Brief Interventions

• Safety Planning: Personalized safety planning has been shown to help reduce suicidal thoughts and actions. Patients work with a caregiver to develop a plan that describes ways to limit access to lethal means such as firearms, pills, or poisons. The plan also lists coping strategies and people and resources that can help in a crisis.

• Follow-up phone calls: Research has shown that when at-risk patients receive further screening, a Safety Plan intervention, and a series of supportive phone calls, their risk of suicide goes down.

Psychotherapies
Multiple types of psychosocial interventions have been found to help individuals who have attempted suicide (see below). These types of interventions may prevent someone from making another attempt.

• Cognitive Behavioral Therapy (CBT) can help people learn new ways of dealing with stressful experiences through training. CBT helps individuals recognize their thought patterns and consider alternative actions when thoughts of suicide arise.

• Dialectical Behavior Therapy (DBT) has been shown to reduce suicidal behavior in adolescents. DBT has also been shown to reduce the rate of suicide in adults with borderline personality disorder, a mental illness characterized by an ongoing pattern of varying moods, self-image, and behavior that often results in impulsive actions and problems in relationships. A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and teaches the skills needed to deal better with upsetting situations.

Medication

Collaborative Care

Collaborative Care has been shown to be an effective way to treat depression and reduce suicidal thoughts. A team-based Collaborative Care program adds two new types of services to usual primary care: behavioral health care management and consultations with a mental health specialist.

The behavioral health care manager becomes part of the patient’s treatment team and helps the primary care provider evaluate the patient’s mental health. If the patient receives a diagnosis of a mental health disorder and wants treatment, the care manager, primary care provider, and patient work together to develop a treatment plan. This plan may include medication, psychotherapy, or other appropriate options.

Later, the care manager reaches out to see if the patient likes the plan, is following the plan, and if the plan is working or if changes are needed to improve management of the patient’s disorders. The care manager and the primary care provider also regularly review the patient’s status and care plan with a mental health specialist, like a psychiatrist or psychiatric nurse, to be sure the patient is getting the best treatment options and improving.