First Suicide Competencies for Psychiatric-Mental Health Registered Nurses Will Help Address Public Health Crisis - American Psychiatric Nurses Association

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The Psychiatric-Mental Health Nurse Essential Competencies for Assessment and Management of Individuals At Risk for Suicide are the first competencies specifically for registered nurses (RNs), providing a guide for evidence-based best practice in nurses’ assessment and management of hospitalized patients who may be at risk for suicide.

When disseminated and implemented, these competencies will make a marked change in the manner in which patients are assessed and managed when at risk for suicide. The accompanying results will help reduce the tragic rate of suicide in this country.

The American Psychiatric Nurses Association (APNA) has released a set of nine competencies for psychiatric-mental health registered nurses that provide a systematic process for assessing and managing persons at risk for suicide in inpatient settings. They are the first competencies specifically for nurses at the RN-level on this subject (2), filling a gap in education and training which, with suicide the tenth leading cause of death in the United States (1), is vital to address.

“When disseminated and implemented, these competencies will make a marked change in the manner in which patients are assessed and managed when at risk for suicide,” says APNA President Susie Adams, PhD, APRN, PMHNP-BC, PMHCNS-BC, FAANP. “The accompanying results will help reduce the tragic rate of suicide in this country.”

The nine competencies aim to increase nurses’ comfort, confidence, and competence in suicide assessment and management of suicide risk and cover the following areas: the phenomenon of suicide; managing personal reactions, attitudes, and beliefs; developing and maintaining a therapeutic relationship; collecting accurate assessment information; communicating suicide risk to appropriate persons; formulating a risk assessment; developing an ongoing nursing plan of care; assessing the safety of the patient environment; legal and ethical issues; and documenting suicide risk. They provide a foundation for training curricula and measuring the knowledge, skills, and attitudes necessary for expert care in this area.

A task force of APNA members with expertise in suicide prevention, including one member with lived experience of suicide, adapted these competencies for psychiatric-mental health nurses from existing national competencies. In addition, an external panel of national experts in suicidology validated the competencies. The competencies align with broader national strategies to enhance behavioral health workforce competencies in suicide prevention. For example the new mobile app, Suicide Safe, released by the Substance Abuse and Mental Health Services Administration (SAMHSA) earlier this month provides a broad application of competencies 5 and 6.

“There has been a gap in training and education in suicide prevention for inpatient nurses, although they provide services to patients in acute psychiatric crises,” says Janet York, PhD, PMHCNC-BC, FAAN, RHJ VAMC , who participated in the APNA task force. “These competencies were adapted from the national Assessing and Managing Suicide Risk (AMSR) Competencies developed by the Suicide Prevention Resource Center and the American Association of Suicidology, and are consistent with the goals of the 2012 National Strategy for Suicide Prevention.”

In conjunction with the release of these competencies, APNA issued a position statement which stresses that these competencies “address serious gaps in education for nurses who provide care to persons with mental health and substance use needs and that their dissemination will improve outcomes in suicide risk assessment, prevention, and intervention, ultimately increasing safety.” The position statement calls upon “healthcare facilities and academic settings to adopt these nursing competencies in order to increase patient and nurse safety, and to enhance nurses’ confidence and competence in caring for patients at risk for suicide, ultimately increasing patient outcomes.”

APNA has also developed an educational curriculum to support the adoption and implementation of the competencies, and plans to broaden and expand the competencies to address the needs of nurses practicing in a variety of settings, such as the medical/surgical and/or critical care hospital settings.

Psychiatric-Mental Health Nurse Essential Competencies for Assessment and Management of Individuals At Risk for Suicide can be viewed here.

1. McIntosh J., Drapeau C. (2012). USA suicide 2010 official final data. Washington, DC: American Association of Suicidology
2. Puntil C1, York J, Limandri B, Greene P, Arauz E, Hobbs D. (2013). Competency-Based Training for PMH Nurse Generalists: Inpatient Intervention and Prevention of Suicide. Journal of the American Psychiatric Nurses Association. July/August 2013 vol. 19 no. 4 205-210. doi: 10.1177/1078390313496275

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