Improvements to Suicide Risk Assessment process for children are live

12/15/23 01:30:pm

Changes to Rogers’ Suicide Risk Assessment process for children 11 and under are live as of December 11, following changes implemented last month for patients 12 and older.

“Overall, we are receiving positive feedback, and we will continue to take questions and consider modifications as needed,” says Rachel Leonard, PhD, vice president of clinical services.

These changes are based on feedback across all levels of care from nurses, therapists, providers, leaders, and Barrins, our external auditing partner.

To better serve the unique needs of children 11 and younger, a child-specific assessment and process has been developed. The assessment and process were formulated from the evidence-based ASQ Suicide-Screening and Brief Suicide Safety Assessment (BSSA).

“Creation of the child SRA process was done with a lot of thoughtfulness around the special considerations of suicide and suicidal thoughts in the child population,” says Kristin Miles, PsyD, psychologist, Oconomowoc. “We wanted to make sure we were not only asking the right questions, but that we were also asking questions the kids would understand. It’s so important to make sure kids feel like they have a safe place to share thoughts that they might have some guilt, shame, and fear around.”

Dr. Miles says it’s important staff feel more comfortable talking with kids about suicide and suicidal thoughts.

“Kids can easily pick up on the anxiety an adult has, and become less likely to share,” she explains.

We also know the importance of including the caregiver in this process so that we can have as well-rounded of a picture as possible of the risks and protective factors. We’re excited to roll out this new process and increase the quality of our risk assessment with this young and vulnerable population.”

Key points to know about this process:

This new assessment and process is required for all children 11 and under. The form will remain available in Cerner if a clinical team determines the questions and format are more developmentally or clinically appropriate for an individual 12+.
Caregiver input is now clearly documented in a “caregiver interview” section of the form. Children may not accurately report or may be hesitant to disclose accurately. Caregiver observations of the child may also be different than the child demonstrates in other settings. Caregiver attitudes toward suicide can also be a marker of child risk level.
Child friendly language and blue text support clinicians in developing and elevating their skills in interviewing and assessing children.
Specific considerations are made for low risk children with no history of suicidal thoughts or behaviors.

This child-specific process also maintains the improvements that were rolled out on November 13:

Removal of consolidation and voice contact requirement
Recognition of the need for clinical judgment
Chronic high suicidal ideation (SI) ratings
Streamlined reassessment
Cerner improvements
Additional training

In order to meet timeline expectations and ensure staff have the opportunity to learn the new SRA process, we will need your support! The SRA changes will affect providers, therapists, and nursing roles – the degree of responsibility for the SRA process between therapists and nurses will be somewhat dependent upon level of care.

These revisions are the result of a Rapid Improvement Event as we continue to refine the system-wide processes we already have in place.