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Suicide prevention in community mental health: changing systems

Allison N. Ponce (Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA)
Rebecca Miller (Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA)
Milania D. Al-Jammaly (Amarillo VA Health Care System, Amarillo, Texas, USA)
Edwin F. Renaud (State of Connecticut Department of Mental Health and Addiction Services, Hartford and New Haven, Connecticut, USA)
Margaret A. Bailey (State of Connecticut Department of Mental Health and Addiction Services, Hartford and New Haven, Connecticut, USA)
Susan Devine (Yale University School of Nursing, New Haven, Connecticut, USA)
Lindsay Oberleitner (Western Connecticut State University, Danbury, Connecticut, USA)

Journal of Public Mental Health

ISSN: 1746-5729

Article publication date: 28 January 2020

Issue publication date: 7 December 2020

259

Abstract

Purpose

This paper aims to describe a performance improvement process related to suicide assessment in a community mental health center. As suicide rates rise in the USA, it is crucial that community mental health providers are capable and comfortable to assess for suicide risk among individuals with mental illness. Support for healthcare providers is emphasized in the quadruple aim model of enhancing healthcare delivery and patient experience. The quadruple aim model is applied in the present performance improvement project in a community mental health center.

Design/methodology/approach

An interprofessional team used provider survey responses, critical incident data and other stakeholder input to implement a new assessment mechanism and education plan to support direct care staff to address suicide risk.

Findings

Although the rate of patient death by suicide at the community mental health center is low, managing risk is a frequent provider concern. Providers’ comfort assessing and managing suicide risk varied widely based on survey responses. A structured suicide assessment process was implemented to offer clarity and direction for providers. Education to address assessment and management was designed and implemented.

Research limitations/implications

Suicide data were retrospective and limited to known deaths, thus there may have been higher numbers of deaths by suicide historically. Providers’ comfort with suicide risk management was based on self-report and future work should also integrate skills-based assessment.

Originality/value

Improving the provider experience in mental health care must be explored. Focusing on provider input and voice in suicide-related efforts in community settings is a step toward integrating the quadruple aim ideals into mental health care.

Keywords

Acknowledgements

This work was funded in part by the State of Connecticut, Department of Mental Health and Addiction Services, but this publication does not express the views of the Department of Mental Health and Addiction Services or the State of Connecticut. The views and opinions expressed are those of the authors.

Citation

Ponce, A.N., Miller, R., Al-Jammaly, M.D., Renaud, E.F., Bailey, M.A., Devine, S. and Oberleitner, L. (2020), "Suicide prevention in community mental health: changing systems", Journal of Public Mental Health, Vol. 19 No. 4, pp. 359-366. https://doi.org/10.1108/JPMH-06-2019-0062

Publisher

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Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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