Modified SAD PERSONS Scale
The score From the desk of David Mee-Lee
is calculated from ten yes/no questions, with points given for each affirmative answer as follows:
S: Male sex → 1
A: Age <19 or >45 years → 1
D: Depression or hopelessness → 2
P: Previous suicidal attempts or psychiatric care → 1
E: Excessive ethanol or drug use → 1
R: Rational thinking loss (psychotic or organic illness) → 2
S: Single, separated, widowed or divorced → 1
O: Organized or serious attempt → 2
N: No social support → 1
S: Stated future intent (determined to repeat or ambivalent) → 2
This score is then mapped onto a risk assessment scale as follows:
0-5: May be safe to discharge (depending upon circumstances)
6-8: Probably requires psychiatric consultation
>8: Probably requires hospital admission
2. Patterson; Dohn; Patterson (April 1983). Evaluation of suicidal patients: the SAD PERSONS scale. http://www.ncbi.nlm.nih.gov/pubmed/6867245
3. Oxford Handbook of Emergency Medicine. Third Edition. Page 609.
Daily Goals Checklist
(i) What needs to be done for the patient to be discharged from the ICU?
(ii) What is this patient’s greatest safety risk? How can we reduce that risk?
(iii) Pain management and sedation
(iv) Cardiac -volume status
(v) Pulmonary -ventilator (plateau pressure, elevate head of bed)
(vii) Infectious disease -cultures, antibiotic levels
(ix) Medications -can any be discontinued?
(x) Tests and procedures
(xi) Review scheduled labs and x-rays
(xiii) Communication with primary service
(xiv) Family communication
(xv) Can any catheters or tubes be removed?
(xvi) Is this patient receiving DVT or peptic ulcer prophylaxis?
(xvii) ICU, intensive care unit; DVT, deep venous thrombosis
Here’s what a Daily Goals Checklist might look like in a residential addiction treatment program:
Daily Goals Checklist
(i) What needs to be done for the client to be discharged from residential treatment?
(ii) What is this client’s greatest safety risk as regards relapse or continued substance use and recovery environment? How can we reduce that risk?
(iii) Physical health needs – now and for ongoing care
(iv) Emotional, behavioral, cognitive and mental health needs -now and ongoing care
(v) Readiness to change and stage of change issues – motivational service needs now and for ongoing care
(vi) Continuing care needs – treatment levels, referral and transition plan
(vii) Recovery environment needs – living place, significant others, school or job, transportation, finances, legal liaison
(viii) Medications -can any be discontinued?
(ix) Psychometric testing
(xi) Review any results of test or consultations
(xii) Communication with referral source
(xiii) Family communication
Experiment with other checklists focused on what your data shows are your greatest challenges e.g., no show rates, premature discharge clients, repetitive brief acute care stays.
TIPS and TOPICS from David Mee-Lee, M.D.
Volume 8, No. 7