the pathway - mental health commission of nsw · the pathway had to cover: identify...
TRANSCRIPT
“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
of 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”
Brief Interventions
Training
3 SRAM-ED Modules
1 GC Module
1 day face to face training.
0
10
20
30
40
50
60
70
80
90
100
Admitted Risk FormulationCompleted
Safety Plan Completed Structured Follow Up
Yes 35 77 88 99
No 65 23 12 1
SPP Data Snapshot"First 100 Patients"