One response to “RTN1604_B3_SEA56 – Detecting and Treating Suicide”

1. For state psychiatric hospitals, the risk of a patient committing suicide is ever present. Preventing a patient from committing suicide is part of our mission as the provider of the most intensive form of inpatient psychiatric treatment. Generally speaking patients admitted into a state psychiatric hospital are in an acute crisis or suffer from the effects of a sever and persistent Mental illness. Most have exhausted other resources and/or have been unsuccessful in other treatment settings. This TJC article reminds all BH providers (not just state psychiatric hospitals) that the risk of suicide, despite our collective best efforts, is rising.

   The focus of the article brings the reader back to the assessment of suicidal thoughts or suicidal ideation, in part because TJC analysis of root cause data has identified shortcomings in this area. But in addition to the focus on assessment, they have given the field more information on “at risk groups” (military vets, and men over 45) and “Care Transitions” following inpatient or ER discharge (especially within one week post discharge when the rate is reportedly 200% higher). This moves us away from just the focus on assessment skills and into the broader functions of continuum of care and collaboration with future providers to successfully transition a patient safely back home.

   As BH providers we are likely familiar with the 8 risk factors listed on page 2. Emergency Departments, Primary care and other Community providers may not have the same familiarity because they are not exposed to the risk of suicide continually. However, the article then additionally provides a recommended action step which asks us to develop “Clinical Environment Readiness” by identifying, developing and integrating, BH care, Primary and community resources to assure the continuity of care that at risk patients so desperately need.

   This directly attacks the transition in care issue and seeks to surround the patient with all the resources available within the continuum. This major effort will require clinical and administrative leadership from these multiple areas to pool resources around these at risk individuals.

   The next recommended step is a standardized approach to detecting SI using an 8 step process (also on page 2) beginning with a review of the patient and family’s history using the 8 risk factors, use of standardized screening tools Referenced in the article, reviewing the results of the data before the patient leaves, taking action and collaborating with all others involved in the transition.

   The last 3 recommendations include developing DC plans and Tx plans specifically targeting suicide, educating all staff about the SI risk factors and documenting all of your efforts.

   This challenge to improve transition of care and detection of suicide thoughts is one that every healthcare organization leaders must consider if not for TJC compliance purpose under a sentinel event alert, then for the benefit of patients within their community, struggling with the risk of suicide.

   TJC surveyors will ask the agency leadership if they have reviewed this sentinel event alert issue #56 and what steps they plan to take as a result.

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