Sustained effectiveness of the mental health environment of care checklist to decrease inpatient suicide.

The Mental Health Environment of Care Checklist (MHEOCC) has been reported to be effective in decreasing suicide on inpatient mental health units. The authors sought to examine whether the effect of the MHEOCC was sustained.

Root cause analysis reports from all Department of Veterans Affairs (VA) hospitals were reviewed to obtain a count of suicides occurring on mental health units from 2000 to 2015. The number of mental health admissions and bed-days of care were obtained for the same period.

The rate of suicide prior to the implementation of the MHEOCC was 4.2 per 100,000 admissions or 2.72 per million bed-days of care. The rate after implementation was .74 per 100,000 admissions or .69 per million bed-days of care. There was no loss of effect in the seven years after implementation.

The MHEOCC was associated with a sustained reduction in suicides occurring on inpatient mental health units.