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1: Suicide Risk Screening Programs

Screening and Assessment » Screening
1: Suicide Risk Screening Programs

There is insufficient evidence to recommend for or against suicide risk screening programs to reduce the risk of suicide or suicide attempts.

Strength:

Neither for nor against

Category:

ReviewedNew-added

Grades and Definitions

Strong for
or "We recommend offering this option …"
Weak for
or "We suggest offering this option …"
No recommendation
or "There is insufficient evidence …"
Weak against
or "We suggest not offering this option …"
Strong against
or "We recommend against offering this option …"

Categories and Definitions

Evidence Reviewed* Recommendation Category* Definition*
Reviewed New-added New recommendation following review of the evidence
New-replaced Recommendation from previous CPG that has been carried over to the updated CPG that has been changed following review of the evidence
Not changed Recommendation from previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed but the recommendation is not changed
Amended Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed and a minor amendment has been made
Deleted Recommendation from the previous CPG that has been removed based on review of the evidence
Not reviewed Not changed Recommendation from previous CPG that has been carried forward to the updated CPG, but for which the evidence has not been reviewed
Amended Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has not been reviewed and a minor amendment has been made
Deleted Recommendation from the previous CPG that has been removed because it was deemed out of scope for the updated CPG
*Adapted from the NICE guideline manual (2012): The guidelines manual. London: National Institute for Health and Care Excellence;2012. and Martinez Garcia L, McFarlane E, Barnes S, Sanabria AJ, Alonso-Coello P, Alderson P. Updated recommendations: An assessment of NICE clinical guidelines. Implement Sci. 2014;9:72.

Recommendation Resources

A suicide risk screening program can be defined as a systematic approach encompassing suicide risk screening, followed by a comprehensive assessment and formulation of a risk management plan for patients identified as being at an elevated risk of suicide. Suicide risk screening programs are frequently part of routine care and are required by accrediting bodies.

Training Resources

This section includes links to resources to help connect providers to suicide risk screening program training materials.

Two clinicians using the SPRC Patient Safety Screener Patient Safety Screener Tools This website contains training resources for incorporating the Patient Safety Screener into a screening program. It specifically highlights resources and guidance for screening, assessing, and developing a suicide care management plan for patients in Emergency Departments.

Manuals

This section includes links to recommended manuals and information about suicide risk screening programs.

Cover graphic for report R3 Report Issue 18: National Patient Safety Goal for Suicide Prevention National Patient Safety Goal for Suicide Prevention This report, published by The Joint Commission, includes requirements that are designed to improve the quality and safety of care for those being treated for behavioral health conditions and those identified as high risk for suicide. The included elements of performance pertain to suicide risk screening, assessment, and risk mitigation – core components of suicide risk screening programs.
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Webinars

This section includes links to recommended webinars about VA’s suicide risk screening program.

CPG Webinar Evidence-Based Practice in Suicide Risk Screening and Evaluation: Why, What, How and When? Presented by Dr. Nazanin Bahraini
CPG Webinar VA Suicide Risk Identification Strategy (Risk ID): Utilizing the CPG to Inform Standardized Suicide Risk Screening and Evaluation Presented by Suzanne McGarity, PhD
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Articles

This section includes links to recommended articles about suicide risk screening programs.

Bahraini, N., Brenner, L. A., Barry, C., Hostetter, T., Keusch, J., Post, E. P., Kessler, C., Smith, C., & Matarazzo, B. B. (2020). Assessment of Rates of Suicide Risk Screening and Prevalence of Positive Screening Results Among US Veterans After Implementation of the Veterans Affairs Suicide Risk Identification Strategy. JAMA network open, 3(10). e2022531. https://doi.org/10.1001/jamanetworkopen.2020.22531
Bender, T.W., Fitzpatrick, S., Hartmann, M-A., Hames, J., Bodell, L., Selby, E.A., et al. (2019). Does it hurt to ask? An analysis of iatrogenic risk during suicide risk assessment. Neurology, Psychiatry and Brain Research, 33. 73-81. https://doi.org/10.1016/j.npbr.2019.07.005.
Carter, S. P., Malte, C. A., Rojas, S. M., Hawkins, E. J., & Reger, M. A. (2020). Examination of potential disparities in suicide risk identification and follow-up care within the Veterans Health Administration. Suicide & life-threatening behavior, 50(6). 1127–1139. https://doi.org/10.1111/sltb.12673
Dunlap, L. J., Orme, S., Zarkin, G. A., Arias, S. A., Miller, I. W., Camargo, C. A., Jr, Sullivan, A. F., Allen, M. H., Goldstein, A. B., Manton, A. P., Clark, R., & Boudreaux, E. D. (2019). Screening and Intervention for Suicide Prevention: A Cost-Effectiveness Analysis of the ED-SAFE Interventions. Psychiatric services (Washington D.C.), 70(12). 1082–1087. https://doi.org/10.1176/appi.ps.201800445
Hom, M. A., Stanley, I. H., Rogers, M. L., Gallyer, A. J., Dougherty, S. P., Davis, L., & Joiner, T. E. (2018). Investigating the iatrogenic effects of repeated suicidal ideation screening on suicidal and depression symptoms: A staggered sequential study. Journal of affective disorders, 232. 139–142. https://doi.org/10.1016/j.jad.2018.02.022
Laguado, S. A., Steavenson, R., & Mehvar, M. (2021). Areas of Improvement in Suicide Risk Identification, Assessment, and Risk Mitigation Documentation by Mental Health Prescribers at a Veterans Affairs Health Care System. Administration and policy in mental health, 48(4). 633–638. https://doi.org/10.1007/s10488-020-01097-0
Roaten, K., Johnson, C., Genzel, R., Khan, F., & North, C. S. (2018). Development and Implementation of a Universal Suicide Risk Screening Program in a Safety-Net Hospital System. Joint Commission journal on quality and patient safety, 44(1). 4-11. https://doi.org/10.1016/j.jcjq.2017.07.006
Syndergaard, S., Borger, J., Klenzak, S., Grello, A., & Adams, A. (2023). Implementation of Columbia Suicide Severity Rating Scale (C-SSRS) as a Universal Suicide Risk Screening tool in a High Volume Emergency Department. Archives of suicide research : official journal of the International Academy for Suicide Research, 27(2). 769–779. https://doi.org/10.1080/13811118.2022.2066495
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Podcasts

This section includes links to recommended podcast episodes about suicide risk screening programs.

Healthcare Strategies Podcast Series
podcast icon Using Risk Stratification to Drive Suicide Prevention Efforts In this episode, Drs. Kimberly Roaten and Jacqueline Naeem share how health systems can help prevent suicides in their patient populations by using data-informed suicide risk assessment and stratification approaches.
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