Suicide risk assessment in an MCO

The failure to detect suicide risk is one of the most prevalent and preventable clinical errors in behavioral health. A managed behavioral health care organization (MBHO) implemented patient self-report assessment as a means of identifying clinical risk. An analysis of the first full year of patient self-report data compared with data collected from clinicians observed that more than 50% of practitioners underdetected the presence of suicidal ideation. Discordance between patient self-report and practitioner report was noted, suggesting that suicide risk might not be sufficiently addressed in clinical practice. The MBHO addressed the underdetection from 2000 to 2002. The result was a reduction in the rate of underdetection for clinicians using the early warning system and adopting process changes implemented during the course of the study.