Project Grant H79SM088315

EXPANSION AND IMPLEMENTATION OF ZERO SUICIDE ACROSS THE PINE REST BEHAVIORAL HEALTH CONTINUUM - BASED IN GRAND RAPIDS, MICHIGAN, PINE REST CHRISTIAN MENTAL HEALTH SERVICES (PINE REST) IS THE NATION'S THIRD LARGEST FREE-STANDING BEHAVIORAL HEALTH PROVIDER, ANNUALLY SERVING OVER 50,000 INDIVIDUALS THROUGH AND EXTENSIVE CONTINUUM OF BEHAVIORAL HEALTH SERVICES, INCLUDING INPATIENT, OUTPATIENT, RESIDENTIAL SERVICES, COMMUNITY OUTREACH, SUBSTANCE USE TREATMENT, TELEHEALTH SERVICES, CONSULTATION, AND PSYCHIATRIC URGENT CARE. WHILE THE FOCUSED GEOGRAPHIC AREA IS WEST MICHIGAN, PINE REST SERVICES SPAN THE STATE OF MICHIGAN, TREATING PEOPLE FROM 98% OF MICHIGAN'S COUNTIES IN 2022. THROUGH WORK ALREADY COMPLETED TOWARD ZERO SUICIDE, PINE REST HAS IDENTIFIED A GAP IN CLINICAL EDUCATION, ASSESSMENT, AND CONTINUITY OF CARE FOR INDIVIDUALS WITH SUICIDAL BEHAVIOR. TO FILL THIS GAP, PINE REST PROPOSES TO IMPLEMENT THE ZERO SUICIDE MODEL ACROSS THE PINE REST CONTINUUM, WITH THE GOAL OF SERVING OVER 15,000 PATIENTS OVER THE 5 YEAR PROJECT. PINE REST WILL FOCUS ON INDIVIDUALS ABOVE THE AGE OF 18 WHO RECEIVE TREATMENT THROUGH THE PINE REST TRANSITION CLINIC. THOSE WHO RECEIVE TREATMENT IN A PSYCHIATRIC INPATIENT HOSPITAL HAVE ONE OF THE HIGHEST SUICIDE RISKS OF ANY POPULATION, WITH SUICIDE RATES 30 TIMES THAT OF THE GENERAL POPULATION FIVE YEARS AFTER HOSPITAL DISCHARGE. THREE MONTHS POST-DISCHARGE, THIS RATE IS 100 TIMES THE GENERAL POPULATION. FOR PATIENTS HOSPITALIZED FOR SUICIDAL THOUGHTS OR BEHAVIORS, THIS RISK INCREASES TO 200 TIMES THAT OF THE GENERAL POPULATION (CHUNG, ET AL., 2017). THE TRANSITION CLINIC PROVIDES INTENSIVE BEHAVIORAL HEALTH TREATMENT FOR THESE HIGH-RISK PATIENTS FOR UP TO THREE MONTHS AFTER DISCHARGE FROM A PSYCHIATRIC CRISIS EPISODE. THIS PROJECT WILL ACCOMPLISH THREE GOALS: 1) REDUCE SUICIDE AND SUICIDE ATTEMPT RATES WITHIN THE TRANSITION CLINIC POPULATION; 2) INCREASE THE CAPACITY TO DIRECTLY TREAT SUCIDIALITY BY TRAINING THE PINE REST WORKFORCE IN EVIDENCE-BASED PRACTICES; AND 3) IMPROVE THE SUICIDE PREVENTION RATE AT PINE REST'S TRANSITION CLINIC BY IMPLEMENTING ZERO SUICIDE FRAMEWORK INTO TREATMENT. THE THREE GOALS OF THE PROJECT WILL ADDRESS THREE MAIN SERVICE GAPS IN REDUCING SUICIDE: 1) THE LACK OF CONTINUITY IN CARE FOR PATIENTS ACROSS THE CONTINUUM; 2) THE LACK OF CAPACITY AND TRAINING OF THE BEHAVIORAL HEALTH WORKFORCE; AND 3) THE UNDERSTANDING OF CULTURAL COMPLEXITIES IN SUICIDE PREVENTION. TO THIS END, PINE REST WILL FULLY INTEGRATE THE SEVEN ELEMENTS AND BEST PRACTICES OF ZERO SUICIDE INTO ITS HEALTH SYSTEM BY DEVELOPING AND IMPLEMENTING ORGANIZATIONAL POLICIES AND PROCEDURES, BY PROVIDING TRAINING IN EVIDENCE-BASED PRACTICES, AND BY ADDRESSING BARRIERS TO TREATMENT CAUSED BY HEALTH INEQUITIES.