Zero suicide implementation-effectiveness trial study protocol in outpatient behavioral health using the A-I-M suicide prevention model.

Autor: Stanley B; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA. Electronic address: bhs2@cumc.columbia.edu., Labouliere CD; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA., Brown GK; Department of Psychiatry, University of Pennsylvania, USA., Green KL; Department of Psychiatry, University of Pennsylvania, USA., Galfalvy HC; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA., Finnerty MT; New York State Office of Mental Health, USA., Vasan P; New York State Office of Mental Health, USA., Cummings AK; New York State Office of Mental Health, USA., Wainberg M; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA., Carruthers JW; New York State Office of Mental Health, USA., Dixon LB; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA.
Jazyk: angličtina
Zdroj: Contemporary clinical trials [Contemp Clin Trials] 2021 Jan; Vol. 100, pp. 106224. Date of Electronic Publication: 2020 Nov 18.
DOI: 10.1016/j.cct.2020.106224
Abstrakt: 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.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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