An examination of suicidal behaviour among veterans receiving mental-health appointments in person versus clinical video telehealth

2020 ◽  
pp. 1357633X2094204
Author(s):  
Sasha M Rojas ◽  
Marilyn L Piccirillo ◽  
Russell A McCann ◽  
Mark A Reger ◽  
Bradford Felker
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Treatment Modality ◽  
Improvement Project ◽  
National Leader ◽  
Suicide Behaviour ◽  
Va Health Care System ◽  
Observation Period

Introduction The US Department of Veterans Affairs (VA) is a national leader in the implementation of clinical video telehealth (CVT) services. Despite the growth of mental-health services offered via CVT, it is unclear to what extent these services are offered and accessed by veterans with previous suicidal behaviour. Methods The current quality improvement project examined this question within a local VA health-care system using data from suicide behaviour reports (SBRs), the Veteran Health Administration’s official reporting and surveillance system. The frequency of SBRs was compared during two different time points among veterans who received individual mental-health appointments in person only or via CVT during the 2017 calendar year. Among veterans with a SBR, time in days elapsed from their first mental-health appointment to a SBR was examined as a function of treatment modality. Results Results indicated veterans who received in-person treatment only were more likely to present with a SBR six months prior to their first mental-health appointment compared to those who received CVT during the observation period. There were no differences in SBRs during the 12 months after the first appointment or the time from the first appointment to the SBR as a function of treatment modality used. Discussion Although veterans who received in-person mental-health services were more likely to have had a SBR six months prior to treatment, suicide risk throughout the observation period did not differ between groups. Clinical implications that arise from these findings are described in the discussion.

Incidence of suicide ideation and attempts in adults: the 13-year follow-up of a community sample in Baltimore, Maryland

2001 ◽  
Vol 31 (7) ◽  
pp. 1181-1191 ◽  
Author(s):  
WEN-HUNG KUO ◽  
J. J. GALLO ◽  
A. Y. TIEN
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Disorders ◽  
Suicidal Behaviour ◽  
Suicide Attempts ◽  
Community Sample ◽  
Suicide Behaviour

Background. Utilizing a prospectively designed community sample, we set out to estimate the rate of newly-incident suicidal ideation and attempts (non-fatal suicide behaviour) in a community sample, to evaluate antecedent sociodemographic characteristics and psychiatric disorders, and to assess use of mental health services in relation to non-fatal suicide behaviour.Method. Prospectively-gathered data was utilized from 3481 continuing participants in the 13-year follow-up of the Baltimore sample of the NIMH Epidemiologic Catchment Area survey interviewed in 1981, 1982 and 1993/6.Results. The incidence of suicide attempts was estimated at 148·8 per 100000 person-years and ideation at 419·9 per 100000 person-years. Persons in the youngest age group, in the lowest socio-economic status, and previously married persons were at increased risk for non-fatal suicide behaviour during the follow-up interval. Persons who reported suicidal ideation at baseline were more likely to report having attempted suicide at follow-up (RR = 6·09, 95% CI 2·58–14·36). Psychiatric disorders, especially depression and substance abuse, were associated with new-onset of non-fatal suicidal behaviour. While persons who reported newly-incident suicidal behaviour were more likely to report use of mental health services, few said that suicidal ideation or attempts were the reason for the visits.Conclusions. Suicidal ideation is a common and important antecedent to suicide attempts and deserves more attention in community and general medical settings.

scholarly journals The impact of strengthening mental health services to prevent suicidal behaviour

2018 ◽  
Vol 53 (7) ◽  
pp. 642-650 ◽  
Author(s):  
Jo-An Atkinson ◽  
Andrew Page ◽  
Mark Heffernan ◽  
Geoff McDonnell ◽  
Ante Prodan ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Attempted Suicide ◽  
Service Capacity ◽  
Forecast Period ◽  
Hospital Staffing

Objective: Successive suicide prevention frameworks and action plans in Australia and internationally have called for improvements to mental health services and enhancement of workforce capacity. However, there is debate regarding the priorities for resource allocation and the optimal combination of mental health services to best prevent suicidal behaviour. This study investigates the potential impacts of service capacity improvements on the incidence of suicidal behaviour in the Australian context. Methods: A system dynamics model was developed to investigate the optimal combination of (1) secondary (acute) mental health service capacity, (2) non-secondary (non-acute) mental health service capacity and (3) resources to re-engage those lost to services on the incidence of suicidal behaviour over the period 2018–2028 for the Greater Western Sydney (Australia) population catchment. The model captured population and behavioural dynamics and mental health service referral pathways and was validated using population survey and administrative data, evidence syntheses and an expert stakeholder group. Results: Findings suggest that 28% of attempted suicide and 29% of suicides could be averted over the forecast period based on a combination of increases in (1) hospital staffing (with training in trauma-informed care), (2) non-secondary health service capacity, (3) expansion of mental health assessment capacity and (4) re-engagement of at least 45% of individuals lost to services. Reduction in the number of available psychiatric beds by 15% had no substantial impact on the incidence of attempted suicide and suicide over the forecast period. Conclusion: This study suggests that more than one-quarter of suicides and attempted suicides in the Greater Western Sydney population catchment could potentially be averted with a combination of increases to hospital staffing and non-secondary (non-acute) mental health care. Reductions in tertiary care services (e.g. psychiatric hospital beds) in combination with these increases would not adversely affect subsequent incidence of suicidal behaviour.

scholarly journals Improving medical residents’ utilisation of integrated mental health in primary care

2021 ◽  
Vol 10 (3) ◽  
pp. e001388
Author(s):  
Jenna Palladino ◽  
Deirdra Frum-Vassallo ◽  
Joanne D Taylor ◽  
Victoria L Webb
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Medical Home ◽  
Medical Resident ◽  
Improvement Project ◽  
Mental Health Integration ◽  
Integrated Mental Health ◽  
Over Time

BackgroundIntegration of mental health services allows for improved prevention and management of chronic conditions within the primary care setting. This quality improvement project aimed to increase adherence to and functioning of an integrated care model within a patient-centred medical home. Specifically, the project focused on improving collaboration between Primary Care Mental Health Integration (PC-MHI) and the medical resident Patient Aligned Care Teams (PACT) at a Veterans Affairs Medical Center in Northport,New York (VAMC Northport).MethodThe project used increased education, training and relationship building among the medical resident PACTs, and the establishment of regularly occurring integrated team meetings for medical and mental health providers. Education of residents was measured with a self-assessment pre-training and post-training, while utilisation was measured by the percentage of patients currently on a PACT’s panel with at least one PC-MHI encounter in the last 12 months (known in VAMC Northport as PACT-15 metric).ResultsTwo resident PACTs that received both training and weekly integrated meetings increased their utilisation of integrated mental health services by 3.8% and 4.5%, respectively. PACTs that participated in training only, with no regular meetings, showed an initial improvement in utilisation that declined over time.ConclusionsTraining alone appeared beneficial but insufficient for increased integration over time. The addition of a regularly occurring integrated weekly meeting may be a critical component of facilitating sustained mental health integration in a primary care medical home model.

Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning

2013 ◽  
Vol 44 (8) ◽  
pp. 1615-1624 ◽  
Author(s):  
I. Kelleher ◽  
N. Devlin ◽  
J. T. W. Wigman ◽  
A. Kehoe ◽  
A. Murtagh ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Health Clinic ◽  
Psychotic Experiences ◽  
Global Functioning ◽  
Community Based Research ◽  
Wide Range

BackgroundRecent community-based research has suggested that psychotic experiences act as markers of severity of psychopathology. There has, however, been a lack of clinic-based research. We wished to investigate, in a clinical sample of adolescents referred to a state-funded mental health service, the prevalence of (attenuated or frank) psychotic experiences and the relationship with (i) affective, anxiety and behavioural disorders, (ii) multimorbid psychopathology, (iii) global functioning, and (iv) suicidal behaviour.MethodThe investigation was a clinical case–clinical control study using semi-structured research diagnostic psychiatric assessments in 108 patients newly referred to state adolescent mental health services.ResultsPsychotic experiences were prevalent in a wide range of (non-psychotic) disorders but were strong markers of risk in particular for multimorbid psychopathology (Z = 3.44, p = 0.001). Young people with psychopathology who reported psychotic experiences demonstrated significantly poorer socio-occupational functioning than young people with psychopathology who did not report psychotic experiences, which was not explained by multimorbidity. Psychotic experiences were strong markers of risk for suicidal behaviour. Stratified analyses showed that there was a greatly increased odds of suicide attempts in patients with a major depressive disorder [odds ratio (OR) 8.89, 95% confidence interval (CI) 1.59–49.83], anxiety disorder (OR 15.4, 95% CI 1.85–127.94) or behavioural disorder (OR 3.13, 95% CI 1.11–8.79) who also had psychotic experiences compared with patients who did not report psychotic experiences.ConclusionsPsychotic experiences (attenuated or frank) are an important but under-recognized marker of risk for severe psychopathology, including multimorbidity, poor functioning and suicidal behaviour in young people who present to mental health services.

Engaging Mental Health Services in Spirituality Conversations: A Spirituality Poster and Café Spirituality

2013 ◽  
Vol 32 (2) ◽  
pp. 59-65 ◽  
Author(s):  
Sharon Smith ◽  
Nancy Clark ◽  
Andrea Grabovac ◽  
Eternal Inlakesh ◽  
Dipesh Tailor
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Mental Health Services ◽  
Health Services ◽  
Focus Groups ◽  
Advisory Committee ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Health Recovery ◽  
Improvement Project

Spirituality can be an important resource for mental health recovery. Yet barriers exist in integrating spirituality into mental health services. This article describes a spirituality quality-improvement project that engaged the system using strategic spirituality dialogue. We formed an advisory committee; developed a spirituality framework/poster; facilitated dialogue among consumers, families, and mental health professionals in focus groups; and hosted a Café Spirituality. The findings highlight the need to create safe places for spirituality dialogue.

scholarly journals Can we expect an increased suicide rate due to Covid-19?

2020 ◽  
Vol 37 (4) ◽  
pp. 264-268 ◽  
Author(s):  
Patrick Devitt
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Suicide Rate ◽  
Suicidal Behaviour ◽  
Economic Recession ◽  
Vulnerable Groups ◽  
Historical Paper ◽  
Economic Recessions ◽  
Insight Into

Human disasters come in all shapes and sizes including wars, terrorist violence, natural events, economic recessions and depressions as well as infection. As a species more fragile than we often allow, humans would be expected to adversely react to these types of disasters in terms of mental ill health and possibly suicidal behaviour leading to increased demands on the Mental Health services. This narrative historical paper examines relevant studies into how previous disasters affected mental health and suicidal behaviour. The characteristics of what is known of the current Covid-19 disease are analysed and compared to other types of disasters with a view to gaining some insight into what we might expect. Of all the types of disasters, economic recession appears most toxic. Mitigating the worst effects of recession appears to be protective. Particularly vulnerable groups are identified in whom we might expect an increase in suicidal behaviour.

scholarly journals Qualitative investigation of relatives’ and service users’ experience of mental healthcare for suicidal behaviour in bipolar disorder

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030335
Author(s):  
Caroline Clements ◽  
Navneet Kapur ◽  
Steven H Jones ◽  
Richard Morriss ◽  
Sarah Peters
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Mental Healthcare ◽  
Service Users ◽  
Open Communication ◽  
Increased Risk ◽  
Health Services Need

ObjectivePeople with bipolar disorder are known to be at high risk of engaging in suicidal behaviours, and those who die by suicide have often been in recent contact with mental health services. The objective of this study was to explore suicidal behaviour in bipolar disorder and how this is monitored and managed by mental health services.AimsTo identify themes within relatives’ and service users’ accounts of mental healthcare, related to management and prevention of suicidal behaviour in bipolar disorder.DesignThematic analysis of 22 semistructured interviews.ParticipantsParticipants were aged 18 years or over, fluent in written and spoken English, and either had bipolar disorder with a history of suicidal behaviour, or were relatives of people with bipolar disorder who had died by suicide.SettingEngland, UK.Primary outcomeThemes identified from participants’ accounts of mental healthcare for suicidal behaviours in bipolar disorder.ResultsTwo main themes were identified. ‘Access to care’ was characterised by a series or cycle of potential barriers to care (eg, gate-keepers, lack of an accurate diagnosis) which had the potential to increase risk of suicidal behaviour if failure to access care continued over time. ‘Problems with communication’ captured the importance of maintaining open routes of communication between all parties involved in care to ensure successful monitoring and management of suicidal behaviours in bipolar disorder.ConclusionsMental health services need to be accessible and respond rapidly to people with suicidal behaviour in bipolar disorder. Open communication and inclusion of relatives in care, where appropriate, could help closer monitoring of changes in symptoms that indicate increased risk.

scholarly journals Using a quality improvement project to enhance the standard vaccination rate for long-term patients in mental health services in Qatar

2021 ◽  
Vol 5 (4) ◽  
pp. 138
Author(s):  
Nervana Elbakary ◽  
Sadaf Riaz ◽  
Islam Mahran ◽  
AhmedHani Assar ◽  
Oraib Abdallah ◽  
...  
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Mental Health Services ◽  
Health Services ◽  
Vaccination Rate ◽  
Quality Improvement Project ◽  
Improvement Project

scholarly journals Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations

2016 ◽  
Vol 188 (11) ◽  
pp. E261-E267 ◽  
Author(s):  
Jitender Sareen ◽  
Tracie O. Afifi ◽  
Tamara Taillieu ◽  
Kristene Cheung ◽  
Sarah Turner ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Canadian Military

scholarly journals Implementation of a Telemental Health Training Program Across a Mental Health Department

2020 ◽  
Author(s):  
Bradford Felker ◽  
Meghan M McGinn ◽  
Erika M Shearer ◽  
Gina T Raza ◽  
Sari D Gold ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Improvement ◽  
Mental Health Services ◽  
Health Services ◽  
Training Program ◽  
Health Care Systems ◽  
Telemental Health ◽  
Improvement Project ◽  
Care Systems

Abstract Background: Telemental Health (TMH) is an effective way to increase access to mental health services. For this reason, many health care systems strive to make TMH a part of routine mental health services. TMH use has increased substantially in recent years; however, health care systems have found it challenging to implement TMH ubiquitously. Minimal literature addresses system wide TMH implementation efforts. To broadly expand TMH throughout a VA medical center’s mental health service, a quality improvement project was conducted to develop and implement a comprehensive, novel TMH training program for staff. Methods: This quality improvement project was informed by implementation science methodologies. PARiHS criteria and Evidence-Based QI Implementation/Facilitation guided the development and implementation of this TMH training program, which included: (a) two online TMH courses, (b) a one-day didactic training including hands-on practice and skills evaluation, and (c) weekly calls where staff could receive TMH consultation. A total of 100 interdisciplinary mental health providers from outpatient mental health clinics participated in this training over the course of two years. RE-AIM criteria were used to evaluate the effectiveness of this training program. Results: Overall, providers reported satisfaction with this TMH training program, and found that it increased their TMH knowledge and competence. The number of providers using TMH and patients who received it nearly doubled in the two years after the launch of the TMH training compared to the two years preceding. Conclusions: This novel TMH training program was well-received by staff and increased the number of providers and patients using TMH. Since this project was completed, the COVID-19 pandemic has significantly increased the demand for telehealth services. This training model offers specific strategies based upon implementation science that could be disseminated to and adopted by mental health programs looking to implement system wide TMH use.

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