Check up from the neck up

Suicide is a public health issue affecting Americans of all ages — it’s the tenth leading cause of death in adults, and the second leading cause of death for young people ages 10 to 24. To shine a spotlight on this important issue, hospitals and health care systems across the nation were called upon to address suicide risks in their patients.

“In 2016, The Joint Commission asked all hospitals to come up with a standardized way to detect and screen suicide risk behaviors among patients , not just in a behavioral health setting, but in the entire patient population,” said John Repique, DNP, RN, psychiatric nurse and system director of Inpatient Behavioral Health for Baptist Health.

A study published in The Joint Commission Journal of Quality and Patient Safety in September 2018 also found that about 49 to 65 suicides occur in hospitals in the U.S. every year. While that’s much lower than the old figure — an estimated 1,500 per year — Repique says that “even one death by suicide is far too many.”

In response, a team of clinical experts was assembled to decide the best way to screen every Baptist Health patient for suicide risk. Today, the result of their efforts is both simple and effective: a two-question suicide risk screening as part of the initial patient assessment at every visit to a Baptist Health emergency room, hospital or outpatient practice.

Two questions in the screening patients are asked are:

1. Over the past two weeks, have you felt down, depressed or hopeless?
2. Over the past two weeks, have you wished you were dead or wished you would go to sleep and not wake up?

“We adopted a brief screening tool that is easy to use and evidence-informed,” said Repique. “With these questions, nurses throughout our health system can quickly screen all patients on their first clinical visit for potential depression symptoms and also suicide risk. If there is a positive response to this, it triggers a more comprehensive assessment. Then, if this assessment determines the individual is positive for being at risk for suicide, the system sends an automatic request for an evaluation by a Baptist Behavioral Health mental health professional as soon as possible,” explained Repique.

Since December 2017, at least 114,000 patient screenings have been administered using the questionnaire. Repique says this assessment is a tool designed to keep patients safe and detect mental health concerns before they escalate or lead to a tragedy.

“We’re really addressing not just their physical needs. Oftentimes patients are coming to us about their physical health, but some folks may not know they’re having mental health issues,” he explained. “With this brief assessment, we can quickly screen for depression symptoms conveniently during their other appointments. It picks up at-risk patients so we can intervene immediately, provide patients with education on the warning signs of suicide, connect them with mental health providers if appropriate and hopefully save a life.”

While support is available for those with depression or suicidal thoughts, it can be hard to recognize when you should reach out for help. There are also certain factors that may put you at a higher risk for attempting suicide. You may be at risk if:

• You live with one or more mental health conditions, including depression, bipolar disorder and substance abuse.
• You have made previous suicide attempts or have a family history of suicide.
• You have physical health conditions that cause chronic pain.
• You have access to lethal means, including firearms and drugs or medications.
• You are experiencing stressful life events, including unemployment, harassment, divorce, financial crisis or loss.

If you feel you might be at risk for suicide or experiencing depression, call the Baptist Behavioral Health 24-hour crisis line at 904.202.7900. If it is not an emergency, call 904.376.3800 to speak with a patient coordinator and find the mental health care provider who is right for you. You can also visit a primary care physician for guidance.