b'|Suicide Prevention Workplan - Los Angleles |75|76 A prior suicide attempt is one of the primary riskResearch demonstrates that risk is elevated particularity in the first few weeks and month following an factors for a second attempt. Risk is elevatedattempt, therefore a follow-up plan should be implemented no later than the first week and continuing during particularity in the first few weeks and monthIn 2014, 10,444the first year. following an attempt.Los AngelinosKey Strategies Include: A study published by JAMA Pediatrics in April 2019, Continuity of care and a caring contact within one week after discharge from the ER or indicated that the number of children and teens in thewere seen inhospital after a suicide attempt.United States who visited emergency rooms for suicidalthe ER or Availability of follow-up interventions (for individuals or families) and effective re-entry thoughts and suicide attempts doubled between 2007 and 2015. The average age of a child at the time ofhospitalizedprotocols for students returning to school after a suicide attempt.evaluation was 13, and 43% of the visits were in children between 5 and 11. In addition, when an individual isafter a suicide Availability of clinicians trained in assessing and ongoing care for suicide risk to support assessed as at high risk for suicide, existing practicestheir recovery.(transports, holds, wait times) often add additionalattempt. Suicide Attempt Survivor Support Groups.trauma and reduce likelihood of treatment linkage for those at-risk in an effort to minimize liability and ensure the safety of the person. California Department of Public Health,Continuity of Care and Caring contactsEpicenter, 2014 (46). In 2014, the most recent year for which dataFollow-up programs, also called continuity of care or caring contacts, implemented after discharge from is currently available,2,824 youth were seen inthe ER or hospital as well as availability of attempt survivor support groups and clinicians trained in suicide the ER or hospitalized after a suicide attempt inrisk specifically are strategies that have shown effectiveness or promise. Potential benefits include reduced Los Angeles County (2052 youth ages 0-18 were seen in an Emergency Room for asuicidality and/or attempts, reduced hospital re-admissions and return visits to the emergency department, suicide attempt; 772 youth 0-18 were hospitalized after a suicide attempt). The majoritycost savings to the hospital system. Caring contacts fit well within safety planning and brief interventions. were female. Some studies focus on patients discharged from psychiatric facilities, while others follow-up on patients discharged from the emergency room. Post-discharge from psychiatric facilities has a suicide rate ofIn 2014, the most recent year for which data is available, 7,620 Los Angelinos aged 19484/100,000, highest in the first three months but continuing for some years (73). The kind of care offered or older were seen in the ER or hospitalized due to a suicide attempt (3,225 were seenvaried in different studies. For example, one program had a nurse calling to encourage the discharged in an Emergency Room and 4,395 were seen at a hospital).The majority were female. patients to follow the psychiatrists treatment plan, while another simply reminded patients that providers wished them well. The format also varies, including letters, postcards, texts, phone calls and in-person visits.A review of the literature suggests multiple contacts with patients discharged from psychiatric hospitalization or emergency departments after a suicide attempt or ideation mayIt is particularly intriguing that positive results were shown with patients who refused long-term care or to prevent future suicidal. Yet, studies estimate that fewer than half of suicidal patients admittedengage with a health care system. Receiving letters was a low-stress intervention for them and one that to inpatient psychiatric units or treated in emergency departments receive aftercare (72). yielded positive results [Motto].Positive results have also been shown with care follow-up among patients discharged after non-suicide events, such as home visits by nurses to high-risk elderly patients (which Like most public health issues, suicidal behavior has identifiable elements that connect one partreduced readmissions) and calls by pharmacists to patients to check on medications (which reduced of the path to the next. This portion of the Los Angeles County Suicide Prevention Strategic Planreadmissions and ED visits).In addition, some crisis call centers provide follow-up calls to some callers specifically addresses interventions to support individuals after a suicide attempt in an effort towithin 48 hours to provide support and assistance with referrals and linkages.prevent future suicide attempts. 3 By expanding partnerships within and outside of the healthcare setting, communities can decrease suicide The weeks and months following a suicide attempt are frequently ones with elevated risk. We knowrisk for individuals that have survived a suicide attempt. Implementation of Suicide Attempt Survivor today that a 48 hour and or 72-hour hold may keep an attempt survivor safe for a short while, but inSupport Groups and other peer-based services, can help to move attempt survivors towards feeling fact does not necessarily mitigate the desire to die. connected and empowered. In addition, suicide attempt survivors should have access to mental health professionals with training specific to suicide risk such as Assessing and Managing Suicide Risk ((AMSR) or The Collaborative Assessment and Management of Suicidality (CAMs).Draft 3.3.2020 Not For Distribution Draft 3.3.2020 Not For Distribution'