September is National Suicide Prevention Month. The 988lifeline website has many resources for getting the word out about the importance of not missing any opportunities to help prevent suicide.
In fact, there is a recently published article entitled “Multiple Missed Opportunities for Suicide Risk Assessment in Emergency and Primary Care Settings.” A few of the important take home points:
- “Screening for suicide risk, while a critical step in potentially preventing death or injury by suicide, is fraught with additional challenges centering around the poor sensitivity and specificity of many of the screening tools. The widely used PHQ-9 question about suicide has poor sensitivity and specificity. A much better screening tool we recommend is the Columbia-Suicide Severity Rating Scale Screener which can be administered by both clinicians and non-clinician individuals who have been trained in its use.
- So called “no harm contracts” are best avoided and, instead, replaced with approaches that emphasize joint planning that more respectfully builds upon patients’ innate resiliency to self-soothe, build upon one’s protective factors and reduce those risk factors that are modifiable, and problem-solve ways to create a series of “what-if” scenarios of what to do if suicidal feelings start to intensify
- Firearms are the leading means of fatal suicides in the U.S. Effort to ensure patients at risk for suicide do not have access is critical
- There is a bidirectional and undoubtedly complicated relationship between substance use and suicide.”
Go Retire Psychiatrist 
Just saw this great piece on firearm regulation and suicides showing the inverse correlation. There is also a link to state by state regulations and a ranking. In this era of gun extremist rhetoric all of these nuances are ignored at great peril to public safety. https://everytownresearch.org/two-decades-of-suicide-prevention-laws-lessons-from-national-leaders-in-gun-safety-policy/
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