Parkland leads nation with innovative suicide screening program

Special to The Dallas Examiner | 11/13/2016, 10:11 p.m.
It’s a little discussed but anguishing reality – suicide in the U.S. has surged to the highest rate in nearly ...
Suicide is the second leading cause of death among for ages 15 to 34. It is the fourth leading cause of death for ages 35 to 44, according to the National Center for Injury Prevention and Control. Stock photo

Special to The Dallas Examiner

It’s a little discussed but anguishing reality – suicide in the U.S. has surged to the highest rate in nearly 30 years. Overall, the suicide rate rose by 24 percent from 1999 to 2014, according to a study by the National Center for Health Statistics released in April. Addressing this mental health crisis is a national challenge. Now, experts at Parkland Health & Hospital System are sharing an innovative program developed at Parkland with U.S. health leaders that could become a template for other health systems.

In 2015, Parkland launched a unique Universal Suicide Screening Program to identify those at risk and help save lives by intervening immediately. Parkland has more than 250,000 Emergency Department patient encounters and more than 1 million outpatient encounters annually.

“To our knowledge we are the first big hospital system in the U.S. to implement a universal screening program for suicide risk and the data we are gathering will be significant for other organizations in the future,” said Kimberly Roaten, Ph.D., Director of Quality for Safety, Education and Implementation for Parkland’s Department of Psychiatry and associate professor of psychiatry at the University of Texas Southwestern Medical Center.

A clinical psychologist working with Parkland patients, Roaten developed the screening program, along with Celeste Johnson, DNP, APRN, PMH CNS, Director of Nursing in the Psychiatric Services, and Russell Genzel, MSN, RN, CEN, Director of Nursing in the Parkland Emergency Room.

“Patients who later die by suicide are often seen by non-behavioral health providers in the days, weeks and months prior to death,” Roaten said. “U.S. data shows that 77 percent of people who die by suicide had contact with a primary care provider and 40 percent had contact with an emergency department provider in the year prior to death. We want to use every patient encounter at Parkland as an opportunity to identify those at risk.”

Roaten and Johnson were invited to share Parkland’s innovative suicide screening program with more than 500 Joint Commission surveyors at a meeting in Chicago on Sept. 7 as an example of the type of program the Joint Commission hopes will become widely used across the nation. The Joint Commission accredits and certifies nearly 21,000 healthcare organizations and programs in the U.S.

In 2014, Parkland dedicated the resources needed to make the universal suicide screening program possible, hiring additional psychiatric social workers, selecting a standardized and validated suicide screening instrument, and building the Parkland Algorithm for Suicide Screening, an algorithm in the electronic health record that triggers the appropriate clinical intervention depending on the patient’s answers to a few simple questions, and training all nursing staff to implement the program.

Parkland implemented suicide risk screenings with all Emergency Department patients and hospital inpatients in February 2015. In May 2015, standardized suicide risk screening was added at all Parkland Community Oriented Primary Care health centers and at the Correctional Health division for all inmates at the Dallas County Jail.

In the first year of the program, Parkland screened 310,000 patients in the ED and 348,000 patients in the outpatient health centers and correctional health unit. Parkland uses the Columbia Suicide Severity Rating Scale, a validated screening tool, with adults 18 and over and the Ask Suicide Screening Questionnaire with 12- to17-year-olds.