The Pathway Dr Kathryn Turner Clinical Director Mental Health - PowerPoint PPT Presentation

“ The Pathway ” Dr Kathryn Turner Clinical Director Mental Health and Specialist Services

 560,000 population  700 ED MH presentations per month  1000 calls to 1300 MHCALL each month  1,500 people admitted per year

The Pathway had to cover:  Identify – Systematically identify and assess suicide risk among people receiving care.  Engage – Ensure every individual has a pathway to care that is both timely and adequate to meet his or her needs. Include collaborative safety planning and restriction of lethal means.  Treat – Use effective, evidence-based treatments that directly target suicidal thoughts and behaviors.  Transition – Provide continuous contact and support, especially after acute care.

The Suicide Prevention Pathway Mandatory Components Definition Identifies the best way we can engage our consumers and detect suicide risk. Screening Identifies techniques and approaches that will enhance the identification of Assessment suicide risk. Synthesis the suicide risk information and articulates a consumers Risk Formulation immediate distress and resources at a specific time and place. Initial Intervention Safety Planning Counselling on Access to Lethal Means Brief Patient & Carer Education Rapid Referral Identifies components of follow up which aims to address drivers of Structured Follow Up suicidality, resolve crisis and identify resolution Transition of care Identifies a process for the safe transition of care between service providers. Suicide Prevention Pathway GCMHSS KT,MW ,2016

Suicide Prevention Pathway Commencement  Criteria: 1. Presents with recent Suicide Attempt 2. Past History of Suicide Attempt and presents with Suicidality 3. At Clinicians Discretion

Assessment Shea, 2009 Source: SRAM-ED Modules, Qld Centre for Mental Health Learning

How to get beyond “Stated Intent” Reflected Real Stated Withheld Intent Intent Intent Intent  Shawn Shea: “Chronological Assessment of Suicide Events”

CASE Approach to exploring Intent

If not a Categorical Risk Prediction – then what?  Moving from Risk Prediction to “Prevention Orientated Risk Formulation”

Pisani et al Formulation model anthony_pisani@urmc.rochester.edu

Brief Interventions

Training  3 SRAM-ED Modules  1 GC Module  1 day face to face training.

SPP Data Snapshot "First 100 Patients" 100 90 80 70 60 50 40 30 20 10 0 Admitted Risk Formulation Safety Plan Completed Structured Follow Up Completed Yes 35 77 88 99 No 65 23 12 1