Developing a Mobile Website for the Self-Directed Violence Classification System Decision Tree Joe Huggins MSW MSCIS, VISN 19 MIRECC Developing a Mobile Website for the Self-Directed Violence Classification System Decision Tree Joe Huggins MSW MSCIS, VISN 19 MIRECC Abstract The field of Suicidology has long struggled with the lack of a universally agreed upon definition for suicide and associated terms. The Self-Directed Violence Classification System was developed jointly by the CDC and VISN 19 MIRECC. The SDVCS includes a decision tree to help clinicians determine the most appropriate term for thoughts and behaviors. The mobile website application allows an easy and always available link to SDVCS for clinicians and researchers from the VA, the DoD and elsewhere. This poster will explore the development and launch of the decision tree and its use since it went live. The poster will also demonstrate how web use tracking tools such as WebTrends, used by the VA, can provide an indication of how the decision-tree is being used and the path to the terminal term. Facts about Veteran Suicide  34,000 US deaths from suicide/ year. Centers for Disease Control and Prevention  ~20% are Veterans. National Violent Death Reporting System  ~18 deaths from suicide/day are Veterans. National Violent Death Reporting System  ~5 deaths from suicide/day among Veterans receiving care in VHA. VA Serious Mental Illness Treatment, Research and Evaluation Center  No evidence for increased rates in OEF/OIF Veterans relative to sex, age, and race matched people in the population as a whole. VA Office of Environmental Epidemiology  More than 60% of suicides among utilizers of VHA services are among patients with a known diagnosis of a mental health condition Serious Mental Illness Treatment Research and Education Center  Before enhancements, rates in facilities depended upon the quality of mental health services Office of Mental Health Services  Veterans are more likely to use firearms as a means. National Violent Death Reporting System  ~1000 attempts/month among Veterans receiving care in VHA as reported by suicide prevention coordinators. VA National Suicide Prevention Coordinator This presentation is based on work supported with resources and the use of facilities at the VISN 19 MIRECC. Acknowledgement of VA Research Support. This material is based upon work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development. I would also like to thank Donald “Gordy” Gordon, Program Analyst, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY for his work on the SDV Decision Tree Algorithm. The Development of a Nomenclature and Classification System Too many ways to describe behaviors and thoughts Suicidal ideation Death wish Suicidal threat Cry for help Self-mutilation Parasuicidal gesture Suicidal gesture Risk-taking behavior Self-harm Self-injury Suicide attempt Aborted suicide attempt Accidental death Unintentional suicide Successful attempt Completed suicide Life-threatening behavior Suicide-related behavior Suicide The Problem… Field of suicidology challenged by lack of conceptual clarity about suicidal behaviors and corresponding lack of well-defined terminology - In both research and clinical descriptions of suicidal acts Variability of terms referring to same behaviors (e.g., threat, gesture). Often pejorative and based on incorrect notions about seriousness and lethality of methods (e.g., manipulative, non-serious, etc). Consequences… Makes interpreting the meaning of suicidal occurrences more difficult and hampers precise communication on individual or population basis –Occurrences that should be classified as suicidal may be missed –Occurrences may be inappropriately classified as suicidal A Solution to the Problem: The Language of Self-Directed Violence Nomenclature (def.): a set of commonly understood widely acceptable comprehensive terms that define the basic clinical phenomena (of suicide and suicide-related behaviors) based on a logical set of necessary component elements that can be easily applied Developing a Mobile WebsiteVISN 19 Self-Directed Violence Mobile Web Decision Tool 39% 36% 25% 80% 20% 30% 18% 52% 55% 45% 73% 27% 0% 100% 0% 9% 91% 14% 23% 63% 90% 10% 24% 76% 17% 0% 83% 19% 22% 59% 100% 0%