Apr 09, 2024

MN Health Collaborative Announces Shared Standards for Suicide Prevention and Intervention in the ED

New initiative seeks to improve care for patients and support Emergency Departments (EDs) with evidence-based guidance for screening, assessment and intervention, transitions and follow-up

The MN Health Collaborative announced today they have developed new evidence-based recommendations for suicide prevention and intervention in EDs. The shared standards, developed by physicians and other leaders from both emergency departments and psychiatry, are based on MN Health Collaborative members’ expertise, shared learnings regarding tools and current or planned practices in use, and review of existing relevant literature. The goal of the initiative is to improve patient care as well as strengthen support for ED staff and others involved in supporting patients.

“In Minnesota, the suicide rate has increased by 40.6% since 1999, with 783 deaths by suicide reported in 2017. In addition, visits to the ED in our state for mental health and substance abuse have increased by 75% in the last seven years,” said Dr. Chris Palmer, Medical Director for the Emergency Department at North Memorial Health Hospital, a MN Health Collaborative member. “Clearly, there is a need to address these alarming statistics by reinforcing and strengthening how we screen, assess and intervene with patients at risk of suicide, both during the visit and afterward.”

Healthcare leaders of MN Health Collaborative have a strong focus on ensuring the use of evidence-based tools and practices. The group’s recommendations on suicide prevention and intervention in the ED provide guidance that is adaptable to a local context and in alignment with CMS and new 2024 Joint Commission requirements.

The Suicide Prevention and Intervention in the ED Shared Standards include recommendations in several key areas of care:

• Determination of patient populations in which to conduct screenings.
• Use of evidence-based, validated screening tools for suicide risk.
• Risk stratification to assist decision-making for safety precautions, rooming and resource needs
• Recommendations for comprehensive assessment and intervention tools for patients with a positive screen or presenting with suicidal ideation/attempt.
• Disposition suggestions based on the assessment that might include admission, observation or discharge.

“To achieve strong, positive change, we felt it was important that these standards addressed the entire spectrum of care, from screening for suicide risk all the way through to follow-up after visits had occurred,” said Dr. Suzanne Witterholt, a practicing psychiatrist affiliated with Allina Health. “We also wanted to address the fact that so many at-risk patients do not have afollow-upp outpatient visit within 30 days of leaving the ED. Outreach to these patients soon after an ED visit is a critical component in reducing suicide risk.”

With a shortage of psychiatrists and other mental health professionals in many areas of the state, along with increased use of the ED for mental health needs, MN Health Collaborative partners have recognized an urgent need to make real progress in improving systems to support mental health. In 2018, the group developed shared standards for medical clearance evaluation to ensure a person is medically stable for transition to inpatient psychiatric facilities.

“Creating and adopting shared standards like these requires strong partnership and real trust among not only EDs and inpatient departments, but between healthcare and other community organizations as well,” said Claire Neely, MD, ICSI President and CEO. “These shared standards represent a dedication to supporting the goal of better care for all people in Minnesota, no matter which ED they visit.”

Download the full report here.

View the webinar recording here.

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About the MN Health Collaborative: The MN Health Collaborative is an initiative driven by ICSI that brings healthcare organizations together to address major health topics affecting Minnesota communities today including opioid misuse and addiction, and system improvements for broader mental health care needs. The MN Health Collaborative consists of physicians and representatives from leading health systems including: Allina Health, CentraCare Health, Children’s Minnesota, Essentia Health, Fairview Health Services, HealthPartners, Hennepin Healthcare, Hutchinson Health, Mayo Clinic, Medica, North Memorial Health, Ridgeview Medical Center, Sanford Health, UCare and University of Minnesota Health/University of Minnesota Physicians.

About ICSI: A trusted influencer in healthcare for over 25 years, ICSI convenes organizations to find solutions to healthcare’s toughest challenges. As ICSI, healthcare leaders work together to find ways to initiate positive change and improve health outcomes. ICSI is activated by an independent, objective non-profit organization with one clear goal – improving health together. For more information visit ICSI.org.