CDS Connect: Mental Health: Suicide Risk Assessment Documentation Template

Mental Health: Suicide Risk Assessment Documentation Template

Description

The intent of the “Suicide Risk Assessment Documentation Template” is to support documentation of findings and decisions from screening for suicide risk, including options for using the Patient Health Questionnaire (PHQ), suicidality-related components of a mental health intake assessment, and suicide risk assessment.

Artifact Type
Creation Date
Version
1.0
Unique Identifier
7b21baf4-5b61-52a6-bcb2-fa7b88c0bdc7
Status
Experimental
True

Artifact Creation and Usage

Contributors
Rani Hoff, PhD, MPH, Director, Northeast Program Evaluation Center Office of Mental Health and Suicide Prevention (10NC5) VA Central Office; Professor of Psychiatry Yale University School of Medicine
Bridget Matarazzo, , Director of Clinical Services Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) Denver, CO 80220
Ira Katz, , Senior Consultant for Mental Health Program Analysis
Edd Post, , VA HSR&D
 
Please contact Mr. Apurva Desai Apurva.desai@va.gov for additional information.
License
IP Attestation The author asserts that this artifact has been developed in compliance with the intellectual property rights attributed to the source material.
Copyrights

Copyright © 2018 Veterans Health Administration, Department of Veterans Affairs. All rights reserved. Contributions from external parties are property of respective copyright holders.

Implementation Details
Technical Files
Repository Information
Approval Date
Publication Date
Last Review Date
Knowledge Level

Structured code that is interpretable by a computer (includes data elements, value sets, logic)

Purpose and Usage
Usage
Target User
Mental health providers; other physicians and nurses performing screening
Clinical Focus
Patients identified as being at risk for suicide; members of patient cohorts identified for suicide risk screening
Clinical Venue
Mental Health Primary Care
Clinical Venue
Outpatient
Cautions

THE CLINICAL CONTENT IN THIS DOCUMENT IS NOT DIRECTLY SUITABLE FOR CLINICAL USE AS PRESENTED SINCE IT HAS NOT BEEN TESTED IN A CLINICAL ENVIRONMENT. IT HAS NEVER BEEN PILOTED, NEVER 100% REPRESENTS THE INTENT OF THE CLINICAL SUBJECT MATTER EXPERTS, AND MAY CAUSE HARM IF APPLIED AS-IS. THIS WORK IS MADE AVAILABLE WITHOUT ANY WARRANTY WHATSOEVER, AND WITHOUT CLAIMS, EXPRESSED OR IMPLIED, OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.

Supporting Evidence
Source Description
Derived From
Mental Health: Suicidality Clinical Content White Paper
Associated Resource
Mental Health: Suicide Risk Assessment Documentation Template Conceptual Structure Document
Associated Resource
Mental Health: Suicide Risk Assessment Documentation Template KNART Validation Report
References

See attached resource files for additional details. Department of Veterans Affairs, Veterans Health Administration, Office of Informatics and Information Governance, Clinical Decision Support (CDS) Content and Health Level 7 (HL7)-Compliant Knowledge Artifacts (KNARTs) Eye Care Clinical Content White Paper, VA118-16-D-1008, Task Order VA-118-16-F-1008-0007, June, 2018.

Columbia–Suicide Severity Rating Scale Screen Version – Recent. Columbia Lighthouse Project website. Accessed October 2017
https://cssrs.columbia.edu/the-columbia-scale-c-ssrs/cssrs-for-communities-and-healthcare
Committee on the Assessment of the Readjustment Needs of Military Personnel, Veterans, and Their Families, Board on the Health of Select Populations, Institute of Medicine. Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families. Washington (DC): National Academies Press (US); Mar 2013. Available from https://www.ncbi.nlm.nih.gov/books/NBK206864/.
https://www.ncbi.nlm.nih.gov/books/NBK206864/
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613.
J Gen Intern Med.
Office of Mental Health and Suicide Prevention. Suicide Among Veterans and Other Americans 2001–2014. U.S. Department of Veterans Affairs Mental Health website. https://www.mentalhealth.va.gov/docs/2016suicidedatareport.pdf. Updated August 2017.
https://www.mentalhealth.va.gov/docs/2016suicidedatareport.pdf
Title 42 - Public Health. Condition of participation: Patient rights. 71 FedRegist 71426, Dec. 8, 2006, as amended at 75 FedRegist 70844, Nov. 19, 2010; 77 FedRegist 29074, May 16, 2012. 42 CFR §482.13.
https://www.federalregister.gov/
Tri-Service Workflow (TSWF). TSWF-CORE AIM Form Version Jan-Apr 2017. TSWF CORE Paper Backup Jan Apr 2017.pdf. (Veterans Administration, materials provided in Mental Health-20170921T220116Z-001.zip, September 21, 2017).
Mental Health-20170921T220116Z-001.zip September 21, 2017
U.S. Department of Veterans Affairs. VA Suicide Prevention Program Facts about Veteran Suicide. U.S. Department of Veterans Affairs Office of Public and Intergovernmental Affairs website. https://www.va.gov/opa/publications/factsheets/Suicide_Prevention_FactSheet_New_VA_Stats_070616_1400.pdf. Published July 2016.
https://www.va.gov/opa/publications/factsheets/Suicide_Prevention_FactSheet_New_VA_Stats_070616_1400.pdf
U.S. Department of Veterans Affairs; U.S. Department of Defense (DoD0. VA/DoD Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide. Version 1.0 – June 2013. VA/DoD Clinical Practice Guidelines website. https://www.healthquality.va.gov/guidelines/MH/srb/VADODCP_SuicideRisk_Full.pdf. Published June 2013.
https://www.healthquality.va.gov/guidelines/MH/srb/VADODCP_SuicideRisk_Full.pdf
U.S. Department of Veterans Affairs; U.S. Department of Defense. VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder. Version 3.0 – 2016. VA/DoD Clinical Practice Guidelines website. https://www.healthquality.va.gov/guidelines/MH/mdd/VADoDMDDCPGFINAL82916.pdf. Published April 2016.
https://www.healthquality.va.gov/guidelines/MH/mdd/VADoDMDDCPGFINAL82916.pdf
American Psychological Association. Patient Health Questionnaire (PHQ-9 & PHQ-2). https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/patient-health.aspx
https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/patient-health.aspx
Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., … Hatcher, S. (2010). Validation of PHQ-2 and PHQ-9 to Screen for Major Depression in the Primary Care Population. Annals of Family Medicine, 8(4), 348–353. http://doi.org/10.1370/afm.1139
https://doi.org/10.1370/afm.1139
 
 
 
 
 
 
Artifact Representation
Testing Experience
Pilot Experience

None