We know a lot of statistics about suicide.
- In 2004 there were 32,439 suicides and 425,650 documented cases of self-harm.*
- In 2014 there were 42,704 suicides and 469,096 documented cases of self-harm (last year of complete data).*
- In just one decade, the number of people who die from suicide has increased by more than 10,000 people per year.*
- About half of people who commit suicide visit a healthcare provider within four weeks of death.*
- More than four out of five have seen a healthcare provider within a year of their suicide.**
The Substance Abuse and Mental Health Services Administration (SAMHSA)-funded Zero Suicide project works under the belief that suicide deaths for individuals under care within health and behavioral health systems are preventable. The project uses a combination of best evidence, best practices and innovative practices to prevent all suicides. It is an aspirational goal, but a valuable one. These prevention efforts rely on clinicians, including physicians, nurses and social workers, to follow best practices and evidence to move toward that goal.
To determine the effectiveness of their efforts and standardize those efforts broadly requires an objective assessment method. Healthcare payers (insurers, including Medicare and others), professional associations and other stakeholders have used clinical quality measures (CQMs) to achieve the goal of objective assessment in many clinical areas. CQMs help payers, patients and others to see how clinicians, hospitals and other providers are doing in following best evidence and delivering excellent care. They can also identify areas for further study and track changes over time.
SAMHSA has selected Battelle to develop a CQM or identify an existing CQM that can assess how well providers follow the best evidence from the Zero Suicide project. What exactly that measure (or measures) looks like is still being determined. It will have to address a process that’s tightly linked to the outcome (overall number of suicides or suicide attempts). Among the options, Battelle investigators have considered tracking the number of times clinicians have completed suicide risk assessments and then followed up positive assessments with psychiatric referrals.
It will take a unique mixture of expertise to help address this challenge. And with our work in quality measures, health analytics and our expertise in mental health-related issues, Battelle is stepping up to take it head on.
*Centers for Disease Control and Prevention, & National Center for Health Statistics. (2015). Compressed Mortality File 1999-2014 CDC Wonder Online Database
**Ahmedani, B. K., Stewart, C., Simon, G. E., Lynch, F., Lu, C. Y., Waitzfelder, B. E., . . . Williams, K. (2015). Racial/Ethnic Differences in Health Care Visits Made Before Suicide Attempt Across the United States. Medical Care, 53(5), 430-435.
About the Author
Dr. Darryl Roberts is a Registered Nurse and a Healthcare Quality Research Leader at Battelle Memorial Institute. He has more than 25 years of experience as a clinician and scientist in psychiatry, neurology, informatics, management, research and education. His recent work includes developing quality measures for SAMHSA’s Zero Suicide project, supporting the quality Measures Management System for CMS, developing economic metrics for public health interventions and developing qualitative research methodologies useful in natural language processing and big data analytics. He has presented and published much of his work at conferences and in scholarly literature, respectively.