Suicide prevention in community mental health: changing systems

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.