BACKGROUND: The treatment of suicidal patients often suffers owing to a lack of integrated care and standardized approaches for identifying and reducing risk. The National Strategy for Suicide Prevention endorsed the Zero Suicide (ZS) model, a multi-component, system-wide approach to identify, engage, and treat suicidal patients. The ZS model is a framework for suicide prevention in healthcare systems with the aspirational goal of eliminating suicide in healthcare. While the approach is widely endorsed, it has yet to be evaluated in a systematic manner. This trial evaluates two ZS implementation strategies statewide in specialty mental health clinics. METHODS/STUDY DESIGN: This trial is the first large-scale implementation of the ZS model in mental health clinics using the Assess, Intervene, and Monitor for Suicide Prevention (A-I-M) clinical model. Using a hybrid effectiveness-implementation type 1 design, we are testing the effectiveness of ZS implementation in 186 mental health clinics in 95 agencies in New York State. Agencies are randomly assigned to either: "Basic Implementation" (BI; a large group didactic learning collaboratives) or "Enhanced Implementation" (EI; participatory small group learning collaboratives; enhanced consultation for site champions). Primary outcomes include suicidal behaviors, hospitalizations and Emergency Department visits; implementation outcomes include protocol adoption, protocol fidelity and barriers/facilitators to implementation. DISCUSSION: This project has the potential to have a significant public health impact by determining the effectiveness of the ZS model in mental health clinics, a setting where suicide attempts and suicides occur at a higher rate than any other healthcare setting. It will also provide guidance on the implementation level required to achieve uptake and sustainability of ZS. TRIAL REGISTRATION: N/A.
BACKGROUND: The treatment of suicidal patients often suffers owing to a lack of integrated care and standardized approaches for identifying and reducing risk. The National Strategy for Suicide Prevention endorsed the Zero Suicide (ZS) model, a multi-component, system-wide approach to identify, engage, and treat suicidal patients. The ZS model is a framework for suicide prevention in healthcare systems with the aspirational goal of eliminating suicide in healthcare. While the approach is widely endorsed, it has yet to be evaluated in a systematic manner. This trial evaluates two ZS implementation strategies statewide in specialty mental health clinics. METHODS/STUDY DESIGN: This trial is the first large-scale implementation of the ZS model in mental health clinics using the Assess, Intervene, and Monitor for Suicide Prevention (A-I-M) clinical model. Using a hybrid effectiveness-implementation type 1 design, we are testing the effectiveness of ZS implementation in 186 mental health clinics in 95 agencies in New York State. Agencies are randomly assigned to either: "Basic Implementation" (BI; a large group didactic learning collaboratives) or "Enhanced Implementation" (EI; participatory small group learning collaboratives; enhanced consultation for site champions). Primary outcomes include suicidal behaviors, hospitalizations and Emergency Department visits; implementation outcomes include protocol adoption, protocol fidelity and barriers/facilitators to implementation. DISCUSSION: This project has the potential to have a significant public health impact by determining the effectiveness of the ZS model in mental health clinics, a setting where suicide attempts and suicides occur at a higher rate than any other healthcare setting. It will also provide guidance on the implementation level required to achieve uptake and sustainability of ZS. TRIAL REGISTRATION: N/A.
Authors: Lea R Ayers; Suzanne C Beyea; Marjorie M Godfrey; Doreen C Harper; Eugene C Nelson; Paul B Batalden Journal: Qual Manag Health Care Date: 2005 Oct-Dec Impact factor: 0.926
Authors: Lisa A Brenner; Ryan E Breshears; Lisa M Betthauser; Katherine K Bellon; Elizabeth Holman; Jeri E F Harwood; Morton M Silverman; Joe Huggins; Herbert T Nagamoto Journal: J Clin Psychol Med Settings Date: 2011-06
Authors: Kelly Posner; Gregory K Brown; Barbara Stanley; David A Brent; Kseniya V Yershova; Maria A Oquendo; Glenn W Currier; Glenn A Melvin; Laurence Greenhill; Sa Shen; J John Mann Journal: Am J Psychiatry Date: 2011-12 Impact factor: 18.112
Authors: Gregory K Brown; Thomas Ten Have; Gregg R Henriques; Sharon X Xie; Judd E Hollander; Aaron T Beck Journal: JAMA Date: 2005-08-03 Impact factor: 56.272
Authors: Aliza Spruch-Feiner; Christa D Labouliere; Beth Brodsky; Kelly L Green; Gregory K Brown; Prabu Vasan; Anni Cummings; Deborah Layman; Maureen F Monahan; Hanga Galfalvy; Mahfuza Rahman; Jamie Kammer; Milton L Wainberg; Terriann Nicholson; Emily Leckman-Westin; Molly Finnerty; Barbara Stanley Journal: J Psychiatr Pract Date: 2022-05-01 Impact factor: 1.841