D.23 36C26126R0014 VA Suicide Prevention Safety Plan and Suicide Behavior and Overdose Report.pdf
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- Community Based Outpatient Clinic - Yreka, CA
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- 36c26126r0014
About this file
This is an internal VA guidance document outlining staff credentials authorized to develop Suicide Prevention Safety Plans and complete Suicide Behavior and Overdose Reports (SBOR).
A Suicide Prevention Safety Plan is a brief clinical intervention collaboratively developed between a patient and provider for use during or before a suicidal crisis. VHA staff may develop a safety plan if three conditions are met: the staff member's credentials appear with a "Yes" designation in the authorization table, the local facility Chief of Staff concurs, and safety planning falls within the facility's scope of practice and competency. Similarly, VHA staff may complete an SBOR—which documents suicidal behaviors and nonsuicidal overdoses resulting in adverse events—if their credentials are marked "Yes" in the table and completion is within facility scope of practice and competency.
The authorization table identifies 16 staff categories. Disciplines with full authorization for both SBOR and Safety Plan functions include MD/DO, Licensed Psychologist (PhD/PsyD), Clinical Pharmacist Practitioner, LCSW/LMSW/LISW, LMFT, LPMHC, Addiction Therapist, RN, APRN (NP/CNS), PA, and Rehabilitation Counselor. Disciplines explicitly prohibited from both functions include LPN, Peer Support Specialist, UAP, Psychological Technician/Social Work Assistant, and Vocational Rehabilitation Specialist. The document notes that trainees in any authorized category may complete marked steps with appropriate cosigner oversight, and disciplines not listed in the table are not permitted to perform these functions.
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Text version
FOR VA INTERNAL USE ONLY 08/17/2022
v2
Department of Veterans Affairs (VA) Suicide Prevention Safety Plan and Suicide Behavior and Overdose Report (SBOR) Templates
Staff Specific Guidance
A Suicide Prevention Safety Plan is a brief clinical intervention, collaboratively developed between a patient and a provider, for use during or before a suicidal crisis. VHA staff members can develop a safety plan with a patient if:
1. There is a “Yes” next to the staff member’s credentials in the table below; AND
2. The local facility Chief of Staff concurs with this determination; AND
3. Safety planning is within facility scope of practice and/or competency.
Suicide Behavior and Overdose Reports (SBOR) collect information on suicidal behaviors and non-suicidal overdoses that result in an adverse event. VHA staff members can complete an SBOR if:
1. There is a “Yes” next to the staff member’s credentials in the table below; AND
2. Completion of the SBOR is within facility scope of practice and/or competency.
SBOR SP Safety Plan MD/DO1 Yes Yes Licensed Psychologist (PhD/PsyD)2 Yes Yes Clinical Pharmacist Practitioner Yes Yes LCSW/LMSW/LISW3 Yes Yes LMFT4 Yes Yes LPMHC5 Yes Yes Addiction Therapist Yes Yes LPN6 No No RN7 Yes Yes APRN: NP/CNS8 Yes Yes PA9 Yes Yes Peer Support Specialist No No UAP10 No No Psychological Technician, Social Work Assistant
No No
Vocational Rehabilitation Specialist No No Rehabilitation Counselor Yes Yes
1Medical Doctor/Doctor of Osteopathic Medicine; 2Doctor of Philosophy/Doctor of Psychology; 3Licensed Clinical Social Worker/Licensed Master of Social Work/Licensed Independent Social Worker; 4Licensed Marriage and Family Therapist; 5Licensed Professional Mental Health Counselor; 6Licensed Practical Nurse; 7Registered Nurse;
8Advanced Practice Registered Nurse: Nurse Practitioner/Clinical Nurse Specialist; 9Physician’s Assistant;
10Unlicensed Assistive Personnel, including Health Tech, Medical Assistant, and Nursing Assistant.
Note: A trainee in ANY of these categories may complete each step marked with a “Yes” with an appropriate co-signer.
If a particular discipline is not identified in the table above, the discipline may not complete the Safety Plan or the
SBOR.
File details come from the government source that posted it. Updated .