Suicide Prevention Resource Center (SPRC): Assessing and Managing Suicide Risk, Core Competencies

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SPRC Training Institute

Assessing and Managing Suicide Risk: Core Competencies for Mental Health Professionals

Core Competencies

Competencies encompass clusters of knowledge, skills, abilities, and attitudes or perceptions required for people to be successful in their work. In this case, core competencies refer to the clinical evaluation, formulation of risk, treatment planning, and management of individuals at risk for suicide to protect their lives and promote their well-being.

The following set of core competencies, based on current empirical evidence and expert opinion, provides a common framework for learning about and gaining skill in working with individuals at risk for suicide. They are not intended to be construed or to serve as a standard of care.

Twenty-four competencies and their sub-competencies fall into seven broad categories as outlined below. Core competencies related to specific treatment interventions have not been developed.

A. Working with Individuals at Risk for Suicide: Attitudes and Approach

1. Manage one's own reactions to suicide
2. Reconcile the difference (and potential conflict) between the clinician's goal to prevent suicide and the client's goal to eliminate psychological pain via suicidal behavior
3. Maintain a collaborative, non-adversarial stance
4. Make a realistic assessment of one's ability and time to assess and care for a suicidal client as well as for what role one is best suited

B. Understanding Suicide

5. Define basic terms related to suicidality
6. Be familiar with suicide-related statistics
7. Describe the phenomenology of suicide
8. Demonstrate understanding of risk and protective factors

C. Collecting Accurate Assessment Information

9. Integrate a risk assessment for suicidality early in a clinical interview, regardless of the setting in which the interview occurs and continue to collect assessment information on an ongoing basis
10. Elicit risk and protective factors
11. Elicit suicide ideation, behavior, and plans
12. Elicit warning signs of imminent risk of suicide
13. Obtain records and information from collateral sources as appropriate

D. Formulating Risk

14. Make a clinical judgment of the risk that a client will attempt or complete suicide in the short and long term
15. Write the judgment and the rationale in the client's record

E. Developing a Treatment and Services Plan

16. Collaboratively develop an emergency plan that assures safety and conveys the message that the client's safety is not negotiable
17. Develop a written treatment and services plan that addresses the client's immediate acute, and continuing suicide ideation and risk for suicide behavior
18. Coordinate and work collaboratively with other treatment and service providers in an inter-disciplinary team approach

F. Managing Care

19. Develop policies and procedures for following clients closely including taking reasonable steps to be proactive
20. Follow principles of crisis management

G. Documenting

21. Document the following items related to suicidality

H. Understanding legal and regulatory issues related to suicidality

22. Understand state laws pertaining to suicide
23. Understand that poor or incomplete documentation make it difficult to defend against legal challenges
24. Protect client records and rights to privacy and confidentiality following the Health Insurance Portability and Accountability Act of 1996 that went into effect April 15, 2003

Learning Objectives

By completing the required pre-workshop reading, you will:

Become familiar with core competencies that enable mental health therapists to assess and work more effectively with individuals at risk for suicide
Define terms related to suicidality
Become familiar with suicide-related statistics
Identify major risk and protective factors
Understand the phenomenology of suicide

By the end of this course, you will:

Increase your knowledge in the following core competencies:
- Manage one's own reactions to suicide
- Reconcile the difference (and potential conflict) between the clinician's goal to prevent suicide and the client's goal to eliminate psychological pain via suicidal behavior
- Maintain a collaborative, non-adversarial stance
- Elicit suicide ideation, behavior, and plans
- Make a clinical judgment of the risk that a client will attempt or complete suicide in the short and long term
- Collaboratively develop an emergency plan
- Develop a written treatment and services plan that addresses the client's immediate, acute, and continuing suicide ideation and risk for suicide behavior
- Develop policies and procedures for following clients closely, including taking reasonable steps to be proactive
- Follow principles of crisis management
Experience a shift in perspective in working with individuals at risk for suicide.
- We expect you will experience changes in perceptions of working with suicidal clients. For example, you may experience an increased willingness, confidence, or clarity in working with individuals at risk for suicide.
Identify changes to make in your practice specific to the assessment and management of individuals at risk for suicide.

Recommended Workshop Schedule

8:30 – 8:45	Introduction and overview of the course
8:45 – 10:30	Attitudes and approach
10:30 – 10:45	Break
10:45 – 11:05	Understanding suicide
11:05 – 12:15	Eliciting suicide ideation, behavior and plans
12:15 – 1:15	LUNCH
1:15 – 2:15	Formulation of risk
2:15 – 3:00	Treatment planning
3:00 – 3:15	BREAK
3:15 – 3:45	Treatment planning (continued)
3:45 – 4:15	Management of care
4:15 – 4:30	Documentation
4:30 – 4:45	Legal and regulatory issues
4:45 – 5:00	Summary and evaluation

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The SPRC is supported by a grant (1 U79 SM57392-05) from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (DHHS). No official endorsement by SAMHSA or DHHS for the information on this web site is intended or should be inferred.

The Suicide Prevention Resource Center (SPRC) is a project within EDC's (HHD)
55 Chapel Street, Newton, MA 02458 877-GET-SPRC (438-7772),

Substance Abuse Mental Health Services Administration (SAMHSA)