Abstract
As deaths from suicide continue to rise, identifying and improving care for suicidal patients are emerging as a healthcare priority. Authoritative voices including the Surgeon General and The Joint Commission have called for action. Data showing that a majority of individuals who die from suicide were engaged and seen in healthcare settings shortly before they died reinforce the need for action. Finally, there is now persuasive evidence about effective methods to identify and intervene with individuals who are suicidal.
This chapter addresses this issue, framing suicide prevention as a healthcare responsibility and summarizing the new, evidence-based approaches that contribute to “suicide safe care.” The systematic approach to care labeled “Zero Suicide” is an amalgam of these evidence-based approaches and is proposed as a core strategy to reverse the rising tide of deaths. Elements of the model and resources for healthcare organizations are described.
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Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS): welcome to WISQARS. http://www.cdc.gov/injury/wisqars/index.html.
Centers for Disease Control and Prevention. WISQARS: fatal injury reports. http://www.cdc.gov/injury/wisqars/fatal_injury_reports.html.
Schmitz WM, Allen MH, Feldman BN, Gutin NJ, Jahn DR, Kleespies PM, et al. Preventing suicide through improved training in suicide risk assessment and care: an American Association of Suicidology Task Force report addressing serious gaps in U.S. mental health training. Suicide Life Threat Behav. 2012;42(3):292–304.
U.S. Department of Health and Human Services. National Strategy for Suicide Prevention: goals and objectives for action. http://www.sprc.org/library/nssp.pdf.
U.S. Surgeon General, National Action Alliance for Suicide Prevention. National Strategy for Suicide Prevention: goals and objectives for action, 2012. http://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention/index.html.
The Joint Commission. Sentinel Event Alert, Issue 56: Detecting and treating suicide ideation in all settings. http://www.jointcommission.org/assets/1/18/SEA_56_Suicide.pdf.
Commission on Accreditation of Rehabilitation Facilities (CARF International). Quality practice notice—September 2016. Suicide prevention in CARF-accredited organizations: advancing clinical and workforce preparedness. http://www.carf.org/QPN_SuicidePrevention/.
Knox KL, Litts DA, Talcott GW, Feig JC, Caine ED. Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: cohort study. BMJ. 2003;327(7428):1376–80. https://doi.org/10.1136/bmj.327.7428.1376.
Walrath C, Garraza L, Reid H, Goldston D, McKeon R. Impact of the Garrett Lee Smith Youth Suicide Prevention Program on suicide mortality. Am J Public Health. 2015;105(5):986–93.
Ahmedani B, Simon G, Stewart C, Beck A, Waitzfelder B, Rossom R, et al. Health care contacts in the year before suicide death. J Gen Intern Med. 2014;29(6):870–7.
Boschert S. New strategies target suicidality in EDs. Irving, TX: American College of Emergency Physicians; 2009. https://www.acep.org/Clinical---Practice-Management/New-Strategies-Target-Suicidality-in-EDs/.
Simon G, Rutter C, Peterson D, Oliver M, Whiteside U, Operskalski B, et al. Does response on the PHQ-9 Depression Questionnaire predict subsequent suicide attempt or suicide death? Psychiatr Serv. 2013;64(12):1195–202. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086215/pdf/nihms598768.pdf.
Suicide Prevention Resource Center. Surveillance success stories: Kentucky. Waltham, MA: Education Development Center; 2015. http://www.sprc.org/library_resources/items/surveillance-success-stories-kentucky.
Suicide Prevention Resource Center. Surveillance success stories: Vermont. Waltham, MA: Education Development Center; 2015. http://www.sprc.org/sites/sprc.org/files/library/SPRC_Vermont_compliant.pdf.
Hiance-Steelesmith DL, Fontanella CA, Sweeney HA, Campo JV. Behavioral health service use among suicide decedents in the public behavioral health system. Poster session presented at: 48th Annual Conference of the American Association of Suicidology; 2015 Apr 15–18; Atlanta, GA.
Bertolote JM, Fleischmann A. Suicide and psychiatric diagnosis: a worldwide perspective. World Psychiatry. 2002;1(3):181–5.
Bickley H, Hunt I, Windfuhr K, Shaw J, Appleby L, Kapur N. Suicide within two weeks of discharge from psychiatric inpatient care: a case-control study. Psychiatr Serv. 2013;64(7):653–9.
Siegfried N, Bartlett M. Navigating suicide assessment: a roadmap for providers. Plenary presented at: The Joint Commission’s 2014 Annual Behavioral Health Care Conference; 2014 Oct 15–16; Rosemont, IL.
Valenstein M, Kim HM, Ganoczy D, McCarthy JF, Zivin K, Austin KL, et al. Higher-risk periods for suicide among VA patients receiving depression treatment: prioritizing suicide prevention efforts. J Affect Disord. 2009;112(1):50–8.
Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press; 2001.
Coffey CE. Building a system of perfect depression care in behavioral health. Jt Comm J Qual Patient Saf. 2007;33(4):193–9.
Stone D, Crosby A. Suicide prevention: state of the art review. Am J Lifestyle Med. 2014;8(6):404–20.
Coffey MJ, Coffey CE, Ahmedani BK. Suicide in a health maintenance organization population. JAMA Psychiatry. 2015;72(3):294–6.
Gould MS, Munfakh JL, Kleinman M, Lake AM. National suicide prevention lifeline: enhancing mental health care for suicidal individuals and other people in crisis. Suicide Life Threat Behav. 2012;42(1):22–35.
National Action Alliance for Suicide Prevention: Clinical Care & Intervention Task Force. Suicide care in systems framework. Washington, DC: The Alliance; 2012. http://actionallianceforsuicideprevention.org/sites/actionallianceforsuicideprevention.org/files/taskforces/ClinicalCareInterventionReport.pdf.
Assessment and Management of Risk for Suicide Working Group. VA/DoD clinical practice guideline for assessment and management of patients at risk for suicide. Washington, DC: Department of Veterans Affairs, Department of Defense; 2013. http://www.healthquality.va.gov/guidelines/MH/srb/VADODCP_SuicideRisk_Full.pdf.
Posner K, Brown G, Stanley B, Brent D, Yershova K, Oquendo M, et al. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168(12):1266–77.
Stanley B, Brown G. Safety planning intervention: a brief intervention to mitigate suicide risk. Cogn Behav Pract. 2012;19(2):256–64.
Edwards SJ, Sachmann MD. No-suicide contracts, no-suicide agreements, and no-suicide assurances: a study of their nature, utilization, perceived effectiveness, and potential to cause harm. Crisis. 2010;31(6):290–302.
Jacobs DG, Baldessarini RJ, Conwell Y, Fawcett JA, Horton L, Meltzer H, et al. Assessment and treatment of patients with suicidal behaviors. APA Practice Guidelines. 2010. http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/suicide.pdf.
Coffey, E. Personal communication. 2013 Sept 16.
Gloaguen V, Cottraux J, Cucherat M, Blackburn IM. A meta-analysis of the effects of cognitive therapy in depressed patients. J Affect Disord. 1998;49(1):59–72.
Churchill R, Hunot V, Corney R, Knapp M, McGuire H, Tylee A, et al. A systematic review of controlled trials of the effectiveness and cost-effectiveness of brief psychological treatments for depression. Health Technol Assess. 2002;5(35):1–73.
Stewart RE, Chambless DL. Cognitive–behavioral therapy for adult anxiety disorders in clinical practice: a meta-analysis of effectiveness studies. J Consult Clin Psychol. 2009;77(4):595–606.
Brown G, Ten Have T, Henriques G, Xie S, Hollander J, Beck A. Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial. JAMA. 2005;294(5):563–70.
Stanley B, Brown G, Brent D, Wells K, Poling K, Curry J, et al. Cognitive-Behavioral Therapy for Suicide Prevention (CBT-SP): treatment model, feasibility, and acceptability. J Am Acad Child Adolesc Psychiatry. 2009;48(10):1005–13.
Linehan M, Comtois K, Murray A, Brown M, Gallop R, Heard H, et al. Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry. 2006;63(7):757–66.
Comtois KA, Jobes DA, O’Connor SS, Atkins DC, Janis K, Chessen CE, et al. Collaborative assessment and management of suicidality (CAMS): feasibility trial for next-day appointment services. Depress Anxiety. 2011;28(11):963–72.
Knesper DJ, American Association of Suicidology, Suicide Prevention Resource Center. Continuity of care for suicide prevention and research: suicide attempts and suicide deaths subsequent to discharge from an emergency department or an inpatient psychiatry unit. Education Development Center: Newton, MA; 2010. http://www.sprc.org/library_resources/items/continuity-care-suicide-prevention-and-research.
Luxton D, June J, Comtois K. Can postdischarge follow-up contacts prevent suicide and suicidal behavior? Crisis. 2013;34(1):32–41.
Group Health. 2015 HEDIS and CAHPS measures and performance. Group Health Cooperative: Seattle; 2016. https://www1.ghc.org/static/pdf/public/about/hedis.pdf.
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Hogan, M.F. (2018). Suicide Prevention: A Primer for Healthcare Professionals. In: Falcone, T., Timmons-Mitchell, J. (eds) Suicide Prevention. Springer, Cham. https://doi.org/10.1007/978-3-319-74391-2_11
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DOI: https://doi.org/10.1007/978-3-319-74391-2_11
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