Managing High Risk Rural Populations with Suicidal Ideation and Controlling Related Malpractice Risk. 
Julie Rickard, PhD, Director for Provider/Staff Relations and Integrated Behavioral Services at Confluence Health in Wenatchee, WA.

Suicide is a preventable cause of death, and training for mental health clinicians in suicide assessment and treatment is proving invaluable.  Rural populations are at highest risk for completed suicides and often present to the wrong door for help.  This training works to improve clinicians’ ability to manage these very difficult patients and to instill hope.  The assessment and treatment of these rural patients is improved through skill building and the art of a skilled interview.  Clinicians will gain a sense of mastery over risk stratification to assist with setting up next steps.  When things go wrong with management of these patients, it can ruin a career.  Part of the focus will be on protecting clinicians from practice errors that lead to legal issues when managing the highest risk rural patient by reviewing malpractice issues.  Lastly, statistics will highlight areas of the country and populations at greater risk.

Learning Objectives

1.  Describe how rural patients may differ from urban populations in initial assessment and presentation for suicidality.
2.  Identify how to determine level of risk and set up risk-matched next steps for referral and treatment.
3.  Identify malpractice issues related to suicide management in rural high risk populations.

Julie Rickard, a licensed psychologist, earned her Ph.D. in Counseling Psychology at Washington State University, Pullman, WA.  She is currently the Director for Provider/Staff Relations and Integrated Behavioral Services at Confluence Health in Wenatchee, WA.  In her current role she focuses on Physician & Healthcare Leadership Coaching as well as the integration of psychologists and mental health providers at all levels of the organization.  She is well known throughout the Northwest for the Integrated Model within a Primary Care setting, coaching physicians, and is a highly sought after speaker on a variety of topics.  Dr. Rickard founded the Suicide Prevention Coalition of North Central Washington in 2012, following multiple local tragedies.  The coalition has been successful at reducing the local suicide rate and raising awareness and skill level for clinicians managing these ongoing patients.  She is also faculty at the QPR Institute, where she travels extensively, teaching a variety of professionals on suicide prevention assessment and treatment.