Suicide risk assessment in an MCO

Area of Science:

• Behavioral Health
• Clinical Psychology
• Healthcare Management

Background:

• Suicide risk underdetection is a prevalent and preventable clinical error in behavioral health.
• Managed behavioral health care organizations (MBHOs) aim to improve patient outcomes and reduce clinical errors.
• Accurate identification of suicide risk is crucial for effective patient care.

Purpose of the Study:

• To evaluate the effectiveness of patient self-report assessments in identifying suicide risk.
• To analyze the discordance between patient self-report and clinician detection of suicidal ideation.
• To assess the impact of an early warning system and process changes on clinician underdetection rates.

Main Methods:

• A managed behavioral health care organization (MBHO) implemented patient self-report assessments.
• Data from patient self-reports were compared with clinician-collected data over one year.
• An early warning system and process changes were introduced to address identified underdetection.
• Underdetection rates were monitored from 2000 to 2002.

Main Results:

• Over 50% of practitioners underdetected suicidal ideation based on initial analysis.
• Significant discordance was observed between patient self-report and clinician assessments.
• Implementation of the early warning system and process changes led to a reduction in clinician underdetection.
• The intervention demonstrated success in improving the detection of suicide risk.

Conclusions:

• Patient self-report assessments are valuable tools for identifying suicide risk.
• Clinician underdetection of suicide risk is a significant issue in behavioral health.
• Early warning systems and targeted interventions can effectively reduce underdetection rates.
• Continuous quality improvement is essential for addressing clinical errors in suicide risk assessment.