Better care at US health care provider stops suicides: study

A US health care provider has managed to completely stop suicides among patients suffering from depression by improving the quality of care it provides, a report published Tuesday said.

The Behavioral Health Services division of the Michigan-based Henry Ford Health System (HFHS) has had no suicides among its patients for two years, the report published in a special mental health issue of the Journal of the American Medical Association said.

That stood in "dramatic contrast" to the annual rate at HFHS of around 89 suicides per 100,000 patients when the initiative began in 2001 and stands in even more dramatic contrast to the rate in the general patient population of around 230 suicides for every 100,000 patients, the report said.

The HFHS achieved its "remarkable" goal by applying the six steps called for in an Institute of Medicine report on how to redesign health care.

The steps aim to make health care safer, more effective, more patient-centered, timely, efficient and equitable.

The HFHS program was dubbed the Perfect Depression Care initiative, and as it was developed, it became clear "that one goal trumped all others for driving breakthrough improvements in care: to reduce the number of suicides to zero in patients seen in both inpatient and outpatient facilities," the report said.

"If we were to provide perfect depression care, nobody would kill themselves," said neuropsychiatrist C. Edward Coffey, chief executive of the Behavioral Health Services at HFHS.

In addition to measures including rapidly analyzing each patient's suicide risk, and giving patients email access to clinicians, patients have to disclose to clinic staff whether or not they have weapons at home.

If they do, they are encouraged "to get rid of them," said Coffey.

"Patients have come to us and said, ‘It’s a good idea that you had me take the gun out of my house; some nights I’d sleep with it on the pillow beside me,’" Coffey said.

"These sorts of comments indicate that suicide is often impulsive and that imposing even a short delay can allow the impulse to pass," he said.

Donald Berwick, who was nominated in March by President Barack Obama to head the Centers for Medicare and Medicaid Services, said it was "remarkable that they’ve had no suicides, particularly in this group."

More than 33,000 people in the United States take their own lives each year, making suicide the 11th leading cause of death in the country, the Centers for Disease Control and Prevention says.

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