Zero suicide framework implementation in rural southwest montana health system - ST

Peter's health (SPH) foundation and our committed partners seek to implement the zero suicide model for adults across the health system with the aim of reducing suicide ideation, attempts, and deaths. SPH is an independent, rural health system located in helena, montana, serving five rural counties in southwestern montana. Suicide is the leading cause of death for montanans aged 10-44; montana has one of the highest suicide rates in the country, with a rate of 25.9 per 100,000 people, which is nearly twice the national average. SPH has made addressing suicide prevention a priority as IT is a major concern for our health system. Total emergency department (ED) visits at SPH with a mental health diagnosis were 3197 in 2019, 4025 in 2020, and 3780 in 2021, with an average of weekly ED visits with mental health diagnosis of 61.5, 77.4, and 72.7, respectively. The SPH mobile crisis team has completed 752 crisis visits in the community over the past two years, avoiding 592 additional emergency room visits. In 2021, we provided 882 acute visits, as an aggregated number of ER and inpatient visits, where patients were seen specifically for suicide attempts and/or active suicidal ideation; and in 2022, that number rose to 1,195 visits, a 35% increase. The zero suicide grant from samhsa will allow SPH to implement the zero suicide model at SPH and emphasize the need for systematic and continuous care for those at risk of suicide. Fully implementing the framework, particularly in light of the increased functionality of our new electronic health record (EHR), would provide the consistent support and trained resources necessary to address the service gaps and disparities in our community, and IT would help US better capture data for and serve the population of focus, including those suffering from depression and other mental health issues. The implementation plan will follow the zero suicide framework, focusing on leadership support through the establishment of a formal zero suicide steering committee, robust training, systematic identification of suicide risk, patient engagement in care planning, ongoing contact and support through transitions, and continuous process monitoring. Implementation goals will include: establish and implement a multidisciplinary collaborative approach to create a sustainable system level culture change that leads to a significant reduction in suicides for the SPH service area; develop a culturally competent, skilled, and confident workforce that understands their role in suicide reduction; implement a consistent and comprehensive screening, assessment, and treatment for suicide risk in all individuals in care, using standardized tools and clear policies and procedures; develop a comprehensive and collaborative pathway to suicide care that prioritizes recovery, saves lives, and ensures safe hand-offs between different levels of care through standardized and continuous contact and support for patients; and implement a comprehensive continuous quality improvement plan that ensures fidelity to evidence-based practices and the components of the zero suicide model, while continually evaluating policies and procedures, patient care outcomes, and implementation metrics. Over the lifetime of the five-year grant, we anticipate serving a total of 64,338 unduplicated individuals with standardized screening and appropriate treatment. In year 1, we will serve 35,629 individuals, or 60% of the population, increasing to 100% by year 2 and continuing this level through the remaining grant years.