Targeted Condition: Suicidal Ideation

Suicide risk screening in acute and intensive care at a Level 1 Trauma Center

Patients hospitalized for medical, surgical, or traumatic injury reasons at Harborview Medical Center are universally screened for suicide risk. The present research will advance knowledge about the practices occurring at this large healthcare institution serving the public and social safety net population and set the groundwork necessary for conducting future research designed to improve services not only at Harborview but at similar institutions across the U.S. A team led by Doyanne Darnell, PhD, and Imara West (Research Scientist at Data Quest) will capture population-level electronic health record (EHR) data on suicide screening rates and outcomes among medically hospitalized patients for a 1-year period and gain insight into the context of the data captured through focus groups with acute/intensive care nurses.

Using routine alcohol screening measures to identify 1-year risk of suicidal ideation, intent, and planning within a large primary care system in Washington

This study will use a large population-based primary care sample in Washington state to understand how heavy alcohol use and alcohol use disorder symptoms contribute to suicidal thoughts. This study will allow examination of how different levels of alcohol use can predict short term risk of suicidality and allow us to better identify and support patients at risk of suicide in the primary care setting.

Consumer perspectives of online & in-person suicide prevention strategies

This study will explore which interventions people with lived experience of suicide find acceptable (e.g., different types of in-person and telehealth care, web-based, text message, app, etc.), who should be the agent to deliver the intervention, and what concerns would they have in having social media and search data used for risk identification and then intervention. These findings have the potential to impact how suicide prevention strategies are brought to scale in a way that is seen as acceptable and appropriate to patients at risk for suicide

Evaluation of a new approach to youth suicidal crises: Swift Outpatient Alternatives for Rapid Stabilization (SOARS)

The study will evaluate a novel program developed by our team to improve the effective outpatient management of youth with acute suicide risk. This program evaluation examines just-in time intervention to assess suicide risk level, address imminent risk, and begin treatment to address ideographic suicidal drivers over time. The clinic has served over 200 youth and families since 2019. Qualitative and quantitative data from youth, caregivers, and clinicians demonstrate high levels of fidelity, feasibility, appropriateness, and acceptability, however, impact on core health outcomes has not been conducted. This funding will allow for analysis of the treatment program to demonstrate the impact of the intervention on suicidal thoughts and behaviors.

Collaborative care for perinatal mental health – the LAMMHA project

Los Angeles Maternal Mental Health Access (LAMMHA) is a five year program (2022 – 2027) funded by The California Health Care Foundation (CHCF) to support health centers in Los Angeles to identify and treat common perinatal mental disorders (CPMD) and reduce the risk of suicide. The LAMMHA initiative is a collaboration between Community Clinic Association of Los Angeles County (CCALAC), Elevation Health Partners (EHP), Maternal Mental Health Now (MMHN), Concert Health and the Department of Psychiatry and Behavioral Sciences at the University of Washington. Co-created with Los Angeles community stakeholders, the LAMMHA program currently offers Los Angeles County providers and community clinics two different levels of support to improve perinatal mental health care.

For more information and/or to apply for the program, please visit the CCALAC LAMMHA page: https://ccalac.org/los-angeles-maternal-mental-health-access-lammha/.

Using technology to scale Caring Contacts and reduce suicide

On top of climate change, political divisiveness and cultural turbulence, we have faced the most devastating pandemic since global influenza 100 years ago. The resulting social and economic stresses have manifested as widespread anxiety, a worsening opioid epidemic and the highest suicide rates in decades.

Proven behavioral health strategies like Caring Contacts offer hope. Caring Contacts is a program where suicidal individuals receive periodic letters or text messages from a behavioral health practitioner, creating a connection and showing someone cares. Caring Contacts have reduced suicide deaths, attempts and thoughts of suicide and offer an easy re-connection to healthcare, but behavioral health practitioners are in high demand and short supply and often struggle with prioritizing messages and sending timely replies. By analyzing a patient’s text messages, computerized algorithms can identify indicators of risk and other important information to help behavioral health practitioners with the nature and timing of their responses, allowing one behavioral health practitioner to reach hundreds of suicidal patients.

This project brings together behavioral health care, mobile technologies that people now expect and innovative informatics methods to identify critical signs of suicide risk that busy practitioners may miss. Our team consists of experts in behavioral health, usability and design, artificial intelligence/natural language processing, software engineering, health care information systems and emergency medicine. Our goal is simple: to use technology to provide critical support for those in crisis, and to save lives.

Understanding mental health problems and health risk behaviors among LGBT Veterans

LGBT Veterans have faced a long history of stigma, discrimination, and exclusionary policies that were intended to exclude them from military service. Despite recent shifts in policy and increased staff trainings, existing evidence suggests that this group is at high risk for health disparities, particularly with respect to mental health and health risk behaviors. While informative, the research to date has been limited in several respects: cross-sectional designs, collapsing LGBT subgroups, severe lack of data on some subgroups, problems with identifying a comparison group, and lack of data on risk and protective factors and care experiences. This prospective cohort study will fill these gaps, recruiting and conducting surveys online with 1,600 Veterans to identify health disparities, test a conceptual model of prospective risk and protective factors, and assess VA utilization, barriers to care, and treatment preferences. Data from this study will inform future intervention efforts to achieve health equity for LGBT Veterans.