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We are pleased to introduce a new short series of articles in Partners in
Health UpdateSM, "Suicide: A concern for all health care
providers", that is designed to provide you with information on suicide and the
importance of your role in assessing your patients who may be at risk.
Part 1 ? An introduction to recognizing the role of all
health care providers to address the issue of suicide
Historically, suicide has been a focus of those in the Behavioral Health
specialty. Today, all health care professionals ? not just those who work in
Behavioral Health ? are being asked to make suicide prevention a priority for
the patients in their practice.
Suicide is the 10th leading cause of death in the United States, and
according to the Centers for Disease Control and Prevention (CDC), there has
been a steady increase in suicides each year since 1999.1 The two
age groups with the most significant increase are ages 45 – 54 with a 5.8
percent increase and ages 55 – 64 with a 5.9 percent increase. This
information indicates that this important health issue needs to be
addressed.
Your role in assessing risk of suicide
Magellan Healthcare, an independent company, and Independence are leading
the way to support a safety-oriented culture for members receiving any health
care services. This partnership is providing guidance that is evidence-based to
assure ongoing quality of care.
Since we do not have definitive information to determine what makes a person
suicidal, we need to rely on evaluating risk factors. The role of the health
care provider is to evaluate the risk factors to determine interventions that
can keep a person safe.
Social determinants include healthy connectedness. This is not just for the
time the person spends in your office but reinforces the need for you to
encourage the patient to use community resources.
Clinical risk factors include many of the reasons that the individual has
come to seek care from both the primary care and behavioral health provider.
Some of these issues may be pain, insomnia, anxiety, suicidal thoughts, making
a plan, and feeling hopeless or like a burden. In addition, substance use/abuse
and trauma are risk factors that need to be assessed. As we assess for suicide,
all health care professionals need to explore any passive ideation as well as
active suicidal ideation because they can be associated with
morbidity.2
As we work towards a "Zero Suicide" goal, team effectiveness is crucial.
Communication among all providers, the individual, and the individual's support
system can bring us closer to reaching this goal.
1Centers for Disease Control: National Vital Statistics Report.
Deaths Final Data for 2010. 61:4. May 8, 2013.
2Baca-Garcia E, Perez-Rodriguez MM, Oquendo MA, et al. Estimating
risk for suicide attempt: are we asking the right questions?
Passive
suicidal ideation as a marker for suicidal behavior. J Affect Disord.
2011;134(1-3):327-332.
Magellan Healthcare, Inc., an independent company,
manages mental health and substance abuse benefits for most Independence Blue
Cross members.
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