Zero suicide implementation-effectiveness trial study protocol in outpatient behavioral health using the A-I-M suicide prevention model.

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Tytuł:: Zero suicide implementation-effectiveness trial study protocol in outpatient behavioral health using the A-I-M suicide prevention model.
Autorzy:: Stanley B; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA. Electronic address: .
Labouliere CD; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA.
Brown GK; Department of Psychiatry, University of Pennsylvania, USA.
Green KL; Department of Psychiatry, University of Pennsylvania, USA.
Galfalvy HC; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA.
Finnerty MT; New York State Office of Mental Health, USA.
Vasan P; New York State Office of Mental Health, USA.
Cummings AK; New York State Office of Mental Health, USA.
Wainberg M; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA.
Carruthers JW; New York State Office of Mental Health, USA.
Dixon LB; Department of Psychiatry, Columbia University and New York State Psychiatric Institute, USA.
Źródło:: Contemporary clinical trials [Contemp Clin Trials] 2021 Jan; Vol. 100, pp. 106224. Date of Electronic Publication: 2020 Nov 18.
Typ publikacji:: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: New York, N.Y. : Elsevier, c2005-
MeSH Terms:: Outpatients*
Psychiatry*
Delivery of Health Care ; Humans ; Suicidal Ideation ; Suicide, Attempted
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Grant Information:: L30 MH114339 United States MH NIMH NIH HHS; R01 MH112139 United States MH NIMH NIH HHS
Contributed Indexing:: Keywords: Effectiveness; Hybrid trial; Implementation; Learning collaborative; Outpatient mental health; Suicide prevention; Zero Suicide
Entry Date(s):: Date Created: 20201121 Date Completed: 20210924 Latest Revision: 20220531
Update Code:: 20240105
PubMed Central ID:: PMC7887031
DOI:: 10.1016/j.cct.2020.106224
PMID:: 33220488
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Background: The treatment of suicidal patients often suffers owing to a lack of integrated care and standardized approaches for identifying and reducing risk. The National Strategy for Suicide Prevention endorsed the Zero Suicide (ZS) model, a multi-component, system-wide approach to identify, engage, and treat suicidal patients. The ZS model is a framework for suicide prevention in healthcare systems with the aspirational goal of eliminating suicide in healthcare. While the approach is widely endorsed, it has yet to be evaluated in a systematic manner. This trial evaluates two ZS implementation strategies statewide in specialty mental health clinics.
Methods/study Design: This trial is the first large-scale implementation of the ZS model in mental health clinics using the Assess, Intervene, and Monitor for Suicide Prevention (A-I-M) clinical model. Using a hybrid effectiveness-implementation type 1 design, we are testing the effectiveness of ZS implementation in 186 mental health clinics in 95 agencies in New York State. Agencies are randomly assigned to either: "Basic Implementation" (BI; a large group didactic learning collaboratives) or "Enhanced Implementation" (EI; participatory small group learning collaboratives; enhanced consultation for site champions). Primary outcomes include suicidal behaviors, hospitalizations and Emergency Department visits; implementation outcomes include protocol adoption, protocol fidelity and barriers/facilitators to implementation.
Discussion: This project has the potential to have a significant public health impact by determining the effectiveness of the ZS model in mental health clinics, a setting where suicide attempts and suicides occur at a higher rate than any other healthcare setting. It will also provide guidance on the implementation level required to achieve uptake and sustainability of ZS.
Trial Registration: N/A.
(Copyright © 2020 Elsevier Inc. All rights reserved.)

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