Allison N. Ponce, Rebecca Miller, Milania D. Al-Jammaly, Edwin F. Renaud, Margaret A. Bailey, Susan Devine and Lindsay Oberleitner
This paper aims to describe a performance improvement process related to suicide assessment in a community mental health center. As suicide rates rise in the USA, it is crucial…
Abstract
Purpose
This paper aims to describe a performance improvement process related to suicide assessment in a community mental health center. As suicide rates rise in the USA, it is crucial that community mental health providers are capable and comfortable to assess for suicide risk among individuals with mental illness. Support for healthcare providers is emphasized in the quadruple aim model of enhancing healthcare delivery and patient experience. The quadruple aim model is applied in the present performance improvement project in a community mental health center.
Design/methodology/approach
An interprofessional team used provider survey responses, critical incident data and other stakeholder input to implement a new assessment mechanism and education plan to support direct care staff to address suicide risk.
Findings
Although the rate of patient death by suicide at the community mental health center is low, managing risk is a frequent provider concern. Providers’ comfort assessing and managing suicide risk varied widely based on survey responses. A structured suicide assessment process was implemented to offer clarity and direction for providers. Education to address assessment and management was designed and implemented.
Research limitations/implications
Suicide data were retrospective and limited to known deaths, thus there may have been higher numbers of deaths by suicide historically. Providers’ comfort with suicide risk management was based on self-report and future work should also integrate skills-based assessment.
Originality/value
Improving the provider experience in mental health care must be explored. Focusing on provider input and voice in suicide-related efforts in community settings is a step toward integrating the quadruple aim ideals into mental health care.
Details
Keywords
Cory A. Crane, Lindsay M.S. Oberleitner and Caroline J. Easton
With an established association between post‐traumatic stress disorder (PTSD) and the perpetration of intimate partner violence (IPV), evaluating the effectiveness of emerging…
Abstract
Purpose
With an established association between post‐traumatic stress disorder (PTSD) and the perpetration of intimate partner violence (IPV), evaluating the effectiveness of emerging integrated treatments for dual substance use and partner violent behavior in individuals with a significant trauma history may serve to improve treatment outcomes for clients with axis I psychopathology. The purpose of this paper is to examine the association between sub‐clinical trauma, treatment compliance, and recidivism in a sample of male, substance dependent IPV offenders.
Design/methodology/approach
The described investigation utilized violence perpetration, substance use, and trauma data collected during a larger, randomized control treatment evaluation study. Data were collected from 56 participants at four time points throughout treatment.
Findings
Participants with a significant trauma history comprised 33.9 percent of the sample and demonstrated poorer treatment attendance, as well as heightened partner violence recidivism throughout treatment, as compared to participants who denied experiencing a significant trauma. This finding held across participants receiving substance treatment only and combined treatment addressing substance use and violence.
Practical implications
IPV perpetrators often have a trauma history themselves. The association between sub‐clinical trauma symptomatology and poor treatment outcomes calls for the adaptation of current partner violence intervention models to accommodate the large subset of clients who suffer from either sub‐clinical or clinically significant trauma.
Originality/value
This paper is the first to address the potential influence of sub‐clinical trauma on the integrated treatment of substance use and partner violence within a forensic sample. Suggestions are offered to adapt existing treatment models to accommodate dual diagnosed clients.