10. Past history of Self Harm
1-h/o previous self harm , 2- No h/o previous self harm.
11. Past history of Mental Health problems
1 - Past h/o mental health problem, 2 – No Past h/o mental health problem
12. Suicides in patients recently discharged from hospital/CRHT/under
CRHT (<3 months) care
1 - Recent Discharges from inpatient unit (<3months)(n=3)
2- With CRHT at the time of suicide (n=3)
3- Recent Discharge from CRHT (<3months)
16. Re: Henry Ford, Suicide Prevention System
‘Depression Care Initiative’ commenced in 2001
The Henry Ford Health Systems Behavioural
Services provides a full continuum of mental health
and substance misuse services through a range of
integrated delivery systems: -
Two hospitals
10 clinics
500 employees
The organisation provides care for South East
Michigan and adjacent states.
17. Results
• During the first four years of the programme deaths
within the department dropped by 75% - to 22 per
100,000 from 89 per 100,000.
• They implemented very rapid suicide investigations
(2 weeks) - probably combining investigation and
debriefing with a clear focus on implementation of
outcomes.
For a similar population the expected figures would be
230 /100.000 population. During the period 2008 –
2010, no deaths from suicide were undertaken by
patients in their care.
18. Dr Ed Coffey the lead clinician believes that the success
of the programme lies in a shift in thinking and culture.
The key components of the new ideology are: -
None acceptance that people would kill themselves.
Pursuing perfection.
Need to know what perfect care for depression would
look like.
Care process is made up of two distinct parts.
Assessing service user’s risk for suicide, the assessment
identifies if individuals are an Acute / Moderate / Low risk.
Implementing measures to reduce that risk.
Ideology of Service provision
19. Staff identify if service users have weapons at home
Service users encouraged to remove these.
Staffs have to undertake a course on suicide prevention
and have to achieve a 100% pass rate or receive
additional education.
Checking along the pathway that practices have been
carried out is a consistent process.
Each level of risk identified has a clear set of interventions
attached to it.
Provision of Cognitive Behaviour Therapy for all patients
on the pathway .
Key focus for Care
20. AIM
Reducing incidents of suicide by service users who
are registered as Mersey care Trust service user
(will include those service users who are assessed)
by 100% over 4 years: -
25%: 2014 ~ 2015
25%: 2015 ~ 2016
25%: 2016 ~ 2017
25%: 2017 ~ 2018
Improvement in Suicide Prevention
21. Improvement in Suicide Prevention
Key Primary Drivers / Work Schemes
Understand evidence internally and externally
Treatment of Depression
o Pathways of Care for Depression
o Effective pathways for high risk groups
Pathway Re: Suicide Prevention (Patient Safety
Pathway)
o Improve identification of suicidal patients
22. Improvement in Suicide Prevention
Key Primary Drivers / Work Schemes
Enhance knowledge and skills of all clinical staff
Transitions of Care / Co-ordination
Engagement with carers
Staffing / Resources
Primary Care Interface