69 Reduce provider shortages in underserved areas One example of a program to

69 reduce provider shortages in underserved areas one

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69 Reduce provider shortages in underserved areas. One example of a program to improve access to mental health care providers is the National Health Service Corps (NHSC) , which offers financial incentives to attract mental/behavioral health clinicians to underserved areas. 77 Programs such as NHSC encourage individuals to work in the mental health profession in locations designated as Health Professional Shortage Areas (HPSAs) in exchange for student loan debt repayment. A 2012 retention survey conducted by the Health Resources and Services Administration (HRSA), found that 61% of mental and behavioral health care providers continued to practice in designated mental health shortage areas after their four year commitment to the NHSC . 78 Although this program has not been evaluated for impact on suicide, it addresses access to care, which is a critical component to suicide prevention. Telemental Health (TMH) services refer to the use of telephone, video and web-based technologies for providing psychiatric or psychological care at a distance. 79 TMH can be used in a variety of settings (e.g., outpatient clinics, hospitals, military treatment facilities) to treat a wide range of mental health conditions. It can also improve access to care for patients in isolated areas, as well as reduce travel time and expenses, reduce delays in receiving care, and improve satisfaction interacting with the mental health care system. A systematic review of TMH services found that services rated as high or good quality were effective in treating mental health conditions such as depression, schizophrenia, substance
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Preventing Suicide: A Technical Package of Policy, Programs, and Practices 21 abuse, and suicidal ideation and suicide. 79 Further, Mohr and colleagues 80 conducted a meta-analysis examining the effect of psychotherapy delivered specifically via telephone and found that it significantly reduced depressive symptoms in comparison to face-to-face psychotherapy. They also found that treatment attrition rates were significantly lower among patients receiving telephone-administered psychotherapy compared to patients receiving face-to-face therapy. 80 Thus, TMH may not only offer improved access to mental health care, but it may also ensure continuity of care, and thereby further reduce the risk for suicide. Safer suicide care through systems change . Henry Ford Health System , which is a large health maintenance organization (HMO) in the state of Michigan, pioneered Perfect Depression Care, 81 the pre-cursor to what is now called Zero Suicide . The overall goal of Perfect Depression Care was to eliminate suicide among HMO members. More broadly, the goal of the program was to redesign delivery of depression care to achieve “breakthrough improvement” in quality and safety by focusing on effectiveness, safety, patient centeredness, timeliness, efficiency, and equity among patients. The program screened and assessed each patient for suicide risk and implemented coordinated continuous follow-up care system wide.
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