Resources

A Checklist for Health Providers and Mental Health Practitioners

Created by the Oregon Council of Child and Adolescent Psychiatry

Rationale and Scope:
Preliminary statistics from Oregon indicate that 701 persons died by suicide in 2012. That was 30% greater than the number of deaths from vehicular accidents, homicide, and HIV/AIDS combined. Oregon’s suicide rate in 2011, 16.9 per 100,000 persons, was far above the national average of 12.4. The rate among Oregon males ages 20-24 was a shocking 29.3. By way of comparison, the death rate from breast cancer was 12.4 per 100,000. Suicide ranks as the second leading cause of death in Oregon among people ages 15-34. But this is not for lack of care. Nationally, 35 percent of those who took their lives were being treated for mental illness at the time of their deaths and 45% of all suicide victims had contact with primary care providers within one month of taking their own lives. (Shen & Millet, 2013; Luoma et. al. 2002)

Communication between primary care providers and/or mental health practitioners and family members of patients seeking treatment for mental illness improves the quality of care provided to these patients, reduces the risk of suicide and self-harm behaviors, and encourages the use of community resources to improve overall outcomes for these patients. While confidentiality is a fundamental component of a therapeutic relationship, it is not an absolute, and the safety of the patient overrides the duty of confidentiality. Misunderstandings by clinicians about the limitations created by HIPAA, FERPA, and state laws for preserving confidentiality of patients has caused unnecessary concern regarding disclosure of relevant clinical information. Communication between providers, patients, and family members or identified significant others needs to be recognized as a clinical best practice and deviations from this should occur only in rare and special circumstances.

This checklist is intended for use by primary care providers, emergency department staff, and any professional providing mental health treatment, to include, but not be limited to, family physicians, general practitioners, pediatricians, physician assistants, nurse practitioners, social workers, counselors, psychologists, psychiatric nurse practitioners, and psychiatrists. If your professional organization does not have a preferred suicide risk assessment protocol, please see page 8 of this document.