Sustained Effectiveness of the Mental Health Environment of Care Checklist to Decrease Inpatient Suicide.

Area of Science:

• Psychiatry
• Healthcare Quality Improvement
• Patient Safety

Background:

• Suicide remains a critical concern in inpatient mental health units.
• The Mental Health Environment of Care Checklist (MHEOCC) was previously shown to reduce suicides.
• The long-term sustainability of MHEOCC's effectiveness required investigation.

Purpose of the Study:

• To evaluate the sustained impact of the MHEOCC on suicide rates in Department of Veterans Affairs (VA) mental health units.
• To determine if the observed reduction in suicides persisted beyond the initial implementation period.

Main Methods:

• A retrospective review of root cause analysis reports from all VA hospitals was conducted.
• Suicide counts on mental health units were collected from 2000 to 2015.
• Mental health admission numbers and bed-days of care were obtained for the same period to calculate rates.

Main Results:

• The suicide rate decreased from 4.2 per 100,000 admissions pre-MHEOCC to 0.74 per 100,000 admissions post-implementation.
• The suicide rate per million bed-days of care fell from 2.72 to 0.69.
• No diminution in the effectiveness of the MHEOCC was observed in the seven years following its implementation.

Conclusions:

• The MHEOCC is associated with a lasting reduction in suicides within inpatient mental health settings.
• The findings support the continued use and potential expansion of the MHEOCC for suicide prevention.
• Sustained implementation of the MHEOCC contributes to enhanced patient safety in mental health care.