What's New?
Youth Suicide Prevention in Primary Care Pennsylvania
A Grant funded demonstration project in Lackawanna, Luzerne and Schuylkill Counties through the Office of Mental Health and Substance Abuse Services
The Commonwealth of Pennsylvania recently received a SAMHSA funded Garrett Lee Smith Youth Suicide Prevention Grant to develop an effective youth suicide prevention program for primary care settings. The Advocacy Alliance has been selected as the Lackawanna County Site Coordinator for this important project. The grant is authorized as part of the Garrett Lee Smith Memorial Act, sponsored in Congress by Senator Gordon Smith of Oregon who lost his son to suicide in 2003. The Pennsylvania grant project, entitled “Suicide Prevention in Primary Care,” will build a suicide prevention program for youth ages 14-24 within the primary care medical system that will provide screening, assessment, family engagement, and linkage to treatment. It will be piloted in Schuylkill, Lackawanna and Luzerne Counties, three counties with some of the highest rates for suicide death and hospitalization for self-injury in Pennsylvania. The Pennsylvania Project is the only one of the Garrett Lee Smith Grants that focuses on primary care physicians screening youth ages 14-24 for suicide as part of their physical health care visit.
The Lackawanna County project will collaborate with Scranton Primary Health Care to enhance their suicide assessment capacity and increase partnerships with behavioral health services. The project targets several goals, key to successful prevention efforts.
Goals of this project:
Provide training to primary care practitioners on suicide risk assessment and triage.
Enhance behavioral health screening in primary care practices by offering a free, web-based screening tool.
Provide training to mental health professionals on evidence-based treatments for suicidal youth.
Increase integration of medical and mental health services.
Create and support local suicide prevention task forces that support this and other prevention efforts.
According to the National Institute of Mental Health, about one in three American teens has contemplated suicide, with suicide being the second leading cause of death among teenagers, exceeded only by traffic accidents. Research also tells us that up to 75% of individuals who complete suicide have seen a primary care clinician in the previous 30 days. Using these facts it makes perfect sense to include a screening for suicide as regular medical practice for teenagers and young adults as they get annual physical checkups.
The psychological and social impact of suicide on the family and society is immeasurable. On average, single suicide intimately affects at least six other people. If a suicide occurs in a school or workplace it has an impact on hundreds of people.
We are looking for practices to participate in this pilot project.
Participation would involve trainings with staff, implementation of the web-based behavioral health screening tool, and increasing collaboration between your practice and key mental health partners. We are looking for a wide range of practices to participate.
Direct Benefits to your Practice
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Participation in development of a national model for youth suicide prevention in primary care.
Free CME trainings for medical staff in suicide assessment, with the potential for ongoing consultations.
Free access to a web-based behavioral health screening tool.
Training and technical assistance for staff relating to the behavioral health screening tool.
New computer for behavioral health screening tool (limited supply).
Assistance in strengthening collaboration with local mental health services.
Follow up tracking of referred suicidal patients to assist them with accessing services if needed.
FAQs
What about liability? If I increase my identification rate, won’t I increase my liability as well?
Yes, standardized screening will likely identify more youth at risk for suicide. Early identification to prevent suicide attempts is the goal of the project. Liability will be the same, but we hope you will identify more patients in need of services. Our commitment to increasing your linkages with mental health services is intended to offset that burden.
How will this interface with current workflow? What will the burden be on my desk staff?
The screening tool should not disrupt workflow too much. An administrative assistant can log a youth onto the system remotely and the youth can complete the screen while waiting to see medical practitioner. Then, a report will automatically be generated for review before the patient’s exam. We can help tailor this process to individual practices.
How will you coordinate better access to care?
The first step is to increase conversations and the general working relationship between medical and mental health agencies. Second, the current referral process will be evaluated and enhanced if needed. Third, the local project coordinators will facilitate referrals when needed.
How will HIPAA standards be maintained?
All aspects of this project are designed in compliance with HIPAA. Consent will be obtained for the screening tool and patient tracking and release of information forms will be used as needed. Both these procedures are facilitated by the computerized screening tool.
My practice is open late some evenings. How will the referral system work after-hours?
Most likely we will follow similar procedures that you have in place now, only we hope to enhance them through conversation and problem solving.
Is this project sustainable?
We anticipate that the enhanced relationship with mental health providers will be sustained after this project. CME training in suicide assessment will be available online. If the screening tool is successful, we will seek state support to roll it out state-wide.
We know that primary care providers are often overburdened with the presentation of behavioral health problems. The aim of this project is to provide some resources and networking that will help reduce this burden by making the assessment and referral process easier.