PRACTICE PARTNER
Defence. These concerns and recommenda-
tions include: while under a "suicide watch" overseen by
military personnel.
CONCERN: Clinical documentation of the
patient’s history was significantly lacking in
the records provided for review. • Guidelines for suicide watch and post-dis-
charge care plans should include frequency
and means of monitoring, follow-up ar-
rangements, and available social supports.
Planning should be clearly communicated
between the necessary military personnel and
health-care practitioners
CONCERN: Upon presentation to the emer-
gency department with reported suicidal-
ity, the treating physician did not appear to
consult with psychiatry.
• Health-care practitioners should consider
consultation with a psychiatrist, either in
person or by telephone/other means (e.g.
Ontario Telemedicine Network), for a re-
ported first suicidal concern. If consultation
is not feasible, the attending physician should
conduct and document a robust mental
health assessment
CONCERN: There did not appear to be a post-
discharge care plan for the patient as he was
able to purchase a firearm and ammunition
50
DIALOGUE ISSUE 3, 2019
• Suicide watch guidelines implemented by the
Canadian military should be clarified, docu-
mented and shared with hospitals in order
to assist with assessment, discharge planning
and monitoring of patients.
• In a recommendation addressed to the
CPSO, the Ontario Medical Association and
the Canadian Medical Protective Agency,
the Committee stated that when a patient is
determined to be at risk to themselves and/
or others and in possession of a firearm and
a Possession and Acquisition License (PAL),
the physician should be required to im-
mediately notify local law enforcement and
request the seizure of the firearms, as well as
the PAL so that the patient would be unable
to legally purchase another firearm.
MD
• Health-care practitioners are to be reminded
to document all relevant history (e.g. psy-
chosocial, related stressors, etc.), including
attempts to obtain collateral history, when as-
sessing individuals with potential suicidality.