Identify and adopt outreach interventions and bridging strategies that motivate

Identify and adopt outreach interventions and

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Identify and adopt outreach interventions and bridging strategies that motivate adherence to the recommended treatment plan. For example, calling the patient and the outpatient facility to confirm attendance is an obvious strategy that can improve adherence. Various forms of pre-discharge treatment adherence counseling and/or post- discharge telephone and/or mail reminders predict arrival for all ages. Require health care systems to provide timely follow-up care in the event that the most appropriate continuity-of-care plan cannot be achieved in a timely manner. Often, emergency departments evaluate a patient at risk for suicide, but the patient has health insurance from an unrelated health system. Out-referral is necessary. For a high- risk patient in this situation, if a near-term outpatient appointment is unavailable in the health system to which the patient is most closely affiliated, the referring facility takes responsibility for providing interim outpatient care. Promote outcomes research that evaluates the Department of Veterans Affairs’ (VA) rigorous standards for clinical care of the veteran identified as either surviving a suicide attempt or as being at high-risk. Do alternative standards of care (e.g., explicit personalized safety plan, close monitoring) have significantly different effects on sui- cide re-attempts? The VA is embarking on a naturalistic experiment that is supported by the small evidence base that closer monitoring improves suicide-related outcomes. The outcomes from the standards for suicide care implemented by the VA can be compared to alternative “usual care” practiced in non-VA mental health systems of care. Make accessible to the every-day, practicing clinician the essentials of clinical per- formance standards expected by the Centers for Medicare and Medicaid Services and The Joint Commission. If there is any expectation that care provided by individual clinicians is improved by the performance standards set by these two organizations, then it should be relatively easy for clinicians to access the essential materials. 7. Randomized controlled trials that use suicide attempts as outcome variables are practical and doable and much less expensive than trials involving the general public. Fund substantially more research that uses randomized methods and that uses suicide attempts as outcome variables. Suicide attempts are the strongest, easily recog- nized predictors of suicide deaths. Suicide attempts are a more viable outcome measure than suicide deaths. Because of their high frequency of occurrence, suicide attempts have advantageous sampling characteristics and provide a close approximate measure of ac- tual suicide deaths, especially in individuals at high risk for making additional attempts.
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