{"id":16,"date":"2021-03-12T18:30:25","date_gmt":"2021-03-12T18:30:25","guid":{"rendered":"https:\/\/wp.media.unc.edu\/suicideprevention\/?page_id=16"},"modified":"2022-04-01T18:11:27","modified_gmt":"2022-04-01T18:11:27","slug":"module-2","status":"publish","type":"page","link":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/module-2\/","title":{"rendered":"What Can I Do?"},"content":{"rendered":"\n<div class=\"smallsquares\">&nbsp;<\/div>\n<h2>Module 2: What Can I Do?<\/h2>\n<h3>What does S.A.V.E.S. stand for?<\/h3>\n<hr>\n<img decoding=\"async\" class=\"floatright\" src=\"https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/05\/iStock-1059613328.jpg\">\n<p>S.A.V.E.S.<sup id=\"popoverA\" class=\"citation\" title=\"Citation\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\">14<\/sup> is an acronym for action that identifies the five components of helping someone experiencing suicidal behavior:<\/p>\n<ul>\n<li><span class=\"emphasize\">S<\/span>igns of suicide<\/li>\n<li><span class=\"emphasize\">A<\/span>sk about suicide<\/li>\n<li><span class=\"emphasize\">V<\/span>alidate feelings<\/li>\n<li><span class=\"emphasize\">E<\/span>xpedite referral<\/li>\n<li><span class=\"emphasize\">S<\/span>et a reminder to follow up<\/li>\n<\/ul>\n<div style=\"clear: both;\"><\/div>\n<br>\n<center><strong>Click each of the tabs below to learn more about S.A.V.E.S.<\/strong><\/center>\n<p>&nbsp;<\/p>\n<ul class=\"nav nav-tabs SAVE\" role=\"tablist\">\n<li class=\"active\" role=\"presentation\"><a class=\"nav-link\" role=\"tab\" href=\"#signs\" aria-controls=\"signs\" data-toggle=\"tab\">S.<\/a><\/li>\n<li role=\"presentation\"><a class=\"nav-link\" role=\"tab\" href=\"#ask\" aria-controls=\"ask\" data-toggle=\"tab\">A.<\/a><\/li>\n<li role=\"presentation\"><a class=\"nav-link\" role=\"tab\" href=\"#validate\" aria-controls=\"validate\" data-toggle=\"tab\">V.<\/a><\/li>\n<li role=\"presentation\"><a class=\"nav-link\" role=\"tab\" href=\"#encourage\" aria-controls=\"encourage\" data-toggle=\"tab\">E.<\/a><\/li>\n<li role=\"presentation\"><a class=\"nav-link\" role=\"tab\" href=\"#setreminder\" aria-controls=\"encourage\" data-toggle=\"tab\">S.<\/a><\/li>\n<\/ul>\n<div class=\"tab-content\">\n<div id=\"signs\" class=\"tab-pane active\" role=\"tabpanel\">\n<h3><span class=\"emphasize\">S<\/span>igns of suicide<\/h3>\n<p><img decoding=\"async\" style=\"width: 30%; float: right; margin: 0 0px 20px 20px;\" src=\"https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/04\/SitStareWalkway.jpg\">Warning signs are behaviors that indicate someone may be at immediate risk for suicide.<sup id=\"popoverB\" class=\"citation\" title=\"Citation\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\">15<\/sup> It is not always easy to recognize when someone is suicidal, but there are some warning signs that you may be more likely to observe in a pharmacy setting. Some people who die by suicide may only exhibit one, others may show several signs, and some may show no signs at all. <\/p>\n<div style=\"clear: both;\">&nbsp;<\/div>\n<strong><center>Signs of Suicide<\/center><\/strong>\n<div class=\"table-responsive\">\n<table>\n<tbody>\n<tr>\n<th style=\"width: 50%;\"><center>Verbal Warning Signs<\/center><\/th>\n<th><center>Behavioral Warning Signs<\/center><\/th>\n<\/tr>\n<tr>\n<td style=\"border-bottom: none; border-top: none;\">Person talks about:\n<ul>\n<li>Death or suicide<\/li>\n<li>Feeling hopeless<\/li>\n<li>Feeling trapped<\/li>\n<li>Being a burden to others<\/li>\n<li>Unbearable pain<\/li>\n<li>No reason for living<\/li>\n<li>No sense of purpose in life<\/li>\n<\/ul>\n<\/td>\n<td style=\"border-bottom: none; border-top: none;\">Person exhibits:\n\n<ul>\n<li>Increased drug or alcohol use\/abuse<\/li>\n<li>Visible decline in appearance<\/li>\n<li>Withdrawing from friends, family, society<\/li>\n<li>Distress (anxious\/crying)<\/li>\n<li>Dramatic mood changes<\/li>\n<li>Difficulty sleeping or sleeping all the time<\/li>\n<li>Giving away possessions<\/li>\n<li>Saying goodbye to friends and family<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border-bottom: none; border-top: none; background-image: linear-gradient(65deg, #ebd996, RGBA(235, 217, 150, 0.25))\">\n<div class=\"pullquote\" style=\"background-image: none;\">\u201cThe patient said he didn\u2019t know why he was even buying any of the medication because hopefully he wouldn\u2019t be around long enough to take it.&#8221;<div class=\"attribution\">-Community Pharmacy Technician<\/div>\n<\/div>\n<\/td>\n<td style=\"border-bottom: none; border-top: none; background-image: linear-gradient(65deg, #ebd996, RGBA(235, 217, 150, 0.25))\">\n<div class=\"pullquote\" style=\"background-image: none;\">\u201cWe had a patient we absolutely loved. They would come in every time to pick up their medicine with a cheerful attitude. They were always well dressed, and they always would stand around and talk to us for a little bit before leaving. Recently this patient has come in upset, fatigued, and looking disheveled all the time.&#8221;<div class=\"attribution\">-Community Pharmacy Technician<\/div>\n<\/div>\n<\/td>\n<\/tr>\n<tr><td style=\"border-top: none;\">&nbsp;<\/td><td style=\"border-top: none;\">&nbsp;<\/td><\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<br>\n<div class=\"calloutbox\">\n<div class=\"calloutbox-header\">Signs of an IMMEDIATE EMERGENCY<sup id=\"popoverF\" class=\"citation\" style=\"color: #ebd996;\" title=\"Citation\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\">13<\/sup><\/div>\n<ul>\n<li>Threatening to hurt or kill oneself<\/li>\n<li>Looking for ways to kill oneself (i.e., seeking access to pills, weapons, or other means)<\/li>\n<li>Exhibiting self-destructive or risk-taking behaviors<\/li>\n<\/ul>\n<div class=\"pullquote\">\n\u201cA patient asked about how much of her antidepressants she could take in order to slip into a comatose state. Personally, I did not know exactly what to say, and she responded with something along the lines of, &#8216;My life would be better if I weren&#8217;t here.&#8217;\u201d\n<div class=\"attribution\">\u2014Community Pharmacist<\/div><\/div>\n<br>\n<\/div>\n<br>\n<\/div>\n<div id=\"ask\" class=\"tab-pane\" role=\"tabpanel\">\n<h3><span class=\"emphasize\">A<\/span>sk about suicide<\/h3>\n<div class=\"callout\">\u201cAre you thinking about killing yourself?\u201d<\/div>\n<p><img decoding=\"async\" style=\"width: 40%; float: right; padding: 0 0 20px 20px;\" src=\"https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/04\/ManStaringAtCamera.png\"><strong><em>In 2019, suicide was a Top 10 cause of death in the U.S.<\/em><\/strong> It is time for suicide to become a part of our conversations. If you think that your patient is at risk, asking the question up front is important, even if it is uncomfortable.<\/p>\n<p>Think about it another way. Imagine you are in the patient\u2019s position. How would you feel if you were in crisis or considering suicide, and your pharmacist <em>had not asked? Or ignored the signs?<\/em><\/p>\n<p>\u201cAre you thinking about killing yourself?\u201d can be an awkward and uncomfortable question to ask, but it is an effective method to find out if a person needs help. Tips for how to make this potentially life-saving inquiry are provided below.<\/p>\n<div style=\"clear: both;\">&nbsp;<\/div>\n<div class=\"calloutbox\">\n<div class=\"calloutbox-header\">If you feel awkward about asking the question, remember:<\/div>\n<ul>\n<li>Ask the question in a natural way.<\/li>\n<li>Ask whenever there are warning signs.<\/li>\n<li>People experiencing a crisis want someone to ask.\n<ul>\n<li>Asking reduces the stigma associated with having suicidal thoughts.<\/li>\n<\/ul>\n<\/li>\n<li>Don\u2019t ask the question in a way that sounds like you are expecting a \u201cNo\u201d answer.\n<ul>\n<li>Example: \u201cYou aren\u2019t thinking about killing yourself, are you?\u201d<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<div class=\"pullquote\">\u201cI had a patient who was becoming more and more withdrawn and disheveled. I asked her what was going on, and she made a vague statement about not seeing the point in living. So then I asked her if she was thinking about suicide, and she said yes. Then I knew I had to do something to make sure she didn\u2019t follow through with it.\u201d\n<div class=\"attribution\">-Community Pharmacist<\/div>\n<\/div>\n<p>Other things to consider when talking with a potentially suicidal person:<\/p>\n<ul>\n<li>Remain calm<\/li>\n<li>Listen more than you speak<\/li>\n<li>Be confident<\/li>\n<li>Do not argue<\/li>\n<li>Use open body language (maintain eye contact, nod to show attentiveness, uncross your arms)<\/li>\n<li>Use supportive and encouraging comments<\/li>\n<\/ul>\n<div class=\"pullquote\">\u201cWe had a patient we absolutely loved. They would come in every time to pick up their medicine with a cheerful attitude, they would always stand around and talk to us for a little bit before leaving, and they were well dressed. Recently this patient has come in upset, fatigued, and looking disheveled all the time. We constantly remind them that we are there for them and would do anything to help. They thank us, get their medicine, and walk away.\u201d\n<div class=\"attribution\">-Member of Community Pharmacy Staff<\/div>\n<\/div>\n<\/div>\n<div id=\"validate\" class=\"tab-pane\" role=\"tabpanel\">\n<h3><span class=\"emphasize\">V<\/span>alidate feelings<\/h3>\n<p>Validation means that you recognize, acknowledge, and value your patient&#8217;s feelings. Engage in active listening, give the patient your full attention, and do the following:<\/p>\n<ul>\n<li>Acknowledge their feelings<\/li>\n<li>Listen and allow the person to talk<\/li>\n<li>Do not judge<\/li>\n<li>Reassure the person that help is available, and you will help them find it<\/li>\n<\/ul>\n<div class=\"pullquote\">\u201cIf I feel a patient is in crisis, I will offer an ear.\u201d\n<div class=\"attribution\">-Community Pharmacy Technician<\/div>\n<\/div>\n<div class=\"pullquote\"><img decoding=\"async\" style=\"width: 45%; float: right; padding: 0 0 0 20px;\" src=\"https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/05\/iStock-1048402842_v2-scaled.jpg\">\u201cShe (the cashier) asked if I would take some time to meet with the patient in our private consultation room, which I agreed to do. She was absolutely broken. She gave me a very detailed history of her experience (on two separate occasions) while on an involuntary hold at a facility. I may have gotten in ten words. But I didn\u2019t need to say more. She didn\u2019t need me to say more.\u201d\n<div class=\"attribution\">-Community Pharmacist<\/div>\n<div style=\"clear: both\"> <\/div>\n<\/div>\n<\/div>\n<div id=\"encourage\" class=\"tab-pane\" role=\"tabpanel\">\n<h3><span class=\"emphasize\">E<\/span>xpedite referral<\/h3>\n<ul>\n<li>Connect the individual with services. Even for individuals who deny suicidal behavior, provide them with information for the Crisis Line.<\/li>\n<li><strong>Encourage the patient to stay in the pharmacy.<\/strong> If you think they may leave before you can connect them to help, try asking them to hold something, like a pen or a pamphlet, to keep them at the counter while you call the Crisis Line.<\/li>  \n<li>If you can\u2019t reach someone immediately on the Crisis Line, please go to the Referral Tool located in the Resources tab for additional national, state, and local resources.<\/li>\n<\/ul>\n<br>\n<div class=\"table-responsive\">\n<div style=\"margin:0; padding: 0px; width: 100%; min-width: 700px;\">\n\t<div style=\"margin:0; padding: 10px 0; width: 100%; background-color: #5a7d7a; color: #EBD996; text-align: center; text-transform: uppercase;\">How to connect with a crisis responder<\/div>\n\t<div style=\"width: 33.33%; float: left; height: 450px; background-color: RGBA(228,242,242,1); text-align: center;\"><div style=\"height: 225px; background-color: #aadcd9;\"><strong>Call<\/strong><div style=\"height: 50px; margin: 0 auto; padding: 0; width: 80%; background-color: #5a7d7a; color: white; border: 2px solid white; border-radius: 10px;\">1-800-273-8255<\/div><span style=\"color: #B30003;line-height: 15px;\">Veterans: press 1<\/span><\/div><div style=\"height: 225px; background-color: #EBD996\"><strong>Text<\/strong><div style=\"height: 50px; margin: 0 auto; padding: 0; width: 80%; background-color: #5a7d7a; color: white; border: 2px solid white; border-radius: 10px;line-height: 15px; margin-bottom: 10px;\"><span style=\" line-height: 15px; position: relative; top: 7px;\">Veterans text: 838255<\/span><\/div><div style=\"height: 50px; margin: 0 auto; padding: 0; width: 80%; background-color: #5a7d7a; color: white; border: 2px solid white; border-radius: 10px; line-height: 15px;\"><span style=\" line-height: 15px; position: relative; top: 7px;\">Non-veterans text: 741741<\/span><\/div><\/div><\/div>\n\t<div style=\"width: 33.33%; float: left; height: 450px; background-color: RGBA(228,242,242,1); text-align: center;\"><div style=\"height: 225px; background-color: #EBD996; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/07\/ChatIcon-01.png'); background-position: center; background-repeat: no-repeat; background-size: auto 100%;\"><strong>Chat online<\/strong><br><div style=\"height: 50px; margin: 0 auto; padding: 0; width: 80%; background-color: #5a7d7a; color: white; border: 2px solid white; border-radius: 10px; margin-bottom: 10px;\"><a style=\"color: #ffffff; line-height: 15px; position: relative; top: 7px;\" href=\"https:\/\/www.veteranscrisisline.net\/get-help\/chat\">Veterans<\/a><\/div><div style=\"height: 50px; margin: 0 auto; padding: 0; width: 80%; background-color: #5a7d7a; color: white; border: 2px solid white; border-radius: 10px;\"><a style=\"color: #ffffff; line-height: 15px; position: relative; top: 7px;\" href=\"https:\/\/suicidepreventionlifeline.org\/chat\/\">Non-veterans<\/a><\/div><\/div><div style=\"height: 225px; width: 33.33%; padding: 0 20px; line-height: 30px; display: table-cell; vertical-align: middle; background-color: #aadcd9; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/07\/HardOfHearing-01-1.png'); background-position: center; background-repeat: no-repeat; background-size: auto 100%;\"><strong>Support for deaf and hard of hearing<\/strong><\/div><\/div>\n\t<div style=\"width: 33.33%; float: left; height: 450px; margin: 0; background-color: #844b81; color: white; font-weight: bold; text-align: left; line-height: 25px;\"><p style=\"padding: 0 20px; margin: 50px auto; color: white\">The Veterans Crisis Line is for veterans, servicemembers, and anyone concerned about their well-being. Support is&#8230;<\/p><ul style=\"width: 80%; margin: 0 auto;\"><li>Free<\/li><li>Confidential<\/li><li>Available every day, 24\/7<\/li><\/ul><\/div>\n<div class=\"footnote\">Adapted from <a href=\"https:\/\/www.veteranscrisisline.net\/\">https:\/\/www.veteranscrisisline.net\/<\/a><\/div>\n<br>\n<\/div>\n\n<div class=\"callout\" style=\"min-width: 700px;\">The current Crisis Line number is due to change to a simple 3-digit number in 2022<\/div>\n<\/div>\n\n<p>Assist the person in finding a care facility by personally referring them, arranging transportation, calling, or providing the appropriate resource(s). Do not leave the person alone. Stay with them until they are safe.<\/p>\n<ul>\n<li>We have included a resource referral tool on this website. Here you will find national resources, as well as resources by county or zip code readily available for people in crisis. These services include help for mental health crisis, substance use disorders, and veteran specific services.<\/li>\n<li>Click <a href=\"https:\/\/www.veteranscrisisline.net\/about\/what-to-expect\">here<\/a> to learn what to expect when calling the Crisis Line.<\/li>\n<\/ul>\n<p><!--html diagram--><\/p>\n\n<center><strong>Making a Referral to the Crisis Line<\/strong><sup id=\"popoverM\" class=\"citation\" title=\"Citation\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\">16<\/sup><\/center>\n\n<div class=\"table-responsive\">\n<table style=\"background-color: #eeefff; font-size: .8em; min-width: 700px;\">\n<tbody>\n<tr>\n<th style=\"width: 50%; font-size: 1.4em\"><center>Process<\/center><\/th>\n<th style=\"width: 25%; font-size: 1.4em\"><center>Examples<\/center><\/th>\n<th style=\"width: 25%; font-size: 1.4em\"><center>Action<\/center><\/th>\n<\/tr>\n<tr>\n<td style=\"padding: 10px;\">\n<p style=\"padding: 10px; margin: 0 auto; width: 85%; background-color: white; border: 2px solid #844b81; border-radius: 10px; font-size: 1.3em\" align=\"center\"><strong>Patient exhibits warning signs<\/strong><\/p>\n<div style=\"width: 100%; height: 60px; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/04\/DiagramElements-02.png'); background-position: center; background-repeat: no-repeat; background-size: 60px 100%;\">&nbsp;<\/div>\n<div style=\"width: 85%; margin: 0 auto; padding: 10px; background-image: linear-gradient(#d28fbf, #844b81); color: white; font-size: 1.4em; border-radius: 10px; text-align: center;\"><span style=\"font-weight: bold;\">Ask<\/span><br>&#8220;Are you considering suicide?&#8221;<\/div>\n<div style=\"width: 100%; height: 100px; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/07\/DiagramElements-07.png'); background-position: center; background-repeat: no-repeat; background-size: 100% 100%;\">\n<div style=\"width: 33.33%; float: left\">\n<div style=\"width: 100%; height: 100px; text-align: center; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/04\/DiagramElements-02.png'); background-position: center; background-repeat: no-repeat; background-size: contain;\">\n<div style=\"display: block; margin: 0 auto; color: #844b81; font-weight: bold; box-shadow: 1px 2px 2px -1px; background-color: white; width: 60px; line-height: 60px; border-radius: 50%; transform: translate(0, 10px);\">If No<\/div>\t\n<\/div>\n<div>\n<ul style=\"padding: 10px 10px 10px 26px; margin: 0 4% 0 0; background-color: white; border: 2px solid #844b81; border-radius: 10px;\">\n<li>Offer empathy for the patient&#8217;s situation.<\/li>\n<li>Consult the referral resource tool.<\/li>\n<li>Provide the patient with the Crisis Line number.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div style=\"width: 33.33%; float: left\">\n<div style=\"width: 100%; height: 100px; text-align: center; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/04\/DiagramElements-02.png'); background-position: center; background-repeat: no-repeat; background-size: contain;\">\n<div style=\"display: block; margin: 0 auto; color: #844b81; font-weight: bold; box-shadow: 1px 2px 2px -1px; background-color: white; width: 60px; height: 60px; line-height: 13px; padding: 13px 0; border-radius: 50%; transform: translate(0, 10px);\">If No Response<\/div>\n<\/div>\n<p style=\"padding: 10px; margin: 0 2%; text-align: center; background-color: white; border: 2px solid #844b81; border-radius: 10px;\">\nProvide the patient with the Crisis Line number.\n<\/p>\n<\/div>\n<div style=\"width: 33.33%; float: left\">\n<div style=\"display: block; margin: 0 auto; text-align: center; color: #844b81; font-weight: bold; box-shadow: 1px 2px 2px -1px; background-color: white; width: 60px; line-height: 60px; border-radius: 50%; transform: translate(0, 10px)\">If Yes<\/div>\n<\/div>\n<\/div>\n<div style=\"width: 100%; margin: 0; padding: 0; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/07\/DiagramElements-07.png'); background-position: center; background-repeat: no-repeat; background-size: 100% 100%;\">\n<div style=\"clear: both;\">&nbsp;<\/div>\n<\/div>\n<div style=\"height: 6vw; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/07\/DiagramElements-06.png'); background-position: center; background-repeat: no-repeat; background-size: 100% 100%;\">&nbsp;<\/div>\n<div style=\"width: 100%; padding: 0 0 40px 0; margin: 0; background-image: url('https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/07\/DiagramElements-05.png'); background-position: center bottom; background-repeat: no-repeat; background-size: 100% 75%;\">\n<div style=\"width: 32%; margin: 0 1% 0 0; float: left;\">\n<div style=\"padding: 10px; color: #844b81; background-color: white; border: 2px solid #844b81; border-radius: 10px;\">\n<p style=\"font-weight: bold;\">Unsure of immediate danger or passive suicidal behavior:<\/p>\n<p>Ask if you can call the Crisis Line for the patient or provide the Crisis Line number.<\/p>\n<p>Provide referral resource tool information.<\/p>\n<p><span id=\"popoverO\" class=\"citation\" title=\"Example\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\">Click here for an example.<\/span><sup id=\"popoverM\" class=\"citation\" title=\"Citation\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\"><\/sup><\/p>\n<\/div>\n<\/div>\n<div style=\"width: 32%; margin: 0 1%; float: left;\">\n<div style=\"padding: 10px; color: #844b81; background-color: white; border: 2px solid #844b81; border-radius: 10px;\">\n<p style=\"font-weight: bold;\">Patient has shared a plan:<\/p>\n<p>Call the Crisis Line or encourage the patient to call the Crisis Line.<\/p>\n<p>Monitor the patient until they connect with crisis services.<\/p>\n<p><span id=\"popoverP\" class=\"citation\" title=\"Example\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\">Click here for an example.<\/span><\/p>\n<\/div>\n<\/div>\n<div style=\"width: 32%; margin: 0 0 0 1%; float: left;\">\n<div style=\"padding: 10px; color: #844b81; background-color: white; border: 2px solid #844b81; border-radius: 10px;\">\n<p style=\"font-weight: bold;\">Patient has shared they have taken harmful action:<\/p>\n<p>Call 911.<\/p>\n<p>If at pharmacy, stay with the patient.<\/p>\n<p>If on the phone, try to stay on the line until emergency personnel arrives.<\/p>\n<p><span id=\"popoverQ\" class=\"citation\" title=\"Example\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\">Click here for an example.<\/span><sup id=\"popoverN\" class=\"citation\" title=\"Citation\" data-toggle=\"popover\" data-html=\"true\" data-placement=\"bottom\"><\/sup><\/p>\n<\/div>\n<\/div>\n<div style=\"clear: both;\">&nbsp;<\/div>\n<\/div>\n<div style=\"padding: 10px; color: #844b81; background-color: white; border: 2px solid #844b81; border-radius: 10px;\">\n<p style=\"font-weight: bold;\" align=\"center\">Set a reminder to follow up with the patient the next day.<\/p>\n<img decoding=\"async\" src=\"https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/07\/StickyNote-01.png\" style=\"width: 25%; display: block; margin: 0 auto;\"><\/div>\n<div style=\"clear: both;\">&nbsp;<\/div>\n<!-- <\/div> -->\n<\/td>\n<td>\n<div style=\"background-color: #5a7d7a; color: white; margin: 10px; padding: 10px; border-radius: 10px;\"><strong>Signs<\/strong>\n<ul style=\"padding-left: 20px;\">\n<li>&#8220;How much of this medicine would it take to kill me?&#8221;<\/li>\n<\/ul>\n<\/div>\n<div style=\"background-color: #5a7d7a; color: white; margin: 10px; padding: 10px; border-radius: 10px;\"><strong>Ask<\/strong>&nbsp;\n<ul style=\"padding-left: 20px;\">\n<li>&#8220;Are you thinking about killing yourself?&#8221;<\/li>\n<li>&#8220;With the question that you are asking, I am wondering if you are thinking about suicide?&#8221;<\/li>\n<li>&#8220;When you say that you are at the end of your rope, are you thinking of killing yourself?&#8221;<\/li>\n<\/ul>\n<\/div>\n<div style=\"background-color: #5a7d7a; color: white; margin: 10px; padding: 10px; border-radius: 10px;\"><strong>Validate\/empathize<\/strong>&nbsp;\n<ul style=\"padding-left: 20px;\">\n<li>&#8220;It sounds like you are overwhelmed with everything going on.&#8221;<\/li>\n<li>&#8220;Tell me more about that.&#8221;<\/li>\n<\/ul>\n<\/div>\n<div style=\"background-color: #5a7d7a; color: white; margin: 10px; padding: 10px; border-radius: 10px;\"><strong>Expedite referral<\/strong>&nbsp;\n<ul style=\"padding-left: 20px;\">\n<li>&#8220;I don&#8217;t want anything bad to happen to you. Would it be all right if I called the Crisis Line for you?&#8221;<\/li>\n<li>&#8220;I could connect you with someone who can help. It&#8217;s anonymous and free.&#8221;<\/li>\n<\/ul>\n<\/div>\n<div style=\"background-color: #5a7d7a; color: white; margin: 10px; padding: 10px; border-radius: 10px;\"><strong>Set a reminder to follow up<\/strong>&nbsp;\n<ul style=\"padding-left: 20px;\">\n<li>Make a note to connect with the patient the next day.<\/li>\n<li>Use a method that fits within the clinical workflow. The solution can be as simple as writing a sticky note or setting a reminder in your calendar to call.<\/li>\n<li>The follow-up conversation should be short and to the point. Just take a moment to check in.<\/li>\n<\/ul>\n<\/div>\n<\/td>\n<td>\n<div style=\"margin: 10px 10px 30px; padding: 10px; border-radius: 10px; font-size: 1.4em; background-color: #844b81; color: #ffffff;\">Practice responding ahead of time<\/div>\n<div style=\"margin: 10px 10px 30px; padding: 10px; border-radius: 10px; font-size: 1.4em; background-color: #844b81; color: #ffffff;\">Try to remain calm<\/div>\n<div style=\"margin: 10px 10px 30px; padding: 10px; border-radius: 10px; font-size: 1.4em; background-color: #844b81; color: #ffffff;\">Be direct<\/div>\n<div style=\"margin: 10px 10px 30px; padding: 10px; border-radius: 10px; font-size: 1.4em; background-color: #844b81; color: #ffffff;\">Allow the patient to talk<\/div>\n<div style=\"margin: 10px 10px 30px; padding: 10px; border-radius: 10px; font-size: 1.4em; background-color: #844b81; color: #ffffff;\">Show that you care<\/div>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<br>\n<p><center><strong>Click the button below if you are interested in learning more about specific resources for veterans.<\/strong><\/center><\/p>\n<div id=\"accordion\" class=\"panel-group\" role=\"tablist\" aria-multiselectable=\"true\">\n<div class=\"panel panel-default\">\n<div id=\"headingOne\" class=\"panel-heading\" role=\"tab\">\n<h4 class=\"panel-title\"><a class=\"collapsed\" role=\"button\" href=\"#collapseOne\" data-toggle=\"collapse\" data-parent=\"#accordion\" aria-expanded=\"false\" aria-controls=\"collapseOne\"> Resources for veterans, servicemembers, and those helping them <\/a><\/h4>\n<\/div>\n\n<div id=\"collapseOne\" class=\"panel-collapse collapse\" role=\"tabpanel\" aria-labelledby=\"headingOne\">\n<div class=\"panel-body\"><p><img decoding=\"async\" style=\"width: 40%; float: right; margin: 0 0 20px 20px;\" src=\"https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/05\/iStock-1148745685.jpg\"><\/p>\n<ul>\n<li>The Veterans Administration (VA) and Department of Defense (DOD) both provide employees who work at the Crisis Line.<\/li>\n<li>Service members, veterans, and their families or friends who are concerned about them are encouraged to <strong>call the Crisis Line and press \u201c1\u201d or text 838255 for immediate crisis resources.<\/strong>\n<ul>\n<li><em>ANY veteran or service member can be served by option 1, regardless of eligibility for VA benefits.<\/em><\/li>\n<li>An advantage to choosing option 1 is that the VA and DOD staff have access to the same protocols as the main number, in addition to scheduling and other resources only available to veterans and service members.<\/li>\n<\/ul>\n<\/li>\n<li>The Veterans Administration also has an <a href=\"https:\/\/www.veteranscrisisline.net\/get-help\/chat\">online chat service<\/a> that is available 24 hours a day.<\/li>\n<\/ul>\n<div style=\"clear: both;\"><\/div>\n<div class=\"pullquote\">\u201cHe was an elderly patient, a VA member, and (he) primarily lived alone. He told the pharmacist how he had these thoughts, and it was troubling him, and he wasn&#8217;t sure what to do. My pharmacist contacted the VA suicide line and asked for them or a physician to reach out to the patient. The patient talked to my pharmacist several times throughout the day and before closing he let the pharmacist know that he was feeling better, and a close friend (would) stay at home with him for some time.\u201d\n<div class=\"attribution\">-Pharmacy Technician<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div id=\"setreminder\" class=\"tab-pane\" role=\"tabpanel\">\n\n\t<h3><span class=\"emphasize\">S<\/span>et a reminder to follow up<\/h3>\n\n\t<p><img decoding=\"async\" style=\"width: 30%; float: right; margin: 0 0px 20px 20px;\" src=\"https:\/\/wp.media.unc.edu\/suicideprevention\/wp-content\/uploads\/sites\/12\/2021\/07\/reminder.png\">Current best practice recommends following up the next day with patients who show suicide warning signs. It\u2019s easy to forget to do this, so it\u2019s important to remind yourself to follow up:<\/p>\n<ul>\n\t\n\t<li>Make a note to connect with the person the next day<\/li>\n\t<li>Use a method that works within your clinical workflow<\/li>\n<\/ul>\n\n\t<p>The note to follow up could be as simple as leaving a sticky note on your computer or setting a calendar reminder to follow up.<\/p>\n\n\t<p>Your follow-up conversation can be short and to-the-point. (See the videos in the \u201cHow does it work?\u201d section for examples.) Just let the person know who you are and that you wanted to check in to see if they are okay.<\/p>\n\n\t<div class=\"pullquote\">\n\t\u201cWe had a new mother call the pharmacy. She expressed hopelessness. As technicians we had to keep the patient on the phone while another staff member got the pharmacist. After speaking with her, the pharmacist provided the number for the Crisis Line and some local resources. The next day we did a follow-up call for the patient, just to make sure she was doing ok.\u201d<div class=\"attribution\">-Pharmacy Technician<\/div>\n<\/div>\n\t\n\n\t\n\t<\/div>\n\t\n<ul class=\"nav nav-tabs SAVE lower\" role=\"tablist\">\n<li class=\"active\" role=\"presentation\"><a role=\"tab\" href=\"#signs\" aria-controls=\"signs\" data-toggle=\"tab\">S.<\/a><\/li>\n<li role=\"presentation\"><a role=\"tab\" href=\"#ask\" aria-controls=\"ask\" data-toggle=\"tab\">A.<\/a><\/li>\n<li role=\"presentation\"><a role=\"tab\" href=\"#validate\" aria-controls=\"validate\" data-toggle=\"tab\">V.<\/a><\/li>\n<li role=\"presentation\"><a role=\"tab\" href=\"#encourage\" aria-controls=\"encourage\" data-toggle=\"tab\">E.<\/a><\/li>\n<li role=\"presentation\"><a role=\"tab\" href=\"#setreminder\" aria-controls=\"encourage\" data-toggle=\"tab\">S.<\/a><\/li>\n<\/ul>\n<\/div>\n<div class=\"lowernav\"><a href=\"https:\/\/wp.media.unc.edu\/studentpharmsaves\/module-1\/\"><button class=\"navbtn prev\" type=\"button\">\u2190 back<\/button><\/a><a href=\"#\"><button class=\"navbtn top\" type=\"button\">top<\/button><\/a><a href=\"https:\/\/wp.media.unc.edu\/studentpharmsaves\/module-1\/module-3\/\"><button class=\"navbtn next\" type=\"button\">next \u2192<\/button><\/a><\/div>\n<div id=\"popoverA-content\" class=\"popover-content hide\">\n<div id=\"A\"><button id=\"A\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"14\">\n<li value=\"14\">Carpenter, D. M., Lavigne, J. E., Colmenares, E. W., Falbo, K., &amp; Mosley, S. L. (2020). Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide. Research in social and administrative pharmacy, 16(3), 349-359.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverB-content\" class=\"popover-content hide\">\n<div id=\"B\"><button id=\"B\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"15\">\n<li value=\"15\">Risk and Protective Factors. (2020, October). In Suicide Prevention Resource Center. Retrieved from <a href=\"https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors\">https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverC-content\" class=\"popover-content hide\">\n<div id=\"C\"><button id=\"C\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"14\">\n<li value=\"14\">Carpenter, D. M., Lavigne, J. E., Colmenares, E. W., Falbo, K., &amp; Mosley, S. L. (2020). Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide. <em>Research in social and administrative pharmacy, <\/em>(3), 349-359.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverD-content\" class=\"popover-content hide\">\n<div id=\"D\"><button id=\"D\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"14\">\n<li value=\"14\">Carpenter, D. M., Lavigne, J. E., Colmenares, E. W., Falbo, K., &amp; Mosley, S. L. (2020). Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide. <em>Research in social and administrative pharmacy, 16<\/em>(3), 349-359.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverE-content\" class=\"popover-content hide\">\n<div id=\"E\"><button id=\"E\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"15\">\n<li value=\"15\">Risk and Protective Factors. (2020, October). In Suicide Prevention Resource Center. Retrieved from <a href=\"https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors\">https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverF-content\" class=\"popover-content hide\">\n<div id=\"F\" style=\"color: #4f4f4f;\"><button id=\"F\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"13\">\n<li value=\"13\">Suicide Prevention (2021, June 16). In Department of Veterans Affairs. Retrieved from <a href=\"https:\/\/www.mentalhealth.va.gov\/suicide_prevention\/\">https:\/\/www.mentalhealth.va.gov\/suicide_prevention\/<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverG-content\" class=\"popover-content hide\">\n<div id=\"G\" style=\"color: #4f4f4f;\"><button id=\"G\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"13\">\n<li value=\"13\">Suicide Prevention (2020, December 22). In <em>Department of Veterans Affairs<\/em>. Retrieved from <a href=\"https:\/\/www.mentalhealth.va.gov\/suicide_prevention\/\">https:\/\/www.mentalhealth.va.gov\/suicide_prevention\/<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverH-content\" class=\"popover-content hide\">\n<div id=\"H\"><button id=\"H\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"14\">\n<li value=\"14\">Carpenter, D. M., Lavigne, J. E., Colmenares, E. W., Falbo, K., &amp; Mosley, S. L. (2020). Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide. <em>Research in social and administrative pharmacy, 16<\/em>(3), 349-359.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverI-content\" class=\"popover-content hide\">\n<div id=\"I\"><button id=\"I\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"14\">\n<li value=\"14\">Carpenter, D. M., Lavigne, J. E., Colmenares, E. W., Falbo, K., &amp; Mosley, S. L. (2020). Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide. <em>Research in social and administrative pharmacy, 16<\/em>(3), 349-359.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverJ-content\" class=\"popover-content hide\">\n<div id=\"J\"><button id=\"J\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"15\">\n<li value=\"15\">Risk and Protective Factors. (2020, October). In Suicide Prevention Resource Center. Retrieved from <a href=\"https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors\">https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverK-content\" class=\"popover-content hide\">\n<div id=\"K\"><button id=\"K\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"15\">\n<li value=\"15\">Risk and Protective Factors. (2020, October). In Suicide Prevention Resource Center. Retrieved from <a href=\"https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors\">https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverL-content\" class=\"popover-content hide\">\n<div id=\"L\"><button id=\"L\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"15\">\n<li value=\"15\">Risk and Protective Factors. (2020, October). In Suicide Prevention Resource Center. Retrieved from <a href=\"https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors\">https:\/\/www.sprc.org\/about-suicide\/risk-protective-factors<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverM-content\" class=\"popover-content hide\">\n<div id=\"M\"><button id=\"M\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"16\">\n<li value=\"16\">Murphy, A. L., Ataya, R., Himmelman, D., O\u2019Reilly, C., Rosen, A., Salvador-Carulla, L., &#8230; &amp; Gardner, D. M. (2018). Community pharmacists\u2019 experiences and people at risk of suicide in Canada and Australia: a thematic analysis. <em>Social psychiatry and psychiatric epidemiology, 53<\/em>(11), 1173-1184.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverN-content\" class=\"popover-content hide\">\n<div id=\"N\"><button id=\"N\" class=\"close\" type=\"button\">\u00d7<\/button>\n<ol start=\"16\">\n<li value=\"16\">Murphy, A. L., Ataya, R., Himmelman, D., O\u2019Reilly, C., Rosen, A., Salvador-Carulla, L., &#8230; &amp; Gardner, D. M. (2018). Community pharmacists\u2019 experiences and people at risk of suicide in Canada and Australia: a thematic analysis. <em>Social psychiatry and psychiatric epidemiology, 53<\/em>(11), 1173-1184.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div id=\"popoverO-content\" class=\"popover-content hide\">\n<div id=\"O\" class=\"example\"><button id=\"O\" class=\"close\" type=\"button\">\u00d7<\/button>\u201cA patient presented to the pharmacy with a prescription for an antidepressant after being seen at outpatient. He was extremely emotional (crying and sobbing). He was brought to the private counseling room in the pharmacy where he expressed his concern and stated that he didn\u2019t know how much longer he can live.\u201d<div class=\"attribution\">-Community Pharmacy Technician<\/div><\/div>\n<\/div>\n<div id=\"popoverP-content\" class=\"popover-content hide\">\n<div id=\"P\" class=\"example\"><button id=\"P\" class=\"close\" type=\"button\">\u00d7<\/button>\u201cThe patient said, \u2018I am afraid that if I go home, I will kill myself.\u2019 I told the patient it was (all right) to stay at the pharmacy, we would help in any way we could, and I called the Crisis Line to request help. The patient admitted the need for help and was admitted to a mental health facility.\u201d<div class=\"attribution\">-Pharmacy Technician<\/div><\/div><\/div>\n<\/div>\n<div id=\"popoverQ-content\" class=\"popover-content hide\">\n<div id=\"Q\" class=\"example\"><button id=\"Q\" class=\"close\" type=\"button\">\u00d7<\/button>\u201c[The] patient phoned to ask how much drugs she would have to take to kill herself. I asked if she had taken anything and she said yes, the whole bottle. She told me her name and I looked up what she had taken \u2013 Effexor XL [venlafaxine]. I explained that this is a slow-acting drug and she really needed to get to ER. She hung up on me. I then called all the local ER departments and found the one she had gone to \u2013 gave them the info they needed, and they treated her immediate OD [overdose] situation and got her into therapy.\u201d<div class=\"attribution\">-Community Pharmacist<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Module 2: What Can I Do? What does S.A.V.E.S. stand for? S.A.V.E.S.14 is an acronym for action that identifies the five components of helping someone experiencing suicidal behavior: Signs of suicide Ask about suicide Validate feelings Expedite referral Set &hellip; <a href=\"https:\/\/wp.media.unc.edu\/studentpharmsaves\/module-2\/\" aria-label=\"Read more about What Can I Do?\">Continued<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/wp-json\/wp\/v2\/pages\/16"}],"collection":[{"href":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/wp-json\/wp\/v2\/comments?post=16"}],"version-history":[{"count":21,"href":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/wp-json\/wp\/v2\/pages\/16\/revisions"}],"predecessor-version":[{"id":2608,"href":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/wp-json\/wp\/v2\/pages\/16\/revisions\/2608"}],"wp:attachment":[{"href":"https:\/\/wp.media.unc.edu\/studentpharmsaves\/wp-json\/wp\/v2\/media?parent=16"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}