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Clinical Guidelines for Suicide Prevention

Suicide is a significant problem for the Defense Department. For providers, an essential piece of suicide prevention is a proven, step-by-step approach to treating potentially suicidal patients. A recent webinar presented by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury highlighted how the military constantly updates its suicide clinical practice guidelines.

Eric Rodgers, director of the evidence-based practice program at the Department of Veterans Affairs (VA), talked about the standards and procedures for updating these guidelines.

Suicide clinical practice guidelines undergo review by evidence-based practice workgroups. Workgroups include representatives from VA and the Defense Department, as well as individuals from multiple disciplines. They incorporate patient input and identify how new guidelines will affect treatment outcomes. The groups which oversee the suicide guidelines include members specifically chosen to address the subject of suicide.

Guidelines often need multiple reviews before approval. In some cases they may not meet standards for approval at all.

“It's not a rubber stamp. They are looked at very rigorously,” Rodgers said.

At the same time, the guidelines are not set in stone, according to James Sall, a clinical quality program specialist for the VA. Health care providers may have reasons for alternate paths of treatment. For example, a patient might prefer not to pursue a certain treatment.

“It is important to remember that these are recommendations, not mandates,” Sall said.

Cmdr. Angela J. Williams, a clinical psychologist for the Deployment Health Clinical Center, reviewed some suicide risk tools available to health care providers and patients:

  • Assessment and Management of Patients at Risk for Suicide Pocket Guide. This guide for providers contains key elements of the suicide risk guidelines: signs for identifying, assessing and managing suicide risk. It also details planning and treatments to reduce suicide risk.
  • Suicide Prevention: Overcoming Suicidal Thoughts and Feelings. A guide for patients to learn how to recognize their own suicide risk. It includes tips for building resilience and developing coping strategies.
  • Safety Plan Worksheet. A planning document for providers and patients to fill out together. It helps develop a personal plan for a patient’s potential triggers, sources of support, and coping strategies.
  • Suicide Prevention: A Guide for Military and Veteran Families. Provides information for families on suicide warning signs, treatments and access to care. It also details how to care for a loved one at risk for suicide.

If you are interested in learning more about suicide prevention efforts in the military, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury blog features many posts on the topic.

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