63N-1.006. Suicide Risk Alerts and Mental Health Alerts

(1) Suicide Risk Alerts.

(a) A “Suicide Risk Alert” designation shall be made by direct care or clinical staff when a youth is identified during screening or by staff observations as having Suicide Risk Factors.

(b) The youth coded as a Suicide Risk Alert must be placed on Suicide Precautions and maintained on Constant Supervision until an Assessment of Suicide Risk is conducted. If a youth exhibits behaviors which require both a “Suicide Risk Alert” and “Mental Health Alert,” the procedures for a “Suicide Risk Alert” must be followed.

(c) Youths on Suicide Precautions shall be coded as a “Suicide Risk Alert” until Suicide Precautions are removed.

(d) An exception is provided for residential commitment programs designated for Specialized Treatment Services where a Mental Health Clinical Staff Person conducts mental health screening at admission, and if a youth is identified with Suicide Risk Factors, immediately administers an Assessment of Suicide Risk. Based upon Assessment of Suicide Risk findings, the Mental Health Clinical Staff Person will determine whether a “Suicide Risk Alert” will be placed in JJIS.

(2) Mental Health Alerts.

(a) A “Mental Health Alert” designation shall be made by direct care or clinical staff when a youth is identified as having mental health conditions and factors which may pose a safety or security risk.

(b) Mental Health Alert indicators include the following:

1. Recent history of self-injurious behavior such as self-mutilation, carving or cutting self, ingestion of objects, or head banging which required emergency medical services within the previous 3 months;

2. Recent history of psychosis and symptoms such as auditory or visual hallucinations or delusions which required hospitalization within the previous 3 months;

3. Recent history of examination or placement under the Baker Act within the previous 3 months;

4. Recent history of Drug or alcohol detoxification, overdose or withdrawal symptoms within the previous 3 months;

5. Recent history of evaluation, or admission under the Marchman Act within the previous 3 months;

6. Severe Developmental Disability.

(c) An exception is provided for residential commitment programs designated for Specialized Treatment Services where a Mental Health Clinical Staff Person administers mental health screening at admission, and if a youth is identified with mental health conditions or factors which may pose a safety or security risk, immediately administers a Crisis Assessment at admission. In such instances, the Mental Health Clinical Staff Person will determine whether a “Mental Health Alert” will be placed in JJIS, based upon the Crisis Assessment findings.

(d) Youths coded as a “Mental Health Alert” must be maintained on one of the following levels of supervision:

1. One-to-One Supervision.

2. Constant Supervision.

3. Close Supervision.

(e) Documentation of One-to-One supervision or Constant Supervision of youths on Mental Health Alert must be recorded on the Mental Health Alert ‒ Observation Log (MHSA 007), or a form developed by the program which contains all the information required in form MHSA 007. The Mental Health Alert ‒ Observation Log (MHSA 007, August 2006) is incorporated by reference and is available at http://www.flrules.org/Gateway/reference.asp?No=Ref-03776 or may be obtained by contacting: DJJ, Office of Health Services, 2737 Centerview Drive, Tallahassee, FL 32399.

(f) Documentation of close supervision is recorded on the Close Supervision-Visual Checks Log (MHSA 020) or a form developed by the program which contains all the information required in form MHSA 020. The Close Supervision-Visual Checks Log (MHSA 020, August 2006) is incorporated by reference and is available at http://www.flrules.org/Gateway/reference.asp?No=Ref-03777 or may be obtained by contacting: DJJ, Office of Health Services, 2737 Centerview Drive, Tallahassee, FL 32399.

(3) A current listing of youths on Suicide Risk Alert or Mental Health Alert in JJIS must be maintained and provided to direct care and clinical staff on a daily basis.

(4) Direct care or clinical staff may place a youth on Suicide Risk Alert or Mental Health Alert in JJIS.

(5) A Licensed Mental Health Professional or non-licensed Mental Health Clinical Staff Person must downgrade or discontinue a youth’s alert status.

(a) If the downgrade of discontinuation of alert status is made by a non-licensed Mental Health Clinical Staff Person, the concurrence of a Licensed Mental Health Professional must be documented by the Mental Health Clinical Staff Person in a progress note and JJIS.

(b) A copy of the documented concurrence of the Licensed Mental Health Professional must be permanently filed in the youth’s individual healthcare record.

Rulemaking Authority 985.64(2) FS. Law Implemented 985.601(3)(a), 985.14(3)(a), 985.145(1), 985.18, 985.48(4), 985.64(2) FS. History–New 3-16-14.