says depression? Hearing a health care professional say you have depression can be confusing. The good
More informationSafety Planning and Lethal Means Reduction to Prevent Suicide Fall Substance Use Conference 2015 Doug Thomas, LCSW Director
Safety Planning and Lethal Means Reduction to Prevent Suicide Fall Substance Use Conference 2015 Doug Thomas, LCSW Director Division of Substance Abuse and Mental Health Overview Suicide Data Where does
More informationMiller SYI: Youth Ministry Conversations
Miller SYI: Youth Ministry Conversations Suicide and Suicidal Thoughts Rev. Erin M. Davenport, LSW Why Are We Doing This? Our alumni board and advisory board has agreed over the last several years to shift
More informationMEDICAL POLICY EFFECTIVE DATE: 04/28/11 REVISED DATE: 04/26/12, 04/25/13, 04/24/14, 06/25/15, 06/22/16, 06/22/17
MEDICAL POLICY SUBJECT: STANDARD DIALECTICAL BEHAVIOR A nonprofit independent licensee of the BlueCross BlueShield Association PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not covered,
More informationDirections: Use your mouse or the arrows on your keyboard to click through this tutorial.
Directions: Use your mouse or the arrows on your keyboard to click through this tutorial. Diamond Healthcare Corporation Suicide Risk Assessment For Outpatient Programs 2009 Objectives 1. Identify the
More informationEarly Warning Signs of Psychotic Disorders and the Importance of Early Intervention
Early Warning Signs of Psychotic Disorders and the Importance of Early Intervention Margaret Migliorati, MA, LPCC The University of New Mexico mmigliorati@salud.unm.edu Mental Health As a Public Health
More informationParent Forum May 17, 2017 BERNARDS TOWNSHIP PUBLIC SCHOOLS UNDERSTANDING LOSS AND UNDERSTANDING YOUTH SUICIDE
Parent Forum May 17, 2017 BERNARDS TOWNSHIP PUBLIC SCHOOLS UNDERSTANDING LOSS AND UNDERSTANDING YOUTH SUICIDE TONIGHT S GOALS 1. Increase understanding of: Youth reactions to loss Problem of youth suicide
More informationSuicide, Para suicide and Risk Assessment
Suicide, Para suicide and Risk Assessment LPT Gondar Mental Health Group www.le.ac.uk Objectives: Definition of suicide, Para suicide/dsh Changing trends of methods used Epidemiology Clinical Variables
More informationAgenda. Brief introduction to our speakers. Today s objectives. A personal story. Epidemiology. Beacon s Zero Suicide story in Colorado
February 2017 Agenda Brief introduction to our speakers Emma Stanton, MD Clarence Jordan Erick Messias, MD Lynne Bakalyan, LPC Today s objectives A personal story Epidemiology Beacon s Zero Suicide story
More informationas Ask Suicide-Screening
as NIMH TOOLKIT ASQ Toolkit Summary The ASQ toolkit is organized by the medical setting in which it will be used: emergency department, inpatient medical/surgical unit, and outpatient primary care and
More informationReal Men Real Depression
Real Men Real Depression Cheryl A. Clark, MD Distinguished Fellow, American Psychiatric Association Diplomate, American Board of Psychiatry and Neurology Medical Director Clinical Director Mental Health
More informationTaking Care: Child and Youth Mental Health TREATMENT OPTIONS
Taking Care: Child and Youth Mental Health TREATMENT OPTIONS Open Learning Agency 2004 TREATMENT OPTIONS With appropriate treatment, more than 80% of people with depression get full relief from their symptoms
More informationC-SSRS/KIT version includes. C-SSRS Scoring/ Administration instructions (13pgs)
This is a Sample version of the Columbia-Suicide Severity Rating Scale (C-SSRS) KIT The full version of watermark.. the C-SSRS/KIT comes without sample The full complete C-SSRS/KIT version includes C -SSRS
More informationDEPRESSION - SUICIDE. Dr.Gregory A. Hudnall Associate Superintendent Provo City School District
DEPRESSION - SUICIDE Dr.Gregory A. Hudnall Associate Superintendent Provo City School District Many are giving up heart for the battle of life... as the showdown between good and evil approaches with its
More informationSuicide Prevention. Kuna High School
Suicide Prevention Kuna High School Why Suicide Prevention is Important? From the 2015 Youth Risk Behavior Survey (CDC). Suicide 32% (up 4% from 29% - 2013) felt so sad or hopeless almost every day for
More informationBASIS-Teen Pilot Project
BASIS-Teen Pilot Project Interim Report prepared for: Sovereign Health In this Report: BASIS-Teen Pilot Project Report Overview BASIS-Teen Survey Summary PSC-Y Survey Summary PSC Survey Summary BPRS-C
More informationBUILDING BARRIERS TO SUICIDE:
BUILDING BARRIERS TO SUICIDE: Mr. F 78 yo male CAD, HTN, CABGx5 Depression? PCP of course you re depressed, your old Sig for anti depressant
More informationPreventing Deaths by Suicide of Older Adults in Minnesota
Preventing Deaths by Suicide of Older Adults in Minnesota Minnesota Gerontological Society March 21, 2017 Suicide Prevention Program 1 Learning Objectives 1) Describe the prevalence, risk factors and lethality
More informationSuicide Prevention Monireh Moghadam, LCSW & Dimitri Ntatsos, LCSW OHSU Psychiatry Grand Rounds June 20, 2017
VA Portland Health Care System Suicide Prevention Monireh Moghadam, LCSW & Dimitri Ntatsos, LCSW OHSU Psychiatry Grand Rounds June 20, 2017 Objectives By participating in this training you will: Have a
More informationPICO QUESTIONS DRAFT
PICO QUESTIONS DRAFT Background This work is primarily intended to inform the VA/DoD working group creating the clinical practice guideline for suicide prevention. The reports will also be disseminated
More informationMood Disorders for Care Coordinators
Mood Disorders for Care Coordinators David A Harrison, MD, PhD Assistant Professor, Dept of Psychiatry & Behavioral Sciences University of Washington School of Medicine Introduction 1 of 3 Mood disorders
More informationNavigating Student Mental Health Issues
Navigating Student Mental Health Issues Brian D. Saunders, MD, FACS Director of Undergraduate Surgical Education Penn State College of Medicine Trouble Shooting Your Clerkship 103 April 22, 2013 Orlando,
More informationSuggested Protocol for Resident Verbalizing Suicidal Ideation or Plan
Suggested Protocol for Resident Verbalizing Suicidal Ideation or Plan Rationale: In the event a [resident] verbalizes suicidal thoughts or even a plan, the carer will know what steps to take for safety
More information5/12/11. Educational Objectives. Goals
Educational Objectives Learn: steps for initial depression screening and management in primary care when to refer to mental health providers tools for providers and patients principles of collaborative
More informationDepression: what you should know
Depression: what you should know If you think you, or someone you know, might be suffering from depression, read on. What is depression? Depression is an illness characterized by persistent sadness and
More informationIntroduction to Suicide Prevention, Safety Planning and Contextual Behavior Science
Introduction to Suicide Prevention, Safety Planning and Contextual Behavior Science Jonathan Weinstein, Ph.D. Suicide Prevention Coordinator VA Hudson Valley Healthcare Service Asst Prof.of Psychiatry
More informationAssessing Suicide Risk and Intervening with High Risk Patients. Acknowledgments 3/19/2019
Assessing Suicide Risk and Intervening with High Risk Patients 2019 Family Medicine Refresher Course Karla Hemesath, PhD, LMFT Acknowledgments Portions of this talk include information from: Suicide Prevention
More informationCondensed Clinical Practice Guideline Treatment Of Patients With Schizophrenia
Condensed Clinical Practice Guideline Treatment Of Patients With Schizophrenia I. Key Points a. Schizophrenia is a chronic illness affecting all aspects of person s life i. Treatment Planning Goals 1.
More informationAdult Mental Health Services applicable to Members in the State of Connecticut subject to state law SB1160
Adult Mental Health Services Comparison Create and maintain a document in an easily accessible location on such health carrier's Internet web site that (i) (ii) compares each aspect of such clinical review
More informationUNDERSTANDING BIPOLAR DISORDER Young Adult: Get the Facts
UNDERSTANDING BIPOLAR DISORDER Young Adult: Get the Facts What does it mean when a health care professional says bipolar disorder? At first, it was quite scary Hearing a health care professional say you
More informationAMPS : A Quick, Effective Approach To The Primary Care Psychiatric Interview
AMPS : A Quick, Effective Approach To The Primary Care Psychiatric Interview February 7, 2012 Robert McCarron, D.O. Assosicate Clinical Professor Internal Medicine / Psychiatry / Pain Medicine UC Davis,
More informationTypical or Troubled? By Cindy Ruich, Ed.D. Director of Student Services Marana Unified School District Office:(520)
By Cindy Ruich, Ed.D. Director of Student Services Marana Unified School District Office:(520) 682-1046 c.t.ruich@maranausd.org Test Your Mental Health Knowledge 1) Mental Illness is a serious condition.
More information