Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 2 - MANAGEMENT OF SCI COMPLICATIONS

O - EMOTIONAL WELL-BEING




Formally screen individuals with SCI for suicidal ideation by using a brief, standardized, evidence-based screening tool. Screen for suicidal intent and behaviour in individuals who report suicidal ideation. Screen:

  1. early during the initial inpatient hospital or rehabilitation stay
  2. as a repeat screen if indicated to assess persistence of symptoms or change in status
  3. at an early discharge follow-up point, and
  4. at least annually or more frequently depending on risk stratification factors.
(PVA-EWB 2020, p.162; Level C)
Recognize warning signs for suicide and expedite the evaluation of such signs by a trained professional. Take immediate follow-up action for anyone who displays direct warning signs for suicide (e.g., suicidal communication, preparation for suicide, and/or seeking access to or recent use of lethal means). (PVA-EWB 2020, p.162; Level C)
Stratify suicide risk on the basis of severity and temporality (acute or chronic) to determine appropriate therapeutic interventions and care setting. (PVA-EWB 2020, p.163; Level C)
Facilitate comprehensive assessment by a trained professional to integrate information about suicidal intent and behaviour, warning signs, ability to maintain safety, and factors that impact the risk of suicidal acts. (PVA-EWB 2020, p.163; Level C)
Hospitalize individuals with high acute risk for suicide to maintain their safety and aggressively target modifiable factors. Directly observe them in a secure environment with limited access to lethal means (e.g., kept away from items with sharp points or edges, cords/tubing, toxic substances). (PVA-EWB 2020, p.163; Level C)
Address chronic increased risk for suicide in the context of long-term outpatient therapy with established providers, adjusting the frequency of contact on the basis of risk level. (PVA-EWB 2020, p.163; Level C)
Establish a treatment plan for high-risk individuals that fosters therapeutic alliance with mental health professionals and includes evidence-based suicide-focused psychotherapies. (PVA-EWB 2020, p.163; Level C)
Optimize treatment for coexisting mental health and medical conditions that may impact the risk of suicide. (PVA-EWB 2020, p.163; Level C)
Educate the at-risk individual, family, and caregivers about suicide risk and treatment options. Provide information on suicide prevention resources, including crisis lines and services (e.g., the Canada Suicide Prevention Service number 1-833-456-4566). (Adapted from PVA-EWB 2020, p.163; Level C)
Establish a safety plan for individuals considered to be at high risk for suicide. Limit access to lethal means (e.g., restricting access to firearms, making use of gun locks, limiting medication supply). (PVA-EWB 2020, p.163; Level C)
Augment personal and environmental protective factors that may mitigate suicide risk. Enhance coping skills. (PVA-EWB 2020, p.163; Level C)