Table 3.

Telehealth Suicide Screening Protocol During COVID Crisis.

If patient is suicidal during a session	Essential that we are confirming the address of the patient during the start of every visit. I would urge us to do this even if we do not think they are at risk of harm. These are challenging times for our patients whom are already at a higher risk for suicide. If patient endorses PHQ-9 #9 prior to session or suicidal ideation during session, conduct usual suicide risk assessment (below)
The patient reported the following	Are you feeling hopeless about the present/future? Have you had recent thoughts about taking your life?
When did you have these thoughts? Do you have a current plan?	Have you ever had a suicide attempt? Please explain: Do you have any weapons? What and where are they?
Chronic risk factors
Depression Alcohol and drug abuse Psychosis Instability Corrosive self-image Isolation Financial problems Insufficient coping skills Chronic medical problems Previous history of attempts
Acute risk factors
Interpersonal loss Critical life events Hostile interpersonal environment Increased agitation and tension Pervasive feelings of hopelessness/helplessness Apathy
Suicidal ideation (select one)	Thinks about suicide but has no intentions of doing it Has an intent and plan
Protective factors
Social support system Economic security Spiritual resources Obligation to others Psychological maturity Willingness to seek help Future oriented
Professional risk assessment	Risk assessment
Plan	Discussed following safety plan with the patient. Patient verbalized understanding: (Detail plan here)
Protocol for fellows	Contact supervising licensed psychologist via text during the session with no identifying information  – Example of text: I am currently seeing my 11 AM via (module, telephone, etc) and patient is endorsing suicidal ideation Supervisor will come in to session (via virtually/telephone, etc) Supervisor proceed with suicide assessment If positive, urge the patient to go to the emergency department Ask permission to call the patient’s emergency contact in the chart Fellow or supervisor remain on the phone with the patient while the other clinician contacts the police where the patient resides emergency contact in the chart Explain situation and provide police with the address of the patient Remain on the phone until help arrives