Questions:

1. Why are optimized or 'no problem' questions problematic when asking about suicidal ideation?
2. What are five biopsychosocial risk factors for suicide?
3. What are four tasks that administrators can assign clinical supervisors in making sure that the tasks involved in extending care beyond the immediate actions are carried out?
4. What are nine suicidal risks that are specific to veterans?
5. What is a three-part response that is recommended for clinicians to use with patients who are extremely irritable?

Answers:

A. Exposure to extreme stress; Physical/sexual assault while in the service (not limited to women); Service-related injury; Traumatic Brain Injury (TBI); PTSD; Lower rank or recent demotion; Access to/familiarity with firearms; Times of transition are particularly at risk; LGBT status.
B. Alcohol and other substance use disorders; Hopelessness; History of trauma or abuse; Previous suicide attempt; Family history of suicide.
C. 1) Reflective listening; 2) Gentle interpretation; and 3) A statement of commitment to keep working with and through the irritability.
D. They minimize the disclosure of suicidal ideation, a tension also described in other medical settings.
E. Following up on referrals; Case management as required, monitoring that clients are following a treatment plan established by the counselor and the clinical supervisors or by the treatment team; Checking in with the client and significant others (if warranted) to ensure that care is progressing; Continued observation and monitoring for suicidal thoughts and behaviors that may re-emerge after the initial crisis has passed.