More than 90% of people who attempt suicide and survive never go on to die by suicide.
The Virginia Department of Health (VDH) supports the integration of screening and assessment protocol into all programming including primary and specialist care.
There are a variety of validated tools that can be used and incorporated into electronic health records for ease of use. This information is provided below. Screening and assessment tools are not predictive and should not be used in isolation. Instead, screening and assessment should be utilized to determine the best course of treatment for patients/clients and never used as a barrier to treatment. A comprehensive program for screening and assessment also includes referral networks, follow-up care, and regular reassessment.
- ASQ
- The Ask Suicide-Screening Questions (ASQ) Toolkit is a brief validated tool for use among both youth and adults. It is a free resource for use in a variety of settings including emergency departments, inpatient medical/surgical units, and outpatient clinics/primary care. The ASQ is a set of four screening questions to assess for suicide risk. More information can be found at https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials
- Columbia
- The Columbia Lighthouse Project Columbia Protocol https://cssrs.columbia.edu/the-columbia-scale-c-ssrs/about-the-scale/
- SAFE-T link
- PHQ-9
- PHQ-9 National Institute of Health Validity of Brief Depression Severity Measure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495268/
- Tool https://www.apa.org/depression-guideline/patient-health-questionnaire.pdf
- ICARE2 – Managing Suicidal Patients in the ED https://www.acep.org/patient-care/iCar2e/
- National Center for Health Statistics (NCHS) Data Briefs https://www.cdc.gov/nchs/products/databriefs.htm
- National Health Statistics Reports https://www.cdc.gov/nchs/products/nhsr.htm
- Practical Playbook Helping Public Health and Primary Care Work Together to Improve Population Health https://www.practicalplaybook.org/
- Clinicians as Survivors: After a Suicide Loss https://jmcintos.pages.iu.edu/therapists_mainpg.htm
- Best Practices in Care Transitions for Individuals with Suicide Risk: Inpatient Care to Outpatient Care https://theactionalliance.org/resource/best-practices-care-transitions-individuals-suicide-risk-inpatient-care-outpatient-care
- Caring for Adult Patients with Suicide Risk https://www.sprc.org/sites/default/files/EDGuide_full.pdf
- Cognitive Therapy for Suicide Prevention https://www.sprc.org/resources-programs/cognitive-therapy-suicide-prevention
- Compliance Standards Pave the Way for Reducing Suicide in Health Care Systems https://theactionalliance.org/sites/default/files/hccj_0102_19_grumet_0.pdf
- Dialectical Behavior Therapy https://www.sprc.org/resources-programs/dialectical-behavior-therapy
- What Clients and Families Need to Know About Suicide https://www.sprc.org/sites/default/files/Handout-WhatClientsOrFamilies.pdf
- Suicide Prevention in an Emergency Department Population https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2623157
- Suicide Prevention Toolkit for Primary Care Practices https://www.sprc.org/settings/primary-care/toolkit
- Suicide Prevention: An Emerging Priority for Health Care https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1672
Recognizing and Responding to Suicide Risk: Essential Skills for Clinicians (RRSR)
RRSR is a two day interactive training based on established core competencies that mental health professionals need in order to effectively assess and manage suicide risk. The goal is for clinicians to be confident, competent, and prepared to meet the needs of distressed clients and their families..
Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) (Pocket Card)
Provides protocols for conducting a comprehensive suicide assessment, estimating suicide risk, identifying protective factors, and developing treatment plans and interventions responsive to the risk level of patients. Laminated SAFE-T cards are available from SAMHSA for free.
Treatment Options for patients struggling with suicide listed on SAMHSA’s National Registry of Evidence-Based Programs and Practices:
- Adolescent Coping with Depression (CWD-A)
- Cognitive Behavioral Therapy for Adolescent Depression
- Cognitive Behavioral Therapy for Late-Life Depression
- Dialectical Behavior Therapy
- Multisystemic Therapy with Psychiatric Supports (MST-Psychiatric)
- Seeking Safety
Suicide Prevention Toolkit for Primary Care Providers
A web-based toolkit that contains the information and tools needed to implement state-of-the-art suicide prevention practices in primary care settings. The Toolkit includes sections on educating clinicians and office staff and developing mental health partnerships, as well as patient management tools and patient education tools.
Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) (Pocket Card)
Provides protocols for conducting a comprehensive suicide assessment, estimating suicide risk, identifying protective factors, and developing treatment plans and interventions responsive to the risk level of patients. Laminated SAFE-T cards are available from SAMHSA for free.
Emergency Department Health Care Providers
“Is Your Patient Suicidal?”
Information on recognizing and responding to acute suicide risk. The guide provides additional clinical guidance for ED personnel.
After an Attempt
Brochures regarding treatment and follow-up for those seen in an emergency department after a suicide attempt.
- Medical Providers in the Emergency Department Taking Care of Suicide Attempt Survivors
- Taking Care of Your Family Member After Treatment in the Emergency Department English | Spanish
- Taking Care of Yourself After Your Treatment in the Emergency Department English | Spanish
Lethal Means Counseling
Many suicide attempts are made impulsively during a short-term crisis period. If highly lethal means are made less available to impulsive attempters and they substitute less lethal means, or temporarily postpone their attempt, the odds are increased that they will survive. “Means reduction” (reducing a suicidal person’s access to highly lethal means) is an important part of a comprehensive approach to suicide prevention. Means Matter based out of the Harvard School of Public Health provides information on means restriction strategies and means counseling for providers.