Suicide Prevention Pilot project

1. All sites who have capacity to be connected via video-conference will be connected automatically. For sites not able to join via video-conference please call-in to 1.866.776.9915. Computer/internet access to review changes to CVR is encouraged. Collaboration of Mental Health and Family Planning counseling Suicide Prevention Pilot project September 26, 2012

2. Why look at this opportunity? • Recent budget cuts • Considered cutting-edge collaboration opportunity by the Regional Family Planning office and other national state offices. • National Strategy • Opportunity to enhance quality services to our family planning clients • Assist Suicide Prevention in counseling and referral of clients in already established clinics. The nice thing about collaboration is that you have others on your side.

3. And the Discussion begins…Client Visit Record (CVR)

4. Suicide prevention counseling (PHQ2 and PHQ9) • Suicide prevention referral • Suicide prevention policy Suicide Prevention Strategies

5. Explanation of PHQ2 Link to access PHQ-2 :http://www.cqaimh.org/pdf/tool_phq2.pdf

6. Explanation of PHQ9 Link to access PHQ-9: http://www.cqaimh.org/pdf/tool_phq9.pdf

7. How do we do This?

8. Revisionsto CVR Box 14- additional check-boxes will include: 88. PHQ 2 89. PHQ 9 Box 15 - additional check-boxes will include: 19. National Lifeline 20. Priv. Counselor 21. Human Svcs Center 22. Taken to Hospital 23. Physician Counseled 24. None Warranted (PHQ2 or 9) 25. Client Denied

9. Requirements of Participation: Development and implementation of local policy – Deadline – October 31, 2012 Complete PHQ2 with FP clients, by following guidelines on PHQ2 form (except for Supply Visits) When necessary (dependent on score of PHQ2) give patient PHQ9 for completion. When necessary (dependent on score of PHQ9) provide referral Pilot Project participation

10. Documentation on CVR for all of the above are mandatory. Input of data from CVR to Ahlers system. Successful implementation of pilot project could lead to continued funding support in the future. Documentation…Documentation…Documentation Pilot Project participation cont.

11. Option to refer to MSA 11 within your local policy. Revisions to MSA 11 reflect mental health referral. Current Policy for Referral and Follow-up - MSA 11

12. Depression is often a chronic condition and requires monitoring. Depression is very common and occurs in all age groups. Because many people will disclose feelings of depression to a health-care provider before seeking services with a mental health provider, routine depression screening will be an essential job function for staff of ________________________________________Family Planning Program and will be completed upon the client visit, other than a supply visit. • Providers will complete the Client Visit Report (CVR), for every client, frequency identified on PHQ-2 form (every 2 weeks) (not including a supply visit). • While screening for mental health, providers will use the Personal History Questionnaire 2 (PHQ-2). • Prior to administering the PHQ-2, the provider must explain to client’s statement of confidentiality such as: “This appt will remain confidential except for three occasions 1) Someone is hurting you; 2) You feel like hurting someone; or 3) you feel like or are hurting yourself.”  • If the client scores 0-3 on the PHQ-2, the _______ will document results in the Ahlers system and continue the appointment as scheduled. • When administering the PHQ-9 agencies will refer to the scoring guidance for follow-up and referral. • Documentation of administering PHQ-2 and/or PHQ-9, as well as follow-up and referral, must be documented in the client record. • Release of information for referral purposes must only include information about suicide risk. Information in regards to other family planning services must be kept confidential as per Title X guidelines. • If parents of adolescents need to be notified of referral of services, notification should follow established protocols. • Because of the link between depression and suicide, a referral to the National Suicide Prevention Lifeline follow up program should be offered if the answer to question 9 is positive in anyway. Further exploration should be conducted and if it is found the patient has suicidal thoughts or a plan and means to carry it out proper action should be taken such as calling law enforcement for an escort to the hospital or treatment center for an evaluation. Documentation should be entered into the Ahlers system. Model Policy

13. 1. Training of providers on completion of PHQ-2, PHQ-9, confidentiality, etc. (Today’s Training) * This training will be provided via video for health-care providers who are not able to attend today’s training. Link will be sent to agency family planning directors to forward on to staff. 2. KognitoTraining – 1 hour online training for all health-care providers. http://www.kognitocampus.com/ed/nd/ Required Training

14. Pilot Project implementation

15. PHQ-2 Scoring Link to access PHQ-2 :http://www.cqaimh.org/pdf/tool_phq2.pdf

16. PHQ-9 Scoring Link to access PHQ-9: http://www.cqaimh.org/pdf/tool_phq9.pdf

17. Revisions to CVR – implementation Date November 1, 2012

18. http://www.ahlerssoftware.com/ Gary will guide everyone on how to access this information at the time of his presentation. Ahlers – Gary Garcia

19. A meeting wizard will be sent to all delegate directors to schedule a meeting in mid-late October on the following: • Reimbursement process • Reporting requirements • Documentation discussion • Documentation of trainings completed by staff • Documentation in client records • Documentation in CVR’s Meeting for Delegate Directors

20. Questions