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The safety and health of the client is paramount.   The steps that you take as a health care professional to ensure that safety are the focus of this Web page.   While research articles, professional organizations, and clinical organizations may have differences in their clinical guidelines for treating a suicidal client, the fundamental and universal components to treatment generally are:

• A thorough and comprehensive evaluation taking into consideration risk factors for suicide (Reference 1)
  • The key factors in treatment being the patient's suicide plan, access to lethal means, social support and judgment
• Determination of appropriate level of care based on level of risk and assessment of potential lethality (Reference 2)
  • Hospitalization (inpatient treatment facility)
  • Partial hospitalization (intensive outpatient)
  • Outpatient
• Treatment of client or referral of client to appropriate level of care (Reference 2)
  • Low to moderate level of risk (outpatient)
  • Moderate to high level of risk (partial hospitalization)
  • High level of risk (hospitalization; voluntary hospitalization is preferred)
• Thorough documentation of evaluation, discussions with family, friends, and/or professionals, reasons for treatment recommendations, and treatment recommendations
  • Documentation is essential due to ethical and legal protocol
  • Thorough documentation helps ensure that the client's history is properly documented so that future treatment needs can be appropriately implemented

All clients are unique and should be treated on an individual basis.   Therefore, while these general guidelines can be helpful, the welfare and health of the client is most important when making clinical decisions.   If you ever have a question as to what level of care is necessary for the client, ask a colleague, supervisor, or other health care professional for their clinical opinion.

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References for Clinical guidance

Article  

Bongar, B., Maris, R. W., & Berman, A. L. (1993). Inpatient standards of care and the suicidal patient. Suicide & Life-Threatening Behavior, 23 (3), 245-256.

Internet

National Guideline Clearinghouse (NGC)

The NGC is an U.S. government Web site.   The NGC is an organization sponsored by the U.S. Agency for Healthcare Research and Quality (formerly the U.S. Agency for Health Care Policy and Research) in partnership with the American Medical Association and the American Association of Health Plans.

The NGC is a public resource for evidence-based clinical practice guidelines and is available at the following Web address:  

http://www.guideline.gov/

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Last Updated: July 2004