In the aftermath of a horrific event like a suicide, we all ask the same question: What could we have done to prevent it?
Yet for some, that is the wrong question. For researchers at Kaiser Permanente, what we should be asking is how we can better predict suicide risk.
In one of the largest studies to date – involving seven large health systems serving a combined population of 8 million people in nine states, and examining almost 20 million visits by nearly 3 million people age 13 or older, including about 10.3 million mental health specialty visits and about 9.7 million primary care visits with mental health diagnoses – the researchers combined a variety of information from the past five years of people’s electronic health records and answers to questionnaires, taken from five Kaiser Permanente regions.
Not only were they able to more accurately predict suicide risk than before, they found that in the 90 days following an office visit, suicide attempts and deaths among patients whose visits were in the highest 1 percent of predicted risk were 200 times more common than among those in the bottom half of predicted risk; patients with mental health specialty visits who had risk scores in the top 5 percent accounted for 43 percent of suicide attempts and 48 percent of suicide deaths; patients with primary care visits who had scores in the top 5 percent accounted for 48 percent of suicide attempts and 43 percent of suicide deaths (Simon et al., 2018).
The researchers also found that the strongest predictors of future suicide attempts included prior suicide attempts, mental health and substance use diagnoses, medical diagnoses, psychiatric medications dispensed, inpatient or emergency room care, and scores on a standardized depression questionnaire (Simon et al., 2018).
“We demonstrated that we can use electronic health record data in combination with other tools to accurately identify people at high risk for suicide attempt or suicide death,” explained Gregory E. Simon, MD, MPH, a Kaiser Permanente psychiatrist in Washington and a senior investigator at Kaiser Permanente Washington Health Research Institute (Simon, 2018).
Better prediction of suicide risk, says Simon, is the foundation of suicide prevention. When better informed, health care providers and health systems can make better decisions, such as how often to follow up with patients, refer them for intensive treatment, reach out to them after missed or canceled appointments – and whether to help them create a personal safety plan and counsel them about reducing access to means of self-harm.
Related Online Continuing Education (CE) Courses:
Suicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults.
Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt.
Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs.
Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies so that healthcare professionals are informed on this complex subject. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2018 | 61 pages | 20 posttest questions
The Suicide Survivor is a 2-hour online continuing education (CE) course that provides an understanding and means of helping the people who have lost loved ones to suicide.
One of the most difficult and complex emotional adjustments many individuals will ever face is the challenging and often lengthy process of dealing with the suicide of a family member or other loved one. These people are called suicide survivors; the family members and close friends who have experienced the death of a family member or loved one by suicide.
Unfortunately, this is a common occurrence because nearly 45,000 people die by suicide each year in the United States alone. Estimates are that an average of six individuals experience major life disruption as a consequence of every suicide. The cascade of emotions that follow can be both unexpected and overwhelming, and many of the survivors who most need assistance in the form of supportive counseling do not receive it.
This course will provide information and helping strategies for health professionals who work with individuals who are struggling with both “normal” grief and complicated grief, sometimes described as “persistent complex bereavement disorder.” Also discussed are myths about coping with grief, the progression through the grief of suicide, stigmas associated with suicide, assessing for religious help, theories of grief, role of the therapist, needs of suicide survivors, and, finally, moving on. Course #21-26 | 2018 | 40 pages | 15 posttest questions
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Target Audience: Psychologists, Counselors, Social Workers, Marriage & Family Therapist (MFTs), Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), Registered Dietitian Nutritionists (RDNs), School Psychologists, and Teachers