UNIONTOWN, PA, May 14, 2019: Chestnut Ridge Counseling Services Inc. (CRCSI), one of the larger providers of mental health treatment and support in Western Pennsylvania, will be utilizing a $25,000 grant from the Staunton Farm Foundation to implement three quality of care initiatives that will enable the agency to provide evidenced based practices which will be evaluated and enhanced upon using proven tools to measure outcomes. Through the implementation of the National Zero Suicide Toolkit, the operationalizing of a dedicated line for a partnership with National Suicide Prevention Lifeline calls, and the addition of the DLA-20 as an agency wide assessment tool, the agency will be on the cutting edge of reliable measuring and reporting of outcome measures as well as implementing some new evidenced based practices, making treatment more effective and recovery specific. The improvements in clinical quality of care using evidenced based suicide care training for staff will be measureable and reportable, enabling CRCSI to continuously monitor and improve suicide prevention efforts and successes.
According to the Kennedy Forum’s “Fixing Behavioral Healthcare in America”, patients with mental health and substance use disorders (MH/SUD) treated in routine care experience worse outcomes than patients enrolled in clinical trials that have demonstrated the effectiveness of evidence-based treatments. This large gap between routine outcomes and optimal outcomes exists across a wide range of patient populations and treatment settings, including primary care and specialty behavioral health.
One of the main contributors to poor outcomes in routine care is that providers do not typically use symptom rating scales in a systematic way to determine quantitatively whether their patients are improving. The primary benefit of measurement-based care is improved clinical outcomes for each individual patient. An indirect benefit of measurement-based care is that patient level outcomes can be aggregated across providers, clinics and healthcare systems to inform quality improvement activities, and reported to payers in order to demonstrate the value of the behavioral health services being delivered. Yet, only 18% of psychiatrists and 11% of psychologists in the U.S. routinely administer symptom rating scales to monitor treatment response.
Similarly, the assessment of suicidal risk through the use of standardized scales can promote suicide prevention and over the course of time, can promote improvement in clinical care and outcome measures. The 2012 National Strategy for Suicide Prevention indicates that individuals at high risk for suicide require clinical evaluation and care to identify and treat mental health and medical conditions, and to specifically address suicide risk. In the past, it was believed that appropriately treating underlying conditions (e.g., mood disorders, substance abuse) would remove the risk for suicide. However, there is a growing body of evidence that suggests that suicide prevention is enhanced when specific treatments for underlying conditions are combined with strategies that directly address suicide risk. In recent years, a small number of health care and community support systems that provide health care services to defined populations (also referred to as “boundaried” systems) have adopted a “zero suicides” goal for the population under their care. Within these types of health care systems, the goal of eliminating suicide can help set into place system-wide changes that enhance service access and quality through continuous improvement. Managing a system of care to achieve the goal of zero suicides requires organizations to evaluate performance rigorously and use adverse events as opportunities to improve their capacity to save lives.
Finally, the National Suicide Prevention Lifeline reports that from 1/1/18 to 6/30/18, 263 nonveteran Fayette County calls were received by the Lifeline. Currently, those local calls are going to the National Lifeline are being answered by counselors who are not local, and who do not know the local services as well as CRCSI staff. While the Lifeline provides training and rigorous standards of care, the individual crisis centers who are part of their network can offer callers local crisis counseling and referrals which can be more effective in getting people into services they need.