Background Concepts and Practice Texas State Health Services Grand Rounds April 2016 Mike Hogan PhD EDC 2016 All rights reserved Health Care Progress Measured by Death Rates National Action Alliance for Suicide Prevention ID: 799462
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Zero Suicide (Suicide Safe Care) in Healthcare:Background, Concepts and PracticeTexas State Health Services Grand RoundsApril 2016
Mike Hogan, Ph.D.
EDC ©2016. All rights reserved.
Slide2Health Care Progress Measured by Death Rates
Slide3National Action Alliance for Suicide PreventionLaunched Sept 2010
Slide4Action Alliance Clinical Care and Intervention Task Force
Access at:
www.zerosuicide.com
EDC ©2016. All rights reserved.
Slide5What Did We Learn About Suicide and Health Care Settings?Most suicide deaths are among people in care or recently seen in healthcareSuicide 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
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Slide6Suicide and Health Care Settings45% 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.
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Slide7Suicide in Mental Health SystemsOhio: 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.
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Slide8Patterns of Suicide in the “Mental Healthcare Neighborhood”Deaths in hospital are unacceptable, and rareTJC: 1089 sentinel events reported 2010-2014NYS: Most suicide deaths in public mental health care (almost 80%) were among community care clientsOf 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 units7
2
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
Slide9WITHOUT IMPROVED SUICIDE CARE, PEOPLE SLIP THROUGH GAPS
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Ask?
Act for Safety?
Treat
Suicidality?
Reduce Lethal Means?
Engagement and Support?
Slide10THE TOOLS OF ZERO SUICIDE FILL THE GAPS
Slide11THE TOOLS OF ZERO SUICIDE FILL THE GAPS
Slide12THE TOOLS OF ZERO SUICIDE FILL THE GAPS
Slide13THE TOOLS OF ZERO SUICIDE FILL THE GAPS
Slide14THE TOOLS OF ZERO SUICIDE FILL THE GAPS
Slide15THE TOOLS OF ZERO SUICIDE FILL THE GAPS
Slide16THE TOOLS OF ZERO SUICIDE FILL THE GAPS
Slide17THE TOOLS OF ZERO SUICIDE FILL THE GAPS
EDC ©2016. All rights reserved.
Slide18What Have We Learned About Suicide and Health Care Settings?Most suicide deaths are among people in care or recently seen in healthcareSuicide 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.
Slide19A Systematic Approach to Health Care Quality Improvement: Henry Ford Health System
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Slide20Zero 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)
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Slide212012 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.
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Slide22Joint 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.”
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Slide23Elements of Zero Suicide
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Slide24A Movement and a Mission
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Slide25Thank YouEDC ©2016. All rights reserved.