330 Barbara Stanley and Gregory Brown have developed a Safety Plan Treatment

330 barbara stanley and gregory brown have developed

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330 Barbara Stanley and Gregory Brown have developed a “Safety Plan Treatment Manual to Reduce Suicide Risk;” there is a version of this made specifically for the VA. 160 More information about the VA’s overall efforts is presented in Parts Seven and Eight. Due to the absence of nationally recognized, explicit and directive standards and requirements for high-quality discharge planning, minimally acceptable practices may become the default standard of care. 266, 267, 331, 332 In the absence of directive expectations for high quality work, more easily and quickly accomplished practices may seduce hospital staff into making minimally acceptable but largely ineffective discharge plans. Indeed, more should be expected from psychiatry inpatient units. New initiatives are needed to improve the process and outcomes of discharge planning. Part Seven of this report (see page 91) examines guidelines and standards in much more detail. Section-at-a-Glance: The difference between a just adequate discharge plan and tight plan are the elements that permit rather than discourage suicide. Immediate follow-up after discharge and adher- ence to the recommended discharge plan are opportunities for suicide prevention. Without explicit and directive best practices and standards, more easily and quickly accomplished practices may seduce hospital staff into making minimally acceptable but ineffective dis- charge plans. Section-related Recommendation: Define expected best practices for discharge planning and eliminate unacceptable practices. In the absence of such information what is easy to do may be mistaken for what is best to do. (Please see Part Seven of this report, page 91, for more information.)
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Continuity of Care for Suicide Prevention and Research 51 Part Five Survival on the Way to Follow-Up Care: Disappointment and Suicide Prevention S ome pretty grim statistics are found along the path to follow-up care. Many patients never make it to their first follow-up appointment, and many that do, do not remain in treatment long enough for continuing care to be successful. For both EDs and inpatient discharges, the risk for suicide attempts and death among all age groups is highest immediately after discharge and over the next 12 months to four years. 10-18 Longer timeframes predict death from suicide or other (possibly related) causes. Clearly, the risk continues in the years subsequent to ED or inpa- tient discharge. 3, 119 Being discharged from an ED or psychiatry inpatient program should, there- fore, provide patients linkage to certain and effective treatment. This logic is not always followed. Just because patients are at high risk for suicide and come to an ED or inpatient psychiatry unit for help does not necessarily mean they will get it once discharged. Regrettably, patients with the highest risk for suicide have some of the lowest rates of adherence after an ED visit.
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