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Materials for clinicians (both medical and mental health professionals) about treating suicidal people and/or people with mental health issues. Mental health self-care materials for clinicians are also included. See Substance Use for clinical information on AOD use and Screening and Assessment for more on tools for assessing suicidal behavior.

AAP statement: Suicide and suicide attempts in adolescents
URL: http://pediatrics.aappublications.org/cgi/content/full/120/3/669
Article in Pediatrics, Vol. 120 No. 3 September 2007, pp. 669-676. This report updates the previous statement of the American Academy of Pediatrics and is intended to assist the pediatrician in the identification and management of the adolescent at risk of suicide.
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After an attempt: A guide for medical providers in the emergency department taking care of suicide attempt survivors
URL: http://mentalhealth.samhsa.gov/publications/allpubs/SVP-0161/
Brochure intended to provide medical professionals with tips on how to enhance care in the emergency department for people who have attempted suicide. The guide also contains information on HIPAA, patient discharge, and resources about suicide for medical professionals, patients and their families.
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Clinical social workers and mental health counselors (SPRC Customized Information Series)
URL: http://www.sprc.org/featured_resources/customized/social_worker.asp
Information for mental health professionals on recognizing and responding to warning signs, resource materials about suicide prevention, including programs and the role of mental health professionals in preventing suicides.
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Clinicians as survivors: After a suicide loss
URL: http://mypage.iusb.edu/~jmcintos/therapists_mainpg.htm
The Clinician Survivor Task Force, under the auspices of the American Association of Suicidology, will provide consultation, support and education to psychotherapists and other mental health professionals to assist them in understanding and responding to their personal/professional loss resulting from the suicide death of a patient/client. Their site contains links to rescources, personal accounts, and therapists that can be contacted.
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Counseling suicidal people: A therapy of hope
URL: http://qprinstitute.com/Counselingbook.htm
The book is for therapists, soical workers, nurses, or any or mental health provider. There are hands-on tools and reviews of many different types of treatment to turn hopelessness into hope.
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Cultural competency: A practical guide for mental health service providers
URL: http://www.hogg.utexas.edu/PDF/Saldana.pdf
Defines the term "cultural competency". Provides guidance for mental health professionals on: developing essential knowledge, skills and attributes; building counselor/client rapport; translator and interpreter challenges; connecting with families; and confidentiality issues.
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Depression screening in a VA primary care clinic
URL: http://psychservices.psychiatryonline.org/cgi/reprint/57/12/1694.pdf
Psychiatric Services. 2006 Dec; 57:1694–96. In 1998, the U.S. Department of Veterans Affairs (VA) mandated annual depression screening at all VA primary care clinics. VA Medical Center, New Orleans, implemented a four-item screening tool. The authors report on an evaluation of the screening program.
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Depressive disorder treatment in the military health system (MHS): A national quality management program special study
URL: https://www.qmo.amedd.army.mil/depress/NQMP.pdf
The purpose of this study was twofold. First, the study obtained baseline measurement rates for the Major Depressive Disorder CPG (the diagnosis codes for depression included non major depression diagnoses). Second, the study measured Antidepressant Medication Management using Health Plan Employers Data and Information Set (HEDIS) 2002 Technical Specifications. MHS (Military Health System) performance rates were compared to rates from HEDIS civilian managed care plans.
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Early childhood mental health consultation: An evaluation tool kit
URL: http://gucchd.georgetown.edu/files/products_publications/TACenter/ecmhc_toolkit.pdf
Combines a brief review of the literature and current research addressing the effectiveness of early childhood mental health consultation with guidance for designing and implementing program evaluation. It will help states, communities, and programs increase their capacity for high-quality evaluation of early childhood mental health consultation in community-based settings.
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Elderly suicide: Secondary prevention
URL: http://www.nursing.uiowa.edu/products_services/evidence_based.htm
This evidence-based protocol provides information that will assist the nurse or other health care provider in recognizing at-risk suicidal behavior in the elderly and providing appropriate and effective crisis intervention. The goal is to decrease the occurrence of suicide among elderly individuals who have contact with nurses or other health care providers. 56 pages.
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Emergency department means restriction education (SPRC EBPP Fact Sheet)
URL: http://www.sprc.org/featured_resources/bpr/ebpp_PDF/emer_dept.pdf
A fact sheet that describes the Emergency Department Means Restriction Education Protocol. Includes a description of the program, evaluation designs and outcomes, the intended audience, and targeted protective and risk factors.
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Follow-up care bibliography
URL: http://www.sprc.org/library/Follow-UpCare.pdf
A selected bibliography of literature from July 1993 – May 2008 about follow-up care after a crisis call, after an emergency department visit, or after hospital discharge.
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Guidelines for working effectively with interpreters in a mental health setting
URL: http://www.vtpu.org.au/docs/interpreter/VTPU_GuidelinesBooklet.pdf
These guidelines from Australia are intended to assist mental health staff to understand the characteristics of interpreted meetings and to develop the knowledge and skills that are necessary for working in partnership with interpreters.
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Integrating mental health services into primary care settings: Summary of the Special Forum held at the 2006 Georgetown University Training Institutes
URL: http://gucchd.georgetown.edu/programs/ta_center/TrainingInstitutes/SpecialForums/Integrating%20Mental%20Health%20Services%20into%20Primary%20Care%20Settings.pdf
Includes an overview of child mental health issues in primary health care sector and a description of effective service delivery strategies.
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Is your patient suicidal?
URL: http://www.sprc.org/library/ER_SuicideRiskPosterVert2.pdf
A four-color poster that provides Emergency Department practitioners with information on recognizing and responding to acute suicide risk. It is designed to be posted in staff-only areas. The poster features the most common and noticeable warning signs of acute risk for suicide as well as simple questions clinical staff can ask to uncover suicide risk when warning signs are noticed or suspected. The poster, resource guide ( http://library.sprc.org/item.php?id=584) and accompanying information insert (http://library.sprc.org/item.php?id=585) can be ordered from the Emergency Nurses Association through the ENA Marketplace (http://www.ena.org/store).
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National Patient Safety Goals
URL: http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/
The Joint Commission evaluates and accredits nearly 15,000 health care organizations and programs in the United States. From 2002, The Joint Commission approves annual sets of National Patient Safety Goals (NPSGs) with related specific requirements.
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Nurses (SPRC Customized Information Series)
URL: http://www.sprc.org/featured_resources/customized/nurses.asp
Information for nurses on recognizing and responding to warning signs, resource materials about suicide prevention, including programs and the role of nurses in preventing suicides.
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Overview: Suicide in the hospital setting
URL: http://www.sprc.org/library/NJsuicideinHospitalJune2008.pdf
Patient Safety Initiative Update. 2008, Issue 6. On April 1, 2008, mandatory reporting of adverse patient safety events took effect for the New Jersey psychiatric, special and comprehensive rehabilitation hospitals. This newsletter summarizes a special training session on event reporting and RCA development, conducted by the New Jersey Patient Safety Initiative for staff representatives from these newly reporting hospitals.
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ParentsMedGuide.org
URL: http://www.parentsmedguide.org/parentsmedguide.pdf
A website that contains information for parents and physicians on the use of medication in treating childhood and adolescent depression, including information on the FDA "black-box" warnings. There is also a Spanish-language version of the site: http://www.parentsmedguide.org/indexespanol.htm
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Patient Safety Initiative: 2007 Summary Report
URL: http://www.state.nj.us/health/ps/documents/ps_initiative_report07.pdf
The third annual report on the New Jersey Patient Safety Act. Includes statistics on suicides and suicidal behaviors in New Jersey hospitals: "The percentage of events related to suicide/attempted suicide has doubled since 2005. The number of suicide events reported increased from 16 in 2005 to 35 in 2007."
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Practice guideline for the assessment and treatment of patients with suicidal behaviors
URL: http://www.psychiatryonline.com/pracGuide/pracGuideTopic_14.aspx
This practice guideline is based on available evidence and clinical consensus and offers recommendations to help psychiatrists in assessing and treating adult patients with suicidal behaviors. This report is not intended to be construed or to serve as a standard of medical care. Standards of medical care are determined on the basis of all clinical data available for an individual patient and are subject to change as scientific knowledge and technology advance and practice patterns evolve. These parameters of practice should be considered guidelines only.
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Practice guidelines for psychiatric consultation in the general medical setting
URL: http://www.apm.org/prac-gui/psy39-s8.shtml
Published in: Psychosomatics, 39:S8-S30, August 1998. This practice guideline aims to provide guidance to psychiatrists who regularly evaluate and manage patients with medical illnesses. Drafted by a work group consisting of psychiatrists with clinical and research expertise in the field, this guideline is intended to delineate the knowledge base, professional expertise, and integrated clinical approach necessary to effectively manage this complex and diverse patient population. A pdf of this guideline is available.
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Practice guidelines: Core elements for responding to mental health crisis
URL: http://download.ncadi.samhsa.gov/ken/pdf/SMA09-4427.pdf
Developed by a diverse expert panel that included individuals with mental illnesses, providers, public officials, and advocates, the guidelines presented here define appropriate responses to mental health crises across various situations and environments.
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Practice parameters for the assessment and treatment of children and adolescents with depressive disorders
URL: http://www.guideline.gov/summary/summary.aspx?doc_id=11404&nbr=005924&string=screening+AND+depression
Provides guidelines on screening, evaluation, treatment and prevention of child and adolescent depression.
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Practice principles : A guide for mental health clinicians working with suicidal children and youth (Canada)
URL: http://www.mcf.gov.bc.ca/mental_health/pdf/suicid_prev_manual.pdf
These guidelines from Canada are intended for practicing mental health clinicians with established clinical competencies working with suicidal children and youth in outpatient settings. The guidelines are based on the findings of an extensive literature review, bridged with the expert opinion of senior mental health clinicians, under the guidance of a Provincial Advisory Committee, British Columbia.
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Preventing suicide: A resource for general physicians
URL: http://www.who.int/mental_health/media/en/56.pdf
Booklet for general physicians on the topic of suicide. Includes information on risk factors for suicide, tips on management of suicidal patients, and a summary of steps in suicide prevention.
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Primary care physicians (SPRC Customized Information Series)
URL: http://www.sprc.org/featured_resources/customized/primarycare_physicians.asp
Information for primary care physicians on recognizing and responding to warning signs, resource materials about suicide prevention, including programs and the role of primary care physicians in preventing suicides.
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Quick guide to working with interpreters in mental health settings
URL: http://www.vtpu.org.au/docs/interpreter/VTPU_Poster.pdf
A manual from Australia on how to: book an appropriate interpreter; check him/her; communicate with an interpreter before, during, and after meeting.
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Resource guide for implementing the 2007 Joint Commission on Accreditation of Healthcare patient safety goals on suicide
URL: http://www.sprc.org/library/jcsafetygoals.pdf
This document serves as a resource guide, using the B-SAFE protocol as a centerpiece to facilitate implementation of the Joint Commission patient safety goal on suicide.
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SAFE-T pocket card
URL: http://www.sprc.org/library/safe_t_pcktcrd_edc.pdf
The SAFE-T card guides clinicians through five steps which address the patient’s level of suicide risk and suggest appropriate interventions. It is intended to provide an accessible and portable resource to the mental health professional whose clinical practice includes suicide assessment. The card lists key risk and protective factors that should be considered in the course of completing the five steps. This version of the card, updated in 2009, addresses both adult and adolescent populations. The PDF image of the card prints out in the center of an 8.5 x 11 sheet of paper because the original is a 6" x 7" two-sided, folded pocket card. Quantities of the SAFE-T cards may be ordered through Screening for Mental Health, Inc. at http://www.sprc.org/library/SAFE-TOrderForm.pdf. To obtain a free print quality file for reproducing the cards, please email info@sprc.org, including your name, the name of your organization/company, and your plans for using the SAFE-T cards.
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Safety plan quick guide for clinicians
URL: http://www.sprc.org/library/SafetyPlanQuickGuide.pdf
Pocket guide to developing a safety plan, a prioritized written list of coping strategies and sources of support.
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Screening for depression and suicidality in a VA primary care setting: 2 items are better than 1 Item
URL: http://www.ajmc.com/Article.cfm?Menu=1&ID=2761
American Journal of Managed Care. 2004 Nov; Clinical: 839-45. Compares To evaluate a single item depression screen the Patient Health Questionnaire (PHQ) as tools in screening for depression and suicidality in a Department of Veterans Affairs (VA) primary care setting.
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Screening for depression: Recommendations and rationale
URL: http://www.ahrq.gov/clinic/3rduspstf/depression/depressrr.htm
Recommends screening adults for depression in clinical practices that have systems in place to assure accurate diagnosis, effective treatment, and follow-up. Concludes the evidence is insufficient to recommend for or against routine screening of children or adolescents for depression.
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Specialized emergency room intervention for suicidal adolescent females (SPRC BPR Fact Sheet)
URL: http://www.sprc.org/featured_resources/bpr/ebpp_PDF/spec_emergency_rm.pdf
A fact sheet that describes a specialized emergency room intervention for suicidal adolescent females. This intervention provides specialized emergency room care for female adolescent suicide attempters and their mothers. Includes a description of the program, evaluation designs and outcomes, the intended audience, and targeted protective and risk factors.
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The suicidal patient assessment and care: An educational video for primary care physicians
URL: http://www.afsp.org/index.cfm?fuseaction=shop.productDetails&product_id=B15CDE98-998B-6FC2-916E70F906534B50
This program teaches physicians to better assess suicidal risk in patients and intervene when necessary. Features America's leading suicide prevention experts: Jan Fawcett, Frederick Goodwin, David Shaffer, David Clark and David Miller. Length: 15 min. 38 sec.
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Suicidality and violence in patients with HIV/AIDS.
URL: http://www.hivguidelines.org/GuideLine.aspx?pageID=261&guideLineID=84&vType=txt
Guidelines for medical professionals on how to handle suicidality and/or violence in patients with HIV/AIDS.
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Suicidality in Adults Being Treated with Antidepressant Medications
URL: http://www.fda.gov/cder/drug/advisory/SSRI200507.htm
FDA Public Health Advisory updating patients and healthcare providers about the possibility of an increased risk for suicidal behavior in adults who are being treated with antidepressant medications.
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Suicidality in Children and Adolescents Being Treated with Antidepressant Medications
URL: http://www.fda.gov/CDER/Drug/antidepressants/SSRIPHA200410.htm
FDA Public Health Advisory announcing a multi-pronged strategy to warn the public about the increased risk of suicidal thoughts and behavior ("suicidality") in children and adolescents being treated with antidepressant medications.
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Suicide among women: A critical review
URL: http://www.amwa-doc.org/index.cfm?objectid=1297D910-D567-0B25-5F32C34C7DDF396C
[Journal article] Published in: Journal of American Medical Women's Association, 59(2), Spring 2004, p.125-134. The article reviews literature and theories regarding suicide in women, provides a practical assessment of suicide risk in women for a clinical setting, and considers further opportunities for research.
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Suicide and gay/lesbian/bisexual youth: implications for clinicians
URL: http://www.ucm.es/info/rqtr/biblioteca/Violencia%20gltb/suicide%20in%20gltb%20youth%20implications%20for%20clinicians.pdf
[Journal Article] Published in: Journal of Adolescence 2001, 24, 39–49. The research indicating the incidence rates and specific risks for suicide in the gay, lesbian, bisexual, and questioning (GLBQ) adolescent population is reviewed. An ecological model of suicide risk assessment for GLBQ youth is presented based on Bronfenbrenner’s model of human development. The model argues for individual, micro, and macro levels of assessment to increase clinical judgement and accuracy in determining high risk GLBQ adolescents. The model also delineates both primary and secondary intervention strategies which could be utilized to prevent GLBQ youth suicide.
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Suicide prevention toolkit for rural primary care
URL: http://www.sprc.org/library/primer.pdf
This toolkit contains the information and tools needed to implement state-of-the-art suicide prevention practices in primary care settings. Although the tools are designed with the rural practice in mind, most are quite suitable for use in non-rural settings as well. 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.
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Suicide risk assessment and management: Emergency department
URL: http://www.health.nsw.gov.au/pubs/2004/pdf/emergency_dept.pdf
Emergency departments are a key point of contact for people who have attempted suicide or who are at risk of suicide. As described in this publication, emergency departments play an important role in triage, assessment and management of people with mental health problems
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Suicide risk: A guide for evaluation and triage
URL: http://www.sprc.org/library/ER_SuicideRiskGuide8.pdf
A short companion piece for Emergency Department staff that includes all the information on the "Is your patient suicidal?" poster as well as additional advice on gathering a history on, evaluating, triaging, and intervening with people at high, moderate, or low risk for suicide. The guide includes a discharge planning checklist to help suicidal patients stay safe after they leave the ED, and find the support and resources they need. The resource guide, poster (http://library.sprc.org/item.php?id=583), and accompanying information insert (http://library.sprc.org/item.php?id=585) can be ordered from the Emergency Nurses Association through the ENA Marketplace (http://www.ena.org/store).
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Suicide survivors: Tips for professionals
URL: http://www.medscape.com/viewarticle/460958
Free registration needed to view full article. Discusses how health professionals can manage care fore suicide survivors.
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Suicidology listserv
URL: http://listserve.apa.org/archives/suicidology.html
This is a moderated discussion list of the American Association of Suicidology, which has a searchable archive from October 1997 to the present.
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TIP 50: Addressing suicidal thoughts
URL: http://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=18118
Research consistently shows a high prevalence of suicidal thoughts and suicide attempts among persons with substance abuse problems who are in treatment. This Treatment Improvement Protocol is designed to assist substance abuse counselors in working with adult clents who may be suicidal, and will help clinical supervisors and administrators support the work of substance abuse counselors. An analysis of the available literature, an annotated bibliography and a general bibliography is available online at www.kap.samhsa.gov.
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Traumatic brain injury and suicide: Information and resources for clinicians
URL: http://www.sprc.org/library/TBI_Suicide.pdf
Information guide designed to help clinicians and care providers in their work with traumatic brain injury (TBI) survivors who may be suicidal.
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Using the “Is your patient suicidal?" poster and Triage Guide
URL: http://www.sprc.org/library/UsingIsYourPatientSuicidal.pdf
A brief set of instructions for emergency department staff who are displaying the poster and referencing the resource guide. The poster (http://library.sprc.org/item.php?id=583), resource guide (http://library.sprc.org/item.php?id=584) and information insert can be ordered from the Emergency Nurses Association through the ENA Marketplace (http://www.ena.org/store).
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Working with emergency departments: Expanding crisis center resources and partnerships
URL: http://www.sprc.org/grantees/statetribe/2009/PDF/8ACook.pdf
Garrett Lee Smith Suicide Prevention Grantee Meeting, January 5-9, 2009, Phoenix, AZ. Describes the Lifeline crisis center – emergency department partnership tool kit, an SPRC publication.
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Working with emergency departments: New tools and grantee models
URL: http://www.sprc.org/grantees/statetribe/2009/PDF/8ALitts.pdf
Garrett Lee Smith Suicide Prevention Grantee Meeting, January 5-9, 2009, Phoenix, AZ. Discusses suicide prevention in the emergency department and SPRC resources on the subject.
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