I wanted to share with you a suicide safety plan that I received permission to use from the authors, Dr. Joti Samra, R. Psych and Dr. Dan Bilsker, R. Psych and the organization CARMHA, and Simon Fraser University, see link Welcome to CARMHA — Centre for Applied Research in Mental Health and Addiction. I’ve been using the plan for several years and I teach resident physicians and medical students how to administer it as part of a suicide risk assessment. Recently I was happy to learn that one of our talented bilingual social workers made a Spanish translation of the safety plan.
The safety plan is not the same thing as a no-suicide contract, which is not recommended. The no-suicide contract is like a promise, and promises are broken all the time. A plan is better than a promise any day of the week. It gives the clinician another way to assess whether or not the patient is able to engage in the therapeutic alliance. It can alert us to clues about perceived lack of social supports, hopelessness, and access to mental health care resources.
That last one about access can be very challenging. If the patient has no mental health care provider, I often give him or her my business card and ask them to give me a phone call in about a week from the time I first encounter them. I’m a hospitalist and not in a position to see them myself in follow-up; however, I can assist in arranging for mental health follow-up. In the meanwhile, I ask them to touch base with me by phone. I have gotten very few calls over the years. On one occasion, when I told a group of learners that, one of them asked me why I bothered if I hardly ever got a call back. You never know when somebody’s going to need you.
And an announcement here: See the link below for registration information to a workshop “Losing a Patient to Suicide”, scheduled for October 10, 2012 at 9:00 a.m. at the Coralville Center for the Performing Arts in Coralville, Iowa. The free program is being offered by the Johnson County Suicide Prevention Coalition. The course is free and open to health professionals whose practice includes treatment of mentally ill individuals. Credit is provided for physicians, nurses, social workers, and Iowa Board of Certification (IBC) approved professionals. Two national presenters will lead the meeting and discussions.
You can view a dirty dozen post on suicide risk assessment at The Geezer’s Dirty Dozen on Suicide Risk Assessment « The Practical Psychosomaticist: James Amos, M.D.Tell me what you think about the safety plan. Drs. Samra and Bilsker are also very interested in feedback and I told them I’d pass it on.