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Slide1

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.

Slide2

Health Care Progress Measured by Death Rates

Slide3

National Action Alliance for Suicide PreventionLaunched Sept 2010

Slide4

Action Alliance Clinical Care and Intervention Task Force

Access at:

www.zerosuicide.com

EDC ©2016. All rights reserved.

Slide5

What 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

EDC ©2016. All rights reserved.

Slide6

Suicide 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.

EDC ©2016. All rights reserved.

Slide7

Suicide 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.

EDC ©2016. All rights reserved.

Slide8

Patterns 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

Slide9

WITHOUT IMPROVED SUICIDE CARE, PEOPLE SLIP THROUGH GAPS

EDC ©2016. All rights reserved.

Ask?

Act for Safety?

Treat

Suicidality?

Reduce Lethal Means?

Engagement and Support?

Slide10

THE TOOLS OF ZERO SUICIDE FILL THE GAPS

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THE TOOLS OF ZERO SUICIDE FILL THE GAPS

Slide12

THE TOOLS OF ZERO SUICIDE FILL THE GAPS

Slide13

THE TOOLS OF ZERO SUICIDE FILL THE GAPS

Slide14

THE TOOLS OF ZERO SUICIDE FILL THE GAPS

Slide15

THE TOOLS OF ZERO SUICIDE FILL THE GAPS

Slide16

THE TOOLS OF ZERO SUICIDE FILL THE GAPS

Slide17

THE TOOLS OF ZERO SUICIDE FILL THE GAPS

EDC ©2016. All rights reserved.

Slide18

What 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.

Slide19

A Systematic Approach to Health Care Quality Improvement: Henry Ford Health System

EDC ©2016. All rights reserved.

Slide20

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.

Slide21

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.

Slide22

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.

Slide23

Elements of Zero Suicide

EDC ©2016. All rights reserved.

Slide24

A Movement and a Mission

EDC ©2016. All rights reserved.

Slide25

Thank YouEDC ©2016. All rights reserved.

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Zero Suicide (Suicide Safe Care) in Healthcare: - Description

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 Download

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