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Let's review the frameworks and toolkits we learned today.

As you interview patients, keep in mind the Suicide Assessment Five-step Evaluation and Triage framework, or SAFE-T:

Identify risk factors
Identify protective factors
If the patient is at-risk, ask about substance abuse and/or current suicidal thoughts, plans, behavior, and intent
Determine his or her risk level and the appropriate intervention
And document your risk assessment, rationale, intervention, and follow-up

Be aware of warning signs and risk factors for suicide and substance abuse as they present themselves in your interview with the patient:

Behavioral warning signs include fidgeting, hesitation, having an evasive, irritable, agitated, or depressed affect, or dramatic or unexpected changes in affect during the conversation.

General risk factors include a personal or family history of psychiatric illness or suicide attempts, chronic illness or pain, substance abuse, social stressors like unemployment or financial loss, a tendency towards impulsive behavior, or the recent death of a loved one.

Protective factors can include family and community supports, restricted access to lethal means, physical and mental health supports, and problem solving and conflict resolution skills.

IS PATH WARM is a good mnemonic to help remember warning signs that a patient may be at risk for suicide:

I: Ideation
S: Substance Abuse
P: Purposelessness
A: Anxiety
T: Trapped
H: Hopelessness
W: Withdrawal
A: Anger
R: Recklessness
M: Mood Changes

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