Suicide risk mitigation

Monitor patients who have had previous episodes of self-harm at regular visits for any current concern, and continue to assess the situation and needs of anyone who has a mental disorder. Tools cannot measure or predict suicide risk, and may be misleading. Closely monitor adherence with medication and psychotherapy and set up a shared safety plan for times of crisis.

Following suicidal ideation or after a suicide attempt by a pediatric patient, at discharge from the emergency department, both the family and the patient should be advised on the importance of follow-up. An attempt should be made to identify and address barriers to subsequent treatment. Counseling should be offered. Families of children and adolescents should be educated about suicide risk and treatment. The greatest risk of reattempting suicide is in the months after an initial attempt. In addition, since counseling takes time to work, emphasizing the importance of having consistent follow-up is recommended.[88]Chun TH, Mace SE, Katz ER, et al. Evaluation and management of children and adolescents with acute mental health or behavioral problems. Part I: common clinical challenges of patients with mental health and/or behavioral emergencies. Pediatrics. 2016 Sep;138(3):e20161570. https://publications.aap.org/pediatrics/article/138/3/e20161570/52770/Evaluation-and-Management-of-Children-and http://www.ncbi.nlm.nih.gov/pubmed/27550977?tool=bestpractice.com