Past history of Self Harm1-h/o previous self harm , 2- No h/o previous self harm.
Past history of Mental Health problems1 - Past h/o mental health problem, 2 – No Past h/o mental health problem
Suicides in patients recently discharged from hospital/CRHT/underCRHT (<3 months) care1 - Recent Discharges from inpatient unit (<3months)(n=3)2- With CRHT at the time of suicide (n=3)3- Recent Discharge from CRHT (<3months)
Number of professionals seen in the last year preceding deathSeries 1 - CMHT , Series 2 - CRHT
Number of missed contacts in the last year preceding death
Re: Henry Ford, Suicide Prevention System‘Depression Care Initiative’ commenced in 2001The Henry Ford Health Systems BehaviouralServices provides a full continuum of mental healthand substance misuse services through a range ofintegrated delivery systems: -Two hospitals10 clinics500 employeesThe organisation provides care for South EastMichigan and adjacent states.
Results• During the first four years of the programme deathswithin the department dropped by 75% - to 22 per100,000 from 89 per 100,000.• They implemented very rapid suicide investigations(2 weeks) - probably combining investigation anddebriefing with a clear focus on implementation ofoutcomes.For a similar population the expected figures would be230 /100.000 population. During the period 2008 –2010, no deaths from suicide were undertaken bypatients in their care.
Dr Ed Coffey the lead clinician believes that the successof the programme lies in a shift in thinking and culture.The key components of the new ideology are: -None acceptance that people would kill themselves.Pursuing perfection.Need to know what perfect care for depression wouldlook like.Care process is made up of two distinct parts.Assessing service user’s risk for suicide, the assessmentidentifies if individuals are an Acute / Moderate / Low risk.Implementing measures to reduce that risk.Ideology of Service provision
Staff identify if service users have weapons at home Service users encouraged to remove these. Staffs have to undertake a course on suicide preventionand have to achieve a 100% pass rate or receiveadditional education. Checking along the pathway that practices have beencarried out is a consistent process. Each level of risk identified has a clear set of interventionsattached to it. Provision of Cognitive Behaviour Therapy for all patientson the pathway .Key focus for Care
AIMReducing incidents of suicide by service users whoare registered as Mersey care Trust service user(will include those service users who are assessed)by 100% over 4 years: -25%: 2014 ~ 201525%: 2015 ~ 201625%: 2016 ~ 201725%: 2017 ~ 2018Improvement in Suicide Prevention
Improvement in Suicide PreventionKey Primary Drivers / Work Schemes Understand evidence internally and externally Treatment of Depressiono Pathways of Care for Depressiono Effective pathways for high risk groups Pathway Re: Suicide Prevention (Patient SafetyPathway)o Improve identification of suicidal patients
Improvement in Suicide PreventionKey Primary Drivers / Work Schemes Enhance knowledge and skills of all clinical staff Transitions of Care / Co-ordination Engagement with carers Staffing / Resources Primary Care Interface