March 30, 2021
Collaborative Care is an evidence based model of care for individuals with common mental health conditions identified in primary care, and provides organizations, practices, and providers with a system that ensures comprehensive care for patients with behavioral health needs. Many of the patients identified at at risk for suicide. Collaborative Cares patient centered, flexible, systemic approach allows for a more “high touch” model of care that individuals would often get in specialty mental health.
With more than 47,000 suicide deaths and an estimated 1.4 million attempts every year in the United States,1 suicide is the 10th leading cause of death, ranking alongside diabetes, heart disease, and stroke. Research shows that approximately 45% of people who died by suicide visited a primary care provider (PCP) in the month before their death.2 This places primary care practices in a unique position to reduce suicide deaths. To do this, primary care practices need to utilize the resources already available to help care for patients at risk for suicide.
One such resource is the Collaborative Care model. Traditionally, primary care providers make a referral for the emergency department or weekly therapy services for their patients at risk for suicide even if these options are not well suited to the patient’s situation or preferences about how they receive services. In contrast, Collaborative Care offers a short-term, patient-centered, high touch approach to caring for patients with thoughts of suicide in primary care.
Collaborative Care is an evidence-based model that identifies and treats behavioral health conditions, such as anxiety and depression, in the primary care settings where patients are already being seen. Collaborative Care is widely supported and is now a Medicare benefit, a Medicaid benefit in 18 states, and recognized as effective by most commercial health plans. Collaborative Care is a treat-to-target approach that has been widely adopted by primary care organizations, large and small, across the country.
Collaborative Care is ideal for patients at risk for suicide because it allows for more flexible and comprehensive follow up than a traditional mental health referral, even though outpatient mental health has traditionally been viewed as a “higher level of care.”
Primary care providers should consider Collaborative Care to treat their patients with mental health conditions, such as anxiety and depression, and some of those patients may be at risk for suicide.
By screening for behavioral health conditions in primary care settings, PCPs can not only identify suicidal risk, but through Collaborative Care they can assist patients by providing interventions such as suicide safety planning and counseling on access to lethal means.
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References:
American Foundation for Suicide Prevention (2019). Suicide Statistics. Retrieved from https://afsp.org/suicide-statistics/
Luoma JB, Martin CE, Pearson JL. Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatry. 2002;159:909-916