Clinical Competencies for Health Care Providers Richard McKeon, Ph.D. Chief, Suicide Prevention Branch

Suicide Prevention and the Clinical Workforce: Guidelines for Training

Assessing and Managing Suicide Risk (sprc.org) Photo: Two women and a man interacting over a table at a business meeting.

AMSR’s Core Competencies Working with individuals at risk for suicide: Attitudes and approach Understanding suicide Collecting accurate assessment information Formulating risk SPRC’s Assessing and Managing Suicide Risk (AMSR) workshop covers 24 core competencies that mental health professionals should have to effectively assess and manage suicide risk. Competencies are clusters of knowledge, skills, abilities, and attitudes required for people to be successful in their work. While this set of competencies is based on empirical evidence and expert opinion, please note that it not intended to be construed or to serve as a standard of care and does not include core competencies related to specific treatment interventions such as CBT or DBT. 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. 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. Collecting Accurate Assessment Information 9. Integrate a risk assessment for suicidality early in a clinical interview 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. 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.

AMSR’s Core Competencies (cont’d) Developing a treatment and services plan Managing care Documenting Understanding legal and regulatory issues related to suicidality 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. Managing Care 19. Develop policies and procedures for following clients closely. 20. Follow principles of crisis management Documenting 21. Document items related to suicidality. Understanding Legal and Regulatory Issues Related to Suicidality 22. Understand state laws pertaining to suicide. 23. Understand that poor or incomplete documentation makes 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.

Dialectical Behavioral Therapy (DBT)

Cognitive Behavior Therapy (CBT)

Collaborative Assessment and Management of Suicidality (CAMS)

Counseling on Access to Lethal Means (CALM) sprc.org Photo: Young woman on couch preparing to speak to older woman sitting in chair (probably a counseling session).

Imminent Risk

Gatekeeper Trainings

TIP 50

Suicide Assessment Five-Step Evaluation and Triage (SAFE–T)

SAMHSA’s New Suicide Prevention App Suicide Safe is designed to help behavioral health and primary care providers integrate suicide prevention strategies into their practice and address suicide risk among their patients. Suicide Safe is a new mobile app for behavioral health and primary care providers, designed to help them integrate suicide prevention strategies into their practice and address suicide risk among their patients. Free from Apple Store and Google Play. #SuicideSafe #SAMHSALive

SAMHSA’s New Suicide Prevention App (cont’d) Key Features of Suicide Safe: SAFE–T Card SAMHSA’s Behavioral Health Treatment Services Locator Patient Education Materials Interactive Case Studies Conversation Starters Suicide Safe is a new mobile app for behavioral health and primary care providers, designed to help them integrate suicide prevention strategies into their practice and address suicide risk among their patients. The SAFE-T: The first feature of the app that I would like to talk about today is the Suicide Assessment Five-step Evaluation and Triage, or the SAFE-T for short. This card is a nationally recognized tool for suicide assessment. It was developed in collaboration with Dr. Doug Jacobs, founder and medical director of Screening for Mental Health. Suicide Safe was developed based on the SAFE-T card and with consultation from Dr. Jacobs and other clinicians and experts in the field of suicide prevention. #SuicideSafe #SAMHSALive

Richard McKeon, Ph.D., MPH Branch Chief Suicide Prevention Branch Richard.McKeon@samhsa.hhs.gov 240–276–1873