Crisis Outreach, Treatment Engagement, and Outcomes After Suicide Risk Screening in a Comprehensive Mental Health...

This study evaluated the short- and long-term outcomes of proactive crisis outreach within 24 hours of identification of suicidal ideation. Outcomes assessed via 6 months of follow-up data included treatment engagement indices and symptom trajectories (suicidal ideation, depression, and anxiety) following the index ideation flag.

Real-world data were drawn from 6,131 individuals ages ≥15 years (mean±SD=35.4 ± 11.5 years; 46.7% female) enrolled in a comprehensive mental health platform (Spring Health) who were flagged for having suicidal ideation and had not engaged in treatment in the past 6 months. The primary exposure was successful care navigator contact within 24 hours of the ideation flag.

Most participants with suicidal ideation (87.3%) attended at least one therapy or medication management appointment within 6 months of the flag. Successful (vs. unsuccessful) crisis outreach was associated with greater odds of treatment initiation (OR=2.37), shorter time to first appointment (time ratio=0.67), and greater odds of early care retention (OR=1.69). Mediation analyses supported time to care as a key pathway linking successful outreach to early care retention and total care use. Even after adjustment for treatment engagement, successful contact was associated with lower ideation recurrence (OR=0.70) and steeper reductions in ideation, depressive, and anxiety symptoms that were maintained over time.

Timely outreach following suicide risk screening was associated with improved treatment access, sustained treatment engagement, and symptom reduction. Results support technology-enabled crisis outreach within a comprehensive mental health platform as a scalable strategy for early suicide intervention and care continuity.