Suicide Risk Protocols: Addressing the Needs of High Risk Youths Identified through Suicide Prevention Efforts and in Clinical Settings

Abstract

Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request of the Substance Abuse and Mental Health Services Administration, we provide an overview of recommendations, as well as steps taken in conjunction with selected prevention programs and in emergency department settings to address the needs and improve the care of these youths.

The Role of the School Nurse in Suicide Interventions: An Integrative Review

“…Additionally, when there are insufficient MH services to address needs, the effectiveness of screening is questionable (Robinson et al, 2013). Further, there may be a potential for harm if adequate support is not available for at-risk students (Heilbron, Goldston, Walrath, Rodi, & McKeon, 2013). Lack of referral services has also been reported as an obstacle to implementing screening of at-risk students (Singer, 2017) and policies relating to nonsuicidal self-injury (Berger, Hasking, & Reupert, 2015).…”

Examining the Unanticipated Adverse Consequences of Youth Suicide Prevention Strategies: A Literature Review with Recommendations for Prevention Programs

“…With the caveat acknowledged that the methodology and evaluation approaches differ widely across studies, for planning purposes, it is prudent for organizations implementing suicide prevention programs to both assess for the possibility of adverse consequences at multiple levels—at the level of youth, at the level of individuals implementing the program, and at a systemic level—even if such adverse effects are uncommonly reported, and prepare with adequate procedures and policies for supporting those individuals who have been negatively affected in some way (Heilbron, Goldston, Walrath, Rodi, & McKeon, ). For example, the Suicide Prevention Resource Center's safe messaging guidelines provide recommendations for safe and effective awareness messaging and could be referenced in the planning stages (Suicide Prevention Resource Center, ).…”

“…Such activities aim to reduce stigma, increase knowledge of available services, and increase awareness of this public health problem. Beneficial outcomes reported for such interventions in different studies include increased knowledge about depression and suicide, increased knowledge about where to get help for emotional problems, and endorsement that the program would help participants deal with their own or a friends' problem (Kalafat & Elias, 1994;Klimes-Dougan, Yuan, Lee, & Houri, 2009;Shaffer, Garland, Vieland, Underwood, & Busner, 1991). Adverse consequences of outreach and awareness interventions have been shown in the literature, particularly among certain subpopulations and previous suicide attempters.…”

“…Individual studies have suggested unintended consequences of psychosocial interventions (Poulin, Dishion, & Burraston, 2001;Wechsler et al, 2003), but most studies have not systematically assessed for and reported these outcomes. Meta-analytic reviews of interventions for a variety of youth problems have noted the absence or dearth of reports of unintended consequences and the need for documentation of adverse consequences (Coren, Hossain, Pardo Pardo, & Bakker, 2016;Hawton et al, 2015;Thomas, Baker, Thomas, & Lorenzetti, 2015).…”

Research with Older Adult Methadone Clients: The Importance of Monitoring Suicide Ideation

“…There is a preponderance of tools to assess risk for suicide in multiple contexts, e.g. adults in primary care, outpatient care, emergency departments, and high risk youth in clinical settings (Gaynes et al, 2004; Heilbron, Goldston, Walrath, Rodi, & McKeon, 2013; Linehan, Comtois, & Ward-Ciesielski, 2012; Randall, Colman, & Rowe, 2011; Simon et al, 2013). Furthermore, there exists a “gold standard” in the Columbia Suicide Severity Rating Scale (C-SSRS) (Posner et al, 2011) which has been validated across three multisite studies in treatments for adolescents and adults.…”