Medium Suicide Risk

• Multiple risk factors, few protective factors
• Suicidal ideation with plan, but no intent or behaviour

Recommendation for Medium Risk

Admission might be necessary depending on risk factors

In Canada, consider referring your patient to the following resources:

• Local emergency department
• Urgent Psychiatric Care Clinic / Psychiatric Consultation Clinic

In Ottawa, consider:

• TOH Mobile Crisis Team (MCT) and community crisis bed program (613-241-8161 health professional line, fax 613-241-7710)
• MCT Referral.pdf
• Mental Health Crisis Line for Adults, 613-722-6914 (within Ottawa), 1-866-996-0991 (Champlain LHIN)
• In Ottawa, if you are with the Ottawa Hospital / Bruyere Academic Health Team,  consider a referral to the Shared Care Mental Health Team

Develop a crisis/safety plan:

• This is a plan developed with the patient on how to deal with things in the event of a crisis and is developed ahead of time, during a time when the patient is calm and not overwhelmed
• It is developed together by the health professional and the patient, using the patient's own words and language.
• In this way, during times of crisis, the patient (as well as caring family, friends and professionals) can use the crisis plan in order to deal with the crisis.
• It includes key content such as signs of a crisis, coping strategies in a crisis, things which give hope and meaning
• Download Crisis Plans
  • Safety plan by Dr. Bilsker (PDF)
  • Safety plan for youth from Children's Hospital of Eastern Ontario (PDF)

Provide handout on coping with suicidal thoughts:

• Coping with Suicidal Thoughts (Bilsker, 2007)
• Coping with Suicidal Thoughts (Vivyan, 2011)

Give the patient a list of local/national emergency information such as: 

• 988 suicide crisis helpline
• Local emergency departments
• Local crisis lines
• Local mental health walk-in clinics
• Find your local crisis resources anywhere in Canada

Reference: Suicide Assessment Five-step Evaluation and Triage (SAFE-T).