Suicide Prevention in Arizona

Can any outpatient mental health program prevent all suicides in the patients it serves?

Reporting at the American Psychiatric Association’s 2016 meeting in Atlanta, GE, researchers from Arizona said that a trial program that is part of the Magellan Health plan in Maricopa County, AZ, appears to have done just that.

In a talk called “Driving Suicide to Zero,” Shareh Ghani, MD and colleagues of Phoenix AZ said patients when first seen are triaged in an interview to determine their immediate suicide risk.

Those thought to be most at risk have alcohol or drug problems, have experienced a sudden loss or trauma, access to firearms, and a fearlessness about suicide.

They also tend to feel abandoned and to be experiencing social withdrawal.

“Best practices can reduce suicides” in this patients, Ghani said.

All patients get care ranging from an appointment for counseling at a future date to immediate admission to inpatient care.

All patients seen give the mental health workers contact information about their own support system and all get team care.

One of the most effective tools is that patients who have expressed thoughts about suicide all get a “caring letter’ from the team texted or emailed the next day.

The follow-up has been easy but surprisingly effective, with patients telling the team the contact really made a difference in their outlook and gave them a sense of hope.

A trickier part of suicide prevention has been getting guns out of some patients’ homes.

The police can be asked to do that, but their attitudes vary, the researchers said.

Some police forces will and some have told the caregivers they do not have the time.

Gun owners cannot legally be forced to give up their firearms.

But in the study reported, during the 90-day study period, there were no suicides.