How you handle each patient will be different, and the conversation can result in many different outcomes. But whenever you detect a suicide risk, there are four critical steps you’ll want to take with the patient and their family:

• Make a safety plan
• Discuss restriction of lethal means
• Documenting your decisions
• Following up

A safety plan is a written list that can be referenced at any time by Justin or his parents, and can be an important tool in keeping the him safe in the case of a crisis.

It contains warning signs and coping strategies, as well as the names and phone numbers of supportive friends and family, crisis hotlines, and contact information for mental health professionals. (printsum: maybe use icons from mgfx? only if makes sense)

Discuss Access to Lethal Means by talking to the patient’s family about removing or securing possible means of harm from the home. This conversation might focus on firearms, sharp objects, like knives or scissors, potential poisons, like prescription drugs or household chemicals, or means of suffocation.

As you are having this conversation with your patients, or even afterwards, remember to document the key facts about their mental state, --including your risk assessment and any specifics that informed that decision, --and any plans you make for treatment. This applies whether or not the patient is at suicide risk or not. By taking notes about your conversation, and especially about the decisions you make and the outcomes this leads you to, you create a record that can be used to track progress and as a reference in follow-up visits. This documentation may also be used to inform other providers who are part of that patient’s care, or as a resource in questions of medical liability.

Finally, you’ll want to schedule a follow up. A follow-up visit or phone call in a week or so to see how the patient is doing is important to their continued safety, to ensure that they is following up on referrals or treatment, and to sustain the rapport you’ve developed.

Conclusion

As a primary care provider, you have a busy schedule, and you may have concerns about being able to identify patients with mental health disorders and have conversations about treatment options in the limited time you have.

Every patient is different; some will be more open with you than others, and some will be more easily identifiable. But, by spending a little extra time with potentially at-risk patients and addressing the root cause of their issues, you’ll save time in the long run and be better prepared and more confident in identifying and treating patients suffering from mental health conditions. As a result, you’ll drastically improve patients’ physical and mental health.