# New suicide risk assessment tool developed in Ottawa to be used in hospitals



## David Baxter PhD (Jan 17, 2014)

*New suicide risk assessment tool to be used in hospitals*
CBC News
Jan 16, 2014 

_No standard of practice for children's mental health care at hospitals, doctor says_

A standardized tool to assess suicide risk will soon be tested at  health care facilities including the Children?s Hospital of Eastern  Ontario in Ottawa as workers try to keep pace with an increasing demand  for mental health care.

  Dr. Mario Cappelli, a clinical psychologist who serves as the  Director of Mental Health at CHEO, helped create the tool, the first of  its kind developed for young people.   Cappelli, who shared the tool at  a suicide prevention forum in Ottawa on Thursday, said frontline  workers use it to assess the risk of suicide in emergency departments.  The need is drastic, he added.

  ?It?s pretty clear there?s no standard of practice or tool to help  guide the assessment or disposition of mental health concerns within the  emergency departments,? said Cappelli, which includes CHEO.

  The void has increasingly worried health care experts who see the number of suicides rise through the last decade.

  Research indicates there are 500 suicides per year in Canada and 68  suicide victims in Ottawa each year, according to information shared  Thursday.

  Epidemiologist Jacqueline Willmore, who works with Ottawa Public  Health, said suicide is the second-leading cause of death among people  between 15 and 24 years old. Only vehicle collisions cause more deaths  in that age bracket. Willmore also said the number of suicides each year has increased between 2003 and 2012.

*Suicide risk assessment tool*
  The Heads-ED enables physicians to take a psycho-social history that aids in decisions regarding patient disposition. It's  a validated interview tool that makes it easy for doctors to identify  children/youth with mental health issues, as well as find local help and  resources.

  The standardized online assessment tool is a survey that assesses a  patient?s behaviour, feelings and background and Cappelli wants to see  facilities use it across the country and even internationally.   The need for a tool to assess suicide risk is higher for centres that  treat youth because a growing number of young people visit the  emergency room with mental health needs, according to the experts.

  Hospitals also have trouble meeting demand, according to Dr. Allison  Kennedy, a psychologist who works at the CHEO Research Institute.

*'Suicide contagion' partial cause of problem among youth*
  That problem has become more apparent because there is a ?suicide  contagion? among youth, said Dr. Ian Colman, the Canada Research Chair  in mental health epidemiology.

  He told the forum youth are more likely to consider taking their lives when they learn of others who have done so. ?One person?s suicide or suicidal behaviour may influence others to  start thinking about suicide or to attempt suicide,? Colman said. Colman said suicide contagion could be either a personal connection  or form of communication between people, or learning of a suicide  through media.

*Suicide prevention*
Groups that provide support to youth:



*Ottawa Distress Line*: 613-238-3311 
*Kids Help Phone* 1-800-668-6868 
*Child, Youth and Family Crisis Line for Eastern Ontario* 1-877-377-7775 
*Eastern Ottawa Resource Centre*: 613-741-6025 
*Mental Health Crisis Line* (Ages 16 and up) 613-722-6914 
*Youth Services Bureau of Ottawa* 613-260-2360


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## David Baxter PhD (Jan 17, 2014)

*HEADS-ED Patient Profile*

*HEADS-ED Patient Profile - HEADS ED*
Retrieved January 2014

*HEADS-ED Patient Profile*


*** The HEADS-ED is a screening tool and is not intended to replace clinical judgment. Please read the terms and conditions of use.         

Age years oldSex  Female     MalePreferred language  English     French     No preference
 
  
*No action needed*  
*Needs action but not immediate*  
*Needs immediate action*  
*H*ome
                                                                                                               Sample questions                             
 
Supportive
  
Conflicts
  
Chaotic/Dysfunctional
  
*E*ducation
                                                                                                               Sample questions                             
 
On track
  
Grades dropping / absenteeism
  
Failing / not attending school
  
*A*ctivities and peers
                                                                                                               Sample questions                             
 
No change
  
Reduced / peer conflicts
  
Fully withdrawn / significant peer conflicts
  
*D*rugs and alcohol
                                                                                                               Sample questions                             
 
No or infrequent
  
Occasional
  
Frequent/daily
  
*S*uicidality
                                                                                                               Sample questions                             
 
No thoughts
  
Ideation
  
Plan or gesture
  
*E*motions, behaviours, thought disturbance
                                                                                                               Sample questions                             
 
Mildly anxious / sad / acting out
  
Moderately anxious / sad / acting out
  
Significantly distressed / unable to function / out of control / bizarre thoughts
  
*D*ischarge resources
                                                                                                               Sample questions                             
 
Ongoing / well connected
  
Some / not meeting needs
  
None / on wait list / non-compliant
 
 I have read and agree to the terms and conditions of use.​ ​


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## Mari (Jan 22, 2014)

I am not in any way disagreeing with the assessment tool/article but I think there is so much missing especially in the ability of professionals to access suicide risk. By my best judgement my son would have fit into category 1 so unless clinical judgement was particularly astute he would have been considered to not require immediate action. Prior to my son's death I knew virtually nothing about suicide which in itself is appalling but what was even more appalling is that the professionals I spoke with following his death seemed to know very little more about suicide than I did. I certainly understand how complicated it is but it is also very frustrating. Recently a friend's daughter went to the emergency department, was assessed, deemed not at risk and was sent home. She immediately attempted suicide and only her parents coming home early saved her life. Unfortunately she has permanent damage and is still at risk. Hopefully her suicide ideation is now being taken seriously.


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## David Baxter PhD (Jan 22, 2014)

It's intended only as a screening test, i.e., an aid to assessment and a reminder to ER staff to ask the questions, rather than a definitive "pass-fail" test for suicide potential. Something like this would not replace a clinical assessment in individuals who showed any signs of possible suicide risk. Like any screening test, the intent is for positive responses to move those who require it onto the next level of assessment.


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