Analysis

Synopsis:

 Relating to mental health care by enacting the Suicide Prevention, Response and Treatment Act, providing standards for treatments, providing guidelines for suicide risk assessments, requiring suicide prevention training for facilities, providing guidelines for treatment of at risk patients in emergency care, requiring suicide stabilization training for police officers , prescribing public safety answering point procedures, creating a suicide response coordinator ,providing for administration of the program by the Department of Health, and providing for penalties. 

Analysis:

 The Suicide Prevention, Response, and Treatment Act provides for a systemic response to suicide in New Mexico. The Act provides for identification, assessment, training, treatment guidelines, training for police, public safety answering point procedures, creating a suicide response coordinator for each county and administrative rule making and penalties for facility non-compliance for the Department of Health to implement.
Several definitions are noteworthy in the Act, to include: at-risk patient which means a patient who has attempted suicide or who has suicidal ideations, behaviors or tendencies as indicated by a formal suicide risk assessment. Department means the Department of Health, a person who is or may be suicidal, means a person who is experiencing a mental health crisis, or is experiencing or expressing suicidal ideations or tendencies or is undertaking or contemplating suicidal actions but who has not yet received a formal suicide risk assessment; suicide prevention counselor, means a licensed psychiatrist, licensed clinical psychologist, other licensed mental health professional or qualified crisis counselor who has specialized certification or has completed specialized training in the standardized assessment of suicide risk and suicide prevention counseling to at-risk patients; 
In addition, supportive contacts, means communications through postcards, letters, email messages, text messages, phone calls or the undertaking of home visits either by an at-risk patient's mental health care professional or suicide prevention counselor or by an outside organization coordinating with an at-risk patient's psychiatric facility or outpatient treatment facility; and. 
Also, warm hand-off, means a care transition that:(1) connects an at-risk patient with a new health care provider or interim contact, such as a crisis center worker or peer specialist, before the at-risk patient’s first appointment with the new health care provider.
Specific direction is provided for assessment of at-risk patients at a psychiatric or outpatient mental health facility at which the level of suicide risk is to be assessed. Adequate staffing of suicide councilors must be met, however care must be immediate to meet the patients needs. 
Psychiatric and outpatient treatment facilities shall establish policies and protocols to provide for the discharge and transition of at-risk patients from care, using warm hand-offs, rapid referrals and supportive contacts.
Prohibitions are included regarding release of a patient into a homeless situation or to a jail unless the patient is uncontrollable and is a significant threat to other and themselves or as provided under New Mexico law.
A section is devoted to the assessment of at-risk patients in which a suicide risk assessment is to be conducted: (1) immediately upon a patient's admission to a psychiatric facility or upon a patient's first clinical encounter with an outpatient treatment facility; (2) when there is reason for attending staff at a psychiatric facility or outpatient treatment facility to believe that a patient is developing new suicidal ideation, behaviors or tendencies; (3) within three days prior to the discharge of a non-suicidal patient from inpatient care.
The assessment will be conducted using standard tools, methodologies, and framework for such assessments. 
Another section focuses on care provided at an emergency department requiring the physician to assess and stabilize the at-risk patient and immediately route the patient to the proper facility for care. Other options for the emergency department is to refer the patient to programs and services through the use of warm hand-offs and supportive contacts as deemed by the suicide prevention counselor to be appropriate based on the results of the on-site suicide risk assessment.
Training for communicating with at-risk patient is required including treating the patient with dignity, and not causing trauma, refrain from testing if patient is in crises, and not behave in a manner that discriminates. Also, follow the psychiatric facility or outpatient mental health facilities policies and procedures. 
Reference is made to required insurance coverage for patients who are treated or in need of assessment. 
A specific section is devoted to law enforcement training which states: The New Mexico law enforcement academy, in coordination with the Department, shall provide or approve training for police officers that shall consist of two hours of in-service training on the appropriate response to emergencies that involve a person who is or may be suicidal.
Such instruction will include how to interact in a calm, gentle, and respectful manner, avoidance of force, verbal methods of communications, and practice role-playing. Instructors are to have forty hours in mental health crises intervention.
In another section the position of suicide response coordinators is created and a requirement that this position be appointed in each county of the state. 
Specifically, the Injury Prevention and Emergency Medical Services Bureau of the Public Health Division of the Department shall appoint a Suicide Prevention Response Coordinator in each county to dispatch suicide prevention counselors to emergency scenes involving a person who is or may be suicidal. A Suicide Prevention Response Coordinator appointed pursuant to this section shall compile and maintain a list of qualified suicide prevention counselors in the county in which the coordinator is located. The councilor may be summoned to the emergency scene to assist law enforcement, perform on site suicidal risk assessments, refer persons to programs, facilities or services and conduct warm hand-offs to appropriate persons. 
The Department shall identify and develop appropriate qualifications for the county positions. In addition, this legislation empowers the Department to promulgate rules and policies to implement the Act. Also, penalties are provided for non-compliance by facilities and programs, which range from five hundred dollars ($500) to twenty-five hundred dollars for continued violations. These are administrative penalties that apply to psychiatric and outpatient behavioral health facilities. Those entities who are cited are provided a right to a hearing.
This legislation is to go into effect on July, 1, 2021.

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