Population-based suicide care program yields 25% reduction in suicide attempts

Population-based suicide care program yields 25% reduction in suicide attempts

Abstract: https://www.acpjournals.org/doi/10.7326/M24-0024  

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A stepped-wedge, cluster randomized implementation trial found that suicide reduction measures integrated into primary care resulted in a 25% reduction in suicide attempt rate when implemented alongside a substance use care program. These findings support primary care-based suicide prevention strategies and align with previous research on the effectiveness of the Zero Suicide Model in reducing suicide attempts and deaths. The findings are published in Annals of Internal Medicine.

More than 40% of persons who die by suicide see a primary care clinician in the month before death and more than 75% in the year before suicide death. Therefore, primary care teams may have important opportunities to engage at-risk patients in early intervention efforts. Researchers from Kaiser Permanente Washington Health Research Institute conducted a secondary analysis of a stepped-wedge, cluster randomized implementation trial to evaluate the effectiveness of implementing population-based suicide care in primary care for suicide attempt prevention. In the study, 22 primary care practices were selected to test a program that combined care for both mental health issues, like depression, and substance use. The practices were divided into seven “waves,” which were gradually introduced to the program. Random assignment was used to determine which practices joined the program first, starting in 2016. Patients were screened annually using a short survey to assess depression, alcohol, and drug use and clinicians used this information to identify and treat patients struggling with these issues early so that they could provide better care overall. The researchers found that in the 90 days after the primary care visits, documented suicide attempts fell to 1.5 per 10,000 visits. Key elements of the Zero Suicide model, such as depression screening, risk assessment, and safety planning, were credited for this decline. According to the researchers, the findings from this study may provide vital evidence for health care teams considering how to respond to patient-reported suicidality during routine primary care encounters, as well as for organizational leaders considering the value of integrating clinical practices in primary care to support suicide prevention.

Media contacts: For an embargoed PDF, please contact Angela Collom at [email protected]. To speak with corresponding author Julie Angerhofer Richards, PhD, MPH, please e-mail Amelia Apfel at [email protected].