Other nations have also begun to focus efforts in their national strategies for

Other nations have also begun to focus efforts in

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Other nations have also begun to focus efforts in their national strategies for suicide prevention on exactly these high risk populations. Norway’s Chain of Care model is highlighted in this report. In Denmark, they have identified four areas where reductions in the number of deaths by suicide could have the greatest impact on their suicide rates. Two of those populations, suicide attempt- ers and those discharged from inpatient units, are very much the subject of this paper, and a third, substance abusers, could also benefit from an extension of these continuity of care principles given the high frequency with which those who are both substance abusers and suicidal are seen in emergency departments and inpatient units for detoxification and other needs. In England, the British National Clinical Study was able to calibrate, by day, week, and month, the degree of post discharge suicide risk, with the greatest risk occurring during the time closest to discharge, lead- ing to recommended standards for prompt follow up within seven days of those discharged from inpatient units (Crawford, 2004). In the United States, this period of high risk and the need for intervention during this time were recognized in the National Strategy for Suicide Prevention. Objective 7.1 focuses on the need for follow up after emergency room discharge while Objective 7.4 focuses on the need for aftercare following inpatient discharge. The American Association for Suicidology, the Suicide Prevention Resource Center, and Dr. David Knesper have provided an extremely valuable service through this comprehensive review and set of recommendations that have the promise, if acted upon, for constructing a critical safety net during these periods of heightened risk. Richard McKeon, PhD, MPH Chief, Suicide Prevention Branch Substance Abuse and Mental Health Services Administration References Crawford, M.J. (2004), Suicide following discharge from in-patient psychiatric care, Advances in Psychiatic Treatment, 10, 434–438. Fleischman, A., Bertolote, J., Wasserman, D., DeLeo, D., Bolhari, J., Botega, N., et al. (2008). Ef- fectiveness of brief intervention and contact for suicide attempters: A randomized controlled trial in five countries. Bulletin of the World Health Organization, 86, 703–709. Motto, J.A., Bostrom, A. G. A randomized controlled trial of postcrisis suicide prevention. Psychi- atr Serv . Jun 2001;52(6):828–833. U.S. Department of Health and Human Services. National Strategy for Suicide Prevention: Goals and Objectives for Action . Rockville, MD: U.S. Department of Health and Human Services, Pub- lic Health Service; 2001.
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Continuity of Care for Suicide Prevention and Research 5 Contents List of Exhibits ................................................................................................................................. 6 Executive Summary ......................................................................................................................... 7 Abstract ............................................................................................................................................................. 7 Parts One through Eight .................................................................................................................................... 8 Part Nine ......................................................................................................................................................... 12 Part One - Suicide Attempts and Risk for Suicide Deaths ........................................................... 20 Definitions: The Language of Suicide ............................................................................................................ 22 Suicide Epidemiology ..................................................................................................................................... 23 Part Two - The Principles of Continuity of Care and Transforming How Mental Health Care Is Delivered in America ........................................................................ 25 The National Strategy for Suicide Prevention and Continuity of Care .......................................................... 26 Part Three
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