191 (191)    MH REPORT (601.93)

|Suicide-Related Coping Scale (SRCS)
|   Gender: <.Patient_Gender.>
|  
|   SRCS Total Score = <-SRCS Total->
|    Internal Coping = <-External Coping->
|    External Coping = <-Internal Coping->
|  
|  
|Questions and Answers:
|  
|   1.  I have contact information for at least one health care professional
|  
|       (such as doctor or therapist) whom I can call during a suicidal 
|       crisis.
|       <*Answer_8614*>
|   2.  I cannot do anything to control my suicidal thoughts.
|       <*Answer_8615*>
|   3.  I know which friends and/or family members to contact to help take
|       my mind off my suicidal feelings.
|       <*Answer_8616*>
|   4.  I know the nearest hospital or urgent care facility where I can go
|       if I cannot handle my suicidal feelings.
|   Date Given: <.Date_Given.>
|       <*Answer_8617*>
|   5.  When I feel suicidal, there are places I can go (such as a coffee
|       shop, the gym, place of worship, or shopping mall) to help me take
|       my mind off my problems.
|       <*Answer_8618*>
|   6.  I have several things I can do to get through a suicidal crisis.
|       <*Answer_8619*>
|   7.  I am able to confide in someone, such as a friend, family member,
|       supervisor, or spiritual advisor when I am experiencing a crisis.
|       <*Answer_8620*>
|   Clinician: <.Staff_Ordered_By.>
|   8.  Seeking help from health care professionals is a good way to keep
|       myself safe when I am feeling suicidal.
|       <*Answer_8621*>
|   9.  I know it is important to limit access to weapons or other ways to
|       hurt myself when I am feeling suicidal.
|       <*Answer_8622*>
|  10.  Even if I am alone, there are things I can do to take mind off my
|       suicidal feelings and thoughts for at least a while.
|       <*Answer_8623*>
|  11.  I do not think there is anything that I can do to help myself when
|   Location:  <.Location.>
|       I am feeling suicidal.
|       <*Answer_8624*>
|  12.  It is useless to talk to anyone about my suicidal thoughts.
|       <*Answer_8625*>
|  13.  When I am suicidal, I know of things to do by myself that help me
|       feel less suicidal.
|       <*Answer_8626*>
|  14.  I can distract myself by doing other things or thinking about other
|       things when I am feeling suicidal.
|       <*Answer_8627*>
|  
|  15.  If one way of trying to cope with suicidal feelings does not work,
|       I have other ways to try.
|       <*Answer_8628*>
|  16.  I am at the mercy of my suicidal thoughts.
|       <*Answer_8629*>
|  17.  I feel that I have no one to turn to when I am feeling suicidal.
|       <*Answer_8630*>
|  
|Information contained in this note is based on a self-report assessment 
|and is not sufficient to use alone for diagnostic purposes. Assessment 
|   Veteran:  <.Patient_Name_Last_First.>
|results should be verified for accuracy and used in conjunction with 
|other diagnostic activities.
|   SSN: <.Patient_SSN.>
|   DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)