SUICIDE

A.  BACKGROUND

1. Introduction
   1. Definitions, classification of behaviors, etiology, risk factors, and severity
   2. The role and expectation of the professional care and coordination of the behavioral health team and the primary care team addressing suicidal prevention.  [SPC, Chaplin)
2. Burden of condition: Suicidality (Ideationand behavior) in military and veteran population
3. Conceptual model of the intent of the CPG for Prevention of Suicide.

B. ASSESSMENT and risk stratification

1. Detection, recognition and referral in primary care
2. Assessment
   1. Ideation/thoughts
   2. Intent/Plan
   3. Behavior/Attempt
3. Risk Factors
   1.  Acute RF 
   2.  Chronic RF
   3.  Warning signs
   4.  Protective factors 
4. Assessment Instrument
5. Determine Level of Risk (Severity of Suicidality)
   1. Acute -High (imminent)
   2. Moderate to high
   3. Low
   4. Factors elevating risk

C. MANAGEMENT OF SUICIDAL PATIENT

1. Management of urgent/emergent - Indications for Referral Criteria for discharge
2. Treatment
   1. Integrated Treatment plan 
   2. Clinical Engagement
   3. Addressing needs
3. Treating co-occurring conditions
4. Enhancing treatment of underlying cause to prevent suicide
   1. Psychotherapies
   2. Pharmacotherapies
   3. Other                                                  alternate outline; by disorders
5. Treatment Interventions to prevent suicide 
   1. Psychotherapies
   2. Pharmacotherapies
   3. Other
6. Restrictions of means
7. Safety (action) plan for patient at risk
8. Assure follow-up and future access to services
9. Continuity of Care
   
   
   
10. Special population
    1. Elderly
    2. Chronic Ill
    3. Neuropsychiatric conditions
    4. Combat/deployed setting
    5. Recent returnees (depression/ptsd; adjustment)
    6. Post partum depression (pregnancy)
    7. Women issues
    8. LGBT

D. POSTVENTION

 

F. Organization of Care (from a clinical perspective)