Suicide was the 12th leading cause of death in the United States in 2020.
According to the Centers for Disease Control and Prevention, suicide rates across the United States increased by 33% between 1999 and 2019. The CDC reports even higher increases among specific racial and ethnic groups. American Indian and Alaska Native women (139%) and men (71%), black women (65%), white women (68%) and men (40%), and Hispanic women (37%). Other people at high risk of suicide include veterans, people identified as LGBTQ, adolescents and young adults, and victims.
Survey data show that most Americans believe that suicide is preventable, and the latest scientific research supports that view. Suicide prevention requires a variety of interventions, but one easy step is hospital screening. That is, ask a few questions to patients entering a hospital or healthcare system to determine if they are at risk of harming themselves. Such screening allows healthcare professionals to assess patient needs and provide or refer to evidence-based care.
According to a recent survey, about half of those who died from suicide during the 10 years surveyed were seen by a medical professional at least once a month before they died. Additional studies suggest that many may have survived with care if they were screened for suicide risk by their donors. In fact, in a 2017 study of eight emergency departments across seven states, suicide attempts in patients who were screened and received evidence-based care were 30% compared to those who were not screened. It turned out that there were few. Another study examining Department of Veterans Affairs hospitals found that patients who were screened and then clinically intervened were half as likely to experience suicidal behavior as those who received regular care. , Found that the chances of receiving mental health treatment are more than doubled.
Most US healthcare systems screen patients for suicide risk only if they have already been diagnosed with behavioral or mental health concerns. However, some industry leaders have already taken steps to screen a wider patient population for the risk of suicide. for example:
- In 2001, Henry Ford Health System, Michigan, became the first company to expand its suicide prevention and screening efforts with the goal of ending suicide within the system. The overall result was an 80% reduction and no suicides in the 18 months from 2009 to 2010. In particular, this statistically significant reduction occurred during the increase in Michigan’s overall suicide rate.
- Parkland Hospital in Dallas, one of the largest public hospitals in the country, successfully conducted a universal suicide risk screening in 2015.
- The University of Pennsylvania Health System evaluates all patients in the emergency department and outpatient settings.
- Billings Clinic, a local healthcare system servicing Montana, Wyoming, and western Dakotas, screens all patients in the emergency department.
Medical clinicians and managers recognize the importance of reducing suicide, but may be worried that screening will already be another costly and time-consuming burden of over-surgery. Fortunately, many, if not all, of these concerns can be mitigated.
First, screening and follow-up care will be reimbursed by insurance. Second, screening surveys can be as easy as two questions. After performing a universal screening, Parkland Hospital screened 96% of patients as negative and found that it did not guarantee further action from their healthcare providers. Finally, in some cases that require special attention, the provider is available, usually within the hospital or medical system, or through other mental health or suicide prevention, such as safety planning, follow-up contact, counseling, etc. Introduce appropriate care and services to patients. Community resources. Anecdotal evidence from Parkland also suggests that screening did not disrupt hospital workflows, and that it linked thousands of people to the coveted mental health care service.
Screening for suicide risk in all patients is still limited to a small number of healthcare providers, so most healthcare providers and managers need help understanding how to incorporate it into their day-to-day operations. .. Some of the key questions are who should be evaluated, who should be evaluated, and make sure that the system provides fair care and addresses the needs of underserved people. There are ways to get reimbursed, how to measure the results and adjust the program as needed. Providers also need screening tools integrated into their electronic health record systems to standardize and streamline the risk identification process. Hospital accreditation and monitoring agencies can play a role in promoting widespread recruitment and consistent implementation.
Because the COVID-19 pandemic amplifies anxiety, depression, financial stress, substance misuse, and other risk factors for suicide, hospitals and healthcare systems identify people who can hurt themselves. There are low-risk, high-paying opportunities to treat. Screening costs are minimal and profits can be measured in thousands of lives.
If you or anyone you know needs help, call the National Suicide Prevention Lifeline at 800-273-8255, or TALK text to 741741 and contact your Crisis TextLine counselor.
Kristen Mizzi Angelone leads Pew’s suicide risk mitigation project.
