Last month’s issue of The Joint Commission Journal on Quality and Patient Safety highlighted a study about suicide detection systems conducted by the Parkland Hospital System in Dallas. The sad reality is that suicide has increased over the past 10 years and many individuals die by suicide in non-behavioral health care. To combat this problem, a team of doctors decided to implement a universal suicide-screening program for inpatient, outpatient and emergency care settings.
This quality improvement program helps identify patients who may have previously gone through the medical system with undetected suicidal thoughts and signs. The study continued for 6 months and analyzed the data accumulated through the screening process. The program involved a team of trained nurses and physicians asking a simple series of questions during the regularly performed admittance procedures.
Data for 328,064 adult encounters was analyzed from the first six months of the screening program. The percentage of patients screening positive for suicide risk was 6.3 percent in the emergency department, 2.1 percent in the outpatient clinics and 1.6 percent in the inpatient units. The odds of a positive suicide screening in the ED was 4.29 times higher than the inpatient units and 3.13 times higher than the outpatient clinics.
If the screening suggestion suicide risk, a mental health screening was also conducted. The process of having a simple questionnaire and being more aware of the possibility of suicide ideation helped to further treat the patient. The data also shows the necessity of mental health services in various medical fields in order to properly treat the whole person.
Lisa M Horowitz, PhD, MPH writes: “Current practice generally misses those with occult risk—that is, who may only disclose suicidal thoughts/behaviors if they are asked directly. Parkland has taken an important step in documenting the feasibility and value of adding universal suicide risk screening in the inpatient, outpatient and emergency care settings, allowing for identification of such occult cases. In doing so, Parkland provides an exemplary model that other health systems could follow to increase the chance that individuals who are struggling in silence may be recognized and treated.”
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