| (A) within 24 hours prior to transfer, a mental health
professional at the sending facility sends a summary of the youth's
suicidal and/or self-harming behavior, assessments, and treatment
to the designated mental health professional and facility administrator
or their designees at the receiving facility and any stopover facilities
en route to the receiving facility; and
(B) staff assigned to monitor the youth at the sending
facility provide the suicide observation folder to the transporting
staff.
(2) A mental health professional at the receiving facility:
(A) as soon as possible, but no later than four hours
after the youth's arrival, reviews the transfer summary and initiates
a suicide risk assessment;
(B) places the youth on the facility's suicide alert
list;
(C) ensures the suicide observation log is provided
to the staff assigned to monitor the youth; and
(D) consults with the designated mental health professional
or designee regarding the plan for treatment and assessment.
(3) Before the youth is moved to the assigned dorm
or living unit at the receiving facility, staff responsible for supervising
the youth and nursing staff are notified of the youth's suicide observation
level.
(l) Moving a Youth on Suicide Alert to a Less Restrictive
Placement.
(1) Prior to moving a youth on suicide alert to a less
restrictive placement (i.e., medium-restriction facility or home placement),
the mental health professional:
(A) provides the youth (or parent/guardian if the youth
is under age 18) with a referral for follow-up care;
(B) coordinates with appropriate clinical staff to
schedule a follow-up appointment;
(C) communicates observation level and precautions
to facility staff, if applicable;
(D) identifies emergency resources, if needed; and
(E) notifies the youth's parole officer, if applicable.
(2) Mental health records are sent to the receiving
mental health provider upon request.
(m) Reduction of Observation Level and Removal from
Suicide Alert.
(1) The observation level for a youth on suicide alert
may be lowered or discontinued only after a suicide risk assessment
by a mental health professional, in consultation with the designated
mental health professional.
(2) A mental health professional may lower a youth's
suicide observation level by no more than one level every 24 hours
unless otherwise approved by the designated mental health professional
on a case-by-case basis.
(3) Only a mental health professional or the designated
mental health professional may authorize removal of a youth's name
from the suicide alert list. Only youth on the lowest available observation
level may be removed from suicide alert.
(4) The mental health professional notifies appropriate
staff when a youth's observation level is lowered and when a youth
is removed from suicide alert. Infirmary staff notify the psychiatric
provider of all such changes for youth on the psychiatric caseload.
(5) The youth's parent or guardian is notified when
the youth is removed from suicide alert (with the youth's consent
if the youth is age 18 or older).
(6) Upon removal from suicide alert, the mental health
professional identifies in the treatment plan any needed follow-up
mental health services.
(n) Training.
(1) All staff who have regular, direct contact with
youth (including, but not limited to, security, direct care, nursing,
mental health, and education staff) receive initial training in suicide
prevention and response during new-hire training. Training addresses
topics including, but not limited to:
(A) identifying the warning signs and symptoms of suicidal
and/or self-harming behavior;
(B) high-risk periods for suicidal and/or self-harming
behavior;
(C) juvenile suicide research, to include the demographic
and cultural parameters of suicidal behavior, incidence, and precipitating
factors;
(D) responding to suicidal youth and youth experiencing
mental health symptoms;
(E) communication between correctional and health care
personnel;
(F) referral procedures;
(G) housing, observation, and suicide alert procedures;
and
(H) follow-up monitoring of youth who engage in suicidal
behavior, self-harming behavior, and/or suicidal ideation.
(2) All staff who have regular, direct contact with
youth receive annual suicide prevention training.
(3) Staff designated to conduct suicide screenings
receive annual training from a mental health professional regarding
suicide alert policy, suicide indicators, and suicide screening.
(4) All training described by this subsection shall
be accompanied by a test or demonstration to establish competency
in the subject matter.
(o) Post-Incident Debriefing and Analysis.
(1) After a completed suicide or a life-threatening
suicide attempt, the facility administrator or designee coordinates
a debriefing with appropriate facility staff as soon as possible after
the situation has been stabilized, in accordance with agency procedures.
(2) After a completed suicide, the executive director
or designee may dispatch a critical incident support team to provide
counseling for youth and staff, coordination of facility activities,
and assistance with follow-up care.
(3) After a completed suicide, the medical director
conducts a morbidity and mortality review in coordination with appropriate
clinical staff. The medical director may conduct a morbidity and mortality
review after a life-threatening suicide attempt.
(4) After a completed suicide or a life-threatening
suicide attempt, a critical incident review is convened to determine
if the incident reveals system-wide deficiencies and to recommend
improvements to agency policies, operational procedures, the physical
plant, and/or training requirements.
(5) In the event of a completed suicide, all actions,
notifications, and reports required under §385.9951 of this chapter
must be completed.
|
| Source Note: The provisions of this §380.9188 adopted to be effective December 1, 2009, 34 TexReg 8543; transferred effective June 4, 2012, as published in the Texas Register June 22, 2012, 37 TexReg 4639; amended to be effective April 15, 2015, 40 TexReg 1976; amended to be effective August 1, 2023, 48 TexReg 2380 |
