Suicide rates have increased recently in the United States, including an almost 20% increase in Washington State in recent years. As healthcare professionals working in outpatient clinics, community pharmacies, dental offices, social service offices, and other community settings, learning how and when to screen for suicidal ideation and behaviors can save a life. The goal of screening is to identify people at risk and quickly refer them to the services that can help prevent self-harm.
Routine screening can identify a person in crisis and provide the support needed to prevent self-harm. If a patient has been referred following a suicide attempt, screening is particularly important because someone who has attempted suicide remains at high risk following the attempt.
Washington law recommends that providers screen patients for suicidal ideation and behaviors. A screening tool such as the Patient Health Questionnaire 2 or the Columbia Suicide Screen can help a clinician gauge the immediacy of the risk, the need for a more in-depth assessment, and the need for referral.
Healthcare providers have an ethical duty to assess patient safety and understand the referral process. Be prepared with a plan, know how to activate resources, and make sure to follow up. Staying engaged will give patients the support they need and may be helpful in reducing depression and hopelessness.
Understanding when a person is at imminent risk of harm and being ready and willing to talk about lethal means are important aspects of suicide prevention. As in other areas of healthcare, a non-judgmental, kind, patient-centered approach is critically important.
Outpatient providers, such as rehabilitation therapists, social workers, psychologists, dentist professionals, and community pharmacists play a key role in reducing suicidal behaviors by routinely screening clients and making timely referrals to mental health resources. These providers also play a key role once a patient has been discharged following a suicide attempt. Risk remains elevated during the days and weeks following hospitalization for a suicide attempt, especially for people diagnosed with major depression, bipolar disorder, and schizophrenia. This is a key issue for anyone providing services to a person after a suicide attempt.