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.

Safety Planning Assessment

Identifies the best way we can engage our consumers and detect suicide risk. Identifies techniques and approaches that will enhance the identification of suicide risk.

Transition of care

Identifies a process for the safe transition of care between service providers.

Suicide Prevention Pathway GCMHSS KT,MW ,2016

Identifies components of follow up which aims to address drivers of suicidality, resolve crisis and identify resolution

Risk Formulation

Synthesis the suicide risk information and articulates a consumers immediate distress and resources at a specific time and place.

Structured Follow Up Brief Patient & Carer Education Rapid Referral Counselling on Access to Lethal Means Initial Intervention

The Suicide Prevention Pathway

Screening

Mandatory Components Definition

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”

• Shawn Shea: “Chronological Assessment
• f Suicide Events”

Real Intent Stated Intent Reflected Intent Withheld Intent

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.

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

SPP Data Snapshot "First 100 Patients"