Michael Hogan, PhD, Zero Suicide in Health Care



we want to make health care suicide safe this may sound like a idea that should have been taken care of a long time ago but tragically it's not we call our approach zero suicide in health care and it's strange that health care hasn't really focused on people who are suicidal except perhaps in emergency departments or inpatient psychiatric units but strangely also the suicide prevention field hasn't focused very much on health care and we've come to understand that health care isn't safe it was said years ago that a hundred thousand Americans died every year because of errors in the health care system these are mostly what I would call errors of commission a wrong medicine or a failure to follow through on somebody who had just received treatment but of the 40,000 Americans who die by suicide every year I think there are many preventable errors as well there are errors of omission we fail to ask if we ask we fail to stay with somebody who is concerned about hurting themselves through their moment of crisis we don't follow up with them when they're in transitions we don't develop a personal plan that they and their family can use to keep them safe this is not acceptable anymore it's time to ask for health care to be made suicide safe making health care suicide safe or working towards your suicide in health care does look a little different in different sectors of health care it's perhaps most important in mental health programs where many people do live with concerns about self-harm and we're surprisingly not all mental health programs are set up to pay attention to suicidality to help people through difficult transitions to stay with them for example after they've been in an emergency department or a hospital or to reach out and touch them during that transition a giant area of concern is primary care where are half of the individuals who have died by suicide we know have seen a primary care physician in the last 30 days for older men this is a stunning 70 percent that is almost three-quarters of older men who died by suicide have seen a primary care physician in the last 30 days primary care operates on a very fast speed doctors don't have enough enough time to spend with people so one of the things that is very important to improve suicide care in primary care is to begin to introduce behavioral health people like social workers or psychiatric nurses into primary care settings where they are available for the doctor to immediately set up a visit and where we can expect that good suicide care can also be provided and we believe that health care organizations like Hospital chains or integrated delivery systems as they're called or accountable care organizations should work to make themselves suicide safe across their whole continuum of care from primary care to the emergency department to their psychiatric programs and inpatient units a lot has to be done we've now built with the help of the suicide prevention Resource Center a website at wowt.com that contains all the elements and tools that any healthcare organization would need to attempt this approach so this is an approach whose time has come we believe that every health care system should be moving in this direction the health care delivery system is where people are at risk it's where people in many cases can be saved that's where we have to do more

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