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NIDA5 NIMH4 BPDRF1 TREATMENT NOTES 2003-2008

1)

of suicide ideation, suicide attempt, or intentional self-injury at intake

suicide ideation/urges to harm (or first report of) suicide ideation/urges to harm

fleeting

frequent

continual

suicide ideation/urges to harm Describe

since last contact suicide attempt/self-injury (Describe):

2)

_____

, because _____ (CHECK ONE) CLINICAL REASONS: (CHECK ALL THAT APPLY)

ideation/urges to harm not ordinarily associated with increased imminent risk for suicide or medically serious self-injury

or negligible no new risk factors or negligible

, impulse control appears acceptable,

, impulse control appears acceptable, no

new risk factors apparent, risk assessment done previously

Self-injury that occurred Determined by:

Threat or suicide ideation best viewed as

and treatment aims best

accomplished by targeting precipitants and vulnerability factors

Threat or suicide ideation best viewed as reinforce suicide ideation

behavior; formal risk assessment may

recently or soon will assess suicide risk. Not of value to have two clinicians treating the same behavior. REFERRED CLIENT to other responsible clinician for evaluation OTHER REASON: FORGOT, PLAN FOR FOLLOW UP:

C : \ D o c u m e n t s a n d S e t t i n g s \ e r i n w 6 \ L o c a l S e t t i n g s \ T e m p o r a r y I n t e r n e t F i l e s \ O L K 8 7 \ 2 0 0 8 - 1 0 - 1 0 _ I m m i n e n t _ R i s k _ A n d _ A c t i o n _ P l a n . d o c

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