Suicide rates have increased by 33% between 1993 and 2017. It is the tenth leading cause of death in the United States, and the second leading cause of death among Americans aged 15 and 34. For every person who takes their own life, there are 30 suicide attempts (see American Foundation for Suicide Prevention).
These are stark statistics that paint a complicated picture of a fragmented system. During The 2019 OPEN MINDS Strategy & Innovation Institute, Carol Clayton, Ph.D., Translational Neuroscientist and Christopher Reist, M.D., MBA, Chief Population Health Strategy for Relias discussed the key issues driving some of these statistics and offered some potential solutions in the session, Beyond Suicide Risk Assessment: Adopting A Comprehensive Solution To Rising Suicide Rates.
We do know that there are risk factors commonly associated with suicide—and screening tools that can help provider organizations and clinical professionals prevent suicide. One huge challenge with assessment tools is that assessment protocols are not standard across organizations and not practiced consistently across providers. The session reviewed two models for identifying those consumers using data to predict risk instead of relying only on assessments—the Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH VET), and the Mental Health Research Network (MHRN) Suicide Risk Calculator Project. Common to both programs are components that ensure a review of treatment and an intervention if indicated for those individuals most at risk, and studies are under way to determine if these approaches reduce suicide attempts or deaths.
In 2017, the Department of Veterans Affairs’ (VA) launched (REACH VET)—the model analyzes data from veterans’ health records to identify individuals with an elevated risk for suicide, hospitalization, or illness (see VA REACH VET Initiative Helps Save Veterans Lives: Program Signals When More Help Is Needed for At-risk Veterans). Over 100 variables have been identified, including demographics, prior suicide attempts, diagnoses, VHA utilization, medications, and interactions.
In 2018, the Mental Health Research Network and Kaiser Permanente conducted the Mental Health Research Network (MHRN) Suicide Risk Calculator Project, which combined data from electronic health records (EHR) with results from standardized depression questionnaires to predict suicide risk in the 90 days following either a mental health care visit, or a primary care outpatient visit (see Suicide Prevention: Research Network Finds New Way To Predict Risk). The study was conducted in seven health systems (HealthPartners, Henry Ford, KP Colorado, KP Hawaii, KP Northwest, KP Southern California, KP Washington) using information from eight million members, and identified 150 predictors. These predictors included demographics, mental health and substance use diagnoses, mental health inpatient and emergency department utilization, psychiatric medication dispensing, co-occurring medical conditions, and PHQ8 and item 9 scores.
But while we have the information needed to identify those consumers most at risk for suicide and effective screening tools, those assessments don’t
For health and human service executives, there is a lot to take in when assessing suicide assessment capabilities. Do you have a screening protocol in place? Do you have data analytics tools to recognize risk factors and build a population health management strategy? Do you understand how to build, find, and/or adopt evidence-based practices for treating consumers with suicide ideation? Answering these strategic questions is essential to building a comprehensive suicide prevention program within your organization and across the market.
For more on bringing standardized decision support models to your organization, check out these resources in the OPEN MINDS Circle Library:
- The ‘Best Practice’ Challenge
- Your Organization Is Ready For VBR When.
- Technology As A Workforce Solution
- Challenges In Changing To A Culture Of Value (Or Making Any Culture Change)
- The Moving Target-Best Practices In ‘Complex’ Care Management
- Mapping Performance To Manage Value: The Clinical Data You Need To Manage The Risk Of Value-Based Reimbursement
- Building A Workforce For Value-Based Reimbursement = Advice From Four Executives
- Clinical & Patient Decision Support Software; Draft Guidance For Industry & FDA Staff
- ‘Virtual Psychiatrist’ Telemedicine Decision Support System Effective In Diagnosing Mental Disorders
- Preparing For Your ‘Augmented’ Workforce
And for more on leveraging your data, join OPEN MINDS Senior Associate Deb Adler on August 12 for her seminar, How To Build Value-Based Payer Partnerships: An OPEN MINDS Executive Seminar On Best Practices In Marketing, Negotiating, & Contracting With Health Plans.
If you or someone you know are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741.