PRiSMM Telehealth Practices

Telehealth practices all strategies

  • Familiarize yourself with your specialty's information regarding telehealth practice guidelines and patient-provider identification.

Identify and assist

  • It is best to observe basic guidelines when working with a potentially suicidal patient:
    • Request the person's location (address, apartment number) at the start of any session in case you need to contact emergency services.
    • Request or make sure you have emergency contact information.
    • Secure the patient's privacy during the telehealth session as much as possible.
    • Inquire about increased access to potentially lethal means.
  • Clinical management issues:
    • Identify a method of increasing safety as part of your response repertoire, e.g., a safety plan.
    • Provide crisis hotline (988).
    • Identify individuals in the patient's current environment to help monitor suicidal thoughts and behaviors in-person or remotely; seek permission to have direct contact with those individuals.
    • If the risk becomes imminent and cannot be managed remotely, arrange for the client to go to the nearest crisis center or medical ED.
    • If the risk is imminent, stay on the phone with the patient until other care is present.
  • Safety planning
    • If the patient is found not to need emergent management, creating a safety plan with the patient is a way to stay safe without using more emergent settings.
    • Arrange a way for the patient to get a copy of their plan (e.g., take a picture or scan, and e-mail or text to the patient).

Identify and Assist

Increase help-seeking

  • Review collaborative care.
  • Have access to tools that can engage individuals such as interpretative services.
  • Use resources that are useful for engagement.

Increase Help Seeking

Care transitions

  • If possible, leverage the client's natural supports to assist them during care transitions. They might need someone to stay with them for a while.
  • Ask your client about their Safety Plan; go over it with them and collaboratively make any adjustments to the plan if needed.
  • Process the experience with your client of going to the emergency department or inpatient setting, etc. These events can be traumatizing, and your client will benefit from processing them.
  • Use an evidenced-based treatment upon discharge that is targeted to suicidality (CAMS, DBT).
  • Suggest the  SPRC website; search for care transitions.

Care Transitions

Respond to crisis

  • Ask the person where they are calling from in case they become disconnected.
  • Ask about their location and if anyone is with them.
  • Evaluate the risk of access to lethal means and risk for implementation.
  • Complete suicide risk assessment and determine the appropriate level of intervention required.
  • Develop your practice crisis response.

Respond to Crisis

Postvention

  • Consider if an in-person meeting is needed in this circumstance (if at all possible.)

Postvention

Reduce access to means

  • Ask about their household firearm storage practices and make recommendations to increase the safe storage of firearms.
  • Ask if all firearms can be or are safely stored (e.g., with a locking device such as cable locks, or trigger locks) or use locking containers (e.g., lockboxes, firearm safes, firearm cabinets).
  • Engage household members to support safe storage.
  • Normalize gun ownership, speak with someone else in the home, move away from the computer when talking- trust is essential, and stress the importance of respecting their right to own a gun.

Reduce Access to Means

Connectedness

  • Need to ensure participants have access to technology to utilize services and review guidelines for use of online group meetings.

Connectedness