The NIMH -funded study used universal detection, risk assessment and security planning to reduce suicide attempts among adult primary care patients
• Outstanding research
Suicide is a main cause of death in the United States and a great public health concern. Previous investigations have shown that identifying and helping people at risk of suicide during regular care visits can help prevent it. Primary Care Clinics are particularly important in this regard, since research has shown more 40% of people who died from suicide They were seen in this environment in the month before his death.
A recent study funded by the National Mental Health Institute (NIMH) found that when Primary Care Clinics added suicide care practices to routine visits, suicide attempts fell 25% in the 3 months after the visit. The findings stand out how impressive it can be for primary care clinics assume an active role in suicide prevention and help empower health systems to integrate these practices into clinical care.
What did the researchers do in the study?
Primary care doctors stop for depression during most care visits, and depression evaluators often include questions about suicide risk. Previous Research backed by NIMH He discovered that the detection of suicidal thoughts and behaviors followed by a brief security planning can reduce the risk of suicide attempts.
Researchers led by Julie Angerhofer Richards, Ph.D., MPH In the Kaiser Permanent Washington Health Research Institute, it aimed to see if the integration of suicidal care in primary care visits for routine adults could prevent subsequent suicide attempts.
This study analyzed the secondary data of a broader integrated study of the NATIONAL ZERO SUICIDE MODEL . The comprehensive suicide zero approach is the first American program linked to a substantial decrease in suicides among patients with behavioral health. The research team previously examined this model in a Study funded by separate NIMH in six health systems in the United States.
Before the intervention, suppliers provided attention as usual, which did not include the detection or monitoring of suicides based on the population. The 22 participating clinics were randomly assigned to start providing suicide care on staggered dates (4 months of difference) for a period of 2 years. During the study, 333,593 patients were observed for more than 1.5 million primary care visits.
Suicide care consisted of:
- Depression detection: All patients completed a brief depression screen of two questions, followed by a longest depression symptoms for those who obtained positive in any issue.
- Depression symptoms: The screen was followed by a longest depression symptoms for patients who obtained positive in any question.
- Suicide risk assessment: Patients with self -harm or suicide thoughts completed a measure of suicidal thoughts and behaviors.
- Suicide security planning: Patients who reported intention or suicide plans in the last month were referred to designated care personnel, including social health workers, for suicide security planning on the same day. Security planning was a process of collaboration between patients and suppliers that involved identifying warning signs, enumerating strategies and coping support, and creating safe environments to administer a suicidal crisis.
Three key strategies supported the intervention:
- The qualified facilitators led training in each clinic and met with the staff continuously to offer support and solve problems.
- Support for the clinical decision, including reminders prior to the visit and visits indications, came from the electronic medical record system of the clinics.
- Regular monitoring of the performance of the medical records reported on medical evaluation and evaluation rates.
The researchers compared clinics who provided suicidal attention to clinics who provide habitual attention in:
- Documentation providers rates for suicide risk assessment and security planning in the medical registry within 2 weeks after a patient’s primary care visit at risk
- Suicide attempts or death attempts for suicide in the 90 days after their primary care visit
What showed the results of the study?
The integration of suicide into adult routine primary care visits led to significantly higher risk detection, evaluation and collaborative security planning. The intervention in turn resulted in a 25% decrease in suicide attempts in the 90 days after a primary care visit compared to the usual care clinics. Together, the results show that the integration of suicide prevention practices in adult primary care leads to more people being examined by suicidal thoughts and behaviors and less suicide attempts once they leave the clinic.
These findings are compatible NIMH prioritization of suicide prevention in medical care environments with the ultimate goal of reducing the suicide rate in the United States. The study provides the next critical steps for suppliers and care teams to respond to suicidal concerns during clinical practice, helping to save lives in the process.
Reference
Richards, Ja, Cruz, M., Stewart, C., Lee, AK, Ryan, TC, Ahmedani, BK and Simon, GE (2024). Effectiveness of the integration of suicidal care in primary care: secondary analysis of a randomized implementation of grocery cluster. Internal Medicine Annals, 177(11), 1471–1482. https://doi.org/10.7326/m24-0024
Funds
If you or someone you know you are fighting or has suicidal thoughts, call or send a text message to 988 suicide and crisis crisis to 988 or chat in 988lifeline.org . In situations that threaten life, call 911.
For more information on suicide prevention, see:
Discharge of responsibility
The Zero suicide framework was developed at the Education Development Center (EDC) through the Federally Federally founded Suicide Prevention Resources Center and the National Action Alliance for Suicide Prevention. The information and the zero suicide brand are available for free in suicide zero Tool kitYE managed by EDC. No official support by EDC is not intended or inferred.
