@article{ref1,
title="Areas of improvement in suicide risk identification, assessment, and risk mitigation documentation by mental health prescribers at a Veterans Affairs Health Care System",
journal="Administration and policy in mental health",
year="2021",
author="Mehvar, Mina and Steavenson, Rosana and Laguado, S. Andrea",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: Veterans have a suicide rate 1.5 times higher than the non-veteran population. The Department of Veterans Affairs (VA) implemented suicide risk  screening recommendations in 2018. This project assessed the impact of mental health  (MH) prescribers on these recommendations and identified areas of improvement. <br><br>METHODS: Seventy MH Clinical Pharmacy Specialists (CPS) and 52 other MH prescribers  were included. Patients with a positive question nine (from the Patient Health  Questionnaire-9) and a same-day Columbia Suicide Severity Rating Scale (C-SSRS)  between 11/01/18 and 11/01/19 at a VA system were reviewed. Completion of same-day  Comprehensive Suicide Risk Evaluation (CSRE), same-day Suicide Prevention Safety  Plan (SPSP), number of patients who were not offered naloxone despite access to  opioids, and number of patients who were not offered a gunlock despite access to  firearms were compared between groups. Time from C-SSRS to suicidal behavior was  compared between those who did and did not receive a same-day CSRE. <br><br>RESULTS: MH CPS  were significantly more likely to complete a same-day CSRE (p = 0.0201) and SPSP  (p < 0.001) when recommended. Naloxone outcomes were not assessed due to  availability of only one data point. Rates of gunlock offers did not differ  significantly between groups (Fisher's exact test, p = 0.3189) however there was no  documentation stating why they were not offered when appropriate 40% of the time. Time to suicidal behavior did not vary across patients based on CSRE completion  (p = 0.16). <br><br>CONCLUSION: MH CPS play an important role in suicide risk screening for  veterans. There is a need for improvement regarding the offering and documentation  of firearm risk mitigation strategies.<p /> <p>Language: en</p>",
language="en",
issn="0894-587X",
doi="10.1007/s10488-020-01097-0",
url="http://dx.doi.org/10.1007/s10488-020-01097-0"
}