Zero Suicide Suicide Safe Care in Healthcare Background
Zero Suicide (Suicide Safe Care) in Healthcare: Background, Concepts and Practice Texas State Health Services Grand Rounds April 2016 Mike Hogan, Ph. D. EDC © 2016. All rights reserved.
Health Care Progress Measured by Death Rates
National Action Alliance for Suicide Prevention Launched Sept 2010
Action Alliance Clinical Care and Intervention Task Force Access at: www. zerosuicide. com EDC © 2016. All rights reserved.
What Did We Learn About Suicide and Health Care Settings? • Most suicide deaths are among people in care or recently seen in healthcare – Suicide prevention must become a core responsibility of health care organizations and systems • We have new knowledge about detecting and treating suicidality. Very little of it is commonly used. – The gap between what we know and what we do can be fatal. We must apply new knowledge • Preventing suicide deaths in health care requires a systematic clinical approach, not “the heroic efforts of crisis staff and individual clinicians. ” – We have work to do EDC © 2016. All rights reserved.
Suicide and Health Care Settings • 45% of people who died by suicide had contact with primary care providers in the month before death. Among older adults, it’s 78%. • 19% of people who died by suicide had contact with mental health services in the month before death. • South Carolina: 10% of people who died by suicide were seen in an emergency department in the two months before death. EDC © 2016. All rights reserved.
Suicide in Mental Health Systems • Ohio: Between 2007 -2011, 20. 2% of people who died from suicide were seen in the public behavioral health system within 2 years of death. • New York: In 2012 there were 226 reported suicide deaths among consumers of public mental health services, accounting for 13% of all suicide deaths in the state. • Vermont: In 2013, 20. 4% of the people who died from suicide had at least one service from state-funded mental health or substance abuse treatment agencies within 1 year of death. EDC © 2016. All rights reserved.
Patterns of Suicide in the “Mental Healthcare Neighborhood” • Deaths in hospital are unacceptable, and rare – TJC: 1089 sentinel events reported 2010 -2014 – NYS: Most suicide deaths in public mental health care (almost 80%) were among community care clients • Of 17% classified as inpatient related, vast majority (85%) were within 30 days of discharge. • Within 72 hours post-discharge: 2 times as many suicide deaths as on inpatient units • 72 hours-30 days post-discharge: almost 4 times as many deaths as on inpatient units • Improvements are needed in inpatient care (assessment, communication, treatment, transition) but the big challenges are in the community
WITHOUT IMPROVED SUICIDE CARE, PEOPLE SLIP THROUGH GAPS Act for Safety? Reduce Lethal Means? Treat Suicidality? Ask? EDC © 2016. All rights reserved. Engagement and Support?
THE TOOLS OF ZERO SUICIDE FILL THE GAPS
THE TOOLS OF ZERO SUICIDE FILL THE GAPS
THE TOOLS OF ZERO SUICIDE FILL THE GAPS
THE TOOLS OF ZERO SUICIDE FILL THE GAPS
THE TOOLS OF ZERO SUICIDE FILL THE GAPS
THE TOOLS OF ZERO SUICIDE FILL THE GAPS
THE TOOLS OF ZERO SUICIDE FILL THE GAPS
THE TOOLS OF ZERO SUICIDE FILL THE GAPS EDC © 2016. All rights reserved.
What Have We Learned About Suicide and Health Care Settings? • Most suicide deaths are among people in care or recently seen in healthcare – Suicide prevention must become a core responsibility of health care organizations and systems • We have new knowledge about detecting and treating suicidality. Very little is commonly used. – The gap between what we know and what we do can be fatal. We must apply new knowledge • Preventing suicide deaths in health care requires a systematic clinical approach, not “the heroic efforts of crisis staff and individual clinicians. ” EDC © 2016. All rights reserved.
A Systematic Approach to Health Care Quality Improvement: Henry Ford Health System EDC © 2016. All rights reserved.
Zero Suicide is… • A focus on error reduction and safety in health care. • A framework for systematic, clinical suicide prevention in behavioral health and health care systems. • A set of best practices and tools including www. zerosuicide. com. • Embedded in the National Strategy for Suicide Prevention and Joint Commission Sentinel Event Alert #56. • A BHAG (Big, Hairy, Audacious Goal) EDC © 2016. All rights reserved.
2012 National Strategy for Suicide Prevention: GOALS AND OBJECTIVES FOR ACTION A report of the U. S. Surgeon General and of the National Action Alliance for Suicide Prevention GOAL 8: Promote suicide prevention as a core component of health care services. GOAL 9: Promote and implement effective clinical and professional practices for assessing and treating those at risk for suicidal behaviors. EDC © 2016. All rights reserved.
Joint Commission Sentinel Event Alert 56: Detecting and Treating Suicide Ideation in All Settings “The suggested actions in this alert cover suicide ideation detection, as well as the screening, risk assessment, safety, treatment, discharge, and follow-up care of at-risk individuals. Also included are suggested actions for educating all staff about suicide risk, keeping health care environments safe for individuals at risk for suicide, and documenting their care. ” EDC © 2016. All rights reserved.
Elements of Zero Suicide EDC © 2016. All rights reserved.
A Movement and a Mission EDC © 2016. All rights reserved.
Thank You EDC © 2016. All rights reserved.
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