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New Tools Simplify Suicide Prevention Efforts

By Beth Schwinn, DCoE Public Affairs on November 20, 2014

Click to learn more about new suicide prevention tools for health providers
Three Army soldiers demonstrate their commitment to preventing suicide. Photo by Steven Baker

New tools to help providers assess and treat potentially suicidal patients are available thanks to a collaboration between the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) and the Department of Veterans Affairs (VA).

The tools are based on VA and Defense Department clinical practice guidelines issued last year. The tools integrate the latest evidence-based practices into recommendations on warning signs, protective factors, safety planning and effective treatments.

The suicide risk clinical guidelines were cited as an example of how to expedite the adoption of new research by providers in a recent report, Developing a Research Strategy for Suicide Prevention in the Department of Defense, by the Rand Corporation. So-called bench-to-bedside delays in translating medical research into clinical care are a challenge for the health system both inside and outside the military.

The tools, which primary and specialty care providers can use without having to memorize the 190-page clinical practice guidelines, will hopefully facilitate wider adoption of the guidelines, said Cmdr. Angela Williams-Steele, clinical psychologist and chief of evidence-based practices at Deployment Health Clinical Center, a DCoE center.

“Providers won’t always have time to thumb through a lengthy guideline to find what they need,” she said.

The first tool, the “Suicide Risk Provider Pocket Guide,” is for providers. It briefly explains guidelines and decision aids for primary and specialty care providers to help them recognize symptoms of suicidal risk, treat and manage them.

The second tool, a “Safety Plan Worksheet,” is a provider-driven tool completed with the patient. Although it seems like a simple idea, the worksheet is crucial because it encourages a partnership between the patient and doctor to help keep the patient safe, Williams-Steele said.

“When someone feels suicidal, his mind may not be clear. He doesn’t know who to reach out to,” she said.

The patient can use the completed worksheet as a quick reference guide to identify stressful triggers and warning signs, who to contact for support, and where to go with questions.

Although the worksheet empowers patients to participate in their care, patients should not attempt to fill out the worksheet themselves, she emphasized. When the patient and doctor work together, the worksheet acts like a prescription, a medically-recognized reminder to the patient that his pain is treatable and that he can take practical steps to minimize risk and access the care he needs. Meanwhile, the doctor also keeps a copy of the worksheet to include in the patient’s electronic medical record.

The suite of tools also includes brochures, one for patients and another for family members or battle buddies. Patients and family can pick them up from a provider if they have concerns about a loved one’s behavior.

“Suicide Prevention: Overcoming Suicidal Thoughts and Feelings” educate patients on risk management, strategies to build inner sources of strength, recognizing warning signs, effective coping strategies and the importance of engaging actively in treatment.

“Suicide Prevention: A Guide for Military and Veteran Families” teaches about suicide warning signs, accessing care, appropriate treatments and ways they can best support a loved one who is suicidal or in crisis.

The tools are available for download at the US Army Medical Department website (under the Health Care Team menu on the left) and the Department of Veterans Affairs website. Print copies of the tools will be available for order in 2015.

Comments (4)

  • Larry Crawford 20 Nov

    If you truly want to see an incredible program that's in acton here in Central Texas check on Emotionalselfsufficiency.com.  This program has been sharedesigned at no charge to two Central Texas VA Vet Centers with both Centers Staffs of Providers being trained on the program. Check with Austin Vet Center on the impact it's having on their PTSD Program participants. Choosing this program over others offered. 

     And the amazing thing is it was created by a Non-Creditionaled Provider. She has committed her life in supporting our Veterans, Troops & Families aND it is provided Pro-Bono to them. 

    Just be curious and ask these centers what itshe involved in it. Oh by the way she's been sharing this on Ft Hood since Feb 2012 when she was provided an office by then Cdr of 3rd Cav Regiment, COL Richardson. Because he and his Deputy Commander LTC Radliff believed in the program. Enough said, check her out and ask questions. Ask Dr. Harry Croft,  San Antonio, Tx. What he thinks of BarBara 'BB' Crawford's ESS program. Thanks for your time!
  • COL (Ret) George Patrin, MD 02 Jan

    Talking about what Families can do to prevent suicide will not be successful until we include Families in health care plans. We must stop 'hiding' behind HIPAA privacy guidelines and begin a culture of asking a patient, before a crisis arises, who they trust, who their 'family' is. This can be blood relatives, friends, work colleagues, and hopefully, their primary care provider. When these contacts are listed in the health record from day one with a release of information form signed by the patient, we can call on them when a person begins talking of depression, even before suicidal ideation. The second requirement is to bring this safety team, along with the Primary Care Provider Team, together when crises arise to address the issues, rather than rely on impersonal emergency department or urgent care clinic personnel to deal with the issue. Until we put these legal cultural issues and processes into place, we will continue to be frustrated with our well-meaning attempts to curb, and eliminate, suicide in our society, whether military or civilian. 
  • DCoE Public Affairs 18 Feb

    COL Patrin, thank you for your feedback. We understand how important it is for providers to have an open dialogue with patients and their loved ones, especially when it comes to preventing suicide. We designed the Safety Plan Worksheet (discussed in the article) for patients and providers to complete together.  It prompts providers and patients to talk about trusted friends and family members and to identify those who can be contacted prior to or during a crisis.  The worksheet also allows patients to identify their own critical triggers and warning signs.  Once the worksheet is complete, it should be added to the patient’s electronic medical record, which allows the patient’s treatment team to have access to the information.  
  • DCoE Public Affairs 18 Feb

    Larry, thank you for sharing about this program. We always enjoy hearing about different programs that help our warriors and veterans.

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