63N-1.0091. Suicide Prevention Plans

(1) Each Detention Center, residential commitment program and day treatment program must have a written plan that details suicide prevention procedures. The suicide prevention plan must be reviewed annually.

(2) A facility/program’s plan for suicide prevention must include the following elements:

(a) Youths identified through screening or alert processes as having Suicide Risk Factors must be classified as a Suicide Risk Alert on JJIS and referred for an Assessment of Suicide Risk. An exception is provided in residential commitment programs designated for Specialized Treatment Services where a Mental Health Clinical Staff person administers mental health screening at admission and immediately administers an Assessment of Suicide Risk as specified in Rule 63N-1.006, F.A.C.

(b) When Suicide Risk Factors or suicide tendencies are indicated by screening or staff observations, an Assessment of Suicide Risk must be conducted to determine the level of suicide risk.

(c) Each facility or program must provide at least 6 hours of staff training annually on suicide prevention and implementation of Suicide Precautions which shall include quarterly “mock drill” trainings (every shift) on response to a Suicide Attempt and/or incident of serious self-injury. The training provided in the facility or program must be documented and on file in either the employee’s personnel file or staff training file.

(d) The areas of the facility designated for Precautionary Observation and Secure Observation.

(e) Use of levels of supervision in the following manner:

1. One-to-One Supervision. If the youth is in a Secure Observation Room, the staff member assigned to One-to-One Supervision of the youth must be stationed at the entrance to the room, no further than five feet from the door. One-to-One Supervision must be documented on the Suicide Precautions Observation Log (MHSA 006).

2. Constant Supervision. A staff member shall maintain continuous and uninterrupted observation of the youth. The staff member must have a clear and unobstructed view of the youth and unobstructed sound monitoring of the youth at all times. Constant Supervision shall not be accomplished through video/audio surveillance. If video/audio surveillance is utilized in the facility, it shall be used only to supplement physical observation by staff. Constant Supervision must be documented on form MHSA 006.

3. Close Supervision shall be used only as a step-down method of supervision of an At Risk youth who has received an Assessment of Suicide Risk, has been removed from Suicide Precautions, and is being transitioned back into a normal routine. Close Supervision is not an option for Precautionary Observation or Secure Observation. A staff member shall conduct visual checks of the youth’s condition while in his/her room or sleeping area at intervals not to exceed five minutes. For example, the staff member will observe the youth’s outward appearance, behavior and position in the room or area. Visual checks must be documented in writing at intervals not to exceed five minutes on the Close Supervision – Visual Checks Log (MHSA 020) or a visual checks form developed by the program which contains all the required information in form MHSA 020.

(f) The procedures for referring At Risk youths to mental health care providers or emergency facilities.

(g) Procedures for immediate and timely communication between Mental Health Clinical Staff and facility staff regarding the status of the youth to provide clear and current information and instructions. Procedures for communication with the youth’s parent or legal guardian to obtain information regarding Suicide Risk Factors.

(h) Procedures for notifying the parent/legal guardian that suicide risk screening indicated possible suicide risk and need for further assessment if the youth is being released to the parent/legal guardian prior to administration of an Assessment of Suicide Risk.

(i) Procedures for both verbal and written notification of the superintendent or program director, supervisors, outside authorities, the Juvenile Probation Officer and the parent or legal guardian of the youth’s Potential Suicide Risk, as indicated by an Assessment of Suicide Risk, or of a youth’s attempted suicide in the facility or program, must also be in place.

(j) The procedures for documenting the identification, referral, monitoring, assessment and follow-up of a youth identified as a Potential Suicide Risk or who has attempted suicide. The forms or formats cited in this Rule and the facility log must be utilized for documentation of suicide prevention processes and procedures.

(k) The procedures for immediate staff response to a Suicide Attempt or incident of Serious Self-Inflicted Injury.

(l) The procedures for the Licensed Mental Health Professional’s and facility superintendent or program director’s review of suicide prevention procedures. The plan must also specify the facility’s review process for every serious Suicide Attempt or Serious Self-Inflicted Injury requiring hospitalization or medical attention and mortality review process for a completed suicide.

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.