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The Collaborative Care Model (CoCM) improves suicide risk management in primary care. Sustained engagement and frequent clinical contact are key, with treatment intensity tailored to initial depression severity for better outcomes.

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Area of Science:

  • Behavioral Health
  • Primary Care Medicine
  • Suicidology

Background:

  • Primary care is vital for suicide prevention, with many individuals interacting with providers before death.
  • The Collaborative Care Model (CoCM) is a structured approach for behavioral health in primary care.
  • Limited research exists on CoCM's effectiveness in managing suicide risk.

Purpose of the Study:

  • To examine the relationship between clinical variables (enrollment duration, touchpoints, consultations) and suicide risk outcomes within CoCM.
  • To investigate how initial depression severity moderates these relationships.

Main Methods:

  • Analysis of data from 3,599 patients with suicide risk flags who completed CoCM.
  • Ordinal logistic regression used to assess changes in suicide risk level (improved, unchanged, regressed).

Main Results:

  • Longer enrollment and more clinical touchpoints significantly predicted improved suicide risk outcomes.
  • Higher baseline depression scores predicted poorer outcomes but interacted with enrollment duration.
  • Increased psychiatric consultations correlated with suicide risk regression, indicating appropriate case escalation.

Conclusions:

  • CoCM demonstrates potential for suicide risk management in primary care settings.
  • Sustained patient engagement and frequent clinical contact enhance treatment effectiveness.
  • Tailoring treatment intensity based on initial depression severity is recommended for optimal results.