Project Grant H79FG000776

MERCY ZERO SUICIDE PROJECT - MERCY HEALTH MINISTRY'S (MERCY) PROPOSED MERCY ZERO SUICIDE PROJECT ADDRESSES THE NEED FOR EVIDENCE-BASED SUICIDE ASSESSMENT, CARE MANAGEMENT AND TRANSITIONAL SUPPORT FOR PATIENTS IDENTIFIED AS HAVING SUICIDE RISK IN THE EMERGENCY DEPARTMENT (ED) SETTING. THE PROJECT WILL BE IMPLEMENTED ACROSS THREE RURAL AND THREE URBAN MISSOURI HOSPITALS, SERVING 300 PATIENTS OVER THE AGE OF 13 ACROSS 7 COUNTIES. BY IMPLEMENTING A DIGITAL PLATFORM, THE PROJECT WILL STANDARDIZE AND IMPROVE THE CARE OF PATIENTS WHILE ADDRESSING CAPACITY CONSTRAINTS OF CURRENT ASSESSMENT PROCEDURES, SYSTEMATIZING WORKFLOW AND FOLLOW-UP, AND REDUCING THE IMPACT OF MENTAL ILLNESS ON MISSOURI COMMUNITIES. PROJECT PILOT SITES INCLUDE: MERCY HOSPITALS IN ST. LOUIS, JEFFERSON COUNTY, WASHINGTON, JOPLIN, SPRINGFIELD, AND LEBANON. THE PROJECT INTEGRATES A DIGITAL PLATFORM (JASPR) THAT WILL SIMULATE A CHAT WITH PATIENTS, ASKING QUESTIONS FROM EVIDENCE-BASED ASSESSMENTS, GUIDE THEM THROUGH SAFETY PLANNING AND LETHAL MEANS COUNSELING IN A CONVERSATIONAL MANNER, AND INTEGRATE THIS INFORMATION INTO THE PATIENT'S ELECTRONIC HEALTH RECORD. PATIENT SELF-REPORTS WILL BE MONITORED BY CLINICIANS AND REVIEWED WITH THE PATIENT TO AID IN APPROPRIATE DISPOSITION AND CARE PLANS. PATIENTS WILL ALSO HAVE ACCESS TO A LIBRARY OF COPING SKILLS AND VIDEOS FROM PEOPLE WITH LIVED EXPERIENCE TO HELP DECREASE DISTRESS DURING THE ED VISIT AND PROVIDE TRANSITION CARE SUPPORT THROUGH A MOBILE APP, JASPR-AT-HOME. JASPR WILL PROVIDE PEER SUPPORT TO FACILITATE PATIENT-USE, DELIVER TRAINING AND COACHING TO PROVIDERS, AND PROVIDE VIRTUAL OUTPATIENT SUPPORT FOR 30 CONCURRENT PATIENTS FOR UP TO 5 POST-DISCHARGE MEETINGS. THIS PARTNERSHIP INCLUDES THE EQUIPMENT, TRAINING, AND TECHNICAL ASSISTANCE NEEDED TO IMPLEMENT A NEW SYSTEM. THE IMPLEMENTATION OF JASPR IS EXPECTED TO IMPROVE COMPLIANCE AND REDUCE COST AND LIABILITY WHILE EMPOWERING PATIENTS TO ADVANCE THEIR CARE AND PREVENT FUTURE SUICIDAL CRISES. GOALS AND OBJECTIVES INCLUDE: 1. INCREASE MERCY'S CAPACITY TO PREVENT SUICIDE ATTEMPTS AND DEATHS BY INTEGRATING EVIDENCE-BASED INTERVENTIONS TO PROVIDE PERSON-CENTERED SAFETY AND SUICIDE-RELATED CLINICAL IMPROVEMENTS REDUCING OVERALL ASSESSMENT TIME BY 30 MINUTES; 2. IMPLEMENT EVIDENCE-BASED TECHNOLOGY THROUGH STEERING COMMITTEES, CLINICAL AND OPERATIONAL WORK GROUPS, AND ED AND BH STAFF TRAINING. BY THE END OF THE PROJECT, MERCY WILL COMPLETE 50 ASSESSMENTS PER MONTH FOR SIX MONTHS AND INCREASE COMPLETION OF SAFETY PLANNING AND LETHAL MEANS COUNSELING TO 50% OF PATIENTS DISCHARGING FROM THE ED; 3. EMPOWER INDIVIDUALS AT-RISK FOR SUICIDE TO STABILIZE, RECOVER FROM, AND PREVENT FUTURE SUICIDAL CRISES BY REDIRECTING THE USUAL ED WAIT TIME TO A LIBRARY OF COPING SKILLS TO REDUCE PATIENT DISTRESS AND AGITATION BY 30% ON A SELF-REPORTED 10-POINT SCALE BY THE END OF THE PROJECT; AND 4. PATIENTS RECEIVING THE INTERVENTION WILL BE BETTER EQUIPPED FOR RECOVERY BY ENCOURAGING THE USE OF JASPR-AT-HOME MOBILE APP FOR CONTINUED ACCESS TO CONTENT AND UP TO FIVE VIRTUAL FOLLOW-UP MEETINGS WITH A PEER SUPPORT SPECIALIST. MERCY WILL REFER AT LEAST 50% OF PATIENTS USING JASPR TO AFTERCARE SUPPORT. WE ANTICIPATE THE OVERALL IMPACT OF THIS PROJECT WILL ILLUSTRATE DIGITAL APPLICATIONS INCREASE ACCESS TO EVIDENCE-BASED PRACTICES AND HELP REDUCE SUICIDE ATTEMPTS AND DEATHS IN MISSOURI COMMUNITIES.