2006 HEDIS outcome data include the following:87
The average national rate of members who stayed on an antidepressant during the initial 12-week acute phase was 61.3%.
The average national rate of members who stayed on an antidepressant for at least 180 days was 45%.
The Joint Commission Standards
The Joint Commission, previously known as JCAHO has published the 2009 National Patient Safety Goals,88 including a requirement related to patient suicide. Screening for Mental Health, Inc., with funding from The Suicide
Prevention Resource Center (SPRC),13
developed a suicide assessment
protocol, “The Basic Suicide Assessment Five-step Evaluation (B-SAFE).” The document, A Resource Guide for Implementing the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) 2007 Patient Safety Goals on Suicide Featuring the Basic Suicide Assessment Five-step Evaluation (B-SAFE.), prepared by Douglas Jacobs, MD, CEO, and President, Screening for Mental Health, Inc., was developed. It is an excellent resource for the Joint Commission expectations of hospitalization and suicide precautions. Below are the five steps in the basic suicide assessment.
B-SAFE (Basic Suicide Assessment Five-step Evaluation)
1. Identify risk factors, noting those that can be modified in the short term to reduce risk.
Identify protective factors, noting those that can be enhanced.
Ask specifically about suicide, suicidal ideation, and history of suicidal
4. Determine level of risk/develop appropriate treatment setting/plan to address risk.
5. Document the assessment, treatment plan, and instructions.
The Joint Commission requirements correspond to the B-SAFE evaluation.13 Regarding suicidal individuals, they are as follows:
M(C) 1: THE RISK ASSESSMENT INCLUDES IDENTIFICATION OF SPECIFIC FACTORS AND FEATURES THAT MAY INCREASE OR DECREASE RISK FOR SUICIDE.
M(C) 2: THE CLIENT’S IMMEDIATE SAFETY NEEDS AND MOST APPROPRIATE SETTING FOR TREATMENT ARE ADDRESSED.
M(C) 3: THE ORGANIZATION PROVIDES INFORMATION SUCH AS A CRISIS HOTLINE TO INDIVIDUALS AND THEIR FAMILY MEMBERS FOR CRISIS SITUATIONS.