Suicide prevention guide to treat at-risk patients

The AMA's "Suicide Prevention How-To Guide" offers practical strategies, actionable steps and evidence-based resources to physician practices and health systems on identifying patients at-risk for suicide and connecting them with the most appropriate treatment plan.

This is part of AMA’s broader efforts to empower health care organizations to  overcome obstacles to accessible and equitable treatment for their patients’ behavioral, mental and physical health needs.

Studies show over 40% of patients contemplating suicide interact with their primary care provider within days of their death. However, primary care staff may feel unprepared to respond when a patient expresses suicidal ideation or behavior.

With advance preparation and proper training, primary care physicians and their care teams can effectively leverage their relationships with patients and play an important role in patient safety, suicide prevention, treatment and recovery.

Being prepared to spot the signs of suicide risk and knowing how to flag patients at risk can be done by any member of the care team and are critical first steps in establishing trust, ensuring safety, engaging others and connecting patients with the most appropriate treatment plan.

Integrating suicide prevention strategies into practice  

In this guide, primary care physicians and their care teams will learn how to include the following best practices into their processes and procedures to address patients at-risk for suicide. 

1. Align and train their teams to recognize and appropriately respond to suicidal ideation.

2. Evaluate and identify at-risk patients or those actively considering suicide along with assessing their willingness for treatment with a behavioral health specialist.

3. Implement a treatment plan that addresses individual risk drivers and providing a benchmark to measure a patient’s progress over time.

• Includes a virtual or in-person "warm handoff" script (PDF) to help the primary care providers facilitate transitioning the patient to a behavioral health specialist
• Treatment modalities highlighted include brief interventions (e.g., motivational interviewing), outpatient services (e.g., pharmacotherapy), behavioral therapy (e.g., cognitive behavioral therapy for suicide prevention), intensive outpatient/partial hospitalization program services or residential/inpatient services. 

4. Understand financial considerations of how to bill for screening, evaluation and treatment of patients experiencing suicidal ideation, including awareness of specific CPT (Current Procedural Terminology) codes, will help ensure the sustainability of a comprehensive suicide prevention and treatment protocol.

5. Gain access to resources such as checklists, training programs, customizable letters and assessment and screening tools. 

Download the AMA's "Suicide Prevention How-To Guide" (PDF) to learn more about how your practice or system can effectively identify and treat patients at-risk of suicide.   

Also, check out the Behavioral Health Integration (BHI) Collaborative’s BHI Compendium, which serves as a tool to help provide health care organizations with a proven pathway for delivering integrated behavioral care and to ensure they have the most recent, actionable information at their disposal.

• Practical strategies for managing suicidal ideation and reducing risk 
• BHI webinar series  
• AMA STEPS Forward® toolkit "BHI Into Primary Care"
• Compendium of BHI resources for physician practices
• BHI in physician practices
• Strategic behavioral health guides for patient care

With an increased number of people reporting worsening mental health in recent years, it is imperative that people are aware of the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) telephone program.

People experiencing a suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress can call, chat or text 988, and speak to trained crisis counselors. The national hotline is available 24 hours a day, 7 days a week.

The previous National Suicide Prevention Lifeline phone number (1-800-273-8255) will continue to be operational and route calls to 988 indefinitely.